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Last week I was at the wedding of an old co-worker. There was a big cast there, all past employees (physical and occupational therapists) from the amputee section of the Walter Reed Army Medical Center. Included in the mix was a former patient I recognized immediately, though I did not remember his injuries. That I remembered his face, but not the fact that he was missing both arms and a leg at the groin, caught me totally off guard.

Finding myself surprised by the extent of this young man’s injuries — injuries that were routine for so many years — well, a light flickered in my brain. And suddenly, I was back there in our old clinic, surrounded by young men on treatment tables. In my mind, their faces blurred softly and their injuries faded into the ever-present background of yellow hospital gowns, wheelchairs, and parallel bars.

At Walter Reed, where most of our patients were combat-injured active duty soldiers and marines — young men in their 20s with crew cuts — the therapists had gotten into the habit of identifying our patients by their injuries when discussing our caseload. Rob from Arkansas was a double AK (missing both legs above the knee) with orange running shoes. Charlie was a triple (missing three limbs) with a nonregulation beard that needed to come off STAT. Chris was an AK/BK (above knee and below knee amputee) who comes to PT in the morning and was really particular about time management (i.e., demanded to be seen at 0645 (6:45 a.m.) even though we didn’t start patient care until 0700.

Our patients did the same thing to each other. Referring to a soldier as a “hip” if he happened to missing a leg at the groin. Or jokingly, “paper cut” if a soldier was “only” missing one leg below the knee — all in spite of the fact that losing a limb is never a minor injury.

After several years in the amputee section, it was not unusual for my colleagues and me to request a favorite type of injury when we were asked to pick up a new patient. Darcy loved the challenge of working with double AK’s (missing legs above the knee). A devastating injury, but Darcy really had a flair for it. She scoffed off any compliments by saying it was only because they “couldn’t cheat” the way someone with a less severe amputation on the other side might.