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Ralph didn't work any better than he looked. The thumb and first two fingers opened and closed like a claw, the grossest of motor skills. The third finger and pinkie, which are employed by natural hands to carry things, were frozen. Ralph's wrist didn't bend. Despite weeks of training on a computer, I had difficulty with the basic functions: my stronger outer forearm muscle kept flexing and involuntarily opening the hand--even when I was trying to close it. I had no more success with the mechanism to rotate the wrist. The simultaneous contraction of both muscles was unnatural and hard to remember in real time. When I did it right, I couldn't keep the hand from spinning 360˚, an annoying loss of control--and embarrassing in public.
My disillusionment with Ralph grew. By the fifth day I was so frustrated I was ready to quit, thinking I'd be better off with one hand. On Feb. 11, I was invited to meet with my rehab team of eight people. Lieut. Colonel Paul Pasquina, medical director of the Army's amputee-care program, cited a few options to the myoelectric arm, including a body-powered prosthesis. They were lighter, unencumbered at the elbow, and ended in a hook. Pasquina said I might adopt a hook as a trademark that people would come to respect for its straightforward honesty.
I bristled. I wanted a prosthesis to disguise my deformity, not spotlight it. "The circles I travel in wouldn't be amused," I told Pasquina dismissively. I still was banking on an easy-fitting, lifelike substitute.
Dec. 10 marked the passing of a year since my injury. I knew I'd never regain what I had lost in penmanship, tennis, home repair, lovemaking, freedom from pain and dexterity. Even putting on a tie remained a challenge, one fraught with danger. Rushing to a TV appearance a few weeks earlier, I tried to knot one in the backseat of a taxi. I gripped the short end with my prosthetic hand, which began to spin uncontrollably, almost strangling me before I managed to extricate myself.
Despite occasional disasters, however, I was adjusting to a fake arm--thanks to certain modifications by prosthetist John Miguelez's team. Ralph had bit the dust, replaced by a more tapered, slightly lighter shell made of carbon fiber and acrylic resin. The modifications improved my range of motion and wardrobe--I could now button a dress shirt. But I was hardly wearing a second skin. The rigid shell chafed my forearm and got so hot in the summer that sweat dripped out of a small hole used to put it on.
Before Iraq, the technology of arm prostheses hadn't changed much since World War II. The tiny population of amputees created little market incentive. Miguelez used the burst in demand from Walter Reed to lean on manufacturers for progress. Before long, he was outfitting Iraq war amputees with an electronic hand that opened and closed 2 1/2 times faster and could be programmed to function at different speeds and grip strength.
The cosmetic arts also had improved. I received a silicone hand that was so lifelike it passed for real in social settings. But Pretty Boy, as I called it, kept tearing and afforded the precision of a boxing glove. It was too spongy to grasp anything small and too slippery to hold most objects for long.