Jeremy, Part 2

My name is Jeremy and I’m a DAK amputee. I wrote a little about myself previously, but I received a lot of comments and encouragement, so I’m writing something a bit longer. I’m not much of a writer and this isn’t going to be really erotic or anything, but it’s a true story about an important experience in my life.

I’m currently a medical intern. I was injured in a car accident the summer after my first year of medical school and I completed my education from a wheelchair. My stumps are fairly small: the right one is about six inches long and the left is eight inches long. I have attempted to use prosthetics in the past, but it didn’t work out very well, so I use my wheelchair full time now.

This is the story of my first rotation during my third year of medical school. The rotation was internal medicine, which is basically all the hospital inpatients that aren’t giving birth or having surgery or something like that. It was probably my worst rotation, although it’s what I wound up picking as my residency.

Each medical student was assigned to a different team. My team had three other medical students, two interns, one second-year resident, and an attending (the attending is like the head doctor). We were quite a huge crowd going from room to room. Each morning, our team would make “rounds”, which meant visiting each patient our team was responsible for, and discussing the patient with the whole team.

The other medical students on my team were Michelle, Ronnie, and Sam. Ronnie was an all-around nice guy from what I knew of him. I mean, he was smart but he wasn’t all obnoxious about it like some of my classmates. He was the sort of guy who I would have been friends with, but I sort of kept to myself in the year following my accident, so I actually didn’t have a lot of friends.

Sam was one of the top students in our class and as rumor had it, very competitive. I was a little nervous when I heard he was going to be on our team. From what I knew of him, he was very assertive and studied all the time.

Michelle was the only female on our team. I was a little nervous about having Michelle around too. Although she had been nice to me every time I talked to her, Michelle was well known in our class as a crusader for black females such as herself. She was the one who got several of our lecturers changed this year when she discovered that our classes on female reproduction were all being taught by males. I always felt that Michelle was a little over-sensitive. As a white male, I was always instinctively scared of offending her.

On the first day of our rotation, we were introduced to our attending, Dr. Mather. My initial impression of Dr. Mather was that he seemed pretty nice, although unfortunately first impressions can be wrong a lot of the time. After he took a few minutes to welcome us to the team, he continued on rounds as if we medical students weren’t even there.

The resident passed us all sheets of paper that had brief summaries of all the patients on the team, which we could read as we were rounding. I looked at the paper and it looked like it was written in some other language. “64 yo male c h/o ESRD s/p tx, s/p cabg x4 in 1995.” As I quickly wheeled to keep up with the team, I looked around to see if anyone else was confused.

Some people were jealous of the fact that I got to sit down during rounds (which could sometimes mean up to three hours of standing), but it’s very hard being on the floors in a wheelchair. Our team stood in the hallway, so nurses and other people were constantly walking by pushing carts and stretchers and all that. It seemed like no matter what I did, my wheelchair was always in the way. I learned this fact on the first day. In the first half hour of rounds, I had to wheel myself away from the team so that someone could get through no less than five times.

At one point, the team was at a narrow place in the hallway and a nurse was trying to come by with a stretcher. She tried to go through, but obviously I was in the way. “You’re gonna have to move, hon,” she said to me inpatiently.

I backed up into the nurse’s station and promptly knocked into a nurse who was sitting inside, causing her to spill her coffee. She was fairly nice about it, considering everything, but I was really embarrassed and when I came out, Dr. Mather looked annoyed at me for disrupting rounds.

Then we finished all the patients on the fourteenth floor and Dr. Mather said, “Okay, let’s go to fifteen.”

So he opens the door to the stairwell and everybody starts going in and I looked at him, like, “Uh, what do you want me to do?”

“We don’t have time for this,” Dr. Mather said impatiently. “Go take the elevator.”

So I had to wheel myself all the way back down the hallway to the elevators. And the hospital elevators, to put it bluntly, really suck. I didn’t choose the school for its elevators. They were so slow, I was waiting about ten minutes before one came. And then it was too crowded to get in, so I had to wait for the next one. By the time I rejoined the team on the fifteenth floor, they had managed to see another two patients.

By the time lunch came, I was feeling really frustrated and thinking maybe it hadn’t been such a good idea to go into medicine after all. Maybe I should have quit after my accident and gotten some kind of desk job. Michelle asked me if I wanted to have lunch with her and I said yes.

