Big Decisions

It had been five and a half years since the accident and I still hadn’t met anyone with the same injury as me. I had never felt the need to and to be honest I was too wrapped up in dealing with the enormity of my situation to even think much about anybody else. I had what is called a trauma brachial plexus injury. The Brachial Plexus is a network of five nerves which control muscles from the shoulder to the diaphragm and I had torn all five out of my spinal cord when I hit the ground after colliding with a taxi on my motorcycle.

I had two nerve operations during those first five years but both had been unsuccessful so I was in the final stages of making my decision whether to amputate. I thought it would help if I met others like me so I could see how we moved and perhaps gain a new perspective. I met with a group of bikers and ex-bikers at a pub in the Yorkshire dales where we set up a camp for the weekend. They were a great bunch of people and it was nice to share time with others who know what it’s like. There was, however one guy who stood apart from the rest, Steve. He had amputated his arm a few months earlier and he had the air of someone with a deep sense of inner peace.

To put it in perspective, those of us who still had our dangly, cold, useless arm, carried it around like a baby, constantly attending to it and in constant discomfort. Watching the others showed me myself for the first time. No-one moved particularly fast, there was no jumping for joy as that would usually lead to a dislocated shoulder. Over the years my own shoulder had dislocated so many times that the joint was worn out and it didn’t take much more than a sudden movement to cause yet another. Having this dead arm was a constant hindrance and I was reaching the end of my patience with it. Basically it came down to this; keeping the arm was putting a malfunctioning part of my body ahead of the rest of me which worked just fine. Over the course of the weekend I kept glancing at Steve and he always looked relaxed. I think I made my decision then but gave myself another six months just to be sure.

January of 2006 came quickly and I penned a brief note to the surgeon who had operated on me on both of the earlier occasions. The letter simply said

‘Dear Professor Birch
I would like to proceed with the amputation at your earliest convenience.
Yours sincerely
Tim’

I was surprised when just four days later I received his reply. In it he stated that he had retired from performing surgery but he had referred me to a colleague who was based at Manchester Hospital, near to where I was living at that time.

Again I was surprised when a few days after that I received an appointment letter to attend a meeting with the surgical team.

On the appointed day I was met by a young intern and escorted to the consultation room. I took a seat and in walked the surgeon with four other white jacketed and serious looking individuals, a psychologist, an occupational therapist and two trainees. The surgeon asked me what it was that I wished to have done so I simply stated that I wanted my left arm amputated as soon as possible. This raised a few eyebrows which prompted me to elaborate.

I explained that I was to turn 30 in July and was keen to begin the next decade of my life with the body which, hopefully, I would have for the rest of my life. I had taken my time to make the decision and was steadfast and committed to the idea. The psychologist spoke up; in a soothing tone asked me if I would like to talk with her in private. With a smile I told her that I was completely at peace with my decision and that no further discussion was needed. Satisfied with my responses, and I guess, by my demeanour I was told that I would be contacted as soon as a date became available.

It was Wednesday May 19th at 2:30pm that I walked through the doors of Manchester General Hospital. I had parked my car in the visitor’s car park and, hefting a small overnight bag was escorted upstairs to a small ward with eight beds in it. There were three others in the room, John who was a concrete cutter working on an elevator shaft when he had crushed his big toe under a 20 Ton slab of concrete. The squished toe had been amputated the week before but he was having a difficult time recovering. Roger had had some kind of cyst removed from his abdomen and just lay in bed saying little and there was an old guy who just slept 24/7 so I never found out his story.

After settling in I was seen by the ward sister and asked which medications I was taking, “none” I said, she then asked if I was allergic to any pain meds. I told her that I would not be taking any medication after the operation, sure, I would have the anaesthetic but nothing post op. This brought a concerned look to her face until I explained that I couldn’t actually feel my arm anyway and believed that taking pain medication only slows down the body’s ability to recover. She agreed and that was that.

Since it was now just a waiting game till the following morning, and the operation, I closed the curtains around my bed and rolled a joint. That done I headed outside to where I had seen a seating area under some willow trees. It looked like the perfect spot for a smoke and sure enough, as I arrived I saw someone was already there and smelt the herb he was smoking. We chatted and smoked and I enjoyed the gentle dance of the shadows and the rustle of the leaves in the light breeze. Afterwards I headed back to my room and into the spacious bathroom. There was a large floor to ceiling mirror and, standing in front of it I removed my sweater and just looked at my reflection. I stayed in the bathroom for about ten minutes, looking at myself in the mirror and searching for any shred of doubt, there was none. I think I hated my arm during those minutes and maybe I needed to in order to continue down the path I had chosen, I don’t really know. I exited the bathroom completely calm, watched a movie then slept soundly.

The next morning the ward was a bustle of activity. The guy who had had his cyst removed had taken a turn for the worse and the guy with the squashed toe was complaining bitterly about the pain. I ignored this and waited for the arrival of the nurse with my pre-med. She came at about 9:00am and with her she brought a marker pen which she used to draw four quick ticks on my left arm. Maybe it was a moment of nervousness but I asked her for the pen and in big, bold letters I wrote on my forearm the words ‘TAKE THIS ARM PLEASE!’

