When I was lying there in the VA hospital, with a big hole blown through the middle of my life, I started having these dreams of flying. I was free…
Jake woke up with a start, sweating. He was wearing a hospital gown and was covered by a plain sheet and a top blanket over his legs up to his waist. The sheet and the gown were wet and clinging to his chest, intensifying the feeling of being trapped. He felt the overwhelming desire to move, to stand up and to run, anything to get his heart rate up, to chase away the feeling of isolation and confinement. He pushed the sheet down to his waist and balled both hands into fists.
Jake tried to swallow but his throat was dry. He reached for the water bottle on the tray next to his bed, but at the moment it was just beyond the range of his fingertips. Fuck. He wanted to scream in frustration. He was lying on his back and the pain in his back was excruciating. Some days the pain was better, on others it was worse; today definitely qualified as worst.
After a month and a half at Walter Reed which had mostly been signified by stupendous boredom, interspersed by encouraging chats with Dr. Lassiter and being fussed over by an all too maternal Janice, grueling physiotherapy sessions and psychological counseling, he had been transferred to the Veterans Association Hospital and Rehab Facility at Fort Belvoir. Jake had been transferred here because it was one of the facilities closest to Walter Reed and near the Marine Corps Head Quarters at Quantico and he hadn't yet made up his mind where else he wanted to go. He had briefly considered a transfer to a facility closer to Tom in New Jersey, but he had soon decided that the proximity would only damage their relationship further. Whenever Tom came by, he didn't seem to be able to look at Jake without a pained look on his face. Their conversations remained superficial, too many things left unsaid. Tom would excuse himself quickly and the periods between his visits grew longer.
Since his move here four days ago they had switched him to non-narcotic painkillers and they definitely weren't nearly as effective as what they had given him at Walter Reed. He still had the IV access above his left clavicle, but it wasn't permanently connected. It just served as a means of easy access to get medication into his blood without having to find veins the whole time. He would have been a pin cushion by now. Unlike at Walter Reed where a computer had provided a continuous stream of sedatives that he could control to a certain degree, the manual administration meant more pronounced ups and downs.
Jake slowly pushed himself up by working his elbows underneath his shoulders, trying to stretch his back muscles somewhat. The pain didn't get any better, if anything it got worse. "Arrrgh, fuck!" He shouted out his frustration and fell back. Fortunately he had the room to himself. Having other people around, observing him struggling physically as well as emotionally would have added a whole new layer of complexity to his life that he wasn't willing to deal with, yet. Other than his brother, the doctors and the nursing staff he spoke to few people and saw even fewer and he was glad about it.
On a good day he was able to sit up on his own now and even hold his balance for more than a few seconds. To cross the thirty seconds mark had been his first big victory. His physio therapist had timed him. Now his record was a minute and twenty six seconds—on a good day. When he had woken up a bit more than six weeks ago, he had had relatively normal sensation in his torso, but the motor function of his back and stomach muscles that had been affected by the bruising in his spine at chest level had since returned. He was fortunate Dr. Lassiter had assured him that only the loss of function in his lower extremities was permanent.
On a good day he was even able to move between the bed and the wheelchair on his own now. Whatever you set your mind to… On a bad day like this one shaped up to be, however, he might not be able to sit up at all or even turn himself over. Jake made a deal with himself. He wouldn't call the nursing station and ask for an injection. He would either get there on his own to ask for it in in person or not at all.
His bed had rails on all four sides for him to grab on to and a bar suspended above his chest to pull himself up. The top layer he was lying on was specialized, soft foam, but on a harder surface it would have been easier to move. He grabbed the left rail with is left hand and pulled himself closer, groaning against the pain, till he could reach with his right hand. He pulled, twisting his torso and he heard and felt a vertebra in his back pop. The pain eased back to a more manageable level. The problem with his weak back muscles was that they couldn't hold his spine in proper alignment and the soft memory foam, beneficial on one hand in preventing pressure sores, didn't support the alignment enough to keep the odd vertebra or disk from slipping and pinching a nerve.
Jake reached under the sheet for his right leg and pulled it up and over the left so that he was lying stable on his side. He could now reach the side table and grabbed the water bottle and a tissue from the table to wipe away the tears the pain had brought to his eyes. Then he balled it up and threw it onto the floor.
