(might need to separate into 2 chapters?)
He missed her terribly, and wished she were with him now. He folded the letter and reverently put it back in the cabinet drawer with the others. He glanced at his pocket watch, and saw that he still had some time before his appointment. Unable to focus on much else, he decided to start walking to the doctor’s office and wait outside. He grabbed his heavy coat, hat and gloves and started walking, listening to the early morning sounds of a city waking up to start a new day.
He got to the main lobby of the building, noticing that the same woman was sitting at the desk in the front, and pulled on the handle, expecting to find a locked door. To his relief, the door pulled open freely, allowing him into the building. He walked inside, anxious to escape the cold breeze, and saw the nurse he’d met the day before just settling into her desk and the day’s work.
“Hello again!” she announced.
“Hello again, ma’am. You start work very early,” Will replied.
“Oh, I love being up early in this town. I don’t sleep well, what with my grandfather tossing and turning in the room next to me, and my younger sister and brother sometimes playing games in their room late at night.”
“Sounds like you live in a full house!” Will said.
“It can be, sometimes. I enjoy coming to work so I can have my own time, away from the family. My mother died several years ago from consumption, so the “motherly” duties now fall to me. My father does his best, but he doesn’t have the female touch, and the kids need proper raising. Plus, he works a lot on the docks from sunrise to sunset. He makes a good living, but he comes home exhausted and often falls asleep without eating.”
“I’m sorry to hear about your mother. That must have been very difficult for the whole family,” Will said apologetically, thinking of his own aunt.
“It was. My father hasn’t been the same.”
“Well, you know my name. What’s yours?” Will asked, trying to change the subject. He lifted on eyebrow in a show of interest, thinking she sounded like she needed a friend.
“Florence McCarthy.” She smiled and held her left hand out, nodding toward Will’s right shoulder.
Will recognized and appreciated the left hand shake, and said, “Well, Florence, it’s a pleasure to meet you.” He extended his left hand to meet hers. “I’m sure I’ll see you again. I hope to be visiting Dr. Zuroli a few times.”
“Speaking of Dr. Zuroli, here comes his nurse, Patricia, now,” she added, pointing toward a person approaching the desk. Will turned to see the nurse he’d met upstairs the day before, and smiled in welcome.
“Hello, Mr. Austin. You’re early,” she said kindly.
He nodded sheepishly. “I am. I couldn’t sleep, I was too eager to see the doctor. Florence here has been kind enough to let me wait in the lobby.”
Patricia nodded at the receptionist. “Thank you, Florence, for taking such good care of our patient.”
“My pleasure, indeed. Mr. Austin is a gentleman, and we had a good conversation. I know Dr. Zuroli will take very good care of him. I hope to talk to you soon, Mr. Austin,” Florence said in a friendly tone. She waved goodbye.
“Goodbye.” Will turned and went up the stairs with Patricia to wait for his 9 AM appointment, grinning to himself at how easy it was to make new friends in this city.
He moved into the waiting room and sat down, as nervous as a kid on his first day in school. First he sat in a chair, but he decided that he wouldn’t be able to sit there long. He got up and looked out the window for a few minutes, watching the street for anyone he knew. Then he sat back down in another chair closer to the door. What would this appointment be like? What would the doctor say? Would it be good news or bad?
“Mr. Austin, would you like to go out to the hallway? You might have more room to walk up and down,” Patricia commented, suppressing a smile at his nervous movements.
He laughed. “No, I’m OK. Just a little nervous. I’ll be fine here in the waiting room. Thank you, though.” He stood up and sat down again in different chair, hoping it was more comfortable than the last. Then he grasped the armrests, holding himself down to keep from standing again. If he moved again, the nurse was going to think he was crazy as well as wounded, and that would never do.
Finally, after what felt like an eternity, Dr. Zuroli walked in the door and saw Will already waiting for him. Will jumped out of his seat to welcome him into the room.
“I had a feeling you would be early, Mr. Austin,” the doctor laughed. “Besides, Florence on the first floor told me you were here. Why don’t you follow me into my office and we can start talking?”