We ate downstairs in the cafeteria. Ronnie and Sam went off and ate together while me and Michelle stayed together. I got the feeling that Michelle didn’t like either one of the other guys.

I brought my lunch, which I kept in a bag in my wheelchair. Michelle brought her own lunch too—she had some weird diet where she could only eat meat from animals that came from the water. The first thing as soon as we sat down, Michelle leaned forward and said, “So Jeremy, what do you think of Dr. Mather?”

“Um, he’s okay, I guess,” I said.

Michelle made a face. “I didn’t like what he did to you on the stairs. We should have all taken the elevators.”

That was when I first got it why Michelle was being nice to me. She was sticking up for me because I’m disabled. It was so obvious in retrospect, but at the time I was kind of surprised, because I didn’t really think of myself as a disabled person yet. I thought of myself as this white male that Michelle would naturally resent. I felt weird about this—part of me wished she’d hate me like Ronnie and Sam, just so I could still be the same person I’d always been. “It’s all right,” I said. “We do have a lot of patients to get through.”

Michelle didn’t look happy about that answer. “I had half a mind to take the elevators with you.”

“You don’t have to do that.”

“Well, I felt like I should,” Michelle said thoughtfully. “But then again, he already ignores the both of us, so it’s not like he would even notice.”

“What?”

“Did you notice that he barely looked at me or you when he was talking about the patients? He looked at Ronnie and Sam all the time and asked them both questions.”

“He looked at me when I knocked into that nurse,” I pointed out.

Michelle looked like she was going to say something, but instead started giggling almost uncontrollably. “You’re right, he did.”

Michelle turned out to be one of the best friends I ever had in my life. She did have a tendency to overreact to things, but I got the feeling she was right more than people liked to admit. She was really smart, but she was also really considerate. And her fights with Sam were always a source of amusement for me and Ronnie. But I’ll talk more about her later.

I got my first patient later that day and I was supposed to go examine him. I had examined patients before, but this was the first time I didn’t have a doctor with me and I was pretty scared.

The patient was an old man named Mr. Kramer with emphysema, heart failure, and about a zillion other things wrong with him, and he was breathing with a nasal canula. I wheeled myself into the room and stopped in front of his bed. Mr. Kramer looked at me curiously.

“My name is Jeremy Andrews,” I told him. “I’m a medical student. Is it okay if I examine you?”

“You’re a doctor?” Mr. Kramer asked with a raised eyebrow. He didn’t say it in a nasty way. Some of these old men can be pretty blunt.

“No, I’m a medical student,” I explained to him, even though I knew that wasn’t what he meant.

Mr. Kramer frowned. “I didn’t know they let... uh... uh.... handicapped be doctors.”

I assured him that they did. Then Mr. Kramer started asking me all these questions about whether I was in the war or something as I tried to get a history from him. Finally, he just straight out asked me, “How’d you lose your legs?”

“I was in a car accident.” Mystery over.

I nearly took down his IV pole when I wheeled over to the side of his bed, but I managed to push it out of the way. My wheelchair is at a good height so that if the patient is reclining a little bit, I can examine them without stretching too much. I checked Mr. Kramer’s eyes, his cranial nerves, his throat, his neck, and I got a listen to his heart. Mr. Kramer probably had the clearest third heart sound I’d ever heard and I was all excited about this physical finding. Then I realized it was going to be a problem to listen to his back. “Can you lean forward, Mr. Kramer?”

The guy looked at me like I was asking him to run a marathon. “Can’t you listen in front?”

“I’m really supposed to listen to the back too.”

With much effort and heavy breathing, Mr. Kramer leaned forward ever so slightly. In the past when a patient couldn’t lean forward, someone else had always been there to help me hold the patient up. But it was too much for me to try to listen to his chest, hold him up, and stay in my wheelchair as I leaned forward. This is part of the problem with having such small stumps—it makes it harder to balance.

Finally I gave up without getting a good listen. I let Mr. Kramer lie back down. “Hey, you got a twitch,” he said to me.

I looked down and saw that my right stump (the smaller one) was twitching almost violently. I put my hand on it to calm it down and I could feel the muscle spasming. And it didn’t calm down.