He wanted to get into the gym. It had a large pool and he figured that swimming would help him speed up strengthening his back and therefore the recovery process. He had asked for permission, but the doctor who was treating him here had said it was too soon. Jake couldn't see the reason in that. He felt that if the pain was under control he was strong enough to swim. So the doctor was either risk adverse or indifferent or both or for whatever other reason he had declined. Last night Jake had called Dr. Lassiter and asked for her opinion. She had encouraged him to try. However, he needed to have the IV and the indwelling catheter removed. Jake tried to decide on the best approach to achieve his goal. Most of the nurses here were women and all they wanted was to get the job done with as little fuss as possible. Jake didn't think any of them would be particularly keen to listen to his pleas to take the catheter out. They would think that it meant more work for them. Hopefully the male nurse he had seen during the week would be on duty again, soon. He felt he stood a better chance with him and Jake didn't see why he couldn't catheterize himself now already. Sooner or later he would have to do it anyway. Bladder control was one of the functions he wouldn't regain.
He considered his knee. His still wore a brace on his left knee, but two weeks ago he had had the surgery that fixed the ligaments. It had been a battle with military and insurance red tape. The insurance' argument had been that someone who couldn't walk wouldn't need an intact knee, but Dr. Lassiter had helped him argue the point that in the long term it would prevent other health issues and thus save the insurance money. After a week of haggling and a bit of support from some high-ranking Marine Corps official, the request had been granted.
This brace was much smaller than the one before the surgery and it was made from neoprene and Velcro and he decided it wouldn't be an obstacle to swimming. The incision on the underside of his knee was all healed as well.
Over the last weeks, Jake had observed the muscles in his legs waste away. When he looked at these atrophied legs now, he felt a strange, almost visceral reaction in his chest. His legs had become entirely alien to him. Not just that he couldn't feel or move them, they also didn't look like his legs anymore. Dr. Lassiter had said that there was a chance that he could regain some feeling and even movement in his quadriceps, but so far nothing. Now, as he traced his index finger over the front of his right quad near the groin he noticed a faint tingling sensation. He put his hand flat on the side of his thigh and pushed his thumb hard into the quadriceps. The tingling intensified. Tears shot back into his eyes and he just lay there and cried. Small victories.
A while later he rolled back onto his back. His lower back was still painfully sore, albeit on a more acceptable level. He grabbed the bar suspended above his chest with both hands and slowly worked himself into a sitting position. He could have raised the head end of the bed and let it do the work for him, but that felt like cheating. He grabbed the bed control and lowered the whole bed, the bar he was still holding onto with one hand for balance, lowered with it. When the bed was level with the wheelchair he stopped. This was not his wheelchair. His own chair that Dr. Lassiter had given him as a symbolic farewell present was parked across the room. It had no arm rests and a very low back and he couldn't use it yet because of his lack of balance and core strength, but his own chair provided a visible goal to work towards.
Very slowly Jake moved into the hospital chair. If he could do it on a bad day like this, it was a definite improvement to be grateful for. He pulled his left leg off the bed and placed it on the foot rest, then the right. He poked his quadriceps again, to make sure the sensation was still there—it was.
Jake's trip to the nursing station was brief, but he was relieved to see Ricardo, the male nurse on duty. He had no interest in chatting to any of the other patients who had gathered in the common room watching TV or playing cards. He just wanted to be alone, so after he had asked Ricardo for the painkiller he went straight back to his room and began the slow and painful process of getting back into bed. When he was finally settled down, the bed raised again and now the head end, too, so that he could lie with his upper body at a forty five degree angle, Ricardo appeared with the syringe. He injected the painkiller into Jake's IV then he pulled the sheet back to check on the catheter and bag. Jake decided now was as good a time to ask as any.
"Ricardo, won't you do me a favor? Won't you remove the indwelling catheter and show me how to do it myself? The doc said he was going to have it pulled next week anyway, but to be honest I feel awkward with the female nurses. I'd rather you show me." It was an outright lie, but Jake figured that Ricardo would either do it without checking back with the doctor, who wasn't here over the weekend in any case or not at all.
"Hmm. I think I can do that for you."