Will grabbed his heavy coat and hat and followed closely behind Dr. Zuroli, anxious for news. When they entered the doctor’s office, the doctor waved a hand toward Will, directing him to sit in one of the chairs in front of the large wooden desk, as he sat in a larger chair behind the desk, with a large window behind him, looking over a well-manicured courtyard.
“First, Mr. Austin –”
“Please, Doctor, call me Will. All my friends do.”
“Ok, Will. Professor Brown spoke very highly of you. We know each other through another friend here at the University, and I trust his judgment. He said he’s known you since you were a young man in your early twenties. You’re now thirty-seven, is that right?” The doctor looked at his paperwork to confirm Will’s birth date of 1849, and glanced back up at Will.
“Yes, 1849. I was born and raised here in Boston, primarily by my Aunt Hannah and Uncle Frank. My mother died just after I was born, and my father died in a robbery at our family’s store when I was eight.”
“I’m sorry to hear that. You were fortunate to have family that took you in.”
“Thank you, yes. Aunt Hannah recently passed away, just after I returned home. It’s been quite a shock, especially to my uncle, who’s frail and elderly. We don’t know how much longer he’ll last on his own.” Will paused, swallowing heavily. It was the first time he’d said it out loud, and that somehow made it more real. He hadn’t expected to find that so painful.
“We? Who is we? You have more family still here?” asked the doctor, surprised. “Does your entire family live in Boston?”
Will snorted. “Yes. My Uncle Benjamin, his wife, Elisia, and their two children also live here. My grandparents lived here until they died several years ago. Now, we all work together to run the family store.”
With a bit of surprise in his voice, the doctor asked, “Will, you help run a large general store with the use of only one arm? You don’t have any use in the right arm, if Professor Brown was correct. Is that true?”
Proudly sitting up in his chair, Will stated, “Oh sure. I can do a lot at the store with only one arm. I’m learning to write with my left hand, and I can do sales at the counter. I’m quite good with picking up things with just my left hand. They aren’t very heavy things, but many things only need one hand.” He glanced down at his left hand, thankful that he’d been left with any functionality at all, and looked up, grinning.
The doctor shook his head in amusement. “Well, I apologize if I said anything to offend you. It sounds like you’re doing quite well, considering the situation. So many of my patients don’t have the use of one arm, and do very little with the other. They’re generally overcome with self pity. They make other people do everything for them. I try to tell their family members to let them do more on their own, to fend for themselves, but very few do. It’s refreshing to meet someone who works to hard to acclimate and grow.”
“Well I’ve always been a very hard-working person, and incredibly independent. I don’t want any handouts, or to be treated like a child. I can’t even image accepting that! I intend to be a person who can take care of themselves,” Will announced proudly. “I do recognize that I’m different than I was before I lost the use of my arm, but I’m trying to work around all that. I do want to see if I can regain any use of my right arm, though, even if it’s small. It would make life … easier.”
The doctor nodded, but then asked another question about his life. “You’re a widower, is that correct?”
Will paused for a moment. He’d forgotten that he wrote that on the paperwork yesterday, and the casual reference to it caused his heart to stop beating for a moment. No matter how much time passed, he thought that particular wound was always going to sting. “Yes,” he said quietly. “Her name was Mary. I was married for a short time to a very young medical doctor. She was murdered by a group of escaped prisoners at our home in Roma, Texas. I went away for the day, and found her when I got home. Neighbors heard the gunshots, found her, and then came to find me in the hills. I’d gone on a short hunting trip.” Will sped through the explanation, knowing that he sounded rehearsed. He’d had some experience with it, though, and knew that this was the only way he could stand to retell the events of that time.
His pain must have been obvious, for the doctor changed the subject again. “How did your arm become injured?”
