Noel’s Memory Book:
One thing that bothers me is that I didn’t have to lose my leg. I had an open tib-fib fracture and a dislocated knee, and they say the blood supply to my foot got compromised and that’s why they had to amputate. But I’ve seen patients with injuries like that who didn’t need amputations. Let me put it this way: if my only injuries from that car accident were the ones to my leg, I’d still have my leg.
But obviously, I had a lot worse injuries when I was brought in to the hospital, so they had to focus on those first. Don’t get me wrong, I’m glad the first thing they did was bring me to my OR to evacuate the blood in my skull. If they didn’t, I’d probably be dead right now or at least much worse off.
But I also feel like they didn’t even try to save my leg. They took one look at me, determined I probably wasn’t going to walk again anyway, and did the easiest thing. I can’t entirely blame them, but at the same time, I wish I still had my leg.
Doctors, especially surgeons, treat you differently when they think you don’t have any potential for quality of life. Then it’s all about keeping you alive, to hell with what they have to do to your body. I should know—I used to be one of them. I still remember when I was an intern, I bullied the family of this demented diabetic patient with a bone infection in his foot into doing an amputation. I remember I said to them, “He’s never going to walk again anyway. He’s better off with no foot than risking getting an infection in his bloodstream. Do you want him to die? Because that’s what will happen if you don’t amputate his foot.” After ten minutes, I had scared them enough that they said yes, and we took the guy’s foot that next day.
Shortly after my injury, I developed an infection in the stump of my left leg. In the bone. The surgeon came in and told my mother they were going to do a revision amputation up to my mid-thigh. My mother said, “Won’t that make it harder for him to walk?”
Of course, I wasn’t there, but I’d imagine the surgeon said something like, “He’s never going to walk again anyway. He’s better off with no knee than risking getting an infection in his bloodstream. Do you want him to die? Because that’s what will happen if you don’t amputate above the knee.”
My mother said she needed to think about it. And according to Rose, pretty much everyone came at her, telling her she had to let the surgeon operate. Even Liz, who was still in the picture then, sat down with my mother and made a really compelling argument. It was all about keeping me alive back then, to hell with what would be left of me.
Even though I hate the fact that I didn’t have to lose my foot, I’m really glad my mother held her ground and I got to keep my knee. A therapist told me that if I didn’t have that left knee, I’d never be able to walk with just a cane for support. I’d need a walker, which is a hell of a lot different from a cane. I’d probably be using a wheelchair at least some of the time.
I guess it’s all about being grateful for what you have, and I guess a below knee amputation isn’t the worst. I just wish that Chloe didn’t have to see it. She’s a really attractive girl and it’s not like it would be hard for her to find a boyfriend who doesn’t have a missing leg. The best I can hope for is she’ll be willing to tolerate it.
I have to admit, Noel’s confession about his amputated left leg shook me a little. Since I’m going to be a doctor, I obviously shouldn’t be bothered by stuff like that, but it’s one thing if it’s a patient and it’s another thing if it’s your boyfriend.
But I can tell he’s already self-conscious as hell about it, so I really don’t want to upset him further by telling him he freaked me out. I wanted to be ready when he showed it to me, so I’ve been looking at photos of leg amputations online, just to get an idea what I’m in for. If anyone looked at my computer history, they’d probably think I’m a total weirdo.
So we’re kissing on Noel’s couch and his hands are respectfully staying on top of my clothes. I know I’m the first girl he’s been with since his injury, so he’s in favor of taking things really slow. And also, I know he’s nervous about scaring me. So I’ve got to be the one to make the first move, which in this case is unbuttoning my blouse.
I can almost hear Noel’s breath speed up a bit. “Okay,” he says. “What should I do?”
I can’t help but laugh. “You were engaged, weren’t you? I thought you’d know that by now.”
His face turns really red. “I mean, do you want me to take my shirt off too?”
“Okay,” I say.
“Okay,” he says.