I awoke about midday and looked down at my left side. My stump was wrapped in bandages and there was a thin tube coming out which led to a bag tied to the side of the bed. A single tear rolled down my cheek, it wasn’t sadness or regret I think it was relief or maybe some kind of closure, I still don’t know for sure but a moment later I was elated and couldn’t wait to get up and feel my new balance. It was an incredible feeling. I still had what I call my ghost arm, this being the burning, crushing, pins and needles sensation I feel from elbow to fingertips but the heavy, cold and dead arm was gone and this actually made me feel more balanced. It’s a difficult concept to explain so I ask you to simply take me at my word on this.

About forty minutes after waking up I was back outside under the willow trees fishing out the remains of yesterday’s spliff. I sparked it up and took a generous lung full of the potent smoke. Within seconds I was having the worst whitey (nausea, sweats and spinning world) I had ever had. I put down the joint and rode the waves until they subsided. It only took a few minutes but they were long minutes believe me. Once the nausea left me I retook the joint and finished it off without incident. The rest of the day was spent meditating, drawing in healing energy. I’d been told that if I had drained less than 30ml of blood by the time the doctor did his rounds the next morning I would be permitted to go home.

Anyone who has spent time in hospital knows that weekends are particularly boring so I was determined to escape. Sure enough, when the doctor came the next morning the bag was virtually empty and I was given the all clear to go home. The nurse came a bit later and re-dressed the wound and at 2:00pm Friday afternoon I walked out the hospital doors and drove straight to the pub eager to see how comfortable it was to play pool.

After a couple of games I headed off to the shopping mall to buy my first ‘T’ shirts in over six years. I wouldn’t wear one with my dead arm as it looked so horrible all covered in scars.

I must go back for a moment: When I was in the hospital I’d told the surgical team that I would require my arm back after the operation. To me it was clear that such a big part of me should be buried with me when I die therefore I should prefer that it not be incinerated along with John’s big toe and Roger’s cyst. There was some consternation at my request and some delay in finding whom it would be that would co-ordinate it. I had checked the situation legally and knew that ownership of my arm would not pass once it had been removed but I also knew that I had an obligation to ensure that no-one else came into contact with it.

On the morning of the operation I was approached by a gentleman in his fifties who introduced himself as Bill and explained that he was the liaison in the event of still-births at the hospital and would be handling the details of my request. I was surprised by this and it must have shown on my face as Bill went on to explain that in his 26 year career no-one had ever asked for their amputated body part back. I knew that what I was asking might seem a little strange but it was part of my process of getting closure and I was determined to see it through my way. After I explained my reasoning Bill was happy that I wasn’t mad and agreed to arrange things. He would call me as soon as the preparations had been made.

Four days after leaving hospital I received a call from Bill. He said that I should come to the hospital later that morning to collect my arm but they just needed confirmation from the undertaker of the burial plot. I was out of ideas. I had planned to bury the arm on a small piece of land I own in the countryside so had no idea how I could get an undertaker to collaborate with my illegal plan. In desperation I called my mum. I explained my dilemma and she told me to wait for her call. There followed a tense thirty minutes as the appointed hour for collection approached but I still had no word from the requisite undertaker. Nervous that my plans would fail I jumped as the phone rang and almost dropped it in my haste to pick it up. My mother’s calm voice came through the receiver; her friend, the undertaker who had buried her father and father in law was happy to fax the hospital on my behalf stating that I had two plots to choose from. This final hurdle overcome I made my way to the meeting with Bill.

He shook my hand and smiled warmly as he told me that they had received a fax and that everything was in order. He went on to ask me if I wanted to identify my arm. I paused. I didn’t really want to look at it but felt that I must so we headed through long hospital corridors with their distinctive smells and flickering fluorescent lighting, down stairs and into what I’m sure was a morgue. There, on a table was a brown paper bag. Bill opened it and I stole a quick glance inside. The image will stay with me for the rest of my days but I don’t want to gross you out further so I’ll keep it to myself.

Bill then wrapped the paper bag in a plastic bag then rolled that into a body bag which he then wrapped in tape. I asked him how long it would take for the plastic to biodegrade to which he replied that about fifteen years should do it. He insisted on carrying it out to my car and placed it carefully in the trunk. Shaking my hand again he said good luck and walked slowly back into the hospital.

Wondering how I would explain it should I be stopped by police on my way I drove at a leisurely pace and arrived at my destination a couple of hours later. I had brought a pick and shovel so headed up to my plot without delay. It’s a beautiful spot with a view of the sea and the opening of a glacial valley spread out below the small plateau. I breathed in the air and thought for a moment about the events which had brought me to this point in my life. It felt good to have re-taken some degree of control and it was with a feeling of deep calm that I took the plastic bags off and buried my arm in the paper bag only. There is no stone to mark the grave but its location is indelibly marked in my mind.

I sat for an hour afterwards and watched the sun go down behind the mountains. I felt a weight had been lifted, leaving me free to move forward again and as I walked back to my car a slow smile spread across my face and I knew I had taken a huge step on the road to recovery.