PTSD – HANDS OFF; STAY AWAY!… (Part I)
When, at the age of three, you have your feet lopped off in a hayfield by a horse-drawn haymower and by some miracle a surgeon delicately reattaches them; then, over the next 14 years have one surgery after another that solidly fuses the fragmented ankle joints and prepares your feet for an active adult life – wouldn’t you think you qualify as some kind of an expert in survivial?
And when the research for a trucking novel you are writing, concerning a recon vet suffering from PTSD, discloses to you that YOU also have been suffering from PTSD, probably from the very day of your accident a lifetime ago – wouldn’t you also say you have some kind of credentials when it comes to discussing PTSD?
Well, guess what?…you don’t!
First of all, 46 agents in NYC could have cared less about the subject matter tackled in my book; “…someone else will love your book” was their rallying cry. And never mind that the wars in Iraq and Afghanistan will be loading our society with 30% more discharged vets than exited Vietnam with PTSD, all of them doing their best to cope with this unwanted afflction. Nor does Congress want to be bothered with our understaffed and underfunded Veterans Hospitals. Taking it down one step, one NY editor bluntly told me: “You’ll never sell this book. There are no books on trucking!” Well, duh… wouldn’t that suggest mine has to be the first one? In the copycat book publishing world, guess not! I’m still not sure what those New York publishing people were running from – trucking; vets with PTSD; or me.
Just look at the trouble Dawn Carlisle, my female lead character in 3 ACES, has when her co-driver and lover, Abner Weaver, winds up in the hospital. Back from three years of deadly combat experience in Vietnam, without a scratch, Abner’s had a near-death experience in his truck during a chain collision on an icy road near Flagstaff, Arizona. Listen in, as a frantic Dawn confronts the medical community, trying to get some answers:
Dr. Avagian—Abner’s thin-faced surgeon with the pencil-line mustache—approached the head of Abner’s bed. “A little levity might do Mr. Weaver some good.” He flipped through Abner’s chart. “. . . Much better. No pain? I want you eating everything on your tray—it’s quite necessary for the healing process. When Ida and the therapist ready you this afternoon for the exercise room, I want a nice long walk down the hall with the walker. Let’s see how that goes today.”
After the knee surgery they’d had him stand up with the help of his walker, tried moving him forward, and he’d passed out stone-cold. Dr. Avagian waved a brusque good-bye and breezed back out the doorway. Dawn pushed out of Abner’s room in pursuit, catching up with the doctor in the center of the corridor just beyond the nurses’ station.
“Doctor, I’m Dawn McManus. I was Abner’s codriver—”
“Yes, I know. We like having a family member coach a patient through the recovery process.”
“But I’m not a family member—”
“His sister was contacted and showed no interest.”
“Doctor, truthfully, is Abner going to recover?”
Dr. Avagian motioned them out of the corridor into the privacy of the exercise room. “The upper part of his femur and the femoral head were shattered, which necessitated a total joint arthroplasty. In other words we replaced the hip ball and socket completely with a composite prosthesis and repaired the upper part of the femur. Following the first surgery we discovered and repaired a torn anterior cruciate ligament affecting the knee of the same leg.”
“My God. Can he recover from all that?”
“With proper rehabilitative attention, in two months he should be walking with a cane. Mr. Weaver’s quite the rugged specimen.”
“But he looks so weak—so uncertain . . .”
“There has been a third complication—a medical condition known as cardiac orthostatic hypotension.”
“Cardiac!”
“Mr. Weaver’s had one fainting episode. Not so much the heart, but a drop in blood pressure caused by the vascular system not constricting sufficiently when the patient stood up. We’ve introduced corrective medication. That’s why I’m testing him with the longer walk this afternoon. Hopefully, the condition is temporary.”
“Abner’s so pale and anxious. He keeps looking around—as if he were terrified of something.”
“He’s making a satisfactory recovery from the surgery. I think you should discuss your further concerns with our staff psychologist.”
Dr. Avagian leaned into the hallway, calling to the nurses’ station. “Ida, Didn’t I see the case manager up here this morning? Will you have her join us in the exercise room?”
“Debby’s down the hall, Doctor. I’ll get her.”
Dr. Avagian stepped back inside the exercise room. “Phoenix is a retirement community with a number of military retirees living here. We see this from time to time—”
“See what, Doctor?”
“PTSD—post traumatic stress disorder—common to trauma cases and among certain military people. The case manager will fill you in.” Dr. Avagian sailed abruptly out of the room and disappeared down the corridor.
A slight woman in her thirties, the case manager arrived with two containers of coffee. She smiled sympathetically, motioned to a row of chairs at either side of a long work table in the exercise room, and put the coffees and an armful of folders on the table. She sank to a seat, extending her hand to Dawn: “I’m Debby Kiley. Coffee’s lukewarm, creamers and sugar are in that paper cup over there. You’re Sarge’s friend, aren’t you?”
“When did you start calling him that?”
Debby proffered a smile. “There’s not much our head nurse, Ida, doesn’t find out about her patients.”
“What else do you know?”
“That he was Special Forces and still carries Vietnam around with him. That you drove a semi together, and you’re probably still in love with him.”
Dawn’s gaze fell on the table. “. . . I’m that transparent?”
“Normally a hip replacement is discharged in four days. With so many complications, Dr. Avagian’s held him over eight more days. We can’t hold him much longer. His insurance carrier’s getting downright ugly. I’ve been trying to work out something between the Carl T. Hayden, a medical center here in town, and the Arizona State Veteran’s Home.”
“A veteran’s home?”
“You really should talk to our staff psychologist.” Debby picked up the desk phone and dialed a four-digit number. “Charles? . . . Debby. A close friend of Mr. Weaver is here—‘Sarge’ in room six eleven. We’re in the exercise room on six. Thanks, Charles.” She set the phone back on its cradle.
Dawn pressed into the table. “Miss Kiley, I’ll guarantee any further payment due the Meyer Clinic if you’ll consider keeping Abner on here.”
“He’s doing well enough to be discharged. It’s now a matter of someone seeing that he continues his medications, his joint exercise regimen, and that he doesn’t fall using the walker.”
“The moment my daughter and I checked into the motel, I started looking for an apartment. Why couldn’t he stay with us?”
“Yes, if you can find a first floor apartment with no tripping hazards and have it fitted out with a high bed, a raised toilet seat and a shower bench. He’ll be able to ride in a car and move around with his walker. He’d have to continue with the elastic stockings and Coumadin pills and be brought back here weekly for blood lab tests until the danger of clotting passes. Truckers are notorious for clots in the legs—too much sitting. But we’ll need his complete acceptance, in writing, that he’s willing to be discharged into your care.”
“You make that sound like a problem.”
“Talk it over with Charles.”
Well, gentle reader…get the picture? Abner’s now got “head problems” along with the physical. But Dawn, bless her, is not running from the mess; whatever the complications, she’s determined to tackle them, and win!
Next week, in Part II, we’ll get into the psychiatric aspect a touch more and look at the attitudes of the medical profession toward PTSD.
