It is coming up on a year since I graduated from the University of Hartford’s MS program in prosthetics and orthotics. It’s amazing how much my life has changed and how different it looks today. Of course, many things are still the same or similar, but it’s been quite the year of growth, self-discovery, risk-taking and bravery, losses and gains, love and living, stumbles and achievements. I have had moments of true joy and peace as well if those of dark despair and pain, not much unlike any other year in my life thus far, but perhaps more self-aware and impactful. It has been a year that tested my resilience, courage, patience, forgiveness, strength, hope, and my relationships with others and myself. I feel like I’ve physically aged a lot in recent years: my health problems have accelerated, I’ve dealt with chronic stress, and my doctors and I have thrown a number of wrong “solutions” at my misdiagnosed problems. But this year in particular, I feel like I experienced the emotional growth catch-up that had been stunted from trauma, lack of self-awareness, and again, trying to slap an improper and inadequate solution on a gaping wound of a problem.
I had long been interested in prosthetics and providing mobility for those with disabilities. Now that I’ve learned about people on the spectrum’s tendency to cultivate “special interests,” I am fairly certain this was one of mine. In first grade, my best friend had cerebral palsy and I loved being the one who got to push his wheelchair or go to physical therapy with him and watch him practice walking. I thought about ways to design his chair to be more play-friendly so he could engage with me on the floor by lowering a special lever on the chair (this was sketched in markers in my notebook) without needing an adult to lift him and transport him into the beanbag. I wanted him to be able to do it himself. In second and third grade, I constantly drew pictures of a hospital scene that was simply a page chock-full of people on crutches, in wheelchairs, or pushing walkers. I’d draw various iterations of the same scene for weeks and staple them all into a book. I added so many pages that eventually I couldn’t staple it and had to punch holes and tie yarn through it to bind it together. There was a storyline: a central boy that was in a wheelchair and the various adventures he had (though everyone around him except his one friend who pushed his chair were also strangely in chairs or otherwise mobility-impaired. I think the world looks pretty different and somewhat isolating from such a position in reality). I also convinced my best friend to make stick crutches with me and practice going around my block in case we lost legs (the irony of this given my current injury-related mobility issues is not lost on me). I loved going to her house because she had a dollhouse with Playmobile figures, including a wheelchair and crutches that could clip on. I could play that for hours. I also purposely removed the arm from one of my little dolls, and would carry BJ lovingly in my pocket. I had a whole backstory for his struggle as well and would fashion ways for him to do things bimanually—my first prosthetic design.
This childhood fixation probably seems bizarre or disturbing, but hopefully these examples begin to demonstrate my early interest in prosthetics. I had carried a very real frustration with my educational and career choices. Although the root of my poor decisions cannot be entirely pinned to one problem, while an undergraduate, I opted to change my major from the premed track of biology to kinesiology (exercise science). To say I struggled with the transition to college is a gross understatement and, at the time, biology seemed like an insurmountable major that was not worth the fight.
Anyway, after years of schooling and working in fitness, even earning a Master’s degree in Exercise Science and Nutrition, I felt pretty locked into the path I had started down, yet the day-to-day job of being a full-time trainer was not only physically exhausting, it was somewhat unfulfilling for me because I was, in many cases, unable to effectuate the change I wanted to in my clients. All of this desire to do something different increased 100-fold after my attack. I needed to distance myself so far from training so as to lose the constant reminder of what happened and my fear that my vocation would perpetuate another trauma. My fears were eating me alive.
I applied to a host of programs and positions, hoping someone would take me and shake me out of my desperate situation, but I lacked confidence that anything would pan out. I didn’t even tell my husband or family that I was seeking a change, too convinced I’d receive only rejections and too emotionally fragile to deal with that outcome in any way more than in my own head.
It was essentially a dream come true to receive my acceptance into the University of Hartford’s graduate program. It felt like not only my chance to change my life, but actually my chance to “redo” and get back into what I had actually wanted to do, years before my lack of confidence and challenges became impossible obstacles. This was my opportunity to run from the trauma, to free myself from the chains of my current job, and to have a career I was proud of.