He looked up, meeting the doctor’s eyes levelly. “I went after the men who killed her.” He went on to tell him about the ambush by the Gomez Gang, who had known he was coming, and the injuries to his arm and leg. He told him that they’d managed to shoot most of the gang, but that his best friend and partner, Roy, was killed during the gunfight. Will himself had taken shots to the shoulder and leg, and had survived; a fact that still made him feel guilty. He could see the affect the story was having on the doctor, who was sitting motionless in his chair, leaning forward onto his desk. People lived a far different life here in Boston, he thought. They were shocked by the idea of anyone shooting anyone else. But it was part of life in the West, and a contract that Will had signed when he went out there.
He just hadn’t expected it to cost him his wife, best friend, and use of his shoulder.
Taking a deep breath, the doctor said, “That’s quite a story! I can’t believe you’re sitting here in front of me, telling the story.”
“Many people say that, doctor,” Will chuckled. “I probably shouldn’t have survived, but I got lucky.”
“So who fixed up your arm?” the doctor asked, wanting Will to continue with his story.
A smile came across Will’s face as he remembered. “A wonderful woman by the name of Elizabeth, who lives on a ranch in Northern Mexico with her family. She’s originally from Georgia, and her family moved to Texas after the war. While she was a teacher in Texas, she met a Mexican man when he traveled into Texas for business, and fell in love. They moved to his very large family ranch after getting married. As it happens, when I got shot, I happened to be on the outskirts of her large ranch, and two of her small children were harvesting some crops nearby. They heard the shots and came to investigate. She told me they rushed over, found me alive and all the others dead, and put me into the wagon to take me home. Elizabeth removed the bullets from my leg and shoulder, and stitched me up as best she could.” He stood up, and patted his left leg, displaying a strong and useful limb. “I used to limp on that leg, but it’s healed.”
The doctor gave a low whistle. “That’s an incredible story. I’m eager to see your shoulder and the work this woman, Elizabeth, did to save your life. Does she have any medical background or training?”
“No, doctor, nothing official. Not like my wife. But Elizabeth has spent her whole life on farms and ranches, stitching up a variety of animals and people when a doctor was days away. She’s very good at understanding the ailments and sicknesses of her people, and she’s helped many animals and people give birth. I suspect that she’s also helped them die in peace, when the occasion calls for it.”
“She sounds wonderful. I think you’re very lucky. She obviously saved your life. I can see why you’re so fond of her. It’s obvious in your voice that you care deeply for her.”
Will blushed. He wasn’t aware that it had been showing, but he couldn’t argue with the doctor. Elizabeth had become one of his closest friends, and was incredibly important to him. He was anxious to return to her, once he had things in Boston settled.
“Do you have plans to return to Texas or Mexico?” the doctor asked, as if he was reading Will’s thoughts.
“Eventually, yes, but first I have to make sure my family here is taken care of. And see what can be done for this arm. I’d like to regain some use of it, so I can go back to Mexico and be a useful person. It would also be safer for me there if I could use both hands.”
Dr. Zuroli smiled. “I’ll do my best to help you get there, Will. Now, let me see that shoulder.” They both rose from their chairs and walked next door to an exam room that adjoined the office.
Will unbuttoned his shirt, removing one arm at a time, revealing the scar tissue that surrounded his shoulder to the first person since Elizabeth. He glanced down at the shoulder, then looked away. He didn’t look at it often, for it reminded him of too many things.
The doctor looked over the shoulder, both front and back, touching the tissue with the tips of his fingers to analyze how much healing had occurred under the skin. To his amazement, the tissue was firm, bouncing back after he touched it, acting like healthy tissue. The skin wasn’t discolored, and appeared to be a healthy peachy tone. Will didn’t seem to have any pain associated with the area.
“Tell me again, Will, when all this occurred,” he asked quietly.
“About eight months ago. How does it look?” Will asked hesitantly.
“From what I can see, it looks great! I can certainly see where the external stitching was performed, but the skin is healing nicely and, besides all the scarring, appears healthy.”
“That’s good, right?”
Ignoring Will’s question, the doctor asked, “Tell me what kind of movement you’ve been doing with your hand and arm since the injury. Do you have any movement or feeling at all in the arm or hand?”