He pulls his T-shirt up over his head. Okay, Noel isn’t ripped like Graham is. But he’s not bad at all. He’s young and fit, with nice muscles in his shoulders, and some dark red hairs on his chest. He’s got some scars across his abdomen, which are kind of rugged sexy, and there’s one puckering of skin above his belly button that I reach out and touch with my fingers. “That was where the feeding tube was,” he says, lowering his eyes. He’s really been through a lot.
I kiss him again, loving the feel of my bare skin against his. Like I said, Graham had the nicer chest objectively, but I’d never been turned on this much by Graham. Noel does something to me. “Do you want to go to the bedroom?”
He nods. I watch as he holds the coffee table for support when he gets to his feet. I know he’s self-conscious about his walking, but the truth is, considering what he showed me of his legs, he walks pretty well. He definitely limps very noticeably, but it’s the not the kind of limping that everyone would turn and stare at, even though I think he might think they do.
He holds onto furniture to make it to the bedroom. When we get into his bed, I remove my jeans and look at him expectantly. “Your turn,” I say.
He shifts uncomfortably. “You know, I have to take my leg off to get my pants off. You ready for that?”
I nod and brace myself.
I’d be lying if I said I wasn’t a little bit shocked by the site of Noel’s amputated leg. I’d never seen one up close before and it looked…. weird. The stump was short, maybe just a few inches from his knee, rounded, with visible scars along the underside. When it wiggled slightly as he was removing the brace from his other leg, I found myself shuddering.
“I’ll put the prosthetic back on,” Noel says quickly, after seeing my face.
“No,” I say firmly. “It’s okay. I promise. I just need a minute.”
I reach out and put my hand on the stump. Noel is watching me, a concerned look on his face. The skin feels very soft to me and Noel shifts as my fingers probe deeper. “Are you okay?” I ask him.
“It’s sensitive,” he says. “Like, really sensitive. When you touch me like that, at least.”
Encouraged, I press my fingers even deeper and this time Noel shuts his eyes and groans slightly. I can see through his boxers that he has an erection. This is actually… pretty sexy. It’s like this whole other new erotic site for me to explore. I kiss Noel on the mouth. “I love it,” I say.
He snorts. “Yeah, right.”
“I swear, I do,” I say. “It’s sexy.”
He shakes his head at me like I’ve lost my mind, but he seems a lot happier and more relaxed after that. He might not believe me, but there’s very little about Noel that I don’t find incredibly sexy.
I’ve never had a secret affair before. It’s fun. Noel and I see each other at the hospital each day, exchange furtive glances, brush against each other accidentally on purpose, and then at night I drive to his apartment. By the end of the day, I can’t wait to fall into his arms.
It’s not all fun and games though. Noel is helping me study for the upcoming anatomy exam. I think I’m going to ace it. Really. He’s been showing me the best books to read and outlining what sections I should focus on. He sits with me while I study. He also made up a bunch of flash cards in his illegible left-handed print and has been quizzing me.
I don’t care what kind of horrible brain injury he had, Noel is incredibly bright. I can’t even imagine what he was like before. He plays it down, acts like he can’t remember anything, but I can tell he knows much more anatomy than I do. I wish I could have him take the test for me as a ringer.
“I’m never going to remember all this,” I say. He’s been pressing me to name all the muscles innervated by each cranial nerve.
“Come on, Chloe, it’s really not so hard,” he says. He puts down the flashcard and recites from memory every muscle innervated by the glossopharyngeal nerve. “See? If I can do it, you should certainly be able to do it.”
“You’re smarter than me,” I mumble.
“Yeah, right,” he laughs.
“I’m serious,” I say. “Noel, I don’t understand why you’re running the elevators when you’re such a smart guy. There are a lot of other things you could do.”
His eyes darken. I hit a nerve. I don’t care, I had to say it. “You don’t understand,” he said. “I can’t even read a paragraph without losing track of what I’m reading. I don’t think you realize…” He swallows. “Look, if I could do something else, believe me, I’d be doing it.”
