Transcripts For CSPAN2 Book Discussion 20140810

And which i did immediately. And then i ran, not walked to politics and prose to introduce the author when she came so today is the day that she is here. A dell received her masters degremastersdegree and doctoral therapy from the university of Maryland School of medicine and then worked at walter reed rehabilitating soldiers whove lost limbs in the war in iraq and afghanistan. Walter reed isnt only americas Largest Military hospital but also has the worlds leading Military Hospital, it also is the worlds leading hospital in treating amputees. I thought that she had just the right mix of compassion and humor. She shared her vulnerability that allowed tremendous empathy with those issues that she was asking so much of a. When shes not working she is also a longdistance swimmer having swum across the Chesapeake Bay six times. So here she is to talk about her book, run dont walk. [applause] thank you for the very nice introduction. Im going to talk a little bit just about how it happened that i wrote a book and how because im sure many of my friends are still in disbelief that this happened and also why i decided to write this book. Succumb in 2007 i owned a 17yearold car thats my friends nicknamed the rustang because the doors were rusted shut and the only way you could get in was to climb through my window but i loved that car and in spite of the fact that i had to use a screwdriver to unlock my seatbelt [laughter] i was never going to stop driving my car except when they either striding home and going down Georgia Avenue and i was about a halfmile from my apartment and my car all of a sudden, fire. I didnt know what to do so i quickly rolled my window down and i unlocked my seatbelt and then i kept driving my car. [laughter] i managed to get it home and i whipped it into the parking lot behind my building and i jumped out of the car and after that day my car never drove again. I felt terrible about it and i just didnt have the heart to call a tow truck and have them come drive my car a waste like it did outback where its just sort of rusted away. One day i was at home reading the Washington Post and they had an article about local eyesores. And at the end of the article there was an inquiry do you know in the eyesore if you do let us know and we will send a reporter out to write about it and then i thought well yes i know in eyesore and its parked out back. [laughter] so i thought i am not going to bother the Washington Post reporters with my tragic car story so i thought i will write it myself. So i wrote it up and then i sent it into the post and then i went out with some friends and when i got home that night there was a message on my machine from the editor and he said that he loved my story and he said if i had anything else i ever wanted to send and to go ahead and send it in and then he added at the end especially if it was about metro. [laughter] i guess he figured here is a person whos definitely taking the bus. [laughter] so for the next three years and never something funny would happen to me i would write it and then i would send it to the Washington Post and i was really lucky. I was lucky for a couple reasons. One is i was lucky because it got my feet wet. The leave me this book never would have happened. I never would have written this book if my car wouldnt have caught on fire on Georgia Avenue. [laughter] but mostly i was lucky because during those three years it gave me an outlet because at the time things at walter reed started to get really hot. I worked as a physical therapist and amputee section and at first we mostly saw single leg amputees and patients that had lost their legs below the knees. But as the war went o on, the injury is steadily got worse and worse. We went from seeing single leg amputees to patients who were double and triple amputees. Meaning they had lost t two arm, two legs and an arm. We watched the amputations so they went from being below the knee and below the elbow to above the knee at the size and of the elbow. We saw patients who started to lose their legs at the grind, and we even begin to see patients with partial pelvic amputations. By that time walter reed closed in 2011 almost all of our new patients were either double or triple amputees and we had rehabilitated three mehaverehabd lost all four of their limbs. But i was lucky because i had a hobbhave ahobby after work thate to sort of look for the funny side of life and all of my coworkers who made it through those years at walter reed had some sort of outlet whether it was baking or training for a 100mile running race or even keeping up with the highly complicated world of celebrity news. And all of us shared a very dark sense of humor. You can go to the Biggest Center in the country and you might see one amputee. At walter reed we regularly rehabilitated 10250 amputees each day and we did it all inside of the rehab clinic so they could lead the tour groups around the perimeter. They led the tour groups all day long so you are always looking out a class of people looking in as you and my coworkers and their patients used to say this is how it must feel to be an animal at the zoo, you know, dont feed the animals. But i always felt