The program was fantastic. It was full-time for twenty-three months with some of the best faculty and curriculum I’ve ever had the privilege of experiencing. I learned all about many of the things I had always wondered about and I was busy in such a different and new way, my day taking on entirely fresh activities and people. It commanded significant mental energy and I threw myself into my studies, which distracted me from my trauma pain. It also got me off the couch, where I wallowed in paralyzing fear, disgust, and depression for six months. I met bright peers who distracted me from my reality and made me remember what it’s like to see the world as one of opportunity instead of one of violence and threat.
Most importantly, in the end, the program led me to hold up a metaphorical mirror to myself long enough to really face what was going on and seek the help, and eventual diagnosis, I needed. Unfortunately, it took 22.5 of the 23 months to get me there, but I choose to think that the challenges and experiences I encountered throughout the program were brewing in my brain and sorting themselves into discernible categories with sufficient evidence so that I could make necessary connections to seek the steps toward the help I needed. It is because of this program that I learned of my sensory processing disorder and autism.
Ultimately, not being able to pursue the path of prosthetics and orthotics and engage in this career is a painful pill to swallow, both for my pride and self-esteem but also for my heart, as it’s a job I’d love to do. I was ripe with shame when I had to tell the professors I so respected, the friends and acquaintances still in my life, my peers at school, and even my own family, that I wasn’t going to be able to embark on the next stage—the residency (which I will explain below)—despite my sustained and honorable efforts during the program. It was embarrassing as well because I had been accepted as a resident at several prestigious sites, thanks not only to my achievements in school but to the support and connections from our esteemed faculty. I felt like I was letting them down as I turned down amazing opportunities, like someone declining an admissions offer from Harvard outright, not even to attend a different program. I was saying no to the profession.
I think that was one of my greatest frustrations with the field is the inflexibility of the residency requirement; it was a deal breaker for me. The required hours mandated a schedule that I just can’t contend with, especially in such a sensory assaulting environment. In all honesty, the only aspect of school that I didn’t like was the internship placements each semester. We had to accrue a certain number of hours of direct supervised clinical experience each semester, which took the form of one full eight-hour workday per week and one six-week full-time placement and an affiliated site in the summer between the two school years. The clinicians were all wonderful people and I loved interacting with the patients, but invariably, I found that nearly every single Tuesday (my usual clinical day), I was stricken with nausea, migraines, unmanageable fatigue, throbbing joint pain, and low-grade fevers a mere hour or two into the morning. These symptoms were particularly apparent on days I had to work in the lab, surrounded by loud power tools and machines, giant ovens melting plastic, the offensive and strong odor of carbon fiber lamination and my most hated offended, Siegleharts, a tacky adhesive used to sure up test sockets that must be stirred and stirred to create the correct consistency, all while the toxic fumes are inhaled. It seems that every preceptor’s favorite ask to task me with was, “can you go mix up the Siegleharts?” It was a miracle that I made it through the graduate program’s internship requirement. I had to make up a lot of hours and days for each placement and it took an unfortunate toll on my health and wellness. It started to become so stressful and physically damaging to me that the symptoms would linger into Wednesday and then Thursday and I’d be tossing and turning Monday night in anticipation of the inevitable pain. Instead of being relieved when I’d finally be checked out and back into my car at the end of a full Tuesday, I’d begin immediately dreading the next Tuesday, disappointed that it was now less than a week away. The irony was, as sick as internship day made me feel each week, I was unable to really identify the pattern accurately enough to determine earlier in the program that there was a striking discordance with my health and happiness and the profession’s work environment. For a long time, I was convinced, it seemed to be just a coincidence to me that I was always sick on Tuesdays. In hindsight, I think overtime, part of me was aware, but did not want to admit the issue, lest it become more of tangible truth that it already was. It was safer and more agreeable to try and ignore the glaring issue, offering a wide array of excuses to myself and my questioning friends and family.
