• Boston Marathon Bombing: For victim, a long walk back
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     | July 09,2013
     
    New York Times Photo

    Jeff Bauman, who lost his lower legs in the Boston Marathon bombings, walks on his own for the first time since the marathon at a final fitting for his prosthetic legs May 31 in Massachusetts. Behind him is his girlfriend, Erin Hurley, left, and a prosthetist, Julianne Mason.

    BOSTON — Jeff Bauman stared straight ahead, his eyes wary and unconvinced, as his doctor told him the next procedure would be easy and painless. He sat in his wheelchair at Boston Medical Center, and Dr. Jeffrey Kalish, his primary surgeon, explained how a resident would remove the sutures from his legs.

    Most of Bauman’s legs were gone. He had been waiting for his girlfriend near the finish line of the Boston Marathon on April 15 when the first of two bombs detonated and blew them off. An iconic sporting event had turned into a scene of chilling devastation, and a photograph of Bauman in the aftermath, his legs gruesomely lost, later became a searing symbol of the attacks.

    The day of the bombings, Bauman had had an emergency, through-knee amputation that lasted about two hours. A surgeon had sifted through layers of skin, tissue and muscle, preserving what was healthy, cutting what was dirty and sick. He had removed what was left of Bauman’s lower legs at the knee joints.

    Two days later, Kalish had performed a formal amputation at about four inches above the knee. He had measured the legs and cut each layer — skin, tissue, muscle and bone — farther up in the thigh, like a staircase. Then he washed out the legs for 10 minutes, tucked the muscle, and stitched the tissue.

    Bauman’s legs had been reduced to stumps, sewn shut across each base. Now, as Kalish spoke, Bauman pulled his left leg toward his chest and eyed the sutures.

    “We literally just yank and cut,” Kalish said. Bauman looked away. “Compared to everything you’ve been through, this is going to be a breeze. How about that?”

    Kalish left the room, Bauman climbed onto a table, and the resident started on his left leg. There were 25 sutures to remove from his left and 24 from his right. The resident worked slowly, pulling and cutting, leaving the especially deep ones for Kalish to do. Bauman did not care to watch. He lay back, rested on his elbows and glanced out the window at the darkening sky and an American flag at half-staff. It had been one month since the bombings.

    The resident moved on to his right leg, and on the third suture, as she pulled and cut, he cried out and grimaced and closed his eyes.

    “OK — pain? OK,” she said. “We’ll just — we’ll go from the other side.”

    She paused and watched his face twist.

    “Do you need a break?” she asked.

    “No,” he said as the pain left his face and he opened his eyes. “That one hurt.”

    She did what she could with the right leg, and then went and retrieved Kalish. There were 10 deep ones left for him to do. He started with the left leg, and a few minutes later, Bauman whimpered again, softer now. He tried to hold back.

    After this, there would be no more procedures. There was nothing more his doctors could do. His legs would be this way for the rest of his life. Learning to walk again, and whatever happened after that, was up to him.

    Kalish said nothing and kept working. Bauman was crying now.

    “Sorry,” Kalish said, without looking up. “Almost done.”

    Five minutes later, he was finished, and Bauman’s legs were bleeding.

    “You did it,” Kalish said. “I hope that wasn’t so awful.”



    A backpack and a bang

    Early on the morning of April 15, Bauman drove his girlfriend, Erin Hurley, to a meeting point for her charity running team.

    “You better win,” he said as she got out of the car. She laughed.

    Bauman then napped at Hurley’s apartment in Brighton, and at about 1:15 p.m. drove with her roommates, Remy Lawler and Michele Mahoney, to a marathon checkpoint in Newton. Bauman spotted Hurley there, and she ran over. The four of them group-hugged, and then Hurley took off. The plan was to meet her again at the finish line.

    Bauman, Lawler and Mahoney took a cab to Boylston Street and waded through the crowd, looking for a good spot. Spectators were five and six deep. Lawler and Mahoney wormed their way closer to the street, and Bauman stayed near the back.

