TIME Magazine correspondent Michael Weisskopf was riding through Baghdad in the back of a U.S. Army Humvee, an embedded reporter alongside soldiers from the First Armored Division, when he heard a metallic thunk. Looking down, he saw a small, dark object rolling inches from his feet. He reached out and took it in his hand. Then everything went black.
Weisskopf lost his hand and was sent for treatment to Ward 57 at Walter Reed Army Medical Center, the wing of the armed-forces hospital reserved for amputees. Alongside soldiers there, he navigated the bewildering process of recovery and reentry into everyday life.
Blood Brothers, Weisskopf’s new book, chronicles the tale of this difficult passage—for him as well as hundreds of others. It’s a story that begins with healthy men heading off to a war zone, and continues through the months in Ward 57 as they prepare their minds and bodies for a life very different from the one they left. A narrative of devastation and recovery, Blood Brothers is a deeply affecting portrait of the private aftermath of combat casualties—the battle after the war. Here is an excerpt.
Room 3J04 pulsated with the sounds of heavy metal, wailing electric guitars and crashing drums. I entered in a manual wheelchair pushed by a hospital orderly, and was greeted by a black, soulshaking colonel and a pair of one-legged soldiers playing foosball. No, it wasn’t a morphine dream. I had landed in occupational therapy.
Located two floors below Ward 57, OT might as well have been another planet. The name made it sound like a job training center. Instead, it helped to get bodies working. This was boot camp for amputees, training for life without limbs. The clinic held out potential to patients who thought they had none, a place to stop grieving and learn how to compensate with technology and ingenuity. The motto was, “Whatever Works.”
Usually that meant use of artificial limbs. But when a prosthesis couldn’t help the legless take a shower or the one-armed tie a shoe, therapists offered new strategies, from bath stools to elastic shoelaces. Leg amputees learned how to jump out of bed without falling on their faces and get in and out of a model car from a wheelchair. Arm amputees practiced hanging shirts, cooking and sweeping the floor of a mock apartment named Fort Independence.
OT returned the real world to patients who had dropped out of it. Everyone trained together in an atmosphere set up for comradeship and comfort. No one paid attention to rank or age. They bonded over a common plight and debated endlessly which limb was worse to lose: an arm or leg. The patients got to play their favorite music and help themselves (if they could) to candy bars, gum and beef jerky from a cabinet. A bulletin board posted hometown newspaper reports on their injuries.
Captain Katie was the queen of OT. When she came to 57 on my first day for an assessment, she asked for my recovery goals. “Return to my abnormal life,” I told her. By the time I started OT in the late afternoon of December 26, she had drawn up a baseline charting the distance I had to go. I still needed supervision to safely reach a toilet and “moderate” aid in unbuttoning and zipping after I arrived. I couldn’t bathe or put on pants without help.
Katie ordered me up from the wheelchair to check my posture. I walked down the hall with my stump folded like a broken wing, listing badly to my right side. She directed me to straighten up, raise my head and swing my short right arm as freely as I did my left. My port side was getting a lot of attention. Now that I was a southpaw by necessity, I had to get my brain used to the new boy in town. Katie gave me shoestrings to lace, buttons to close and sentences to write on notebook paper. I’d do it and she’d have me do it again—only faster. On December 30, I was promoted to her hottest class: Bionic Hands 101.
Myoelectric is the non-sci-fi name for bionic. A myoelectric hand works off tiny electrical signals released when muscles (myo is the Greek word for muscle) are contracted. The signals are picked up by electrodes that line the inside of a prosthesis, and cover the muscles of a stump. Electrodes send the signal to a computer chip that instructs an electronic hand to open, close or rotate—depending on the muscle flexed and the speed and intensity of its contraction.
For long stumps like mine, forearm muscles located three inches below the elbow drove the process. Flexing the one on the outside of my forearm signaled a hand to open. Tensing the inner muscle would close it. The technology mimicked nature. Katie held out a cup and told me to grab it with my good left hand. I felt the inner muscle tighten as I grasped it. The outer muscle relaxed when I let it go.
The first lesson focused on how to isolate those muscles. Captain Katie had a tool, called Myo-boy, as high tech as the device I hoped to incorporate. She strapped electrodes onto each forearm muscle and plugged the other end of a cord into a laptop computer. The object was to generate a spike on the monitor by flexing the right muscle. It was more difficult than it looked. I jerked, twitched, and turned my stump. Nothing happened. I pumped again, hunting for the right spot, but the monitor stayed blank. When I grew frustrated, Katie had me close my eyes to map the muscle in my mind. I contracted. She let out a cheer: “You did it.”
I opened my eyes and saw a tiny streak on the monitor. I squeezed, again, sending the spike higher. I was getting stronger. Unfortunately, as I kept practicing, the computer indicated that I was firing both muscles at the same time. I closed my eyes again and accessed my outside one. Katie released another yelp of encouragement. I finally managed to distinguish one muscle from the other and triggered each separately so as not to send conflicting signals. Manipulating those tiny muscles was exhausting. I felt as if I had pressed two hundred pounds. My hospital gown was soaked in sweat.
Over the course of the next week, I spent at least an hour a day working on the Myo-boy, graduating to new levels of virtual reality. One was a monitor that showed cars careening toward a brick wall. I could lift the car and avoid disaster by flexing the right muscle. I took turns connecting the electrode to the inside and outside of my forearm, compiling a good enough driving record to increase the challenge. Katie ran two cars at the same time, each controlled by a different muscle. Finally, I simulated the mechanics of a virtual hand, including the wrist rotation I had paid so dearly for. It took an extra step, hitting both muscles at the same time. That would change the gears of the hand, preparing it to turn clockwise when I squeezed the outer muscle and counterclockwise with the inner muscle.