Remembering back to the day when he woke up in the ranch hand’s building on Rancho Arroyo, Will shook his head. “My arm was immobilized in a sling while I was there on the ranch, under the direct care of Elizabeth. After that, I just let it hang to the side. I couldn’t use it or move it, but I didn’t want to use a sling in public. I didn’t want to draw attention to the fact that I was injured that badly. Some of the people who killed me are still out there, and I was worried that they might come after me.”
“I understand. That makes sense,” the doctor responded. “Have you been trying to use it at all since, say in the store?”
“No, I can’t use it on a day-to-day basis. When I’m at home, sometimes I’ll sit on my bed and see if I can move my hand or shoulder, or any muscles in my arm.” Will’s voice tapered off. What he had to say next might sound foolish, and he wondered suddenly if it was a good idea.
“And …?” the doctor asked, waiting for Will’s response.
“Doc, this is going to sound foolish. I’m not sure how to explain it, really.”
“Go ahead, Will. Tell me what happens when you’re sitting on the bed and trying to get your arm to move.” The doctor seemed to know what Will’s next words would be, but wanted Will to say them for himself.
Will waited a few seconds while he gathered the right words. “Damn it, Doc, it’s the strangest thing I’ve ever experienced. I thought I was going crazy at first, but then it kept happening. My arm won’t move on the outside, but, on the inside, I would swear I can feel some type of very small movement. Sometimes it feels like I’m only imagining the movement, but I know I can feel something. Some of the muscles inside my arm are working. They’re just not producing any movement. Does that make sense?”
Dr. Zuroli smiled. “That’s real feeling you’re experiencing. It’s not your imagination. That’s a good sign of healing from the inside. A good first step.”
Will breathed out slowly, feeling like he’d been holding his breath for a month. “That is great news. You’re the first person I’ve told about that. I was afraid other people, like my family, would think I was crazy.”
“Honestly, Will, they still might think that for now. The work I’m doing here and what another doctor is doing in New York isn’t considered brand new, but it’s new enough that most regular medical doctors don’t practice it. They don’t have the techniques or training, and the average person knows nothing about it. Your friend, Professor Brown, is a very open-minded person, and he knew enough to know that just because something is new doesn’t mean it’s wrong. He thought it was worth having you see me, even though he doesn’t understand the techniques himself. That movement you’re feeling means we have something to work with, but I wouldn’t talk to many people about it. They might not understand.”
I owe you another one, Professor, Will thought to himself, nodding. He didn’t care how experimental the techniques were; if they helped him get his arm and hand back, they were worth it.
The doctor called the meeting to attention at that point, clapping his hands together once. “Well, let’s start with some very basic movements in the rest of your body, just to confirm that everything else is working.”
“I don’t understand, doctor. I thought I was here about my arm not working,” Will answered, confused.
“What we’ve learned is that the body, both in animals and people, is that it’s not just arms and legs and a head and a chest all working by themselves. Instead, we know that they all work together, and when one of those parts isn’t working properly, it can’t support the whole body. For example, if your arms doesn’t work right, it makes other parts of your body work harder, sometimes causing an overload or breakdown.”
“Well when you put it that way, it makes more sense,” Will said.
“Exactly. So I want you to stand up here in front of me and put your feet on the ground, keep your arms to your sides, and look straight ahead,” the doctor instructed.
Will jumped up from his chair, stood as straight as he could, and let his arms fall to his sides. Then, like an eager schoolboy, he said, “What next?”
“Bend your knees, first with both legs, and then one leg at a time.”
Will accomplished that exercise with ease, feeling no pain.
“Great, now bend forward at your waist and then come back up.”
Will completed that exercise as well, wondering what exactly these were supposed to prove.
“Great, can you twist from side to side at your waist, letting your arms hang freely? First looking over your left shoulder and then over your right shoulder,” the doctor said, scribbling madly on his pad.
Will completed the turn over his left shoulder with no problem and full range of motion, but when it came to looking over his right shoulder, he hit a spot where he had to stop. Just there, his action stopped; he couldn’t turn his head any farther, as if there was a wall sitting on his shoulder. He looked back at the doctor, confused.