like to me it felt like just a really kind of dark sitcom because the tour groups always looked horrified but then on the other side of the glass, on our side of the glass we were all busy joking and laughing into the patients especially. They would make fun of each other. They would call each other names like ugly stump or princess if someone was having a hard day and they were tshirt that said things like i had a blast in afghanistan and marine, 40 off. And you know, the staff we were not much better. We were always consumed with whatever junk we had seen on late night tv including ordering a snuggy for the clinic but the overall feel is that this was normal. This was life. And we were all going to move through it together. This was the longest war that our country has ever been in. And as my coworker puts it, this is our generations war but it affects so few people in on a personal level i remember how completely astounded i was the day that i got a patient that had lost both of his legs after doing six deployments. When walter reed began to shut down in 2010 it coincided with the surge in afghanistan and that year the caseload walter reed tripled. Unfortunately walter reed was also in the process of moving to bethesda and the first thing that happened was that they started to shut down the employee parking lot to find parking you have to get to work no later than six in the morning which we all did. We got to work at six and we worked through lunch and we stayed up late. We were so busy that night that in my dreams everyone within amputee coming even me. Now i know my friends over the years have gotten really sick of hearing me say that i was going to quit walter reed. I was going to quit. Find a job with parking and with better hours but then the next day they saw me i was still at walter reed and david get irritated that i never could quite explain it. The reason that i ended up staying, and i stayed for nine years was because i was a part of something that was much larger than myself. And i couldnt just walk away because it was hard and i was lucky because i night i was trying to find something funny to write about to send to the post and hopefully have them publish it and that took my mind off of privacy network. Then one day my partner surprised me. I was shocked. She said they are cute and funny but you are missing the real story. And she said i should be writing about walter reed. And i thought that was a crazy idea. You know, that is completely insane. The reason im writing in the first place is to get my mind off of work. And the last thing i never going to do when i get home from work is right about work. And a week later it was almost as if they had kind of planned it the editor i worked with at the post called me a hand he said it would be interesting if i were to write a few articles about a job and i said pretty much the same thing to him but probably in a nicer way. I said i didnt feel comfortable doing that. So the next day my phone rang and it was a reporter from the post and he said he was going to be writing an article about the clinic and i was so mad when i heard that. I was just seating on the phone and he was asking me questions and i was just getting angrier and angrier and i could tell that he just didnt get it and how could he, he didnt work in our clinic. He seemed to be hunting for what i felt like was a grotesque shocking story about the horrifyingly mutilated patients. He was just seeing the devastation and in spite of all the devastation that we did see it wasnt a depressing place at all it was a happy place where we celebrated life and in fact the kernel always referred to the clinic as a happy place and she was right it was a happy place and so i decided i was going to write the article and i wrote it and i wrote what i felt like it was a pretty innocuous article. I wrote about taking some of our patients swearing for the first time swimming for the first time. I had deliberately kept it pretty my old so i was pretty surprised by the reaction that it got. People called me and emailed me and one day at work this elderly woman stopped me in the hospital and she asked if i was a dell and she was in her 80s and she handed me this envelope and then she walk away and when i opened the envelope there was a letter and she said she was a retired army physical therapist and she had read my article in the post she knew she had to come to the hospital and hand deliver it so that i would note how much it meant to her to read about it. When i read her letter i realized that moment that ashley was right that this was a story that people wanted to hear and i was the right one to do it i would be able to write about walter reed in a humane and humorous way with the insight it may be an outside writer would not have. So walter reed to shut down and i was part of the group transferred to the new walter reed at the bethesda Naval Hospital and i wrote the book. Before i turned the manuscript to my publisher i kind of ran up the chain of command. I have some of my coworkers read it and my supervisors and then i had to give it to the Department Head and this is a guy whose management style, and he isnt here i would classify as being highly unpredictable and slightly