Katie spent the last ten minutes of each session massaging my stump. She pressed hard on the scar tissue to keep it flat and supple. The kneading also gave me comfort. Once the pain of surgery had subsided after Christmas, I began to suffer the bane of amputees: phantom limb pain. When I first heard the term, I thought it sounded like a form of self-delusion, a mind game of amputees who couldn’t accept their loss. How could something that didn’t exist hurt?
The name recalled a favorite childhood action figure, the Phantom. But I certainly wasn’t fantasizing the deep ache in what had been my right hand. Sometimes I felt as if my fist was clamping tighter and tighter until my fingers were ready to explode. The pain brought back memories of that horrible night in the Humvee. In those moments, my hand felt as if it were cupped around a hot object, burning and throbbing as it did after the explosion. At other times, the Phantom could create the sensation of twisted fingers or a bent thumb. Sometimes, it was an annoying tickle on the heel of my hand.
Virtually everyone on Ward 57 had some phantom limb pain. Its cause remained as mysterious as it had been when a Civil War doctor coined the term to identify the complaints of soldiers whose injured limbs had been sawed off. Their symptoms had been dismissed as psychosomatic, but today’s doctors recognized the pain as a bona fide neurological condition. Nerve endings that had naturally extended to the fingers of my right hand no longer had a place to go; they were frantically crashing into one another, sending pain signals to my brain and tricking it into thinking I still had a hand. Some experts believe the brain has a blueprint of body parts that persists even if they’ve been cut off. According to one theory, when the brain sends signals and receives no feedback, it bombards the missing limb with more signals. That aggravates the swollen nerves that once served it, inducing pain.
Doctors were as hard-pressed to treat phantom pain as they were to explain it. They resorted to trial and error, using remedies originally intended for other ailments that seemed to relieve nerve pain. I had a sampling on my nightstand: pills to combat seizures and depression, lozenges for bronchitis, allergy nasal spray, arthritis cream, medicated patches for shingles and an electro-stimulation device. It was hard to tell if any of them worked. The crushing, stabbing pain in my right hand flared and subsided—but never went away. Doctors said it might last a month, a year or a lifetime. Every amputee was different. I had resolved that 2004 would be the Year of the Phantom.
Phantom pain was a daily topic at OT, the whittling porch for amputees. I made my first friends there. I’d been in no mood for small talk the first two weeks on 57. Most of my neighbors were half my age and from different backgrounds, smalltown boys who had passed up college or bluecollar trades for a military life. I was urban, overeducated, untattooed and distrustful of uniforms and blind patriotism. But I soon discovered that I shared something with those soldiers larger than the differences in our biographies. We were men struggling for identity. The psychological scars of amputation ran deeper than those from conventional wounds of war. The blasts took away something deeply personal. None of us felt like the man who had gone to Iraq. We possessed the same minds; they just resided in different bodies.
The loss of my writing hand launched an assault on my self-image. If I couldn’t be a reporter, then who was I? What would I do? The questions left me raw and wide open, no more so than my new friends who had honed their bodies for a completely different cause: war. The military represented the perfect synthesis of muscle and discovery, a place to play out feelings of invincibility. Now they confronted the world from a wheelchair or without an arm. Life looked different with no war to fight, orders to follow and comrades to love. The question was how to fill the void, and with what.
No one knew what to make of me at first. I was rumored to be a colonel who had stumbled into harm’s way. Fortunately, the suspicion was short-lived—soldiers had even less regard for officers than for reporters. Once word got out that I had coauthored TIME’s cover story on the American soldier and saved a couple of privates, I was let into the club. No one knew my name—I became known as “the reporter who ate the grenade.” Most of my interactions with other amputees took place off the ward, in more friendly territory like OT or the hospital cafeteria. We swapped stories of our injuries, compared notes on painkillers, and competed on the Myo-boy. The arrival of someone’s prosthesis created a lot of excitement. Everyone would wait for him to strut into OT to show it off. I felt at home in the small universe of men, who, like me, were trying to figure out what was left of them and the lives they once led. We had the privilege of working through our pain, insecurity and clumsiness without the stares and questions of outsiders.
Not everyone enjoyed the company. The tone in OT could shift from laughter to grave silence in the moment it took a soldier to scream in pain or explode into anger. Captain Katie segregated the angriest amputees. If they wanted to poison the atmosphere, they’d have to do it together. Her morning sessions bristled with tension. Metallica and Motorhead blared from speakers. Amputees leaned back in their wheelchairs and spun the wheels. One specialist who had trouble picking up a peg with his above-the-elbow prosthesis flung the $115,000 device against a wall. “I ain’t doing it anymore,” he shouted. Another threw the metal pedal of his wheelchair into a costly exercise machine.
My own moods fluctuated between anger and joy, frustration and triumph. But a feeling of melancholy prevailed as I came face-to-face with the larger tragedy beyond my own: stolen youth.
The above section is excerpted with permission from Blood Brothers by Michael Weisskopf, copyright 2006 by Michael Weisskopf and published by Henry Holt and Company. Blood Brothers is available now through retail bookstores and at www.henryholt.com.
A senior correspondent for TIME Magazine, Michael Weisskopf is a Pulitzer Prize finalist and a winner of the George Polk Award, the Goldsmith Award for Investigative Reporting, the National Headliners Award and the Daniel Pearl Award for Courage and Integrity in Journalism. He lives in Washington DC.