Out On A Limb VII: Every Superhero Needs A Team

Nearly 20 years ago, when pagers were all the rage and sending a text message involved turning said pagers upside down to decipher cleverly written numbers, I went on a first date with this really cute guy.

Being a true gentleman, he came to pick me up at my grandmother’s house where I was living (during my grad school years) and introduced himself to my Cuban matriarch (not for the faint of heart). He took me to dinner and was careful about opening doors, having me walk on the inside of the sidewalk, and pulling out my chair. And I loved it. Conversation was easy and all was going well…….and then came the movies…..

As we approached the ticket booth, I groaned internally. My date had picked out a romantic comedy. It was a sweet gesture as I had a sneaking suspicion that he was not exactly a rom-com kinda guy. As I looked up at the show listings, I saw…”Oh my gosh Highlander V is out! That is so cool!”

The stunned look on my date’s face made me cringe. “Good going Cosi,” I thought to myself, “…way to scare off another one.”

Rememer folks, this was back in the day before George Lucas redid Star Wars and gave our generation its own trilogy (granted a lousy one). “The Lord of the Rings” was at least a couple of years away from making its spectacular debut. And Marvel and DC were eons from bringing their universe to life on the silver screen and making its sensational characters a part of mainstream popular culture. Girls who liked sci-fi and comic books did not get a lot of second dates….

“You like Highlander?” he asked incredulously. I recall trying to mumble some lame excuse but he cut me off saying, “…let’s grab the next show!” After the movie we both agreed that Duncan and Connor Macleod duking it out was not as cool as would be expected (poor script)—but in my book, the young man had won himself second date…

Fast forward a beautiful wedding and four children later, and Dave and I still like to geek out over the latest installment of our favorite comic book or see the newest incarnation of Wonder Woman (Gal Gadot is a rockstar).

Our favorite topic of (geek) discussion often revolves around superheroes and their journeys to becoming high powered vigilantes. Unless they are blessed with Kryptonian genes, oftentimes these champions undergo a whammo traumatic event that changes them emotionally and physiologically forever. Whether it’s exposure to gamma radiation or being bitten by a radioactive spider, these unsuspecting average citizens have to then cope with their transformed bodies and even more daunting still, how to re-establish themselves into a society that is not always equipped or tolerant in accommodating their needs.

And then, to make things more “fun,” the villain sashays in stage right.

Everyone loves a good villain—-said no sane person ever.

In an amputee’s world, the villain can come in many insidious shapes and forms. You have your nasty infections that keeping popping up unexpectedly and puzzling the medical team–The Riddler has nothing on some of the superbugs that can crop up in a patient’s wounds causing these poor souls to endure multiple surgeries. After successful release from the hospital, there lies the challenge of creating a bionic arm or leg that would make even Iron Man cringe. And even after making it through grueling therapy sessions to learn to walk again, the very community that patients must navigate afterwards is constantly tripping them up and you can almost hear the Joker’s evil cackle. To top things off, the sly and sneaky masterminds like Lex Luthor are lurking to attack the very psyche of the superhero by bringing him/her down in the guise of PTSD, anger, anxiety, depression, and worst of all, self doubt.

Just reading this makes me appreciate even more the grit and determination that my patients display time after time. But while inner superhuman strength is paramount to attaining victory, even the strongest of superheroes need a team.

While I am no superhero (although I have superpowers that allow me to now glow in the dark after all that chemo), I definitely appreciate having a superhero team. My team consists of a breast surgeon, a plastic surgeon, an oncologist, a radiologist, my ob/gyn, countless techs and nurses, an amazing family and community friends, and a priest (seems like there’s a joke here somewhere).

No different for my amputee patients. Perhaps the titles and names of these sidekicks are slightly changed, but the concept of a team approach is still the same.

Allow me to introduce the cast of characters:

The Surgeon: This is usually the head of the amputee’s team. The surgeon can be a plastics, trauma, orthopedic, or vascular specialist. I like to think of this clinician as the “Professor Charles Xavier” of the group. Much like the wise Professor, the surgeon is oftentimes the initial point of contact for the patient and provides the game plan as to how the recovery will proceed. As the patient heals from surgery, the surgeon then quietly fades into the background and allows the next team member to take the reins all the while observing the patient’s progress from afar.

