October 22, 2025

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I've been told that some of the things I comment on in these essays are unpleasant. But then, life is full of unpleasantries, and discussing them is part of the cargo of this column. If it happens, if it's part of life, then even if I wouldn't bring it up at dinner, it bears thinking about, evaluating, ameliorating (if possible), and demystifying.

A few years back, a good friend of mine, who had always carried too much weight, succumbed to a common outcome of type 2 diabetes -- his feet became incurably infected, and to save his life, his doctor decreed the amputation of both feet.

My friend had always worked out, pumping iron mostly, so he was fiercely strong. But now he was wheelchair-bound. It didn't stop him. In his post-amputation life, he still took part in the plays I put on with our little amateur dramatic troupe. He was still full of humor and life.

I don't know how long he lived after giving up his feet, but it was not long enough, in my opinion. Whether that was his opinion, I wouldn't know. We never discussed life without feet. And now I can't ask him, because his body gave up. He's not the only friend or family member I've lost to ailments tied to old age: Cancer has cost me more friends than type 2 diabetes.

All the roads to death are effective, though. Some of them provide opportunities to visit, to tell the friend how much he or she has meant to you, to say good-bye. Others are very short; almost before you know they are setting out on that journey, they are gone.

At 74, I know that my road is getting shorter by one day per day. And having had a stroke at just the age when my mother's father had his terminal stroke, I thought I knew what my road would be.

But taking poor care of my body opened another gateway. I began to develop sores and suppurations on my legs and feet. The message was clear: Exercise. Walk. Eat way less sugar.

Gotta do that, I told myself as I took another David Bradley nonpareil chocolate from my well-stocked candy jar. Gotta get out on the treadmill, just to improve circulation in my legs.

But trying on a new pair of compression socks tipped some kind of balance. The socks were comfortable. They had some kind of magical metal in them -- I don't remember what. I just know that after wearing them a day, two closed sore spots on my right foot were now open, weeping ulcers that were beyond a few bandaids' ability to heal.

A regularly scheduled podiatrist visit set off the alarms. The doctor who has worked with my toenails for years called in another doctor from the practice, and they scheduled me for a blood-flow analysis. The sores were causing little if any pain, and the technician was genial. His result? 70% circulation in my right foot. "How bad is that?" I asked.

The answer was: We scheduled me for a vascular procedure last Monday, to restore as much circulation as possible. In order to avoid ... amputation.

When my friend lost his feet, I made a private vow: I was going to die with my feet on. My friend had lived months, perhaps years without feet, but death came anyway; at my age, any procedure to prolong life can be followed by those words: Death came anyway.

I looked at Johnny Joey Jones, one of my favorite commentators on Fox, who has a thriving career despite the loss of both lower legs in combat. He is in robust good health, or so it seems, and he brings wisdom and humor and calm to his conversations.

But I am not in such good shape, and I don't think I would bring off amputation with panache, as he has done.

But I didn't have to wait till Monday to go to the hospital. On Saturday night, after a superb supper of my wife's perfect pot roast, I went into the family room, where my recliner has become my office (despite my excellent office upstairs). I have written my last couple of books in this recliner, putting a second-rate (but lightweight) laptop on a lapdesk and putting ASCII codes onto the screen, hoping that I can still come up with interesting lies that other people will want to spend money on.

As I sat there, my bladder informed me, with some urgency, that I needed to set down the lapdesk and hie me to the bathroom. But when I tried to stand, I realized that I was weak and trembly, and hadn't the strength to get to my feet and achieve balance. My wife tried to help steady me, but I kept falling back into the chair.

The room was perfectly warm, but my teeth were chattering and I was getting scared. I also knew that my bladder could not hold out much longer. "I'm going to call the EMTs," said my wife, and I agreed. She recalls that she diagnosed my ague as a sign of sepsis, presumably from one of the ulcerated sores on my feet. I have no memory of that.