Even though I have feeling in my stumps, the muscles are pretty atrophied, so I’m not really able to control how they move. I had gotten a few spasms before, but this was the worst one I’d ever had and it was on my first day of medicine. It was obvious I wasn’t going to be able to finish the physical exam.

“Wow, look at that,” Mr. Kramer said, staring at my leg. I had probably provided him with entertainment for the day.

I apologized to him and said that I should leave. I borrowed a spare blanket from the closet in the room and put it on my lap so that nobody would see my stump jumping around like that. I wheeled to the men’s room on the floor and locked myself in the handicapped stall. I pulled my pants leg up from underneath my stump and examined the stump to see if there was anything wrong. It looked okay, but I could literally see the muscles twitching. I kind of kneaded the stump with my hands and eventually the spasms stopped. All in all, it was a pretty bad first patient experience.

I didn’t tell anyone else exactly what happened because I was embarrassed. I don’t like to talk about my stumps to people and I think they don’t like it either. But I hinted to Michelle that the exam didn’t go too well. When I told her that, she rolled her eyes, took me aside, and told me the nightmare of her first patient. She said the guy had sleep apnea and he kept falling asleep as she talked to him and examined him. She told me that after every question he answered, he would fall asleep before she could finish asking the next question. “I was like, ‘Sir! Sir!’ through the whole interview.” Then when it was time to do the physical, he was so deeply asleep, she couldn’t even wake him up.

Michelle made me feel better, like she always did, but her experience wasn’t her fault and mine was. And now I was imagining other things that could have happened, like what if I actually fell out of my chair while I was trying to prop him up? And what if Mr. Kramer told everyone about how my stump kept twitching? I dreaded him mentioning it in front of Dr. Mather.

I was kind of scared of going back in to do an examination after that whole experience, but thankfully, it went more smoothly the next time. I don’t try to strain myself if the patient can’t sit up. I listen if I can and if I can’t, most of the nurses are understanding enough to help me out. Right now, I’m probably one of the best physical diagnosticians of all the interns.

The other medical student Sam turned out to be just as bad as everyone warned me he was, maybe even worse. I was pretty competitive myself back before my accident (although I was never a jackass about it) and I think I could have given Sam a run for his money, but the way things were, he never stopped finding ways to make the rest of us look bad.

Michelle really despised Sam. He would always be making some arrogant statement and Michelle would call him on it. I almost felt sorry for him the time when I had a female patient who I suspected was being abused by her spouse, and Sam volunteered that he thought the woman would have left her husband if she was being abused. “After all, she had the financial means to leave,” Sam said.

Michelle crossed her arms. “Just because she has money, that doesn’t mean she has the emotional means to leave.”

Sam pontificated for another few minutes and then Michelle broke in and proceeded to tell him off for the next five minutes. Sam stood there with his mouth open and when he tried to respond to her, Michelle said, “Forget it, talk to Jeremy. I have no interest in speaking to you about this.”

Sam turned to me and smiled at me, like, That crazy bitch. As if I was his best friend after he had ignored me all year.

Sam hung out with Ronnie, who was the one person who would tolerate him. It was too bad, because Ronnie was a basically nice guy who got stuck in the middle of all this.

I remember one time after taking my elevator route to get to the next floor ten minutes after everyone else, I found my team and they had just reached my patient’s room. Dr. Mather gave me his annoyed look. “Jeremy, we’re waiting for you to present your patient.”

I had interviewed and examined my new patient this morning and I felt like I was well prepared to present her case. I wheeled over to the team and picked up my notes off my lap. “Ms. Smith is a 44 year old female with a past medical history of gallstones and fibroids who presented with a two week history of fatigue...” I went through the details of the case, then went through my physical exam, and I was mostly through the labs. I was reading off Ms. Smith’s blood count, which showed that she was anemic, when Dr. Mather interrupted me.

“Did you get a retic count?” he asked.

“Uh...” I looked down at my notes. “It wasn’t on the computer this morning.”

“Her retic count was four point eight,” Sam spoke up. “I checked half an hour ago.”

I couldn’t believe it. Sam had looked up the labs on my patient and hadn’t told me, so he could recite them during rounds to make me look bad. “I guess it just went up,” I said. “It wasn’t there before rounds.”

“A lot of labs aren’t up in the morning,” Sam said in this mock-understanding voice. “That’s why I keep checking them during rounds.”