    He was looking for Hurley when a man behind him, about five feet to his right, caught his eye. The man was wearing a dark, heavy coat, sunglasses, a backpack and a baseball cap low and tight on his head. He looked strange. Why was he dressed so warmly on a sunny day? He looked serious, too. And why was he standing so far back? Bauman looked away. He scanned for Hurley again, and then looked back over his right shoulder. The man was gone, but his backpack was there on the sidewalk.

    Then Bauman saw a flash and heard a bang. Suddenly, he was lying on the sidewalk, dazed and a bit numb. He smelled sulfur. Or was it burning metal? What a firework, he thought. He sat up and saw bodies strewn and a lot of blood. Mahoney was a few feet away. She tried to scoot toward him, but her left leg would not budge. She looked at Bauman, then at his legs, and then back at him. He looked down, then back at her, horrified.

    Bauman grabbed what was left of his legs, lay back down and was writhing there when Allan Panter found him. Panter, an emergency room physician from Gainesville, Ga., had been in the crowd, too, but was unharmed. He pulled Bauman from the pile of bodies and placed the loose tissue back into his leg. Bauman screamed.

    Panter tied a makeshift tourniquet around his right leg, placed a jacket on him and left Bauman so he could tend to the woman sprawled nearby whose eyes were open and empty.

    I’m going to die, Bauman thought, lying there alone.

    He had sat up again when a man in a cowboy hat named Carlos Arredondo came bounding toward him. Arredondo had watched the chaos unfold from across the street. He called for help, and a woman came with a wheelchair. He nudged Panter, and they lifted Bauman into the chair, and off Bauman went, Arredondo running by his side.

    Then the tourniquet on Bauman’s right leg caught in the wheel and came undone. Arredondo tried holding the tourniquet together, but an emergency medical technician caught up to them and grabbed Bauman’s right leg, applying pressure to slow the bleeding, while Bauman held his left leg up with his hands.

    They made it to the medical tent, and Bauman was loaded into an ambulance headed for Boston Medical. A woman sat behind him and leaned over his face. He looked up at her and realized she was trying to talk to him. His eyes widened, and he said, “I can’t hear.”

    She spoke louder. “Where were you on Boylston Street?” she asked.

    “Up the street a little, by the grandstand,” he said. He was calm. She asked what he was doing there, and he told her about Hurley. She asked how old he was, and he said 27. She asked where he was from, and he said, Chelmsford, Mass.

    The questions were mostly to keep him engaged and conscious. They arrived at the hospital just as the pain started to set in.



    What was left of him

    Bauman lay asleep in a bed at Spaulding Rehabilitation Hospital in Boston as the sun peeked over the buildings across the harbor. Light filled the room, and when it came across his face, he stirred. His face was long and thin and forlorn with deep lines under his eyes and eyelashes singed so short they looked like eyeliner. He hardly slept anymore. The pain from his injuries kept him up at night, and this morning sun did not help.

    It had been two weeks since the bombings, and the burns on his back were still healing. Much of the skin was bright red and a few patches were raw, and it stung if he rolled or shifted or turned the wrong way. The bedsheets also bothered his sutures. So at night, he tried to lie still, but his legs would spasm. The pain pulsated down his thighs. Sometimes, it felt as if someone were beating on his knees. Most mornings, he woke up sore.

    On this morning, Hurley fetched his clothes and his toothbrush and climbed into bed with him. She had spent the night on the couch at the foot of the bed, as she spent most nights now. After a while, she kissed him goodbye and left for a run.

    Bauman pulled his wheelchair alongside the bed and took the 2˝-foot wooden plank from the chair’s back pouch. He laid the plank from the bed to the chair, and, pushing down on it, he lifted himself slowly and scooted across into the chair. This was his new means of moving around.

    Now, for a fleeting moment, he was alone. His mind wandered. He thought of the marathon, that day. He had accepted what had happened, perhaps as much as anyone could, but he was reminded whenever he saw his legs. He could not stand to see them. He was getting better about it, but he still got shaky. And they were always so sore. Sitting there, he held them and tried to rub away the pain.

    Carlyn Wells, his physical therapist, arrived for his 8 a.m. session, and they went down to the rehabilitation gym. He started his stretches, lying on his left side and lifting his right leg sideways into the air. He did this 12 times, his leg wobbling more with each lift. Then he flipped onto his right side and did the same with his left leg.

