Limb Loss in the Novel

(SPOILER ALERT: This post reveals critical plot details about limb loss in the book. So if you haven’t read it yet and are planning to do so, you may want to skip this one for now.)

When I was fourteen and a freshman at Boston Latin School, I took a part-time job at a dental lab on Massachusetts Ave. Three days a week after school, I’d show up at the office, where I’d grab an old briefcase, and an umbrella on rainy days, and deliver crowns, bridges and other dental work to the offices of several dentists around the Back Bay neighborhood. I’d also pick up packages at each office to bring back to the lab.

Commonwealth Ave, Back Bay, Boston

There were three men in the actual lab, visible through a large window in the entrance hall. There was also a young woman working as receptionist. Her name was Madeline, and she was always nice to me. Among her many duties, Madeline made sure that each of the plastic containers carrying the lab’s dental work had the correct patient information attached to it. I’d chat with her briefly as she sat in her chair behind a desk before I headed out on my rounds.

One day, she needed to get a new ribbon for her typewriter, so she stood up and made her way across the room to a file cabinet. The way she moved caught my eye, and I saw that one of her legs was prosthetic. It was the first time I had ever seen one. I looked at it closely. On my subway ride home, I wondered if Madeline had noticed me staring.

In high school, I spent hours a day on Boston’s subway system. It was like a second home to me.

My Own Experience

Twelve years later, I was in an emergency room at Kennedy Memorial Hospital (its former name) in New Jersey. One of my fingers had been mangled in an accident at a construction site. It was a Sunday, and the doctor on-call for situations such as mine was Dr. Sternschien. I had studied German in high school, so I knew his name translated as “star shine.” A source of light in the darkness.

He was a young doctor with a black beard and wore a polo shirt with the word “Tanglewood” embroidered on the chest. Apparently he was a fan of the outdoor music venue in western Massachusetts that was the summer home of the Boston Symphony Orchestra. His connection to music made me immediately comfortable, at least as much as I could be in that situation.

The doctor explained the options for what remained of the middle finger on my dominant hand. He said that he could maintain the length of it, but with some of tissue and bone missing from the top section, or phalanx, the finger would be thinner there. Also, circulation would likely be a persistent problem. And the now slimmer bone in that phalanx would be very susceptible to breaking, not just once but any time I applied too much pressure to it. I would have to use great care and caution with it for the rest of my life, particularly during physical activity. He then asked me if I played any musical instruments, ones that would require me to maintain the full length of the finger. I told him I listened to all kinds of music but didn’t play any instruments myself.

Calculating the Loss

Option two was to remove the top phalanx completely and take what tissue remained and use it to build up the remainder of the finger. The bone in the second phalanx was whole and could be rounded at its tip and padded with tissue. That would make it suitable for an active lifestyle.

I was sedated and drifted in and out of consciousness while the doctor performed hours of microsurgery. I had chosen option two, and I am still satisfied with the decision. After some therapy, I got the remaining finger joints to flex fully. And I was soon able to use the finger and left hand in very physical ways, such as climbing hand over hand up a rope.

However, as I recovered from the accident, I considered what I had lost. I got very analytical about it and decided it was roughly twenty-five percent functional (I never keep small items like change in my left pocket anymore), twenty-five percent sense of touch (sliding fingers across a surface, for example) and fifty-percent cosmetic.

I’m a writer, but I never learned how to touch type. So I’m content with my thirty five words a minutes max. I’ve also learned that the process of creative writing requires me to slow down the pace at which we humans think. It’s estimated to be somewhere around 500 words per minute. I’d never come close to that even with two complete hands and advanced proficiency in touch typing.

How Limb Loss Played Into the Novel

As much as I’m going into detail here about the partial loss of a finger, I don’t consider it to be anything close to the partial or complete loss of a limb. My injury inspired me to explore limb loss in my fiction, but there’s an enormous world of difference between the two.

The character who suffers the loss in my novel is an eight-year-old girl named Nora. When I reached the point in the narrative where her accident occurs, the writing slowed down and was interspersed with more research. Once I wrote the scene where her mother Anne rejoins the family with a visit to the hospital, I decided to break the novel into two books because what was to follow would be so different from what preceded it. Book II would be focused on rehabilitation. Primarily it was about Nora’s recovery in every sense, but also for the rest of her family, and the larger community connected to her.

In the next book in the series, the character Nora Mahoney will be twenty-three years old. I also am imagining a fourth book when she is perhaps in her mid or late thirties. My goal is to have her portrayal as a person with limb-loss be as accurate as possible in every aspect of her life and through each stage of her life.

Photo Credits

Massachusetts Ave photo by Google Street View

Back Bay photo by Maloney Properties

Boston Subway photo by Jorge Ramírez on Unsplash