It would have been good if Dr. Mather had defended me in some way, but instead he said, “You have to come to rounds prepared, Jeremy.”

I wasn’t about to try to explain that it was hard enough for me to keep up with the team, much less slip away to check labs every half hour. Luckily, after that Michelle tried to help me by checking the labs on my patients when she looked up hers.

Sam was the hero of every story he told. I don’t think he would tell a story if he didn’t think it would impress you. The few times Michelle wasn’t around during lunch, I joined Ronnie and Sam. The conversation usually consisted of Sam regaling us with his stories about mountain-climbing or something else he did.

One time Sam had just finished telling us this story about how he managed to get to the top of this mountain even while feeling lightheaded because his oxygen tank was low. “Wow,” Ronnie said at the end of the story. I didn’t say anything.

“Ronnie, you have to come with me next time I go climbing,” Sam said.

“Okay, maybe,” Ronnie said.

“Jeremy, do you climb?” Sam asked.

I looked down at my legs like this was the most ridiculous question ever. “No.”

“You should try it sometime.”

“Um, I don’t think so.”

“What, do you think there aren’t disabled people who climb mountains?” Sam said. “They have special equipment that you could use in order to climb using only your arms.”

“I don’t like heights,” I said.

Most people that would have shut up, but not Sam. “That’s the best reason to climb,” Sam said. “You need to get over that fear.”

“Uh, why?”

Sam continued to try to convince me to do this for like the next twenty minutes. I told Michelle about it later and she couldn’t stop laughing. It might have been a nice gesture that he wanted to help me do mountain-climbing if he hadn’t been such a condescending prick about it.

Michelle helped me find the humor in all the frustrations I had in the hospital. She was really great. She was also the one who set me up on the first date I had since my accident. Even though I didn’t want to go, she pushed me to do it, and even though it didn’t work out with the girl, it made me feel good about myself to be out there and dating again. Plus Michelle told me later that the girl liked me a lot, so that gave me confidence.

And I’ll admit it now: yes, I was in love with Michelle. It was hard not to fall for her. I mean, she was my first really close friend as a disabled person. Plus there were really no other women in my life.

When I met my ex-girlfriend Wendy for the first time, I thought she was the most beautiful girl I ever saw. She was everything I had always wanted in a girl. I couldn’t believe it when she liked me back. She was the only girl I ever wanted to be with for the rest of my life. Then when she told me that she couldn’t be attracted to me anymore without my legs, it pretty much wrecked my world.

Michelle was absolutely nothing like Wendy. Physically, Michelle was a pretty girl but really not “my type” at all. But she was so cute and sweet to me, I found myself thinking about her all the time.

The other thing about Michelle was that she was the first girl I ever fantasized about where I was an amputee in my fantasy. I started jerking off again eventually after I lost my legs, but usually I imagined myself as able-bodied in my fantasies. But when I thought about Michelle, I never had legs in the fantasy. I guess part of it was the fact that I was finally developing an identity as a double amputee, but also, it was that Michelle made me feel comfortable with not having legs. Now when I fantasize, I almost never imagine myself as being able-bodied, because that’s just not me.

One fantasy I used to have was that I’d be lying in my bed with my boxers on and no shirt on, and Michelle would come in for a study session. I would start to apologize for not being dressed and my stumps showing and all, but Michelle would tell me to stay the way I was. Then she would sit down next to me and pretend to study, but she would actually start rubbing one of my stumps. (Usually I would imagine her rubbing the left stump, which is the more sensitive one.)

She would keep rubbing it as she read her book like it was no big deal and then the stump would start quivering like it always does when I get really excited. Michelle would look over to see why it was quivering and see how excited I was. She would put down her book and roll on top of me, still holding on to my left stump. “What are you so happy about?” she’d whisper.

By that point, I’d be so excited, my stumps would be shaking uncontrollably (both in the fantasy and in real life). Sometimes I’d imagine her rubbing and kissing my stumps and other times I’d imagine picking her up and plunging into her. Usually I didn’t even get that far, because just the thought of Michelle touching one of my stumps erotically was enough to get me to orgasm.