Likewise, I have no memory of the EMTs trying to help me get to a suitable repository for my bodily wastes. At that point I was no longer able to follow simple instructions and whatever I said was incoherent or wildly out of sync with what was happening. They all agreed that wetting myself was nowhere near my most serious problem. Somehow they got me on a narrow wheelchair and put in the back of an ambulance and got me to Moses Cone's emergency room.

They tell me I never lost consciousness, but that only means that I never stopped talking. I imagine I will have to be dead for several days to actually achieve silence, so volubility is not a symptom of consciousness in my caae.

Without my knowing it, they got me undressed and gowned, put IVs in my left hand and right elbow, started a course of serious antibiotics, and fixed me up with the new alternative to catheterization, an external collection and disposal system called PureWick, which is so effective my wife immediately ordered a setup for home use.

Here's what they learned from the Xrays they took during my delirium. The bone infection that had triggered my sepsis was not from the obvious sores on my right foot, but from the left foot that I thought was "fine." No, sir, Uncle Orson. The big toe -- no, I have been corrected to call it the "great toe" -- on my left foot had become painlessly infected and it had to go. Right away.

I regained consciousness to find myself in a room in the Emergency Department, with a good friend who works nighttime security in the hospital visiting me as he came off shift. My wife tells me that the first half of the conversation was incoherent -- still delirious -- but at some point I regained some kind of mental equilibrium and the conversation ended with cheerful optimism.

So everything was going to be fine.

This was Sunday morning, and the next day they were going to go ahead with the unblocking of the circulation in my right leg. They didn't bother with working on my left leg, because the circulation was better there, and they were going to take my great toe off anyway.

My left great toe was not a point of particular vanity for me. I had seriously damaged the toenail when a spade dropped on it in my garage some twenty years before. Ever since then, the nail had stopped growing longer and instead great thicker, requiring that it be filed down so I could do things like wearing shoes. Losing that unfortunate limblet did not fill me with dismay. They don't make prosthetic toes, as far as I know, and I was quite sure I'd be able to learn to walk without that toe in place.

So my previous decision to die with my feet on did not extend to dying with all my toes. I could lose one. I agreed to the procedure.

I had begged for total anaesthesia for the vascular procedure on Monday, but they assured me that one of the lawful uses of Fentanyl was to keep me both conscious and happy while they performed all kinds of procedurs inside my femoral artery. But being conscious also meant feeling my back get stiffer and more painful on the flat bench where they did the work.

And because a hospital miscue had given me a dose of Pradaxa on Sunday morning, my blood didn't clot very well. I bled into a hematoma at my groin, so when they removed the needle they had a devil of a time stopping the arterial bleeding. This includes a highly skilled nurse leaning heavily with a knuckle digging into my groin to stop me from bleeding out. It was the only painful part of that day. But they saved my life, the artery managed to heal well enough, and I was all set to lose my toe on Tuesday morning.

Total anaesthesia this time. Nobody wanted to chat with me while amputating my dying toe.

Prior to the procedure, I had fantasized how the toe would be taken. First thought: A giant pair of nail clippers that would envelop my entire toe and chomp down to clip it off. Then a mini-guillotine came to mind, making its diagonal slice and letting my toe plop into a tiny basket on the other side.

I'm reasonably sure neither such instrument was used (or even exists).

But one of the features of fentanyl appears to be hallucinations. While lying there getting stents and balloons applied to my arteries, I could see, very clearly, an array of videogame tiles drifting downward in front of my eyes. I also believed that my fingers -- which were resting neatly by my side -- were selecting this or that tile which was altered in some way. Apparently I knew, intuitively, the rules of the game, and could play it without ever understanding what was pictured on the sepia-colored tiles.

Later, in my new hospital bed (yes, it took three days of torture lying on a stretcher to finally be admitted to a room with a bed), I could see that someone had mounted a phone-sized monitor to the left side of the bed, and there I was continuing a full-color hallucination of the game of Civilization 5 that I had been playing at home, earlier. No such screen actually existed, but it was nice to be able to play a familiar game at such a stressful time.