“Whoa, doctor, what was that? Why couldn’t I turn my head completely?”
“Don’t worry about that, Will. It’s normal, given your injury. With certain exercises, we can work on improving that and getting more range of motion over time.”
Will was glad to hear that, but it didn’t explain why he’d had so much trouble turning his head. “But what does moving my head have to do with my arm?”
“Remember what we talked about before. Your arm and head and chest and legs are all connected, and must work together as a team to move your body properly. When one piece, like your arm, isn’t doing its job, it affects the rest of your body. The connection from your right arm to your head hasn’t been working properly since your accident. So you can’t turn your head the way you’re supposed to because your shoulder isn’t doing its job. Make sense? Let’s finish up with the rest of these exercises.”
After checking Will’s left arm and the remaining head movements, and not finding any range of motion limitations, Dr. Zuroli had Will sit back down again. He took Will’s right arm, turned the hand with the palm up, and asked Will to try to move his fingers.
Will paused for a moment, focusing on bringing about the movement, and felt some muscles inside his arm. But his fingers remained motionless. “Nothing, Doc,” he said sadly.
Dr. Zuroli took his own right hand and, while supporting Will’s hand with his left hand, moved Will’s fingers in and out several times.
“What are you doing?” Will asked, confused.
“I’m doing something for your arm that, at this time, it can’t do on its own. However, the movement, even being done by myself or another trained person, can still give the stimulation the muscles need to get your arm working properly again,” the doctor explains patiently. “Since the shooting, your arm has been in a healing state, rather than a working state. Before, it worked. Now, it’s just healing. So all the muscles, nerves, blood vessels, ligaments, and bones are kind of out of practice. Meaning that they have to re-learn how to work, since they haven’t worked in a while. So what we’re doing here is teaching all the muscles and ligaments and tendons how to work again. We’re showing them what they’re supposed to be doing. Until your arm is able to work on its own, a trained person can do these exercises to help your arm start to learn to work again. Does that make sense?”
Will nodded, laughing. “Perfectly! I never thought about all those things, but it makes sense.” He stopped for a moment, and then asked, “Doc, will I be able to use my arm again?”
“There are many factors involved in the recovery of any motion after any type of accident. How severe was the injury, for example and how effective was the immediate care given to the injury? What is the timeframe between when the injury occurred and when these exercises are started up? What type of exercises are prescribed and how efficient are they? How effectively are the exercises followed up by the patient? And, finally, how motivated is the patient to gain full recovery?”
“I see,” Will answered slowly. He was certainly motivated to recover, but it would depend on things over which he had no control. He wasn’t certain he liked that, but there wasn’t much he could do about it. “So some of those things I can affect, some of those you control by how well you prescribe the exercises, and some things are over and done, like how well Elizabeth did on her initial surgery.”
“Exactly! You understand perfectly. Based on the hundreds of patients I’ve seen in many years, I would say that you’re one of the most motivated patients I’ve had. You want your arm back, so I have no doubt that you’ll do the exercises and movements in your own time. As for me, I’ll prescribe the exact exercises you need to regain as much movement as possible. The third element: what is the full extent of your injury, and how was the immediate care? We won’t know that until we get a little farther along in the treatment. However, from what I’ve seen so far, though the injury was extremely traumatic to your shoulder, it certainly could have been worse. There were no broken bones, which are extremely difficult to heal without the use of an immediate hospital visit. The bullet seems to have missed the vital organs in your chest and neck. If it hit those, you would have bled to death within minutes, no matter how close help was. And, the bullet didn’t go out the back side, which would have caused additional bleeding. Overall, as much as it probably doesn’t feel like it, you were lucky.”
“That all sounds very promising, Doc.”
“I think it is promising. Will Austin, you’re a very lucky man. I know it might not seem like it sometimes, but in my view, you’re very lucky to be sitting here in my office asking how to regain the use of your arm.”