insane and i was really nervous about giving it to him i thought hes goin he was going s top so i thought well i will wait until friday and they will give it to him at the end of the day and that way he will have the weekend to hopefully cool off so friday came and he shows up at work and i gave it to him and i just took a step back because whoever is how hes going to react and he got really sentimental and he said that we have this new hospital, this nice facility and most of the staff had to stay on but he always felt like there was something missing and he couldnt put his finger on exactly what it was and then one day he realized what it was and he said it was a spirit, it was a ghost that you could actually feel when you were at the old walter reed and i think my coworkers who are here can attest to that. There was a feeling there and there had to be 150,000 people were treated at walter reed and it was the oldest Military Hospital in america and it is exactly 2. 8 miles from here. Frequently i thought about coming here on my lunch break but i never had a lunch break. But if you do drive past it at this catty corner from the park and if you drive past before they knock it down and turn it into a supermarket and a new condominium i hope you think about the spirit. And i hope that you enjoy the book. The selection that im going to read is the article that i wrote first for the Washington Post about taking our patients swimming for the first time. I revised it and expanded it and it later turned into this book. And i also want to say that ive been coming to politics and prose since 1994 and i loved this bookstore and i actually wrote large parts of my book downstairs at the big table. So, okay. When you lose a leg o or two its hard to exercise. You gain a valley and sometimes more especially where we were surrounded by trees of homemade chocolate chip cookies. Thanks to the generosity of the administration and athletes and our patients were constantly being introduced to unusual sporting events they couldnt do like rock climbing. The centerpiece of the clinic was ever larger than life climbing wall. It was two stories tall and whenever there was a new teacher got the clinic the cameras always zoomed in on that wall and it was easily the most photographed piece of equipment in the entire hospital yet weeks and sometimes months would go by without a senior patients ever climbing it. When the new patients saw the climbing wall in their eyes lit up and they got immediately excited. I knew what they were thinking. It may not be that bad if im going to climb this wall. Im going to climb this and do everything just like i did before. I was guilty of facilitating this kind of deception. The climbing wall with th was ty first thing i showed that patients. I did it because they cheered them up and it was a way to get them to buy into physical therapy. But it might as well have been an ice skating rink. He was limited by his prosthetic leg. His reputation was so high up it was hard to get a good fit. It frequently slipped off and sometimes it rotated on him while he walked but swimming was something i thought he could do because you didnt have to worry about falling. In the pool you dont need fancy equipment or special water. Dont even need prosthetics just boggles and some bravado. I had begun training again with a recreational Swimming Team a few nights a week and we practiced at a Community Pool close to walter reed. One day i called and asked the pool manager if it would be okay if we brought some of the patients. I thought he would say no or at the very least charge us but he said that it would be fine and it would be free so the next week we borrowed a band from the disablevan from thedisabled spoe them to the pool. I am not a Swimming Coach and i have no idea how to teach anyone how to swim but i am a physical therapist which puts me on the same level so when i suggested everyone get out of their wheelchairs and into the pool no one argued with me. It was only 4 feet deep so if it didnt necessarily have to be able to swim. But for the others that had no legs at all my only strategy was for them to claim across the pool in any way they saw fit. Its impossible for someone missing both legs to sink. You can do back flips off the side using just your arms to spring you into the air and even if you are a triple amputee missing both legs and an arm you can pull your self easily and gracefully half a dozen times back and forth with your one good arm. I figured the program would gradually lose its appeal but the next week when we brought it around eight patients waited into any of them. I consulted with the coach from my Swimming Team. She didnt have a car but she took two trains and a bus to meet us in the middle of the day you she was a strict and serious coach. His injuries urged into the water listening to the feedback before pushing off to swim and other lap under her guidance. The soldiers learned of modified terms in the racing starts indicated trills and races and worked up to 500 yards of continuous swimming. Having a coach gave some legitimacy to the program and for two hours once a week for the soldiers stopped being patients and were transformed into a Swimming Team of sorts. We