    “Can you hear me well?” Wells asked. He had not answered her last question.

    Bauman stopped and sat up. He rubbed his face.

    “It’s hard to hear in this room,” he said. “It’s so big.”

    His right eardrum was destroyed in the blast, and his left one had a sizable hole in it. He had told people it felt as if someone were holding something over his ears, only to let up every now and then. His ear doctor said he was missing about 20 decibels of hearing and that the holes were unlikely to close on their own. He recommended surgery, but Bauman refused. He had had three operations since the bombings and had decided that was his limit.

    “You want me to talk louder?” Wells asked.

    “Yes, please,” he said.

    “Will it bother you if the others turn music on?” she asked.

    “The sound, it ricochets off the walls,” he said, looking up. “It, like, echoes.” He paused and looked back at her. “I hear it more than once. I won’t be able to hear.”

    He finished stretching, and then worked with leg weights and a medicine ball. After 45 minutes, he was done, and Wells left him alone again in his room. He climbed back into bed and watched television. He tried to nap, but doctors and nurses kept popping in, and his thighs were sore. So he just lay there, resting. The room was starting to smell distinctly like him. He showered only a few times a week because it was such a challenge.

    Later that morning, his mother, Patty, arrived. She worked as a waitress, but was given time off to attend to him. She nervously paced around the room, tidying things and reading unopened mail. She was always fretting over him, it seemed, cringing whenever he moved. Then he had to calm her down.

    In the afternoon, he had occupational therapy, and his mother left. Then he climbed back into bed, rubbed his legs, picked at his eyelashes, and watched TV. More people visited. Some days, amputees from support groups came, showing off their prostheses. Sometimes, Chris Carter, the hospital psychologist, stopped in to chat.

    Each Tuesday afternoon, Carter led a discussion with the marathon victims. When it was his turn, Bauman said he was optimistic, he had goals, he was trying to move on, and it could have been worse. He called the bombers cowards and clowns. He rarely thought of them, only when someone asked. He was more concerned with himself now.

    His father had closely followed the manhunt. He came to see Bauman each night after work. This was by design. Bauman’s mother and father had separated when he was a toddler, and they generally did not get along. So by day and night, Bauman had two sets of relatives competing for his attention. Then his friends brought food, or he played the guitar, or Hurley came over, and he felt better.

    At some point, though, they had all stared at him. They expected him to be broken, angry and sad. He joked about his legs. He was trying to move on. But there was no escaping all these people, all their pity and all their questions. Then his legs were always so sore.

    He never asked any of his visitors to leave, but he was a private person, and here he was confined to this bed or his wheelchair. He felt as if he were on display — hurt, tired and vulnerable for all to see. He hated the hospital for that. But he kept this to all himself.

    One night, just as his patience waned, Hurley arrived; seeing her was the best part of his day now. They had been together for about a year. He had decided he wanted to marry her, buy a house with her, start a new life with her. But he sensed her guilt. She said she loved him more now. She was more affectionate. They had figured out how to be intimate in his hospital bed. She just had to be careful of his legs.

    Now she kissed him and sat in the large chair next to his bed. He was lying there, his left hand behind his head. She was playing with her hair, twirling an end with her finger. She asked about his day. He wanted to talk about hers instead. She asked if she should renew the lease on her apartment. He hesitated. He tried to dissuade her, but when she resisted and made a case to keep the apartment, he suggested they buy a house together.

    “It’s a lot of work buying a house, you know,” she said, looking down. She felt his eyes watching her. “You have to like — I don’t know. It’s a lot of work. It might be too much for you right now. And me, too.”

    She let go of her hair and scratched her nose. His eyes glossed over.

    “Eventually, though,” she said softly.



    Painkillers and new legs

    Bauman was discharged from the rehabilitation center about four weeks after the bombings. He went back home to live with his mother in Chelmsford, and during the day, most days, it was just the two of them. Sometimes, his cousin came over to play video games. Otherwise, Bauman passed the time lying in bed until Hurley came over after work. He slept easier at home. There was not much else he could do.