The Prosthetist: This is the gadget guy/gal. In the comic books, this person is represented by a highly intelligent and physics minded individual who always seems to come up with the right tool the superhero needs to fight the bad guy. Think Morgan Freeman character in “Batman” or Felicity Smoak assisting the Green Arrow. The prosthetist, aside from constructing a new leg or arm is integral with determining the right fit and troubleshooting all the accessories needed to ensure a solid platform for mobility.

The Social Worker: To me, this is the unsung hero (pun intended) of the bunch. This is the Pepper Potts to Robert Downey Jr’s Iron Man. Social workers are angels in disguise who work furiously behind the scenes to assist patients and their families with everything from arranging a transfer to a rehab facility for continued therapy to battling it out with insurance to have auxiliary services provided in the home for the newly discharged patient. And believe me, this is a very abbreviated list. I have yet to meet a social worker who doesn’t put in long hours and have a heart of gold to boot.

The Psychologist: This person can come in many forms for our superhero amputee. The first line of defense lies with the clinical psychologists or psychiatrists. These highly trained clinicians are indispensable when it comes to the management of PTSD, depression, and anxiety. Working alongside them are entities such as support groups and buddy systems that provide a safe haven for the recuperating amputee (think Justice League and the Avengers). Relationships develop among the amputee community where the veterans helps out the newbies and it is a mutually beneficial situation. And yet others, like my favorite superhero Daredevil, turn to a priest or a pastor in their community who may have training in counseling. In my experiences as a PT, I have noticed that those patients who seek out some form of emotional support in conjunction with that of their immediate family and friends develop a healthier perspective on their new life as an amputee. Ultimately, they are better equipped to fight these demons and move forward with their lives.

The Physical Therapist: This is the team member who helps the superhero learn how to use their gadgets and get into shape for future skirmishes with the bad guy (think cool training video montage a la Batman coaching Robin “WHAM! POW!”). Physical therapy for the amputee includes educating the patient on how to don/doff their prosthesis, how to manage and protect their skin, how to improve and maintain range of motion and overall strength to all joints, and how to ambulate using efficient body mechanics. Again, this is a very simple synopsis. Most importantly, the PT helps the amputee attain the mobility they need in order to achieve their goals in life be it returning to the work force, becoming an athlete, or being able to keep up with toddler children/grandchildren. The physical therapist also tends to be the best looking clinician on the team…..hey, it’s my blog!

Listed above is the foundation of the amputee team but by no means is this a comprehensive list. Also included in their short and long term recovery are occupational therapists, pain management physicians, vocational rehab managers, endocrinologists, cardiologists….just to name a few.

The most critical component of the team is communication. I hammered this point in my previous blog “Is Anyone Listening?” Communication amongst the clinicians and with the patient is key to minimizing and correcting these errors to ensure success of this special individual. Oftentimes a superhero is out in the field fighting their battle and they require their team to keep communication going (albeit with really cool headsets like Felicity Smoak uses to aid the Green Arrow). For the amputee, this translates into assisting reintegration with the community including home and work abodes—environments that can initially seem like hostile ground when navigating with a new prosthesis. Patients communicating their obstacles to clinicians and those clinicians in turn relaying message to one another allows for these blockades to be overcome as quickly as possible (down with the bad guy!).

Superheroes and their team members are flawed individuals. They all make mistakes. But when working together as a team, they are greater than the sum of their parts.

So I’ve pretty much beat this superhero analogy to a pulp and I thank you kind reader for indulging me in this endeavor. Oftentimes during my own illness, I would think back to these superhero sagas that I enjoyed reading during my youth. It would make me chuckle to think of which superhero I could turn into (minus the crazy spandex) with the right gadgets and sidekicks. (I told you, chemo gives you super powers….)

Now that I’m on the other side of the hospital bed, I am grateful for being one of those sidekicks for my patients as I assist with their transformation into becoming <<insert suspense music theme>> …a superhero.