were still a motley crew at the pool. I was convinced that our time is limited and in addition to the battle injuries, most of the patients had big semioffensive tattoos. They left their prosthetic legs and arms lighting around the pool deck and in between the sects they would generally create inappropriate chaos but no one ever got mad at us and instead a strange thing began to happen. People started to swim with us. They would get off of their lane and they would say you are doing a good job you keep on swimming. You can do this. One day we got to the Recreation Center and the elevator going down to the pool was broken. I thought that some of them could go down the stairs on their behind but it was two flights that they have enough energy to lift themselves back up the stairs later. Later. If we were getting ready to leave when the manager and the lifeguards came running up and began carrying the most injured down the stairs. It happened so fast i didnt get the chance to secondguess. An hour later when we got out of the pool they were standing there ready for us. I have seen a lot of good years but nothing at this level. Physically reaching out and carrying another person and in my world of heroes into superheroes i put those lifeguards of their with firefighters and ambulance drivers. Thanks for coming here. [applause] you have a question . Here comes the question. Itspinnaker sounds like you alo great work. How do they approach for legitimacy in the questions from the patients . We have a chaplain that is in the clinic who handles most of those questions. Thats right. They are only interested in making you work. Did you show the buck to many of the actual soldiers you had been treating and what did they think about it . I didnt but i was surprised thathat a lot of them ordered it and read it and they seemed to like it. I was surprised because i thought they are not going to be interested in what they are doing. But i guess they are kind of interested in what we do. When we are not giving them a hard time. But they have been very supportive. Do i still keep in touch with them . Yes on facebook where everybody keeps in touch. Yes. I am meeting one of them tomorrow actually but my friend and therapist there is a relatively notorious guy that lost both legs in an accident on washington where he was caught in the cave with a rescuer and so on. But hes gone on to try to read emails off by developing very advanced for the amputees that allow them to climb walls and i wonder if you ever ran into people who were able to use his prostheses decline this infamous climbing wall. I forgot what his name is. We did have an amputee come visit us but is a bilateral below the knee amputee that we habut wehad so many amputees cot us and we have access to all of the latest and greatest prosthetics but i have to say that its really the work that you put into it. I know for climbers the smaller your foot is the better you can fit it into the cracks so one of the advantages i guess of being an amputee is that you can get a really small foot but there is a big world of difference between being a below amputee and above. Most below can get back to everything they were doing before their injury with some modification. They might walk a little funny going up the hill because their ankle doesnt spend that much otherwise they can ride a bike and swim and mountain climb and it becomes a little difficult when you are missing both legs below the knee but again versus missing your life above the knee is such a different world. But i do think i render him coming remember him coming [inaudible] the question is what was the purpose of the amputee tourism. I dont know. I just think we were under the spotlight quite a bit at walter reed and we used to have we were in a smaller clinic before and we used to have a lot of visitors like celebrities and the media that would come into our room and it was so crowded to begin with, so i dont think that things started out to build it for us to be under this spotlight like that. I think they wanted to give us our space but still a loud of visitors to come, but then it did sort of start to become amputee tourism. I like that term. [inaudible] obviously a lot of humor but how would you describe your approach . The question is what is your advice for the writers. My advice is to get a coffee maker with a timer on it. Seriously, get up at 5 00 and write every day. Because for me i just found that it became easier when i sort of got into the habit. And also i mean what else are you going to do that early in the morning . You are not going to post a status on facebook and say 5 a. M. [laughter] so thats just my opinion, to get up every day and you know, i would run for the coffee maker. You mentioned it to the advances in prosthetics. You must have seen quite a few over the years that you were doing this. Can you talk a little bit more about that and whats more you think needs to be done to improve them. I think it is interesting that most of the prosthetics have been at the knee and its just a hinge joint so it is the simplest prosthetics thats out there but if you dont have your knee you are in a world of trouble as far as walking. But the arm prosthetics are civil war era