I don’t know if I believe him. Obviously he’s got real physical injuries, but part of me wonders if a lot of his mental deficiencies are psychological. But I can’t say that to him. He’d be furious.
“I’m sorry,” I finally say. “I’m just getting frustrated. I think my brain is full.”
Noel’s face softens. “All right, let’s take a break. Fifteen minutes, then we get back to work.”
“Yes, sir!” I say and he laughs.
I get up to go to the bathroom. When I shut the door, I notice his medicine cabinet is slightly ajar. Noel has mentioned once or twice that he had to go take his pills, but he just brushed off my questions about which pills. Okay, I know looking in his medicine cabinet would make me a really terrible person. But I’m really curious. Honestly, this isn’t something I do a lot. But it’s already open…
I tap the cabinet open a few more inches with the tip of my finger, as if that makes it any better. As it swings open, I gasp slightly. Wow. There are a lot of medications in there. Pharmacology is a second year class, so I don’t know what any of these things are, but god, there are a lot of them. I can’t believe he takes all of these. Even if he just takes half of them, that’s a lot.
I hear a noise from the living room and quickly shut the medicine cabinet door. I feel really guilty all of a sudden. I shouldn’t have peeked. That was a terrible thing to do.
I flush the toilet so he thinks that I was using it. When I come out, Noel is sitting on the couch, making up a new flashcard. For me. All this is for me.
I walk over to him and drop my hand onto his shoulder. He looks up at me and smiles. He’s so cute. I bend down and give him what I initially intend to be a quick peck, but ends up with me climbing on top of him and pushing him down onto the couch. I hear the anatomy book fall to the floor with a plop. So much for studying.
Noel’s Memory Book:
Sometimes I stare into my medicine cabinet at all the damn bottles of pills and I just want to throw them out the window. Every pill has a side effect. They all make me feel tired or dizzy or make my mouth dry. Sometimes I wonder what would happen if I just stopped taking them all. I wouldn’t die. Maybe I’d be fine.
This is the inventory:
I’ve got my seizure medication. That’s a must, I guess. I can’t go around having seizures all day.
My headache prophylaxis. I was getting bad headaches when I first came home, so I finally got put on a medication to prevent them. I tried to get off this about six months ago and the headaches came back twice as bad.
Some nice painkillers, for when I get headaches in spite of the prophylaxis.
A medication specifically for nerve pain. If I don’t take this one, I get this awful burning pain in my left foot, which is all the more annoying considering I don’t have a left foot. With the medication, the burning pain becomes just a dull tingling. This med makes me slightly dizzy, but it’s better than feeling like my foot is on fire.
Two medications for the increased muscle tone in my right arm and leg. Both these medications make me really exhausted. But if I don’t take them, the tone gets so bad in my leg that I can’t walk. I guess I’d rather be able to walk.
An antidepressant. As soon as I was with it enough to know what was going on, I got really depressed. I don’t know if I’ll ever get off this medication.
A medication that I take in the morning to “increase arousal.” I know how that sounds, but it’s nothing dirty. Basically I’m taking it because I was so zonked from all the other meds, I couldn’t do much during the day. I was just lying on the couch all day, staring at the walls, and my mother got freaked out. If I take this pill, I can actually function. Coffee just doesn’t cut it.
An antipsychotic. This is the one I hate the most of all the pills in my medicine cabinet. I’m not psychotic. I never was. I take this pill purely for sleep. Despite the fact that I’m always tired, I used to have a really unrestful sleep and always be tossing and turning. With this medication, I sleep like the dead. But I feel like there’s a stigma associated with taking an antipsychotic. When my doctor first recommended it, I was really resistant, but I have to admit, it helps me a lot.
I keep looking at all my pills and trying to figure out which one I can give up. But the answer right now, unfortunately, is none of them. I need them all. Maybe someday, I don’t know.
Chloe is somehow interested in my pills. When my watch alarm went off to remind me to take them, she asked me what I take. I really don’t want to talk to her about that though. If she knew all the chemicals I put in my body on a daily basis just to be semi-normal, she might run the other way.