“You’re right, Doc. I am lucky. I have great friends. But …”
The doctor raised his eyebrow, curious to know how Will could follow that up.
“I know, and even you said, that it all does comes down to how effectively I do the exercises and follow through with everything. So it still comes down to me and what I do. If I don’t do all these things, it won’t work. Right?”
The doctor nodded, confused at Will’s train of thought. “Yes, but nothing will happen until we’ve been treating your shoulder for months, perhaps years. It will, in the end, come down to your perseverance, but please don’t expect this all to happen by next week. Regaining the use of your arm will take time, dedication, perseverance, and a little luck. If I were you, I would plan to return to Mexico and the ranch with Elizabeth in a year. I think it will take that long, at least, to see the outcome of the movements and other exercises, if everything is done correctly.”
Will looked up, shocked. “A year?! I was hoping for around six months at the most!” He’d known that he was going to be away from Elizabeth for some time, but a whole year away from her seemed interminable. He couldn’t even imagine it.
“I would plan for a year, honestly. My normal plan is to arrange the routines and exercises for a month at a time, recheck the progress, and then set a new plan again for the upcoming month. It allows both the doctor and the patient to align themselves on the same goals. And we’ll be able to design your new exercises based on how well your arm is doing.”
Letting everything sink in, Will responded politely, looking straight at the doctor. “OK, Doc. I trust you. I certainly have plenty to do here in Boston. Until Uncle Benjamin finds more help for the store, I can be useful there, and Uncle Frank needs somebody to stay with him. But how am I going to explain this to Elizabeth? Are we certain it’ll only be a year?”
“You’re an intelligent man, Will. I’m sure you’ll figure out the best way,” the doctor chuckled lightly.
Will caught his light sarcasm and grinned, but couldn’t bring himself to accept that it was going to be a whole year before he saw Elizabeth again. His face returned quickly to a frown, and the doctor shook his head.
“I do have an alternative for you, or additional help, if you so desire,” he offered.
Will paused in his thoughts and looked closely at the doctor. “What’s that?”
“There’s an outstanding doctor in New York City who was the pioneer in this field. His name is Dr. Daniel Gabel. We went to the same school in Switzerland. He was many, many years ahead of me, of course, but he learned the same things. He wrote a book explaining how movement and exercise can help many ailments, diseases, and injuries. I think he would be a great second opinion for you, and he might be able to offer alternatives and exercises that I don’t know about. He’s been helping patients for twice as long as I have, and, if I remember correctly, does specialize in war and gunshot injuries. He began working with men coming back from the war.”
Will nodded, thinking about it. “That sounds interesting. I’ve never been to New York City.”
“Never? Really? It’s a wonderful city, and there are both trains and steamships to get you there in fashion.”
“Oh, I don’t care about fashion,” Will laughed. “I just want to … Wait, did you say steamships? There’s a steamship I can ride?” Will perked up, remembering the wonderful steamship he took up the Mississippi from New Orleans. It had been one of the highlights of his life, a marvel of engineering and science.
“Yes! Big, powerful steamships! You can take a train from Boston to Fall River, and then catch the overnight route through the Sound. It’ll get you to New York first thing in the morning. Then you can ride it back at night and get back to Boston in the morning. I’ve taken that route many times.”
“That does sound like a jolly good time!” Will said, getting more interested.
“Would you like me to write a letter to Dr. Gabel and ask him when he would be able to see you?”
“No trouble, Doc? I know you’re very busy.”
“No trouble at all. I want you to have the best care possible. You can still work with me on our monthly plans, and then see Dr. Gabel in between. I think that would be the best route for your care. I’ll write him a letter today, detailing our visit and everything we have talked about. I’ll let you know when I hear back from him.”
“Thanks, Doc! I really appreciate all your help. I’ll write a letter to Elizabeth telling her everything.” Will rose and walked quickly out of the room, his mind spinning with all that had transpired in on short hour.
In a year, maybe sooner, he’d be able to use his arm. And he’d be back in Mexico with Elizabeth. He wasn’t sure which was better.
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