even though you see it on the news all the time they are always showing a mindbody connection or some that can respond to your thoughts or actions but in reality, they are not very functional. And most people i know who have those dont use them because they are heavy. And again, nothing can really replace your hand. At walter reed, we started all of our new above the knee amputees on a prosthetic knee called the c. Language was the first computerized microprocessor knee and he has had many advances. You have to throw your leg out there to make sure that the knees are straighneeds are strad out before you put your read through it cause it was going to give way underneath you and you would go down if you concentrate on the walking cycle it would suddenly give way. But the sea life changed all of that because when a patient puts about 70 of their body weight on the total of their leg the knee as well lock up and so it is a very safe and stable knee and it takes a lot of that constant thinking about with your knee is doing. You can see the patients when they are new and walking and you talk to them they will stop in order to answer your questions or continue the conversation he cause they are thinking so much. But as it becomes better you are able to walk and talk at the same time its just something that we dont ever really think about. And i think that the microprocessor needs because they dont have to worry over time if theyre knee is going to give way underneath them remember you cant feel the floor under your foot so theres a lot of strength and control thats going on and if you were a bilateral amputee you are giving thats twice as much. So the advances have been good with that and they are just working on the power prosthetics but i have to say that i find that those are really much more gimmicks and heavy and more of a money maker. I hope that there are no prosthetics here. It was pretty mild but in the beginning things were not as patients were a little more irritable. They were irritable to begin with but maybe now they are more irritable. But they had more trouble with sequencing. The world o is physical therapy and working with the amputees, but walter reed also works with the genetic brain injury. Is there any crossover approach that it would take for both treating both types . Lee workewe worked as a big d walter would read so the therapists were in the clinic. They would go to a Rehab Facility first. They would sort of stabilizing heel up first at walter reed and then they would go to the specialized and then they would come back to do their amputee rehab. You mentioned some of your amputees, three of them i think you said, and was there a prosthetic developed to help them and how does it work . They have a prosthetic that is like a padded bucket they would sit in it is dependent on both parts of their pelvis or if they are missing their legs at the hips. Its to be Walking Around all day but we did allow them but wanted to try. Would that have special wheelchair cushions for them that were kind of molded to th them. They are wheelchair bound most of the time. And what are you doing now . I work for myself now im not sure that i know how to verbalize displaying a Military Spouse living where we lived there is a disconnect where my husband was in a pentagon in 9 11 and we lost a lot of friends and weve gone and we were that small part of the world that actually has been affected about the type of people who joined in the fight or are in the military. There are assumptions about who they are in their political views versus what you were signing at walter reed if you ever were in an odd position in that way. J. Would be like he works at the pentagon. He must love rush and i would be like no. So i was wondering if that happened to you today to definitely. I dont know i know my partner ashleys family is very liberal. I was asked do you treat iraqis or people from afghanistan this was an american Military Hospital but sometimes i felt that but i always just felt like politics just doesnt have a role in rehab, you know we are all good people and sometimes we would have some goodnatured teasing in the clinic between some of my patients who are definitely much more conservative than i was and they knew it and i knew it so we would make fun of each other during the elections. But i think it opened up my eyes to the different kinds of people. And i also thought that it was interesting because at walter reed we were, and you know because this thing at the pentagon, you are surrounded by people in all walks of life and all over america and also all over the world come and you know, you would think by watching the news that you wouldnt get along but actually you do and i think having those differences is really important because instead of letting our politics get in the way we all sort of pull together to tackle the problems. So i wonder if we were really homogeneous if that would happ happen. Thats a good question. Its actually i had to fill out this Reading Group, something for the Reading Group and that was one of the questions they asked. But i was much more political before i worked at walter reed and now i just dont what should the news that much. I am a big dummy i guess. [laughter] i