by Diane Morrison
“Hey, I’m looking for advice. My character lost a limb in the last fight. Does anyone know about writing amputees?”
I was inspired to write this because I’ve had this conversation on Twitter a few times. My husband is an amputee from a traumatic accident that happened while we were married, and I write amputee characters in my own fiction. So it’s clear a resource is needed.
Recovery Takes Time
Please don’t have your character get their arm chopped off and pop back up the next day with a funky new magitech prosthesis to fight the baddie!
Even if you have nanobot superscience, losing a limb is a horrible shock to the system. Your character might lose a lot of blood, or get a systemic infection (that’s why they amputate severely damaged limbs, even today,) and at the very least, there’s going to be physiotherapy.
How much? I’d say at least three to eight weeks, maybe more, depending on recovery time between operations, sophistication of the equipment (supertech, or steam-powered marvels, will probably take longer because of their complexity,) and how severe the nerve damage was at the original site of amputation (burns, for example, could take months; nerves heal at a rate of one inch a month up to two years before they quit, but nerves are quite long.)
Disability is About Adaptation
The world is not built for disabled people. If you think you’re going to give your character a bionic limb and things will go back to normal – think again. You’d be amazed at how much of the simple process of walking is directed by tiny muscles and nerves in your foot, some of which regulate pressure and balance. Learning to walk on an artificial leg, even a marvel of supertech, takes practice. Level ground helps.
Likewise, the simple process of trying to do dishes with a prosthetic arm. Or typing on a keyboard. Or playing a musical instrument. Thumbs are complex organic machines that are almost impossible to imitate with current tech. This goes back to recovery time, but also, it goes to creating convincing technology.
It is likely that without some form of alien biotech, the replacement limb is a) not intuitive, like our body parts are, to operate, and b) deficient in some way from the original limb. Maybe it lacks sensation. Maybe it’s so strong that concentration is required to keep it from crushing things. If you give the amputee a price they’ve paid for the loss, it makes any cool superpower stuff you want to do more believable.
Phantom Pain is Not in Your Head
Phantom pain is caused by nerve damage. As severed nerves try to heal, they tangle up together and often mix signals, which is why there’s usually a trigger (my husband’s is getting his leg cold.) I don’t imagine this is ever going to change, because if you deaden nerve pain, you deaden nerve sensation. That’s what neuropathy is. If you have supertech that creates artificial nerves that connect with the original nerves, this is likely to cause excruciating pain on initial application, and ongoing pain issues thereafter.
Same if you want to regenerate nerves. That causes a horrific pins-and-needles sensation, like you’ve sat on your foot for an hour and just stood up. My husband has post-ICU neuropathy (did you know that your nerves are cannibalized by your system in the ICU sometimes, just like your muscles?) and to help it heal, I had to rub his hands and foot to encourage the nerves to make the connection. Electric jolts might take that place in a techno-utopia, but it won’t be pleasant.
There’s a Limit to the Pain We Can Tolerate
Even if your character is a superhero, after a point, the body simply dies if there’s too much pain. To survive traumatic injury, the character might be put into a coma. This also happened to my husband due to severe injuries to his heart, lungs, ribs, neck, arm and hands, as well as his severed leg.
Prosthetics Are Not User-Friendly
The body doesn’t want prostheses and sometimes resists them. Your system might reject them, just like a transplanted organ.
Fitting a prosthetic limb takes work because not all amputations are shaped the same. Each limb has to be individually fitted, and the residual limb changes shape and size over time, just like the rest of you, so that fitting has to happen every few years. Inorganic equipment does not naturally heal, so it periodically wears out and has to be replaced. Those replacements aren’t cheap, so who’s paying for them?
Once, they would just attach a prosthetic to the broken part, and sometimes broken bones would punch through the skin. Now they take part of the nearby flesh, fat and skin, and shape it into a soft pad, which they fasten over rounded bones. There’s often hair on that bit, and it pulls out when you take the prosthetic on and off.
If you can’t take it on and off, be aware that the place where it attaches is a constant source of possible infection. It will sweat and get dirty. Sometimes prostheses are so hard to clean it’s almost not worth it. And prosthetics currently don’t go in the bath with you, so they have to be cleaned separately.
But Wish Fulfillment is Okay
If you want your character to have a series of interchangeable Go-Go-Gadget Hands™, go for it! (I did.) Sometimes inorganic parts can do things organic ones can’t. Maybe your artificial eye has a built in laser sight and zoom function (consider how that’s controlled.) Maybe your character has a pistol in their index finger. I’ve had devastating blows stopped because the opponent didn’t realize they part they were striking was metal. It’s totally up to you. Why not have fun and imagine what could be? That defines the genre, after all.
If you have any questions beyond the scope of this article, feel free to contact me.
Diane Morrison in an emerging hybrid neo-pro writer who just successfully ran a Kickstarter to publish her book, “Once Upon a Time in the Wyrd West,” which features a major character who is an amputee. She recently appeared in Third Flatiron’s “Terra! Tara! Terror!” This winter she will be offering a class through the Rambo Academy on finding time to write when you have none. Under her pen name Sable Aradia, she is a traditionally-published non-fiction author and blogger. She lives in Vernon, BC, Canada and she manages the SFWA YouTube channel. You can catch her on Twitter as @SableAradia, which means she’s not writing when she should be.