A Walk with Florica
FLORICA SAT ON THE EXAMINING table, waiting for a doctor she had never met before to come in and tell her if strangers would have to take more of her leg before they could fit her with a better prosthesis. She wore a shirt with butterfly wings that spread across her chest like a sequined open heart. The 8-year-old swung her right leg back and forth under the table. She lost her left leg to the 2010 earthquake in Haiti. The prosthetic leg she received in her home country looked doll-like and clumsy. She had painted its toenails with nail polish to make them sparkle.
Pediatric ortorthopedic surgeon Brett Shannon walked in and introduced himself to Florica as a children’s bone doctor. He opened up a laptop to show her an X-ray image of her leg, which came to abrupt end below her knee. He seemed pleased with the look of the growth plates. He spoke with his eyebrows raised in optimism. She looked at him more
than at the picture of her leg bones. She seemed trusting yet wary of his confidence and her future. How could she not be, for in one of her most formative memories — the earthquake — she sat playing on the floor, when the walls came crashing down, crushing her leg.
All she wanted was to run with her friends. But the earthquake left her with only one foot to put on the ground.
The trauma would set Florica’s life on an unexpected trajectory: She could not run, but she would be carried across the Caribbean to the care of a Naples nonprofit that would find a Southwest Florida doctor willing to perform reconstructive surgery on her residual limb, giving her a new leg with which she could learn to run again.
The third grader sat fidgety on the examining table, someplace between sadness and gratitude, trying to take this all in. She knew how to be strong, not to be scared, but now she was learning she could be ambitious.
Her amputated leg looked mystical. When she bent her knee, what she had of a lower leg would curl up under her thigh, like an elephant trunk lifting food to mouth. Also like an elephant trunk, the end of her leg had a point and a lip, a reverse teardrop shape. But the point, Florica’s tibia, was going to keep growing sharper and sharper.
Dr. Shannon, who had been called in as a consultant on the case, explained to Florica that when she lost her leg, the bone did not know what happened, so it kept growing. This was good. She was young. The doctor who would operate on her leg did not want it to stop growing, but he didn’t want the bone to grow sharp and skinny like a spike, so he would have to surgically smooth the bone, contouring it to comfortably slip into the cradle of her prosthesis.
“Well, that’s a thing called scheduling. That’s really hard compared to doing the surgery itself,” Dr. Shannon said. Acknowledging that the surgery to touch up Florica’s crude amputation would be relatively simple in comparison to the financial challenge of outfitting the child with a prosthetic limb, the doctor turned to Bob Ayres, the founder of Miracle Limbs—Courage in Motion, and said, “I think you will do a lot more good than I will.”
Miracle Limbs strives to show amputees that though they have lost a limb, they need not lose hope. The 501(c) (3) has helped provide prostheses for amputees of combat, accident, diabetes and natural disaster. The organization also helps them and their families pay rent, utility bills and phone bills, hoping to ease life stresses until loved ones can return to work.
Mr. Ayres and his wife, Diana, find money to buy groceries and fill gas tanks. They build ramps and modify homes. They arrange counseling sessions and job skills training. They say Miracle Limbs is one of only a handful of nonprofits nationwide helping to provide prostheses. Doctors and prosthetic companies have told them Miracle Limbs could be the only organization of its kind, one that tends to all needs of amputees.
From the moment the Ayres met Florica, they were determined that although she had been a victim of circumstance, she would not be a victim of neglect. It pained them to see her walk. Like a bird whose leg seems to bend backward when it steps forward, Florica’s short leg bent in toward her long leg, looking like it was going to sweep her stability right out from under her. Every step looked like a slip.
Prosthetic advances could correct this “knock-kneed” gait. Florica would need a new leg every eight to 12 months. The Ayres would be there for her forevermore.
“We want to find out what she wants to be, what her natural-born talents are,” Mr. Ayres said that day in Dr. Shannon’s office. He expressed this sentiment often. “Athletics, music, whatever she wants to do, we want to help her in that endeavor.” Beyond giving her a leg, they wanted to help her find and fulfill her life dream.
Dr. Shannon tried to assure her that she would run with her friends again, consoling the room that some semblance of carefree childhood would be returned to this little girl. Wrapping up the office visit, he asked Florica if she had any more questions.
She started telling a story of when she was in Haiti. A whimsical childhood story, it was hard to follow: She’s with all of her friends — no, not all of them, just girls — they’re at school, they’re at church, they’re thirsty, they want something to drink, someone tells her something, she’s off and running, running in her memory, running in her storytelling.
That’s where Florica runs, in her storytelling. As she talks faster and faster, her eyes run with possibility, her smile runs into her cheekbones. If only she could run backwards, be standing up, sitting somewhere else on the day that wall came crumbling down.
