Chapter 14: "Recovery"

WEDNESDAY, SEPTEMBER 30, 2009, SELLY OAK HOSPITAL

2:00 p.m.

That afternoon, since John was still too weak to sit up, let alone walk, he was lifted onto a trolley and wheeled down the hall and up the lift to the regular military ward, where a cot was waiting for him; in the process, Nurse Jenkins manoeuvred the portable dialysis machine alongside the trolley towards that ward. Upon their arrival, the orderlies lifted him onto the cot and spread the soft bed covers over him, and the nurse set the dialysis to the left of his new hospital cot. Since, by then, the dialysis had already flushed out his bloodstream for the day, it was left off.

Nurse Jenkins smiled at him. "I've got to return downstairs," she told him. "There'll be nurses here who will see to your needs, Dr. Watson."

John nodded and smiled wanly. "You've been very kind to me, Nurse Jenkins. Thank you."

She touched his arm. "It's been my pleasure, though I would have preferred better circumstances."

Rolling his eyes, John snorted. "You and me both." Nodding agreement, Nurse Jenkins brushed John's hair out of his eyes and left the ward.

John lay on his backside and scanned the ward. A few of the cots were empty, and some of the soldiers were asleep in their cots. None of them were his Fusilier mates; he noticed; they must have either already been transferred to Headley Court or discharged altogether. One of the soldiers was sitting in a chair next to his bedside, reading a hardback book; apparently, he was convalescing. He was probably almost ready for his transfer to Headley Court. The soldier glanced up to nod a greeting at John, who smiled and nodded back, and then he returned his attention to his book.

"Hello," one of the other soldiers told him. His cot stood directly across the ward from John's. "I'm Lieutenant Carl Tomlinson of the Parachute Regiment."

John raised a hand in greeting. "Captain John Watson, MBBS, army doctor, Fifth Northumberland Fusiliers. Combat surgeon in training. I just got out of ICU."

"What happened?" the lieutenant asked curiously. "Gunshot wound? Mortar? Grenade? I'm guessing you weren't hurt by an IED."

"No, I wasn't. It was a gunshot wound," John answered. "I was shot by an insurgent while tending a patient on a retrieval mission near the end of July." Lieutenant Tomlinson nodded. "And you?"

The lieutenant grimaced. "Bloody hand grenade, a month ago during a skirmish with some insurgent. Thrown at us by a member of the Taliban. Killed several of my mates and injured the rest of us." He shook his head. "I was lucky to escape with my life."

"We both were," John agreed. "I was hit in the shoulder, but it's not hard to guess the insurgent was aiming for my heart."

"I'm sure. I only got out of ICU myself last week." Tomlinson peered at John. "Come to think of it, I remember seeing you there. I was near the other end of the ward, so you probably didn't see me."

"I was in no shape to take notice of anybody," John said. "First, I was battling sepsis, and then I was forced to fight off osteomyelitis. I had to be operated on, to be purged of a bloody brain abscess, while I was at it. I'm only now in the process of recovering from the bone infection." He gave the lieutenant an easy smile. "If I were strong enough to get on my feet, I'd shake your hand. Pleased to meet you, Lieutenant Tomlinson."

"And you, Captain Watson." Carl raised his own hand in greeting.

John raised his head and scanned the soldiers' faces in the ward. "Is—is there a Corporal Ryan here?"

"He was transferred to Headley Court a few days ago. His cot was right next to mine while were in ICU," Carl said. "You know him?"

John nodded. "He's a Fusilier. My nurse and I were in the process of treating his leg during the retrieval mission, when I got shot. A bloody IED had just torn his leg apart." With a sigh, John flopped his head back down on his pillow. "If you'll excuse me, the trip up here's tired me out. I think I'll take a nap before I do anything else."

"Same here." Lieutenant Tomlinson laid his head back on his pillow and closed his eyes, and John did the same. Shortly, he drifted off.

When he woke up, the late-afternoon sunlight was pouring in through the windows, and it was time for dinner; nurse's aides were bringing in meals on trays. John smiled, but he didn't feel especially eager to eat. He'd had no appetite since he'd been shot, and even with a healthy appetite, hospital food didn't taste all that appealing, anyway. Still, he'd try to eat some of it. There was a dull throb in his shoulder; it was time for him to take his non-prescription painkiller. He would ask for some when the next nurse came into the ward.

One of the nurse's aides laid a tray on the rolling table next to John's cot and slid it over his chest; pushing the button, he folded his cot higher into a tilting position. "Thank you," he told the aide, who nodded, smiled, and left the ward.

As John had feared, he was unable to eat more than a few bites. Even though it was cottage pie, it just didn't taste good, and neither did the green beans. Only the jam roly-poly tasted good; he was able to eat half of it, and to drink the entire glass of orange juice. When he had finished, he pushed the table away and manoeuvred his cot back into a flat position.