have a question. The spirit to your superior identified as being present at walter reed when you got to the new hospital, did that change . I feel like its changed quite a bit but it was such a different field even when you look at it its very sterile and modern looking and the old hospital just had this comfortable feeling to it it just felt homey. It had to be his hundred year old brick buildings with the multipainted glass and when you would walk up the stairs of the old hospital there were stone steps they were born in the middlworn in themiddle so they d and i loved that because how many people walk up and down the stairs before me. But there was a feeling and there was also a lot of pride. It was a different feeling. Was there anything that prepares you because it seemed like what happened hadnt been for a long time and i wondered who in the academic programs dont prepare. The question is was i prepared for what i was going to see and the answer is no i was in a way prepared. I had no idea what i was doing when i walked in i was completely floored. I remembered the first patient i saw who was combat injured and how completely blown away i was and i remember it was a physical reaction i remember feeling my heart speed up and i couldnt understand why i was feeling that way because i had seen bad injuries before. But i think it was because it was the first time i had seen anyone that was maliciously or deliberately hurt so i wasnt prepared by have to say i worked with a great team of people and everybody pitched in and helped each other out and there was a lot of education and nobody has ever seen injuries like this before. We sent our soldiers and marines and Ground Troops off to battle this time carrying their own turn the kids and about combat medics. Powder and cauterizing bandages so that they could to stop the blood flow immediately so they were able to save so many lives that ordinarily wouldnt have been saved solely for injuries that people would have very easily died from just ten years prior to the injuries got worse and worse because the medical care of better and better and the bombs got more extreme but nothing could prepare you for. Only we worked as a team. Im very interested in your comments about walter reed because the one claim i Read Everything about the articles i did read were extremely negative and they were about the scandal and the conditions in the sum of the wars. Do you think that in fact it could have been caugh cut the dt but these could have been retained . Of course i think it should have been retained and as far as the scandal they were talking about a building that wasnt on the base. It was across the street and outside of the gates. I never saw it myself so i cannot attest to the conditions. The hospital was in use and the administrative place my house was built in 1943 and i hope nobody is going to come and talk it down because its so old we have buildings that are a thousandyearsold and still in function. We have a big bureaucracy and things work better when they are a little smaller. That is my opinion and im not in the administration. Particularly when you hear now that the shortage of facilities of veterans in all that it does seem. They are not active duty they are an activeduty military facility did you ever have any qualms about they were so gravely injured. I felt bad for some people like what their life going to be like when they leave. But though i guess we were all about business as usual. Just get them up. Get them walking. Another question. Most people dont have much experience with others whove lost limbs and so it can be kind of awkward when you meet somebody like that. Do you have any advice on what to say and how to act, did you acknowledge the injury . I would ask them how big the shark was. We always dealt with it with humor. Again i worked in an army facility where you made fun of people left and right and they made fun of you, too. But yes i think that people hate to be pitied thats just my opinion but im not an amputee but i would not not acknowledge it. But yes i think the shark is always good. [laughter] we have time for one more question. You worked a pretty specific demographic you worked with a very specific demographic that is generally speaking younger and more active because they were serving in the military. Did you find that to be a blessing or a curse in rehab . Thats a good point. It was both. Because they were younger. They had been up all night playing xbox. They were not going to roll in and have me give them a hard time. But we said some patients use that to their advantage and they would be in the clinic for six hours a day and they were incredible. So it was a blessing and now i work with older patients and i tell you i think i went in there and hammered some people. 1 foot over the other patients figured out how to do it. I had a patient that ran on this. There were all sorts of myths like one of my professors told me you will never see a bilateral above walking especially if they are not holding onto some in. [applause] hell do you acquire your ebook and find those books . There are millions of ways to do it. One that isnt often talked about is you come up with an idea and you try to find the