Unfortunately, it wasn’t meant to be between me and Michelle. She already had a boyfriend. Also, I “wasn’t her type”, something she actually told me once, I think because she suspected how I felt about her. We were watching TV at my place once and she made some comment about one of the “teen heartthrobs” being really disgusting. So I came right out and asked her what type of guy she liked. I think the question made her nervous. She kind of laughed and said, “Well, not you. I don’t like redheads.” (I’m actually not a redhead, FYI. My hair is brown but I guess in some lights it looks a little red.)

I don’t think it was my disability so much as the fact that I’m white that turned Michelle off. I can’t really fault her either. My parents, with all their liberal talk, were pretty happy when they found out I was marrying Wendy, a nice Irish Catholic girl. I think they would have secretly freaked out if I brought home Michelle with her dreadlocks.

I know there are girls out there who are attracted to guys who are amputees. Although I’ve been out on dates, I don’t think any of the girls were like that. I think most of them were okay with me being a double amputee, but they weren’t particularly turned on by it. But I really like the idea of a girl who would be very turned on by my stumps.

Part of it is that since the accident, I haven’t thought of myself as being very attractive. I mean, my stumps look kind of weird, being very thin, with the skin kind of flapped over and all. Plus I wish they were longer. I have to confess that in the past, I used to stuff my pants legs to make my stumps look longer than they were. I know it’s kind of dumb, but I just wish they weren’t quite so short. I don’t like the idea of people looking down at my lap and there’s nothing even there. I’ve seen patients with legs that were twisted or paralyzed or something, but at least they have legs. You wouldn’t think that I could look at a pair of malformed legs with no muscle tone at all and actually feel jealous, but I do sometimes.

I would really like to be with a girl who got turned on by my stumps. I’ve imagined all kinds of things she could do with them. I think if I met a girl like that, we’d probably never leave the house again. (Okay, I’d probably have to go to work eventually.)

Back to my story. Anyway, the rotation went as smoothly as I could have hoped, between Sam and Dr. Mather and the slow elevators. At the end of medicine, Dr. Mather called me into his office to give me my official evaluation. I remember there were like five chairs in front of his desk so I couldn’t even get my wheelchair in there until he pushed everything to the side. He knew I was coming so I found it upsetting that he didn’t bother to take care of any of it in advance.

“Well, Jeremy,” Dr. Mather said to me. “How do you think you did?”

I hate it when people ask stuff like that. “I think I did all right.”

“And you’re happy with just doing ‘all right’?”

I thought that with everything going against me, it was a miracle that I even did that well.

“Jeremy,” Dr. Mather began, “I know it’s been a little harder for you because of your disability. In any other field, I would make exceptions for that. But not in medicine. You can’t compromise patient care.”

I told him I thought I took pretty good care of my patients.

“In the future, you won’t always have Michelle to look up lab values for you,” Dr. Mather said. “The other interns will be just as busy as you. And then what will you do?”

I told him I thought I was always pretty well prepared.

“Compared to the other students? I’m a very astute observer and I’ve noticed you struggling many times. If you can’t keep up, I think you owe it to your patients to be honest with yourself.”

It was like a repeat of what the dean had said to me when he told me he didn’t want me to come back to medical school after my accident. And when Dr. Mather handed me an awful evaluation, I really was getting the feeling he was right.

I came out of the office and I ran into Sam, who was talking to the second year resident he had been sucking up to all month. “Wow,” Sam was saying, “thank you for such a great evaluation! But is there anything I could do to improve myself?”

“You know, Sam,” the resident said, “if you asked me what you could do better, I would say... nothing. I mean, you just did a great job all around.”

Ronnie was standing nearby, writing a note. I wheeled up to him. “Did you get your eval from Mather?”

Ronnie nodded. “Yup.”

“How was it?”

“Really good.” Ronnie looked up. “How about you?”

“Really... awful, actually.”

Ronnie nodded. “Yeah, he’s been riding you all along.”

“Yeah...”

“Look Jeremy,” Ronnie said, “you’re really smart about your patients. You get everything done a lot better than I do. You probably know more about your patients than the interns do. So don’t let Mather get to you.” Ronnie glanced over at Sam. “Plus you’re not an asshole to work with.”

That got me to laugh. It still amazes me that there could be jerks like Sam and Dr. Mather occupying the same space as really wonderful people like Ronnie and Michelle. And you know the end of this story, which is that I made it through school and I’m now a doctor (first graduate of my school who was an amputee). So sometimes things do eventually work out.

To be continued...