The amputation did not require me to be moved out of my precious bed -- they wheeled me down and the whole procedure took place on the bed.

The surgeon took my toe from behind the first knuckle, and it was trotted off to pathology to spend a few days making sure the infection had not spread too far up the toe. All clear on that.

I have not yet seen the stump of my toe, though I'm sure the surgeon did a splendid job of capping the stump and allowing the wound to heal. And I can see, by the shape of the bandages, that the toe is definitely missing. But I never felt and still don't feel even the slightest pain in that toe or its remnant. After a couple of doses of oxy, I am now taking only extra-strength Tylenol as a prophylactic against pain.

I have taken a few steps just to prove that I can, and on my first full day out of the hospieal, Friday, my wife took me to my hair stylist, to shorten my hair and to wash it, because a week of unwashed hospital hair is enough to drive me crazy. (And I have seen crazy recently enough to know when I'm being driven there.)

So I am now five days into my life-with-nine-toes, and so far, it's fine. My wife, who is always kind and helpful, has exerted herself more than I would have thought possible. I have had a couple of welcome visitors, who learned that even missing a toe, I can still talk on and on about pretty much nothing, so I have to assure them that in order to leave, they have to interrupt me and I won't be offended when they do.

I finished that game of Civilization 5 just a few minutes ago. I didn't feel like writing anything, but I also thought that if I were to write about my venture into Amputationland, I should do it now, while the memories (where I have memories) are still clear.

I have spared you many dozens of impertinent and indecorous details -- hospital life is not for the faint-hearted. I know there is a medical engineering department that designs all kinds of instruments that beep savagely, not because there is something going wrong with me, but because the battery-powered device requires being plugged in to recharge. These beeps can continue hundreds of times (I counted) without ever being noticed by any of the nursing staff.

When I summon them, they are very understanding as they come in and stop the beep. Sometimes it resumed again as soon as they left the room. Other times it remained silent until I had finally drifted off to sleep.

But the staff was always patient and kind, and by swapping out this bag and adding in another, they keep me full of antibiotics and a few of the meds that could be delivered through the IV. I was offered meals that I usually declined. (The first dinner they offered was a roast with potatoes that wanted desperately to be as good as the last meal my wife had cooked for me. But I declined to eat it because I wasn't actually hungry.)

Because we're in the South, every meal came with iced tea. Mormons like me don't drink tea, so I've never acquired a taste for it. They also offered a minicarton of milk, but there was no chance that it would be cold enough for me to drink it.

During the hours prior to surgery when I was ordered to take nothing by mouth, I knew I wouldn't die of thirst because I was being continuously dripped with fluids. But my mouth was so dry it was hard to pry my tongue from the roof of my mouth. That was when I was given that most perfect of foods:

Hospital ice.

Regular ice is too hard to be chipped and given to patients. You can break teeth trying to chomp regular ice.

But hospital ice comes in the form of porous cubes that crunch easily and deliciously between my teeth, bringing a splash of water into the dry arroyo of my mouth. Each new cup of ice -- shavings or porous cubes -- came to me as a gift from the angels, and no matter what else was going on or looming in the coming hours, for those minutes if ice consumption, I was happy.

If our favorite restaurants acquired the right kind of ice machine, I would gladly pay beverage prices for cups of hospital ice during a meal.

The process of amputation? I slept through it. The aftermath? I can still walk and get to the bathroom when I need to. I assume that I'll do rehab in the coming days to expand my walking range. Maybe I'll get on the treadmill pretty soon and begin the process of improving my circulation and muscle tone so that this is not only my first amputation, but also my last. I will contribute to the aesthetics of the world around me by never wearing sandals again.

And I'll post this probably disturbing essay for those strong-stomached readers who might find value in it.