Anyway, it’s virtually unheard of for a facility to offer a part-time schedule and compensate by extending the duration of the residency. Even if this were offered, the governing body of the profession’s accrediting agency sets limits on this accommodation and it was barely a shorter day. After the mental and physical exhaustion of the school program, my doctors said it would be wise to take a break and they cautioned me to seriously consider abandoning the path of residency was the only option to certification, which it is. It’s a behemoth of a gatekeeper—an incompatibility with my physical and emotional health needs. The sensory processing problems and the autism fatigue are the greatest offenders that render this impossible.
Then there’s the problem of support. One of the enticing but also apparently unfortunate aspects of prosthetics is that it is a unique and niche profession. There aren’t prosthetists’ offices in every town and even fewer that are certified to accept and train hopeful residents. In fact, in New England, there are just a handful of possible residency sites, which is one of the reasons that landing a good placement is an honor and a highly competitive process. The residency for which I was selected was many states away from the family I so desperately need for emotional support, especially at the burgeoning awareness of my sensory problems. Instead of moving closer to home after graduation, which both my husband and I felt was an important and necessary decision, accepting the residency would have landed us a plane ride away, in Virginia, for a minimum of two to five years.
I initially accepted the offer without hesitation: it was a pretty unbeatable opportunity and the culmination of my work and dreams during my studies. I was certainly disappointed that it was so far away, but I understood this was a definite possibility when I signed up for school, knowing full well, through research, that the scarcity of sites would certainly increase the chance that I’d need to travel for residency. Sitting at home on a computer imagining my life post-degree, two years down the road was so far removed from reality that I couldn’t gauge my discomfort and repulsion to this idea. I was still living in fear of death from the trauma, and picturing a week or month into the future in any realistic sense was virtually unthinkable. I was still unsure if I’d wake up the next morning, and more seriously, if I’d even want to. Every little thing I did each day felt like a major achievement and a surprising accomplishment, and I thought in abstract ideas rather than concrete realistic plans. My whole self-concept and identity was entirely lost in my trauma; I felt like I not only occupied a foreign body, but had a new mind. What felt unknown, I feared. I hated the changes and I longed for my old self, but that’s the thing about some monumentally devastating traumas: to survive them, you have to change. The “old you” had a coveted innocence and peace that is forever lost; at the same time, I’ve learned that with overcoming such a horrific challenge, comes deep and unparalleled strength and courage: the “new me” is braver, tougher, and more appreciative of seemingly small victories and gifts because she needed to be. I used to hate her, but I’m starting to admire her and give her a chance.
As the “doomsday” of my residency start date drew nearer, I started to panic. Words that were initially filled with promise began to form a faint picture of what my residency life would actually look like, nearly one thousand miles from home. It even became clear that Ben would be unable to join me there for “several months,” while we determined if it was a good fit and he could find a job. Even in that less informed stage, we were building in contingency plans, as the track record for my health and robustness has been marred over the past several years, and my ability to successfully withstand the physical demands of a more-than-full-time job were called into question. The sheer utterance of the word “residency” became enough to send me into complete chaos, crumbling into an emotional wreck. I would have full-blown meltdowns when we tried to plan out or talk through the coming months. I have faced many uncomfortable or even dreaded transitions in my life; it’s one of my guaranteed struggles (which is not uncommon for those on the spectrum), but for many of them, despite the disproportionate and overwhelming anxiety that characterized their lead up, in my heart I was excited enough or sure enough that it was the right decision, that I was confident I’d be okay. Not with residency. The notion of it filled my body with a sweeping wave of stifling heat, suffocating not only my physical ease of breathing but my emotional outlook and mood. I’d become diabolically irritable, moody, and despondent. I’d cry so hard that I would choke on my breath or unintentionally throw up my last meal. My sleep, while undeniably restless and problematic since my attack, became punctuated with even more nightmares: a messy blend of flashbacks from my trauma with creepy fantasy scenes from a prosthetic lab in which I had never been. In this way, we discovered my insomnia and my post-attack PTSD were significantly exacerbated with the increased anxiety imposed by the impending residency. Deep in my heart, I kept asking myself: Am I just afraid of change or being away from Ben? Am I afraid to fail? It wasn’t difficult for me to know the answer with conviction. It was difficult to admit that that (failure) was the answer because I so wanted it to not be. I wasn’t afraid of failing in the sense that I thought anything bad would necessarily happen if I did, and it wasn’t a matter of “if” I did, because I knew, without a shadow of a doubt, that I would “fail.” And that’s the operant word here. Fail didn’t necessarily mean I wouldn’t do well at the residency; it meant my body and my mind would break, maybe not literally, but certainly by all measures of practicality. The happiness, improved sense of physical and emotional well-being, and semblance of progress that I had fought and clawed so hard for were still so fragile, yet intensely important for my survival. I didn’t want to risk shaking them off and I was positive that the challenges imposed by the residency would not catapult my growth to even greater heights but would be immensely counterproductive.