Beneath the rubble
When Florica tells the story of the earthquake, it does not sound rehearsed. It sounds like a chore.
With a shrug and a sigh, her body seems to beg, “Please don’t make me tell this story again. Why do I have to tell this story, always this story, all the time?” She gives in. She rattles her arms and makes the sound she has attached to her memory of the earthquake: “Gudugudugudugudugudu!”
When her father, Gaethjens, flew to Florida to sign custody papers over to his sister, hoping Florica would find a better life in Immokalee with her aunt, he told a different story. Florica was not living with her father at the time of the earthquake. She was living with her mother. It typically took him a half hour to drive to their house. The day of the earthquake, it took him four hours to walk there. He saw the house in shambles. “I think she die,” Gaethjens said of his daughter. (Miracle Limbs asked Florida Weekly not to print the family’s last name.)
The house collapsed; he could not find her. According to Gaethjens, when communications were back up three days later, he received a phone call. Florica was in a makeshift hospital of tents. He said medics were not giving her medicine because she had no money. He ran home, fetched the equivalent of $100 and had Florica transported to another hospital where doctors told him they would have to amputate her leg to keep an infection from reaching her heart.
‘Mom, don’t cry’
Bob and Diana Ayres first met Gaethjens at his sister’s apartment in Immokalee on a rainy day. Florica was the subject of conversation. She sat on the couch. Her hair was braided in ponytails, clipped with barrettes. She fiddled with a rubber band around her wrist when she didn’t know what to say.
She showed everyone the toy she had made: a magic wand. “It doesn’t work for real,” she said. “But I pretend it works.” She told them when she grows up she wants to be a doctor. She talked about when her mom called her crying from Haiti: “I said Mom, don’t cry. Everything going to be OK. People are dead. People have arm broken. They cannot do anything. Don’t be crying, Mom, ’cause I’m OK.”
She told the Ayers she was scared, however, to play outside because there were alligators in the pond out back and if they were to chase her, she could not run away. “I think they’re going to bite me,” she said.
She sat on the couch next to Mr. Ayres. “Bob, I have to tell you something,” she said, pointing to the toe on her primitive prosthetic leg. “That is almost going to fall off.”
“Oh, this one here? Well, don’t you worry about that,” Mr. Ayres said. “You’re going to get a whole new leg. All brand new.”
He wiggled her prosthetic toe around. “Does that tickle? Does that hurt your toe?” he asked.
“No,” Florica laughed. “I don’t feel it.”
“Yeah, don’t worry about it,” Mr. Ayres said. “You’re going to get a whole new leg.”
Florica wondered if her leg would look like her new friend Bob’s leg.
A visit from an angel
Mr. Ayres was hit by a speeding car while changing a tire on the side of the road. The impact threw him more than 80 yards, shattering his legs, breaking his arms, his ribs, every bone in his body except for two fingers and his spine. After years and years of surgeries and physical therapies, he had his right leg amputated above the knee. He was angry. He started popping pills. He drank himself into a coma. He saw an angel. He knew he did not survive his accident by mistake, hence the beginnings of Miracle Limbs.
Mr. Ayres now walks with a Symbionic leg. It has a sporty, stylish, superhero look. Some might argue that war has accelerated the acceptance of bionic limbs by society, but Mr. Ayres knows society can still be unforgiving.
He remembers a woman at the grocery store looking at his leg and telling him: “If something like that ever happened to me, I’d want somebody to pull the plug.” Sometimes when people ask him if he’s a veteran and he tells them no, they cast off his injury like, “Oh, well.” He feels like saying, “Well, wait. It still hurt.”
The day before her reconstructive surgery, Florica sat beside Mr. Ayres in a waiting room. She looked up at him with her bright brown eyes that so badly wanted to believe in magic. “Is it going to be hurting?” she asked him.
He wanted to tell her the procedure would feel as soft as her pillow. He chose thoughtful words. “If you have a positive attitude it will heal faster,” he said.
“What does that mean?” she asked.
“It means you shouldn’t be sad,” he tried to explain.
“I’m not sad,” Florica asserted. “After they cut the leg, I’m going to have a new leg and I can run again. The end.”
Her thoughts turning to worries too big for her age, she asked, “How much is it going to cost?”
The cooperation of doctors and prosthetists would save Miracle Limbs tens of thousands of dollars in the mission to help Florica. Miracle Limbs will continue to provide limbs and services for Florica as she grows, spending an estimate of $8,000 to $10,000 a year, but Mr. Ayres did not want her to think about the money. “Don’t you worry about that,” he told her.
