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I’m exhausted as well. Despite my tactical batons, I’m barely sleeping. Every door closing, every bus honking, every person talking in the hall, every parade of excited high school or college kids sprinting past – my anxious brain registers all these as lethal threats, keeping me in a perpetual state of hypervigilance. I’m averaging an hour and a half of sleep at night, broken up into two or three brief spurts between panic attacks and night terrors.
To hide my weariness, I act as Mark’s personal morale booster, buying a cheap printer and covering his hospital room walls with photos and humorous sayings. I pick up outside food or treats most days to give him something to look forward to. I also schedule video chats every evening with Tucker and Lila, and he seems more relaxed after talking with them.
A few days later, Dr. Paxton sees us making our awkward laps in the halls. Because of Mark’s bicep injury, I act as a human crutch on his right side. His injured arm rests along my shoulders while I grip his canvas gait belt. He uses his left crutch normally. Dr. Paxton stops to examine Mark’s arm. “We can remove these sutures today. Maybe soon you’ll be able to use crutches with both arms.”
Mark is eager to try, but ambulating using two crutches causes pain in his broken ribs and healing abdominal wounds. He persists, ignoring his aching bones and burning muscles, convinced that stubborn determination is all he needs. More than once, he’s forced to rest on a hall bench to avoid collapsing.
Dr. Paxton comes in the next morning as we’re drinking coffee. I tense at his resigned expression, knowing immediately that it’s bad news. “Put down your coffee, Captain. I just reviewed your femur x-rays. I’m taking you back to surgery this afternoon.”
Mark’s screwed-and-plated thigh bone isn’t healing. The bone fragments stubbornly refuse to fuse together. The new plan involves a Humpty-Dumpty-esque plan involving external pins and a device resembling a roll cage. It’s a last ditch effort. If the bones won’t heal, he could end up losing his upper leg as well. But Mark doesn’t know that, and I’m sure as hell not going to tell him.
Dr. Paxton removes all the old hardware before scuffing the bone surfaces and cementing pieces together, filling gaps and adding bone grafts. Then comes the new hardware: internal pins, plates, screws, external fixators, and the external cage. It’s an extensive surgery, nearly five hours long, and all I can do is hope it’s enough.
Because if it’s not, I don’t know what we’ll do.
CHAPTER SIX
CHARLIE
Mark’s additional femur surgery puts him back at square one. He’s under strict orders regarding his activity, and rule number one is that he’s not allowed to get up without help. This has been stated ad nauseam. Monica even wrote it in capital letters on his whiteboard. Despite the warnings, a few mornings after surgery, I enter his room to find him getting out of bed alone. He’s upright, but his bedsheet is tangled around both the cage and his crutch. “Freeze, Big Guy.”
Mark glances up with a guilty expression. It quickly turns to annoyance when he realizes I’m not the nurse. “I’m not a fucking invalid,” he snaps. “I’m a goddamn soldier. I’m going to the bathroom and I don’t need an escort.”
“Well, Captain, perhaps you should unwrap the sheet from your leg and crutch.” My voice is calm, my expression neutral as I kneel in front of him.
He dips his head, seeing the fabric caught around his leg and the crutch. “Lean on your left crutch,” I instruct, and when he does, I lift the right one, freeing it and the cage from the offending sheet. “You’re good now.”
“Charlie,” he begins, his face reddening, but I shake my head.
“Bathroom.” I point, barely resisting the urge to add, “Soldier”.
When he returns at a snail’s pace, he still looks sheepish. “Sorry.” He eases onto the bed, slowly positioning his caged thigh on a pillow and moving gingerly, wincing with every movement. Normally he’d be up in the recliner, watching the sunrise. Today he’s pulling the covers up, his expression tight, the shades still down.
“Want me to call for something for pain?”
He glares. “No.”
I’m not surprised. I can’t recall Mark ever taking anything stronger than an aspirin before this. Whatever discomfort he had, he pushed through. Pain medications are one more thing forced upon him. His expression sours every time the nurses administer pain meds, but it’s a necessary evil. If he can’t participate in rehab, he can’t achieve his recovery goals.
“I’m going back to sleep. It was a rough night.”
“Want me to wake you for breakfast?”
“Powdered eggs and soggy bacon? I’ll pass.” He drags the covers over his head.
Hostility oozes from him, composed of layer upon layer of frustration. The abrupt end to his career. The loss of his identity, nearly inseparable from the military after all this time. Losing the only home he’s known for fifteen years. His surviving brothers-in-arms he couldn’t tell goodbye. The brothers who fell beside him and never got up. Survivor’s guilt. Lackadaisical healing. Pain. Body image issues. Being trapped in a hospital. His loss of independence. And now phantom pain. It’s agonizing, seeing him struggle under the weight of his growing despair.
Phantom pain is understood by few, even within the medical community. After an amputation, particularly traumatic ones, amputees sometimes experience severe, unrelenting pain that seems to originate in the missing limb. The only proven treatment? His nemesis, pain medication. As a result, discouragement and depression have crept in, black panthers slinking through the darkness after scenting their prey.
Mark views his phantom pain as a failure because it forces him to take pain medication. I’d hoped Dr. Friedman could get through to him. He’s one of BAMC’s top psychiatrists, and he specializes in head injuries and limb loss. They’ve been meeting twice a week, discussing depression, anxiety, mood swings, and pain – or rather, Dr. Friedman discusses them. Mark ignores him. Therapy is another thing Mark equates to personal failure.
Dr. Friedman has explained that shrugging off a headache is far easier than coping with the brutality of burned flesh and shattered bones. He encourages Mark to view his pain as a healthy response to overwhelming trauma. That might have been a concept Mark could accept, but as soon as he brought up psych meds, Mark tuned him out. To him, if pain signifies weakness, depression is even worse. He dismisses every suggestion of meds for his emotional turmoil.
“Try viewing medications as one more tool in your arsenal,” I encourage him one day over pineapple and pulled pork sandwiches from the nearby deli. “They’re a resource to boost your recovery. You’re learning to cope with your injuries by using crutches to walk and climb stairs. Meds can help you push through the pain and bolster you emotionally.”
My words fall on ears that choose to be deaf.
Not only does Mark adamantly shun antidepressants, he starts ditching his mandated appointments with Dr. Friedman. In a military hospital, that flies about as well as a lead balloon. Dr. Paxton pays him a stern visit with the psychiatrist in tow.