As soon as I was brave enough to admit this to Ben, I started feeling like I could breathe again. I was gripped with fear of letting him down; after all, we had moved to Connecticut for me to do the program, sacrificed income and quality of life, and I had been unemployed or otherwise a non-contributing member to our financial state since the attack. School represented the promise of a successful career and a life of less penny-pinching and more affluence. I felt indebted to him and responsible for completing the loop on our investment in a better future by pushing through the residency and beyond to a career as a clinician.
So, I tried to troubleshoot the problem and seek as many alternative arrangements as possible in typical Amber fashion. I’m almost always cooking up some kind of plan or seeking any number of opportunities. As I say, you never know what may work out so it’s good to cast a wide net.
As painful and embarrassing as it was to turn down the one residency, I was fueled with motivation to reconcile the situation. I figured arranging a placement closer to home would negate some of the challenges and make the situation more plausible: a workable battle. My good fortune and hard work landed me another opportunity closer to home, about a two-hour drive and within striking distance of a reasonable commute for Ben’s job, meaning that we could live together. This had all the makings of a more feasible solution, so I again agreed and was temporarily filled with such a gulp of relief that the remaining obvious problems were muted to me. It wasn’t in Virginia and it wasn’t to be tackled in complete isolation, so I was blindly hopeful. At least for a week or two.
The elimination of my paralyzing shame of telling Ben that I needed to amend the plan restored enough courage and self-esteem that I was able to confess to my professors that I had to withdraw my commitment to the one residency for another. I was still filled with guilt, driven by my desire to repay their servitude and legwork to facilitate my success during my tenure in the program, I was disappointing them by not jumping at the chance afforded by the first position. Apologetically, I assured them that I would still work hard and make them proud, bestowing as much honor as I could to the program that so well-equipped me for a bright future in the field. I was eager to progress through the remainder of the required steps to become a board-certified clinician and excited to have an impactful change on the lives of my future patients. The initial relief that my problem-solving plan afforded wore off as quickly as the days before graduating were passing. It was only a matter of weeks before I was to move and begin my exhausting residency. Once again, I was filled with panic at the thought of my impending life. It wasn’t what I wanted because it wasn’t what felt right for me.
