Writing Amputees

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.

6 Responses

  1. Carrie Ives

    Writing a character as an amputee is hard. I recently wrote a short story about a man confined to a wheelchair that taunts him. My husband is a veteran battling a spinal disorder. Some days are good days and he is out of the chair but others have him confined and very … shall we say… “pissy” about the confinement. When I first started writing the piece, I told him my premise and he was pretty critical about it, but as time went along, he warmed to the idea.

    My point being this, our veterans often suffer the loss of limbs during combat, or suffer from illnesses that eventually limit their mobility and function. Touch base with your local VA hospital and speak with the Patient Advocate to see if she thinks any vet in the system would be willing to talk with you. Amputees often seek an outlet for their thoughts and feelings about the loss of limbs, but none of them will seek your pity.

    This way you get an honest answer, and you help a vet with moving forward in their life.

    Be Blessed,

    Carrie Ives

    1. Diane Morrison

      Thanks for this. You’re so right. I agree, the psychological aspect is also important (but I only had 1000 words and I used them all). It’s a *loss*. It’s hard. There’s grieving. There’s a sensation of not being whole anymore. Talking about it is important, and I think that holds true of anyone who has suffered a traumatic permanent injury, especially if it’s in wartime.

    2. Jason Bender

      Good discussion! I would just warn that like every population group, everybody is on a spectrum with how they feel about disability, how they understand advocacy that affects the whole, and how they feel about themselves and their own disability. For example, as a prosthetist I always try to use respectful and person-first language (stump = residual limb, amputee = person with limb-loss), but I always run across people who are like “What’s with this PC crap? I’m an AMPUTEE and this is my STUMP!!!” We need to be careful not to take that as anything other than permission to use those terms with that one single person. People’s perspective also often changes over time, so talking with people newly experiencing a disability may give VASTLY different answers than those further down the road.

      P.S Carrie you’re husband is free to feel however he wishes, so I don’t say this to him, but for you as someone who is supporting him, I would really encourage you to reconsider using the “confined” language with regards to his wheelchair. Wheelchairs mean freedom for a lot of people!

  2. Kelly Ditmars

    Hello,

    I came across your article and really appreciate all you have shared.
    I am the daughter of an amputee. My father lost an arm in his late twenties, decades before I was born.
    I too have included an amputee in my debut novel, a thriller in the last big round of revisions I hope.
    I appreciated all the information you gave about the healing and recovery process. Not having experienced that aspect of my dad’s process, I found it very informative.
    My character also is in the stage of having lived with the loss of his arm for decades. It has been a wonderful way to honour my dad, even if I am the only one that knows about it.
    I lost my dad when I was ten, but have vivid memories of him and how he adapted to his loss.
    He was an amazing man.
    Thank you for your post.
    Sincerely,
    K.L. (Kelly) Ditmars

  3. Doyle Carver

    Hi Diane,
    My character lost both legs in combat. So that is a wholly different thing than what Ive been able to find. Still working on that. I do, however, I have a friend that had a leg removed above the knee due to diabetes. He has been giving me amputee advice and wisdom and an idea of the time frame I need to write around. Im fortunate to have this guy as I had only heard the words ‘phantom pain’ and didn’t really know what they meant.
    The best thing about science fiction is how humans deal with future advances, so knowing how people have already dealt with this makes my story much more authentic.

    Till later,
    dc

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