Jake breathed a sigh of relief. He doubted that Ricardo would get into trouble even if the doctor disagreed, they would just put it back. Ricardo was a young guy, probably a few years younger than Jake himself and he seemed to still have some compassion, not like many of the older staff who considered the patients a nuisance. Janice had been one notable exception.
"Okay, here we go." Ricardo had removed the catheter and Jake hadn't even noticed because he hadn't paid attention.
"Now I want you to drink lots over the next two hours and then I'll come back after lunch and show you how it's done."
"Thanks, Ricardo. Won't you get me my surf shorts and a T-Shirt out of the drawer? I'm tired of wearing hospital gowns the whole time and my brother is coming to visit. I want to surprise him by actually welcoming him at the doors." This was also a half-truth, Tommy would be coming later this afternoon, but he doubted that Ricardo was going to support his plan if he knew that Jake wanted his shorts so he could sneak into the pool.
"Sure." He pulled open the drawer and got the clothes. "Do you want help putting them on?"
"No, thanks. I think I can figure out how to dress myself."
"Just don't fall out of bed. You wouldn't be the first."
"Thanks for the vote of confidence." Jake said acerbically.
Ricardo just shrugged and left.
Taking off the hospital gown was easy. Then Jake pulled the IV needle out of the skin above the clavicle. He used some tissue to apply pressure and after a while the bleeding stopped. He didn't have a plaster to stick on and he sure wouldn't ask for one now. It didn't matter; the T-shirt was black, it wouldn't show any conspicuous blood stains. He pulled on his shirt and for the first time he almost felt like himself again. With his legs hidden from view under the sheet and blanket he could pretend for a brief moment that it was Saturday morning and he was at home in his flat in San Diego, propped up on his bed on some big pillows and watching something on TV. Emily would walk back into the bedroom now with two mugs of coffee...
"No!" He opened his eyes and pulled the covers back from his legs to bring himself back into the present. He didn't want to think about Emily. She had dumped him shortly before he had been deployed to Venezuela and the last person he wanted to think about at this point in time was her.
He grabbed the shorts. Now what? Jake grabbed his left leg and pulled his thigh towards his chest, but the range of motion in his knee was limited because it had been immobilized for six week prior to the surgery and then due the surgery itself that had reattached the shortened ligaments. His knee wouldn't even bend to ninety degrees and his back was even stiffer so that he could reach no further than halfway down his shin, let alone manage to slip his shorts over his left foot. Jake howled in frustration, trying to escape the thought that kept going around in circles inside his head. Why me?
He let go of his leg and it flopped down, just a useless piece of meat. Jake stared at it in disgust. Why me? He couldn't even dress himself. A surge of anger rose up in him; anger at being defeated by his own body. He grabbed the plastic water bottle off the table and hurled it against the wall with another roar of frustration. It made him feel better. He closed his eyes and thought logically about the situation; there had to be another way. He grabbed the bar and pulled himself upright. Then he leaned forward, putting his hands down on either side of his legs to prevent himself from falling over, and eased himself forward bit by bit. He could bend well at the hips, but the stiffness and fused vertebrae in his back still limited how far he could reach. The pain spiked again and he had to balance himself on one hand, but finally he managed to slip the shorts over his feet. Very slowly he pulled them on, one tug at a time and pushed himself up until he fell back against the raised head end. Why me? He was so exhausted he had to rest for half an hour until he felt strong enough to get back into the wheelchair. When he finally arrived, he pulled the fleece blanket from the end of this bed and draped it over his legs. Then he got a towel, folded it neatly, hid it under the blanket and slowly made his way to the gym. Nobody stopped him to ask where he was going.
There were a few people working out in the gym, but he recognized none of them. Jake noticed a black guy stacking weights who looked like he was working here. He rolled up to him.
"Hi, there. Do you work here?"
"Hi, yes, I'm Trev. I'm one of the trainers here at the gym. Can I help you?"
"Jake." He extended his hand and Trev shook it. "I want to go for a swim. Would you please give me a hand getting in and out of the water?"
"Sure. You want to get changed first? I'll keep an eye out for you and meet you at the edge of the pool in a few minutes."
"No, no need to get changed. I just need to take the shirt off."
"Okay, let's go then." Together they made their way towards the pool.
"Thanks, Trev."
"Paraplegic?"
Jake nodded.
"Complete or incomplete?"