I asked my therapist to help me evaluate and understand what was going on. She strongly encouraged me to see my physician and request medical accommodations at the site for some of my health issues. I figured she was right; I had long since tried to force myself to meet all requirements and expectations “normally,” but I had some real and serious hindrances. It was through that process of determining what accommodations would be beneficial yet not incompatible with the job requirements that the sensory processing issues and autism were diagnosed, after a trail of appointments, testing, and specialists were seen. That journey is best saved for another day, but the outcome is the same: I suddenly was given access to the more complete picture of what was going on with me, both at that time, and throughout my life. All of the challenges and confusions began to be met with more clarity. It was both a relief and a burden at the same time. It had taken me nearly 30 years to be properly diagnosed, and when I finally was, it felt like my self-concept was significantly altered overnight. Like the moments of rising after my attack, I suddenly felt like I needed to get to re-know myself, only this time, unlike the attack, I didn’t initially hate the “new” self that was emerging. I realized she needed more compassion and credit for her achievements despite the numerous and clearer barriers to her success. It was the first time since becoming a teenager that instead of berating myself and tearing myself down, I paused and granted myself just the slightest bit of grace with the incredibly stringent expectations that I normally hold myself to. That perfectionist attitude isn’t lost overnight, but it was at least relaxed just enough to give me permission to make the right decision for my psychological and physical needs, and abide by the boundaries I needed to set to respect these needs. I had battled long and hard enough, particularly after surviving the attack, and I just needed to let myself choose the less popular or esteemed route. I had to walk away from prosthetics, at least for some time. My journey of emotional healing from my trauma was only just beginning and my journey towards cultivating an environment and life that supported the needs imposed by my neurodiversity had not yet begun.
Much of this came to a head the Tuesday before graduation. In light of everything going on, my husband and I decided that indeed a residency was not the right thing for me at the time, and I politely and supremely apologetically declined the second offer. I had no alternative plan. The future was a completely blank canvas, save for the dozens of occupational therapy and social/behavioral therapy appointments that were scheduled to begin helping me work on various challenges of the new diagnoses. I desperately wanted to cancel my plans to attend the graduation ceremony. First and foremost, I knew it would be long and boring, crowded and over-stimulating, a recipe for a very Amber-unfriendly event. I also hate attention so I didn’t want to walk across the stage. Most importantly, I seriously questioned whether I deserved to march and receive my diploma, both because I felt ashamed that I wasn’t going to be doing residency any time soon, if at all, and because as much as the new diagnosis helped me see myself in a new light, it also made me feel “disabled” and undeserving of success. I am not entirely sure why; I know that people with all sorts of challenges and abilities can achieve great feats, but it’s different for me somehow. My own self-esteem is so low, and has been for years, that I don’t naturally grant forgiveness for my own weaknesses or mistakes; and that’s a gross understatement to how I viewed my participation in the prosthetics program: a mistake. I felt so stupid for “wasting” two years of my life fully dedicated to a career that was not viable for me. I felt even more stupid for not knowing how to identify and then articulate my challenges. It was Ben who helped me see how short-sighted this blame was. After an emotionally painful conversation in which I was completely vulnerable in how I felt regarding everything going on, Ben helped me see that the program was not at all for naught. In fact, it had saved me. Before receiving my acceptance letter from the program, I had no desire to live and I certainly wasn’t engaging in a life that could be considered living, beyond the basic biological definition. For all intents and purposes, I was so broken and hopeless after the attack, so traumatized and disenfranchised, that I was often mad at myself that I had pulled my body up from the floor after the attack and ultimately saved my own life. In many post-attack moments, I figured it would have been preferable and easier to die. The prosthetics program completely changed that. I not only enjoyed my day-to-day life much more again, but I saw reason and relief for my survival. It renewed the sense that every human should have: that life, even when impossibly challenging, is worth living. When that basic operating premise disappears, it is so far beyond scary that I lack the vocabulary to convey it.
During the program, I re-learned to trust people, particularly men. Despite my social challenges that come part and parcel with the autism, I tried to make friends. Prior to that, I vowed that I never wanted another friend because the risk of a possible attack was not worth the reward, so the valiant effort to be social and make meaningful relationships was a big achievement. I learned to dream again, to love myself and others, and be grateful for my strength. The twenty-three months of hard work and focused studying may not have been leading me to the next logical step on the path, but it did pay me in dividends, just in a different form than most people would have assumed. Ben and I decided that needed to walk for me and for us. No contests are fought in solitude, and this one was no exception. My graduation was as much my own accomplishment as that of Ben’s (or my mom’s). After all, he had been the one I considered when deciding if my life was worth salvaging and he had been the sturdy rock above me, from which he offered an endless number of hands to pull me up and steady me when I stumbled in my physical and then emotional recovery.