    Sitting in his wheelchair for a long time strained his legs. On the few occasions he did go out, he packed a zipper bag with his medication. He regularly took 1,200 milligrams of gabapentin for the phantom leg pain, 1,000 milligrams of Tylenol and 5 milligrams of oxycodone. And if the pain was still unbearable, he took more oxycodone.

    He packed a baggie of painkillers the day he had his sutures removed and then again a few days later for a friend’s bachelor party. It was an all-day affair at a local gun club. He had never fired a shotgun and was a bit apprehensive about it. But he learned how, and the others wheeled him out between rounds to shoot by himself, all eyes on him. He was a sideshow again. Maybe that would change when he could walk.

    A few days after that, Bauman had his first appointment with the prosthetist, Paul Martino, of United Prosthetics in Dorchester. Bauman sat on the edge of a bench in a patient room and listened intently as Martino explained how his new legs would work.

    To put them on, Martino said, Bauman would roll a gel liner, which resembled a skintight sock, onto his thigh, then slide his thigh into a carbon-fiber socket. He would strap the liner to the socket, and the socket would be connected to the rest of the leg.

    Ottobock manufactured the legs, Martino said. It was a German company that he had trusted for years. Its Genium knees had microprocessors, he said, that would be programmed to follow Bauman’s gait, to swing as he stepped, move as he moved.

    Bauman nodded and rubbed his thighs. He was trying to retain it all.

    He did not know what it would be like, walking on the prosthetic legs, but he hoped he would like it. He figured he would be restricted. He had made a running mental list of all the things he thought he could no longer do. He could not fly a plane, he thought, or work construction. He could not play hockey, as he used to in his father’s backyard, or play sports in general. He was not sure he could ever wear pants again.

    The purpose of this first visit was to make casts of Bauman’s thighs to create the sockets. So first, he rolled on the gel liner; it felt strange and tight on his thighs. Then Martino put a plastic bag over it and a mesh netting over that. He took measurements, and then marked the netting and applied the plaster by dipping strips in water and setting them on.

    Martino had come recommended by a doctor at Spaulding, and Bauman trusted him. He was lying on his back, watching Martino work, when Martino’s assistant asked where he worked before the injury. He told her he had worked at Costco. He had started there, in the delicatessen, about 2 1/2 years ago, while he was taking college classes. And when he left college without a degree, he had committed himself to his Costco shifts.

    The assistant said she wanted to make sure his prosthetic legs would not prevent him from doing anything he was doing before. He thought for a moment and said: “I just want to get to the places I can’t get in the wheelchair, you know? I want to stand up.”

    When Martino finished casting both thighs, he wiped down the bench, and the assistant showed Bauman an Ottobock leg. It felt solid and surprisingly heavy.

    “Can you put pants on right over this?” he asked, and they assured him he could. He nodded. He was satisfied. On his way out, his mother noticed a photograph on the wall.

    “Look, Jeffy!” she said. “An all-amputee hockey team!”



    Face of the tragedy

    Another week passed, and Bauman started going out more in his wheelchair. His legs would still get sore, but by now, he was familiar with the pain and was bored at home. He and Hurley went out to eat, and inevitably, someone recognized him. He rarely paid for a meal anymore. Chefs and managers offered him gifts. They had seen the marathon-day photograph, published around the world, of Arredondo wheeling him away, his legs shredded.

    Bauman could not bear to see the photo now. But it resonated with people in Boston. It was shown on the scoreboard at Fenway Park when the Red Sox had Bauman and Arredondo throw out ceremonial first pitches together. The crowd roared as they took the field. One man asked Bauman for an autograph. “You’re an inspiration,” the man said.

    Bauman had recently asked his mother why people so adored him. They respected his bravery, she had said, and he was the face of the tragedy, of those who survived.

    The day after the Red Sox game, Bauman and Hurley were invited to attend James Taylor’s rehearsal as he prepared to perform at a concert to benefit the marathon victims. After the set, Taylor sat with them.

    “So, you’re a guitar player, I hear,” he said, tapping Bauman’s forearm.

    “Yeah, I can play a couple of chords,” Bauman said. His ears were still ringing from the music, but he did not mention this, or how he played the guitar for only five minutes at a time now, his ears frustrated him so.