The physical condition that he was in was certainly affecting his appetite, as he well knew, but he felt sure that part of the problem was that he was so fearful of the future. Of his future. Facing the very real prospect that he would have to leave the army for good and give up his career as a surgeon and possibly as a doctor was frightening, to say the least. He loved being a doctor, and he loved being a surgeon and a soldier; although he hated the losses and hated seeing people suffer, he loved being able to save lives and relieve his patients' suffering. He took deep, measured breaths in an effect to soothe his anxiety.

There's nothing I can do about that, he told himself firmly. It's out of my hands. The only thing I can do is do everything I can, to get well; that's the only thing I've got any control of.

Folding his arms upward, John started to slowly press the fingertips of his left hand with the thumb on his right, hoping against hope that just maybe, his left fingertips would feel it. None of them could quite feel his thumb; they were all sort of numb. Next, he pressed his right index finger against his left palm; it, too, was sort of numb. So was the back of his left hand, as he discovered. With a sigh, he dropped his hands on the cot.

With a sigh, and in an effort to take his mind off things, he picked up the paperback novel he'd been reading that Nurse Jenkins had brought up and left on the rolling table by his bedside that morning and, with difficulty, managed to open it to the page where he had left off earlier. Perhaps, by reading, he could forget his troubles, if only for a little while.

Wish I still had that Tolkien book, he thought, a few minutes later. I left it back in my officer's quarters, on my nightstand, and it hasn't been brought to me. If only I'd remembered in time, I'd have asked Bill to send it to me when he returns to Afghanistan. I would have loved to find out how things turned out for the hobbits. As big and heavy as that book is, though, it would have been hard to hold one-handed. He shrugged. Oh, well, this one will have to do. He turned his attention back to the book. The air conditioner had been turned off, so the only background noises were the sounds of soldiers chatting, nurses paging doctors over the intercom, and the treads of people walking up and down the hall outside the ward, some of whom were speaking in low voices.

John spent the rest of the day resting in his new hospital cot, alternately reading, sleeping, and chatting with the other soldiers. Several times, he intently touched the fingertips of his left hand with the fingertips on his right, hoping each time that just maybe, his left fingertips would feel them this time. Twice, he also pressed against his left palm and the back of his left hand with his right index finger, with the same results. Each time, none of the fingers of his left hand could quite feel his thumb, and neither could the rest of his hand. Soon after dinner, a nurse gave him a dose of his over-the-counter painkiller, which brought his shoulder some relief. At one point, Clara and Harry came to see him. At bedtime, a nurse gave him a sedative, and he fell asleep in a few minutes.

THURSDAY, OCTOBER 1, 2009, SELLY OAK HOSPITAL

1:00 p.m.

Early the following afternoon, Dr. McLemore strode into the military ward; an hour earlier, a lab technician had drawn some blood out of John's arm. The orthopaedic surgeon smiled broadly as he approached the injured doctor's cot.

"Well, I've got some good news!" He sat down by John's bedside and crossed his legs. "I just had a look at your potassium and calcium levels, and so far, they're normal, even though you haven't used the machine yet today. And there's more good news. There's no trace of the bacteria left in your bloodstream, the infection's almost completely gone from your bone marrow, and your temperature's back to normal."

John smiled. "That is good news. All of it." He paused, glancing at the dialysis machine. "What now?"

"For now," the other doctor said, "we'll continue leaving you off of the machine, but we are going to monitor your condition very carefully, to see if your kidneys are doing their job of flushing out your blood. If they start to fail again, we will use the machine once more. Otherwise, if they're still functioning normally a few days from now, I'll remove the catheter and take you off of the machine altogether."

John crossed the fingers of his right hand and held it up, and then he started slowly pressing the fingertips of his left hand with the thumb on his right. None of them could quite feel his thumb; they were all still sort of numb. "Let's hope that's the case!"

"Agreed!" Dr. McLemore nodded. "I will also have a look at your shoulder while I'm at it, to see how much it's healed. You no longer need the sling, and it should be possible to remove the bandage anytime now; once it's off, I'll refer you to an occupational health team who will start planning your rehabilitation. That will consist of physical and occupational therapy. Hopefully, you'll be off the dialysis altogether by then."

John nodded agreement. He could only hope. Maybe, if he was lucky, feeling would be restored to his left hand by then. He dropped his hands on the cot. "Where will I go, for that?"

"Well, you'll start your rehab here," Dr. McLemore said, "and then, once you're ready, we'll transfer you to Headley Court to finish it there." John nodded. That was what he had expected.

Taking a deep breath, he bit his lower lip and cleared his throat. "A—and then?"

Dr. McLemore's face turned serious, yet compassionate. "And then, you face whatever you must, when that time comes. You won't be forced to face it alone, John, whatever the Medical Board recommends, and whatever the Army Personnel Centre—and the General Medical Council—decide. If you are discharged, you will have the assistance of rehabilitation and support services to help you through the change from army doctor to civilian. At least it'll be an honourable discharge, which will help."

