Wayne was never the sharpest tool in the shed, but he appeared to be a hard-working, dedicated husband and father with two young children. He supported them through his labor, and progressed to owning his own water well drilling equipment in which he was self-employed in Western Kansas. With two good arms and a strong back, he towed his rig, and drilled water wells all over the north-west corner of the state for some time. The rig and the associated dangers may have been beyond Wayne’s full comprehension, and on one fateful day an accident happened. He was about 30 years old at the time.
After several months Wayne received what was considered the optimum medical service. During the intervening years, Wayne and his family became welfare recipients, and was referred to Kansas Rehabilitation Service by the county welfare department.
Initial observations identified problems with his right arm, which he carried in a sling. The hand was atrophied and deformed, the elbow was non-functional, and the arm above the elbow had only a trace of voluntary movement. Sensation was absent except for pain. He indicated that there was almost continual pain in the arm, and he believed that the sling alleviated the pain a little. He said the sling kept the arm from getting in the way of whatever he wanted to do. Clearly Wayne was still active doing things around the house.
He also had a deformity of the right foot and walked with a slight limp. He complained of discomfort in the foot as well. Otherwise, he was able to care for himself completely, adapting to left-handed activities.
Medical evaluations included both orthopedic and neurological evaluations. The findings suggested the nerve roots to the right arm had been pulled from the central cord with no regeneration possible. With the completely useless arm, amputation at the elbow was suggested to alleviate the need for the sling. Slight motion at the shoulder suggested that a small bit of function might be recovered with amputation, although whether amputation of the forearm would eliminate any of the pain was left an open question. Fusion of bones in the foot was believed would correct both the gait and pain in the foot.
With these specific recommendations and the possibility of getting Wayne and his family off of welfare through farm work, the medical procedures were authorized at the nearest hospital with an orthopedic surgeon. Wayne and his wife drove the 150 miles to the hospital early on the day of the scheduled surgery. Wayne expected to remain in the hospital for several days for the two procedures.
Just before noon following the first surgery, I received a phone call from Wayne’s wife. She was crying desperately, and finally managed to explain that Wayne’s surgery went fine. Immediately afterward she said a person came out of the operating room, and handed her Wayne’s amputated arm wrapped in a bloody towel. With no further instructions, she was told to bury it. She was shocked by this unexpected turn of events, and was completely unprepared to perform such a request, being 150 miles from home. She had hoped to be with her husband as soon as he returned to his hospital room.
It was at about this point that visions of archaic or medieval rituals come readily to mind. Is this hospital practice required of the families of all patients who receive amputations? Coming back into the 20th century, it was well known that phantom sensation is almost a universal experience for all amputees. When some structural portion of an extremity, hand, arm, or leg is removed and the remaining nerves are intact, the amputated part remains neurologically present. The amputee is still able to imagine the member as though it is still there, and is able to wiggle, flex, and feel the amputated part. Phantom pain is regularly experienced by amputees, and is often relieved by wiggling the missing part. With some stumps that remain, it is often possible for the amputee to physically locate and touch parts of the missing extremity.
From this it was inferred that the practice was a carryover from earlier days when the notions of phantom sensation and phantom pain were not fully understood. The old theory held that if a family member personally buried the amputated part, the sensation or pain might be improved. According to Wayne, the pain in his arm was significant, making him a prime candidate for the hospital’s traditional response.
I told Wayne’s wife that I would call the hospital administrator to see if they could dispose of the limb in their incinerator. Wayne and his family were protestants, while the hospital was Catholic. It was never known if this figured in the episode.
On calling the hospital administrator, I explained the family circumstances, and asked him to have the staff dispose of the surgically removed arm. He agreed and relieved Wayne’s wife of the arm and the burial burden, a shock she would no doubt carry the rest of her life. With that she was able to join her husband in the hospital room following his first surgery. Most likely she told him the same story she told me, possibly without the crying.
Wayne was successful in his return to work as a farm laborer. Somewhat surprisingly most of the pain in his amputated arm disappeared with the surgery, and the little function in the right arm was enough for Wayne to use it as an assistive device with selected tasks. The sling was gone, and the grotesque and deformed hand was no longer a preoccupation hanging in the way.