    They chatted about Bauman’s first pitch at Fenway, about his rehabilitation, and the future. Bauman had to learn to walk first, and after that, he did not know what to expect. Taylor was asking questions Bauman had to ask himself.

    Taylor asked about Costco and whether Bauman would return to work there. Bauman said yes, he would, once he was strong enough. But he had worried about having to stand all day. He had thought, maybe instead, he could do something that helped people.

    Taylor asked about his health insurance at Costco and if it was covering his expenses, and Bauman said yes. But he did not know entirely. He had not seen a bill from Boston Medical or Spaulding. His new legs cost about $100,000 each, but he expected them to be covered by his insurance and a foundation called Wiggle Your Toes.

    “You probably get a lot of donations, too, huh?” Taylor said.

    “Yeah, I get a lot of donations,” Bauman said. “It’s a lot. I’m getting money all the time.”

    An online fundraiser for him had reached nearly $800,000, and he would soon receive a $2.2 million check from the One Fund, which was established to benefit the marathon victims. But he feared his money and fame would run out. He retained a lawyer and two financial advisers. He put his money in a trust fund. He would trade it all, though, just to have his legs back.

    But he tried not to think like that.

    “Yeah, I guess I’m going to need it,” Bauman told Taylor. “I guess this stuff’s expensive.”

    “You should sit back and let people do what they can,” Taylor said, “because it makes people feel good — like they’re doing something.”

    Bauman nodded and stared at the ground.



    The first steps

    The day after the concert, Bauman was going to try to walk. His prosthetic legs had been made, and now the thigh sockets needed to be fitted. At his last appointment at United Prosthetics, he had taken a few short steps, but Martino had held his hips. Martino wanted him to walk on his own now, to see how everything felt and if any more adjustments were necessary.

    Bauman’s mother, his girlfriend and a few others gathered to watch in a hallway narrow enough that Bauman could reach the railings on each wall. He was in his wheelchair as he rolled the gel liners onto his thighs. He held his left thigh and squeezed it.

    Martino held the legs in place as Bauman pulled on the sockets. He strapped the liners to the sockets as Martino adjusted the knees and set the feet on the ground, with their black, size-10 1/2 sneakers. Bauman scooted forward in the chair, grabbed the railings and pushed himself up. Martino had a hold of him and helped him stand all the way up.

    Hurley was behind him, and she, like the others, watched quietly. Bauman pursed his lips as he balanced using the railings and straightened himself over the legs. The chair was pulled out from behind him, and Martino crouched down in front to examine the sockets.

    The first time Bauman had stood, the top had pinched his skin and the bottom had hurt the ends of his thighs. But Martino had corrected the sockets, and everything felt fine now. Bauman’s legs were sore, as they always were, but the pain no longer deterred him.

    He seemed at ease with his torso leaning forward and supported mostly by his hands on the railings, as Martino worked. Then Bauman let up on the railings, stood up straighter, and felt the pressure on his thighs, the ground firm underneath him. He felt in control.

    “All right, you OK to stand on that?” Martino said. “I’m going to run for a wrench.”

    Martino left the room, and Bauman arced his neck back toward Hurley.

    “How you doing, honey?” she asked.

    “Good,” he said. He was completely upright now. He looked sturdy.

    He turned forward and watched himself in the mirror at the end of the hallway. He lifted his hands off the railings, wobbled a bit and put his hands back. Hurley had not seen him do it. He did it again, lifting his hands higher now, and grinning.

    “No!” Hurley said. “Be careful!”

    She wrapped her arms around him and kissed the back of his neck.

    “Be careful,” she said softly. “You’re making me nervous.”

    She leaned against the wall, keeping hold of his midsection.

    She looked down at his legs. “Does it hurt?” she whispered.

    “No,” he said. “I feel tremendously balanced.”

    Martino returned, and Hurley moved away and left Bauman standing there by himself. Martino examined the legs, then stepped back and asked Bauman to walk.

    Bauman leaned on the railings, hunched over, and swung his left foot ahead, barely off the ground. His face strained.

    He took five steps, each a bit more cautious than the last.

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