"Complete L1, but I also had spinal bruising at T6 so I need to work on core strength mostly at the moment."
"Swimming is a good choice. How long ago?"
"Eight weeks Monday."
Trev looked surprised. "That recent? You are doing better than most. Okay, Marine, huh?" He pointed at Jake's T-shirt.
"Yeah, First Recon."
"U-huh, the ultra-tough guys."
They had arrived next to the pool. Nobody else was using it at the moment. Jake pulled off the T-shirt and put it aside with the towel and blanket.
"Your first swim?" Trev helped Jake onto the floor and slide into the water.
Jake nodded. "Yeah."
"Okay, just stay close to the edge so you can hold on in case you get a cramp or get tired. Don't want to have to dive you out."
Jake managed a tentative smile. "Understood. I'll take it easy today. Just want to see how it goes."
"Okay, I'll keep an eye on you anyway."
Jake enjoyed being in the water. He felt less clumsy and confined. He had been a serious athlete since childhood and the only other time in his life he had had to take it easy for a while was when he had broken his arm at seventeen. He swam a few slow lengths. Breast stroke didn't work so well, but he could crawl and do back stroke. His shoulder muscles were doing fine. That, he decided, was what he would be doing every day from now on.
He even managed to push himself out of the water and sat on the edge, his feet still in the pool. He grabbed the towel with both hands and thoroughly and deliberately toweled off his hair and face, arms and upper body. Then he dropped the towel, stuck his arm under his knees lifting them and rolled onto his side bringing his legs out of the water and toweled them off as well. Trev walked up to him with a stop watch in his hand.
"What's your record sitting upright without holding on for balance?"
"Eight six seconds, yesterday."
"Congratulations. You just managed a hundred and thirty three toweling yourself off until you rolled over onto your side."
Jake looked surprised. He had really struggled to hold on for the eighty six. Trev brought the wheelchair closer. Jake folded up the towel and put it on the seat. Then Trev helped Jake back into it. He continued. "Don't look so surprised. The reason you could sit up much longer today is because you didn't think about it. Be aware of self-limiting beliefs. If deep down you believe that it will take months to regain full balance, then it will."
"Thanks for pointing that out."
"Okay, you're welcome."
Jake put his T-shirt back on and replaced the blanket over his legs. "Are you working tomorrow again?"
"Yup."
"I'll see if I can sneak out again."
Trev laughed. "I thought you did—good for you man, good for you." He extended his fist and Jake touched knuckles with him.
Jake was still on a high when he got back into his room and into bed just in time for lunch. After lunch Ricardo returned for the catheter lesson. It wasn't difficult, just annoying having to do it in the first place, three times a day at least, for the rest of his life.
Jake put the bed's head end back at the forty five degrees angle and slept for a while. By two forty five when he woke up, he was in serious pain again. The injection had worn off and the pain was approaching the morning's intensity. With the IV removed he couldn't just ask for another injection without getting into a lengthy explanation or even argument why he had removed it in the first place. He could barely move now and Tommy would be here by three. He had a bottle of oxycodone from Walter Reed in the chest of drawers across the room. Jake wanted to scream in frustration again that the three yards that separated him from the drawer had become another impassable chasm.
He had wanted to be in the wheelchair for a change when Tommy arrived. Maybe that would make Tom more comfortable in Jake's presence. Tom's tentative and uneasy behavior remained a mystery to Jake. Sure, as far as identical twins went they were probably the most different you could be with an identical set of genes, and the older they were, the more distant they had become and the more often they got into arguments. During every one of the three visits Tom had paid him over the last few weeks, he had been highly uncomfortable and unable to maintain proper eye contact with Jake. Their conversations had been superficial and he had never stayed very long. On the positive side, Tom had not been as openly dismissive of Jake, the way he used to be before the injury. Jake wondered why he came in the first place.
Jake checked the time again, it was ten to three. Getting into the wheelchair was out of the question with this amount of pain. He put his arms above his head and grabbed the rail at the top end of the bed, his hands as far apart as possible. He pulled himself up and the pain eased off a bit. Another pinched nerve then or still the same. Jake crossed his hands over and tried to twist his upper body again, but the vertebrae wouldn't budge. He crossed his hands the other way and tried to twist the other direction. It had been the wrong move to make. Fiery pain shot through Jake's upper body, made his eyes water and another shouted, "aaargh, fuck," escaped from his mouth—just as the door opened.