Noel’s Memory Book:
Rose picked me up after work to drive me to our parents’ house. She was really subdued during the drive, which is unusual for Rose. Usually she chatters about her week, asks me what I’ve been up to, and then lectures me about taking my medications. And lately, about not drinking. I’ve said before that she kind of acts like my mother sometimes.
Prior to my accident, Rose and I were really close. You wouldn’t think so, since I was kind of a bastard and she’s so sweet, but we just had a great relationship. Maybe because she felt more maternal than sisterly toward me, she was able to be proud of my accomplishments rather than feeling in competition. Rose is a high school teacher and was never particularly ambitious.
Rose continued to be quiet, even when we were at our parents’ house. She kept toying with her red hair, which is much redder than mine. We have Scottish blood, but Rose looks it much more than me. Red hair and a pale face full of freckles. She hates it and got teased a lot as a kid for being a ginger, but I think she’s very pretty and not just because she’s my sister.
We were halfway through my mother’s meatloaf when Rose suddenly blurted out, “Noel has a girlfriend.”
Kind of took me by surprise. My parents looked up at me, startled. My dad’s face broke into a huge grin. “Noel, that’s great!”
“What’s her name?” my mother asked. “How did you meet?”
They barely gave me time to answer each question before firing the next. In the next twenty minutes, I had to recite practically every fact I knew about Chloe. The whole thing was a little embarrassing, especially when my father announced that he was “proud” of me. It reminded me of when I was sixteen years old and had my very first girlfriend.
After making the initial announcement, Rose was quiet through the whole thing. I would have thought she’d have plenty of her own questions about Chloe, but she didn’t. She just sat there. It was a little unsettling.
By the time Rose was driving me home, I realized we’d barely exchanged a word all evening. I know Rose and I knew something was going on. “Rose,” I said, “what’s wrong?”
“What’s wrong?” she repeated. I looked down and saw that her knuckles gripping the steering wheel were white. “It’s way too soon, that’s what’s wrong.”
“Too soon for what?”
“For a girlfriend.”
Oh. So that’s what this was about. I should have guessed.
“I can handle it,” I said.
“Really,” she said flatly. “You think with all your medical issues and your cognitive problems, you should be in a relationship with another person?”
I frowned. “So when do you think I’ll be ready?”
“I don’t know. Maybe never.”
Never? I stared at her. “Are you serious, Rose?”
She sighed. “Noel, I don’t know what that girl knows, but I don’t think she realizes what kind of issues you have. If the two of you were to, you know, have sex, would you even be able to give consent?”
I felt sick in the pit of my stomach. What was Rose saying? That I was some sort of mentally challenged person who wasn’t even competent to give my consent for intercourse? I felt horrified by this implication. I’m not like that. How could she think that?
“Rose,” I said quietly, “what you’re saying is really insulting.”
“You need to hear the truth,” she said stubbornly.
I looked at my sister. She’s been great since I got hurt. She’s done so much for me and was always around to help me, more so than my parents even. And that’s what destroyed her marriage. I couldn’t let this continue. Rose and I both needed to have our own lives.
“I don’t think we should see each other for a while,” I finally said.
Rose looked shocked. “What? What are you talking about? You need me to—”
“I don’t need you,” I said. “I’ve got mom and dad, and anyway, I can manage on my own. I should manage on my own.”
Two small circles appeared on Rose’s pale cheeks. “What about your bills? What about the laundry??”
“Dad can help me with the bills,” I said. I remembered what Sonya told me. “Also, I can set up automatic payments. And I can do my own goddamn laundry.”
“What about your doctor’s appointments?” she said. She sounded desperate now.
“I can make it on my own, I swear,” I said.
Rose didn’t say anything. She stared straight ahead at the road. She looked really upset, but there wasn’t much I could do. It’s been almost three years since my injury and my brain is probably as good as it’s going to get. If I don’t start doing things for myself now, when is it going to happen?