The two walked back to see the orthopedic surgeon who would do the operation. Florica’s residual limb was so tender now, she walked with crutches. If anyone went to touch her leg, she scampered back, making a whimper sound.
In walked Robert Casola, D.O., looking disheveled in his scrubs, like a man who starts work early and never sleeps enough. His comportment was that of a man who is hard on himself, like no matter how much good he does, he can never do enough.
Dr. Casola had wanted to go to Haiti in the aftermath of the earthquake, but his health kept him from it. He had bone cancer. He was immuno-compromised. Looking at Florica, he said, “This is my payback. I didn’t make it down there, but any way I can help the less fortunate, that’s what we’re here for.”
A surgeon’s artistic touch
When Dr. Casola speaks of amputation, he uses the words “limb salvage.” That’s what he put on his business card.
“An amputation does not mean a failure,” he said. “An amputation sometimes is a heroic salvage of the person.”
No matter how crude Florica’s limb salvage may have been, he feels it was courageous. “In the field, anything is acceptable,” he said. “Anything that will save a child’s life or a person’s life is acceptable, so it’s not a question of could he have done the surgery differently or what the quality of the surgeon was. He saved her life. Period. That’s all that matters.”
Other doctors who looked at Florica’s leg suggested a clean start, an above-the-knee amputation. But Dr. Casola wanted to save her knee. The next morning at Gulf Coast Medical Center, he did a technique he calls feathering, whereby he surgically elongated the muscle, like a feather, covering bones and nerves to give her residual limb a cushion.
Prosthetic professionals say what Dr. Casola does cannot be found in books, that he has an innate way of manipulating tissue and advancing muscle. He did have to remove part of Florica’s bone, as it had grown infected waiting on health-care politics to clear the way for the procedure. But Florica had her knee. Her residual limb was round. She went home with the Ayres to recuperate.
Matters of trust
A few weeks later, Florica kept asking Mr. Ayres, “How many minutes, Bob? How many minutes?” They were driving to her fitting for her new prosthetic leg.
Florica wanted a pink leg. She got Tinker Bell, a leg colored in pastel hues, emblazoned with the fairy that only exists when children believe.
Paul Weott, the owner of Orthotic & Prosthetic Centers, wanted Florica to believe in her new leg. Teaching her how to walk again, he said, “Bend your knee. Put all your weight on it. Walk through it.” It was like hearing someone say: ‘Fall back. I’ll catch you. Don’t worry. Trust me.’ Florica was learning to trust her new leg.
Within the hour she was walking backwards, taking side steps, making lunges down the hallway. She wanted to look in the mirror. Seeing herself — not yet running, but believing — she announced: “It looks pretty to me.”
Mr. Weott and his team made that pretty leg — starting with a cast of Florica’s residual limb, filling it with plaster, making a mold of her leg, fitting prosthetics to the mold, putting her in a clear test socket so they could see the inside mechanics while she walked, shaping it all up into Tinker Bell — they made a way for Florica to run with her new friends at Lake Trafford Elementary School in Immokalee.
“You’re ready to go now,” Mr. Weott told Florica.
“Yes, I am,” she said.
Looking up at him with her arms outstretched, she squealed, “Hug!”
“Oh, my goodness,” Mr. Weott stumbled. “I didn’t expect that from you. You’re a tough girl.”
Her perseverance and her spirit — rather, her magic — almost took the legs right out from under a man who makes legs.
On the ride home she turned to her driver and said, “Bob, I will never forget you.”
Mr. Ayres had no words. ¦
More about Miracle Limbs
Miracle Limbs—Courage in Motion is a Florida registered nonprofit committed to providing amputees and their immediate families the resources necessary to overcome the physical, emotional and financial hurdles that accompany the loss of a limb. Founders Bob and Diana Ayres of Naples made a list of things they need and ways you can help:
¦ Donated office space in the North Naples area
¦ Corporate sponsors for event sponsorship or annual grants
¦ An appropriate vehicle to accommodate participant and equipment transfers (preferably a compact, cost-efficient SUV)
¦ Volunteers for specific events, professional development and marketing expertise
¦ Airline travel vouchers allowing Miracle Limbs to broaden its outreach to assist veterans
¦ Personal donors, private family foundation grants, corporate grants
¦ People willing to spread the Miracle Limbs mission through Facebook and social media
For any questions, suggestions or support, call Mr. Ayres at 591-8393 or Mrs. Ayres at 300-8156, or send an email to Robert@miraclelimbs.org.
Financial contributions can be made online at www.miraclelimbs.org or can be mailed to Miracle Limbs, 6017 Pine Ridge Road, #303, Naples FL 34119.