John nodded. Dr. McLemore was right. "Right now," the orthopaedic surgeon said, "as I said before, let's take it one day at a time. For now, let's concentrate on making sure your kidneys work once more, and on seeing your shoulder recovered from those fractures. Afterwards, we'll take it from there. Meanwhile…" He looked down at John's left hand. "…I noticed that you kept pressing your left fingertips a few minutes ago."

"Yeah." John grimaced. "My left hand's sort of numb. I can't—I can't quite feel my—my fingers when I touch them. My fingertips. Nor can my left palm or the back of my left hand feel my right index finger pressing down on them." He held up his left hand as he spoke and scowled. "It's because of the damage to my posterior cord, isn't it?"

Dr. McLemore looked serious. "I'm afraid it is, John. Whether you'll ever get feeling back in your left hand, I don't know. But don't give up hope. Even if you don't, you can still learn to compensate for the damage to your arm and shoulder. The therapists at Headley Court will teach you how." John nodded, and the orthopaedic surgeon rose to his feet and turned to leave the military ward.

John cleared his throat. "Before you leave this ward, Dr. McLemore, I want to thank you." Dr. McLemore turned back towards the cot. "For keeping me alive and saving my leg; for a while there, it really looked as if I was going to have to sacrifice it to save my life." He grimaced. "Also, you kept me from getting hooked on the morphine. I know that was no easy task, monitoring my doses to keep me from becoming addicted, while at the same time preventing the pain in my leg and shoulder from becoming unbearable. As bad as the throbbing was while it lasted, morphine withdrawal would have been a lot worse."

Dr. McLemore smiled. "It certainly would have been, wouldn't it? I wasn't about to let you become a morphine addict if I could help it. And it was my pleasure. As a fellow doctor, you know the feeling when you've been able to save a patient's life and restore him to function." Smiling weakly, John nodded agreement. He certainly did. "I'll see you later, John." Patting his arm, Dr. McLemore left, and John picked up his paperback book to resume reading it.

MONDAY, OCTOBER 5, 2009, SELLY OAK HOSPITAL

5:30 p.m.

To John's relief, his kidneys continued to function; when his calcium and potassium levels were checked late Monday afternoon, they were still normal, so Dr. McLemore finally removed the catheter hooking John to the dialysis machine and had the machine removed from the military ward. He then unwrapped the bandage from John's shoulder and examined it gently and carefully.

"I'm afraid, John, that you're not going to be able to regain full function in this shoulder. But you already know that," he told the army doctor; grimacing, John nodded. "Even without the nerve damage causing the numbness and the impairment of hand mobility and dexterity, there would still be some impairment to your ability to use your arm, and from now on, you will have a portable barometer as well. You will need to continue to take the non-prescription painkiller to relieve the pain in your shoulder even after you're released from Headley; any Boots pharmacy will sell it. As soon as I return to my office, I'll refer you to an occupational health team, and starting tomorrow morning, you're going to undergo physical and occupational therapy on a daily basis." Dr. McLemore inserted his hands into his lab coat pockets. "We don't yet know how much function you're going to regain in your arm and hand, but you will regain at least some of it, maybe even most of it. Maybe you'll also regain full feeling in your hand; we'll have to wait and see how that goes. It's going to be hard work, though; make no mistake about that. You've also got to regain your strength, and that's going to be hard work, too. Quite rigorous, in fact."

John nodded. "I know. I've got my work cut out for me, regaining my strength and hand mobility. Starting with sitting up unassisted and just standing on my own two feet once more. Well, I'm ready to begin." A mirthless smile spread across his face. "At least I've had no more seizures since last Wednesday, so hopefully, I don't have to worry about epilepsy now. Maybe, if I'm lucky, the occupational health team and Army Personnel Centre, and the GMC, will take that into account in making their decisions." He sighed. "So, then, when do I start?"

"Tomorrow morning," Dr. McLemore told him. "For today, since it's late afternoon now, you remain in your cot. In the morning, after breakfast, a physical therapist will come here to administer your first exercises."

John smiled wryly. "That'll have to consist of standing up, I suspect."

Dr. McLemore nodded agreement and rubbed his nose. "Sitting up in your cot unassisted, to be more precise, and then standing up and walking, in that order. You've been off your feet and lying on your back so long that your leg and back muscles are probably atrophied, so they're going to have to regain their strength so they can hold you up once more. The physical therapist will also assign you exercises to strengthen the muscles in your left shoulder and arm; you'll have to be prepared to take a dose of your painkiller at the end of each P.T. session. And while you're at it, the occupational therapist will be working with you every day, to regain the ability to use your arm and your hand."

He rose to his feet. "Rest for now, John. Tomorrow's going to be a busy day." John nodded, and the other doctor left the ward. John laid his head on the soft pillow and closed his eyes. He was ready for a nap.

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