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Prologue

Published onOct 02, 2019
Prologue

On the morning of April 26, 2014, I began my daily stretching routine, lifting my left leg up onto a stair. Suddenly my right leg collapsed. I landed flat on my back. Blows to my third, fourth and fifth cervical left me with four phantom limbs where my real ones had been.

On April 30 I underwent a 9.5-hour operation at Massachusetts General Hospital in Boston, Massachusetts to relieve the pressure on my spine. Ten days after that a surgical infection necessitated an additional 3.5-hour operation. A hole was discovered in the membrane surrounding my brain. It was plugged. My heart stopped beating for an instant. Then it restarted. The word on the ward was that my body would be unable to stand the punishment. I wouldn’t make it. At 78 I was just too old.

A week after the operation a doctor I'd never seen before came into my room. He stood at the foot of my bed and told me that while the operation was a success, I would never walk again.

Three weeks later, thanks to the efforts of Dr. Ron Hirschberg, director of Physical Medicine and Rehabilitation at MGH, I was transferred to the Spaulding rehabilitation Hospital in Charlestown, Massachusetts. Even if walking was out of the question, the idea was to see how much of my motor system could come back.

Spaulding was one of the best rehabilitation hospitals in the country. It had the finest equipment, expert therapists, a fine medical staff, including a roster of talented visiting doctors who sought out the hospital because of the variety of difficult cases that it attracted. Unfortunately, I was unable to benefit from any of that.

As bad luck would have it, an infection the day after I was admitted quarantined me for my first four weeks. Very little rehabilitation therapy was possible. For one thing, I was so weak I kept falling asleep in the middle of a session. And then, quite unexpectedly, I came face-to-face with the rock and hard place at the heart of the US healthcare system, the “length of stay” issue. My insurance was about to run out. Medicare and Medicaid would only pay for two more weeks. For Spaulding it was no pay, no play. What irony! As soon as I was I able to benefit from Spaulding’s marvelous resources, they turned their attention to moving me out.

I don’t know how good they would have been at rehabilitating me. But they did a bang-up job of sending me elsewhere. A Spaulding case manager, charged with my relocation, somehow discovered that 52 years prior to my accident, I had spent 3½ years on active service in the United States Air Force.

I was a second lieutenant when I went in and a captain when I was discharged. Even though the Vietnam War was going on, I was never in combat. Instead, I was assigned to the Electronic Systems Division in Bedford Massachusetts. I spent 3½ years in the Computer Directorate. My job was to evaluate how users interacted with databases. The information in those databases might range from inventories of airplane parts to locations of military bases and the time it might take to travel from one to another.

I left the Air Force in 1965. I went to work for the Research Laboratory of Electronics at MIT. In 1965 I began a university career as an assistant professor at Brandeis University, then as department head at the University of Massachusetts at Amherst. I ended up at MIT as Head of the Department of Linguistics and Philosophy and then as Associate Provost. My Air Force career quickly receded in the rearview mirror. By the time I was in my 70s I had all but forgotten about it.

It never occurred to me that by virtue of having been a veteran I was eligible for admission to the VA healthcare system. Fortunately for me precisely that thought occurred to the case manager at Spaulding. She contacted the VA Rehabilitation hospital in West Roxbury, Massachusetts. They confirmed her suspicion. Spaulding Rehab had given me the best possible birthday present. They passed me on to the VA’s spinal cord injury ward. I was admitted on July 7, 2014, my 79th birthday.

Four and a half months after that admission, I took my first step. Two years after that, I was walking a mile a day with the aid of a walker. I can now walk with crutches. I can even climb the practice stairs in the VA gymnasium where I still receive physical therapy and my mobility continues to improve.

Not only that, but my ability to play the trombone—something I thought was gone forever—has come back. Within six months of my becoming a VA outpatient, I played six gigs with my old bands. This could not have happened without the help of the VA’s incredibly dedicated therapists. They believed in me as much as I believed in them.

I love life. I find people and things—everything from music and museums to the latest electronic gadgets and, of course, food—extraordinarily interesting and occasionally very beautiful. Wines can be superb and making love—yes, even at my age—can be sublime. I want to enjoy them as long as I can. My wife Nancy visited me every day, even those days when I was dead to the world. I was determined to walk again for her sake as much as my own. I was not going to leave her the widow of a husband who wasn't dead.

Everyone who offered their help gave me something to work for; a stronger body, an unfettered wife. If you don't have something to look forward to, then what is the point?

As soon as I was able to think straight after the accident, I started writing this book (first, through Nancy’s copious note-taking, then with voice-activated software, and finally with my own hands on the keyboard). The writing kept depression at bay. In the face of a kind of death I managed to conjure up a kind of birth. I focused my attention on something other than myself. I had no idea what story it would tell.

When that doctor told me I would never walk again, he was armed with all the familiar badges of authority, a nametag, a white coat, a stethoscope hanging from the breast pocket and a clipboard. He turned out to be wrong. Instead I got my life back.

I would be lying to myself and to the reader if I didn’t describe how luck played a major role in my recovery. I was lucky to be living in a city with one of the world's best trauma hospitals, MGH. I was lucky to have served in the United States Air Force 50 years ago and was therefore eligible to be admitted to the Boston VA, which has one of the best spinal cord injury rehabilitation centers in the country. l was lucky that my care at the hospital was untrammeled by the dictates of an insurance company. Money never ran out because money was never in the picture to begin with. I was just plain lucky.

So this is not the story of a skilled neurosurgeon and his crackerjack team and how they brought me back from the abyss, although they were indeed superb. It is not the story of an individual who, faced with a catastrophe like none other in his life, managed to come back from the edge. It is not the story of a faithful wife who stood by him in his darkest hour and helped him to the light. It is the story of a humane healthcare system freed from the shackles of an insurance company, an unfettered healthcare system able to focus exclusively on precisely what I and every patient like me needs in order to be as whole as he or she can be.

Once in a conversation with a VA doctor I referred to myself as a tetraplegic.

“You are not a tetraplegic,” he said. “You are Samuel Jay Keyser with tetraplegia. Don’t ever allow yourself to be defined by your disease.”

FFVHC - Keyser


Photo by Anna Wangler on Unsplash

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