As I sat under the large circus tent during my graduation ceremony, I was surrounded by twenty of the most interesting and hopeful peers. Moreover, there were hundreds of excited graduates from other departments, excited to take to the stage and receive their diplomas for all of their hard work. They couldn’t wait to embark on the careers for which they had so long been dreaming of and working towards. Parents, friends, and family surrounded the periphery of the huge tent in countless rows of chairs. There was a dizzying sea of people I had predicted and part of me really wished I had heeded to my wish not to come. Only two of them knew my secret. I didn’t know how to appropriately broach the subject with my peers who were all too excited to be taking the next big step and I didn’t want to rain on anyone’s parade, so I kept to myself, a familiar position anyway.
When my row was finally in queue to receive our diplomas, my heart was racing. I felt like a fraud and once again, I was flooded with feelings of “undeservedness” and shame. I looked to Ben and my mom, who were clearly talking quietly but excitedly that the boring ceremony was about to experience its five seconds of interesting air time. While everyone else’s fear was just that they would trip while walking across the stage, I was worried that someone would yell, “you wasted your degree!” (which, incidentally, is what one of the residency directors shamed me by commenting). When the dean called my name, all of this vanished. Suddenly, I stood tall and proud, as if endowed with the task of proudly receiving my diploma. There are pictures capturing the moments that I traversed the stage. My smile is so genuine and so rich that it appears my whole body is smiling. I shook the dean’s hand with conviction and as I posed for my photo at the far end of the stage, my sole thought was, “good job, kid”—an exceedingly rare self-directed compliment.
Nearly a year later, my life looks very different but I’m okay with that. In fact, I’m generally trending toward increased happiness. I am beyond grateful for the gifts in my life, both in terms of people, opportunities, and my own unwavering ability to eventually turn toxic lemons into the sweetest lemonade. I still have so much healing and growing to do, and that need is not lost on me. In fact, it becomes more clear to me that I bury some of the deepest and hardest parts of my trauma instead of working through them, but I’m getting there. It’s been the most trying and rewarding year in many ways.
I still feel a major loss regarding my prosthetics dream; it remains a devastating heartache. It is a loss; the acknowledgement and acceptance of the fact that it’s not compatible with my current (and likely future) means that that goal is unattainable and I have to re-envision a life that I will be happy with and proud of. And I’m doing just that, one day at a time, with my trusty companion, my copilot, the wind in my sails when my own winds are flagging. The other day Ben so astutely commented that marriage is largely about taking care of one another even when it’s hard. It feels like he’s been dealt an unfair hand, but if anyone or anything has the ability to restore my faith in humanity, it’s certainly Ben’s loyal and staunch support, patience, guidance, and love. Extending beyond ourselves as a cohesive unit, I am also learning to reach out to other family and friends for support and connection; some of the most meaningful relationships over time have their genesis in unfortunate or otherwise strange situations or between unlikely participants so it is good to cast a wide net and accept any and all love and connection offered.
Lastly, I am trying harder to respect and value the person that I am, the needs that I have, and the decisions that will bring me the most happiness, even if they are unpopular or confusing to others or otherwise feel like they are letting myself or someone else down. It seems that is the first requisite to improving my self-esteem and building a life that gives me fulfillment, happiness, meaning, and peace. As Steve Jobs so wisely stated: “Don’t let the noise of others’ opinions drown out your inner voice. And most important, have the courage to follow your heart and intuition.” Right now, I’m happy to be alive, I’m grateful for the life that I have and the people in it, I’m enjoying my job and exploring different hobbies and interests, and I’m hopeful that my growth and strength will continue to create a future that is healthy, meaningful, and rich in the things that truly matter.