Tom stood like a statue, staring at Jake while the door closed in slow motion behind him. Then he turned around and reached for the door handle.
"Tom, no, wait." Jake managed to say.
Tom turned around again. Jake hooked one arm over the top rail and let go with the other pointing at the dresser. "Top drawer, orange bottle on the left." He was panting.
Tom walked up to the dresser and pulled the drawer open. He took the bottle of oxycodone, read the label and opened it.
"Two," Jake held his hand out. Tom dropped two of the capsules into it. Jake popped them into his mouth. He was still holding on above his head trying to take pressure off his spine. He tried to reach the water bottle on the table again, but couldn't. Tom handed it to him. The first expressions of surprise and then horror had now been replaced by the usual pained look he wore when in Jake's presence.
"Hi Jake. I don't think I need to ask you how you are."
"Tom, just give me five minutes and I will be better. Sorry you had to witness this, but then again now you know what it's like to be me."
Tom's carefully maintained composure cracked. He started pacing around the room.
"Fuck you, you got what you deserved! Why did you have to join the Marine Corps in the first place? If you had used just a fraction of your intelligence and opened your eyes to what is going on around us, none of this would have happened. You wouldn't be lying here paralyzed."
Jake's mouth compressed into a grim narrow line. "Tom, please now is not a good time…"
"No? When is a good time? When will you finally wake up and understand that our planet is dying a slow, but not so distant death and that our own government is one of the worst culprits, a government that has been using you to do its bidding and you have only been too happy to oblige. It's always been about you. About your ego, about what you want. When have you ever done anything for anybody else? And now that the system that you are a part of has used you up and spit you out broken and screaming in pain, now you want me to feel sorry for you? Grow up Jake!"
Jake closed his eyes. He was squirming, trying to maintain his hold on the bed. The rail was cutting into his arm and he switched to the other. I can't deal with this now. The physical pain was bad enough, but on top of that Tom's words were scathing and cut deep. He couldn't hide and he couldn't stop hearing what Tom was saying. He was a grunt, a pawn in a chess game that he didn't understand. Easily wasted and cast aside broken into the gutter; Tom's words revealed the futility of Jake's sacrifice. "Tommy, please," he pleaded. Tears were now running down his face. He wiped at them angrily.
"You have an IQ that most people can only dream of, yet you chose to crawl around in toxic mud instead of applying your mind on how to clean it up. Now your government shipped you off to dispose of another, democratically elected government and for what? So that they can drill some more holes and pollute our planet a bit faster to hasten its untimely demise? People are dying out there like flies without any access to clean water or sufficient food or medical treatment. What did you ever do for them?"
"I don't care about your people, there are too many of them in any case!" Jake shouted back; he had finally found his voice.
"You selfish prick. The only person you ever cared about is yourself; and now once more you are making those who care about you suffer and you don't give a fucking damn!"
"Like you care. You have never given me any credit for my achievements or just once acknowledged that my values and beliefs are worth standing up for."
"Yeah, well, you're not standing up anymore."
"That doesn't make them any less valid!"
"So what do you believe in then?"
"Honesty, integrity, honor ..."
Tom laughed out loud. "You believe in honesty and yet you work for a government that lies to you through their teeth. You believe in integrity when your government sells you out to the highest corporate bidder and where is the honor in vilifying others and then taking what is rightfully theirs by force?"
"Go away and fuck you, too, Tom! You don't care about me either. Whatever I did—what I need right now is for you to accept me, broken as I am and not put a guilt trip on me for not living up to your expectations! Because they are your expectations, not mine. As you have correctly pointed out—right now I am just trying to get through each day without screaming in pain! Try to imagine just for one minute what it's like to be this broken and with no hope of ever being whole again. Then come talk to me again!" Jake's angry voice was choked with tears.
"You just don't get it." Tom turned around and walked out of the door.
Jake grabbed the intercom and pressed the call button.
Ricardo answered. "What's up Jake? A bit of a family feud going on there?"
"Ricardo, I need a strong pain killer, the strongest you can get me, and—bring a needle." It would at least douse the pain if not the anguish.