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"The 17th Surgery      One year after the Boston bombing, a maimed survivor faces the choice of amputation.            by Eric Larson                                \u201CI think I\u2019m ready to chop it off.\u201D                                Rebekah Gregory is weary \u2014 confident one moment, hesitant the next. Staring down at the stitches in her left leg, she emits a nervous laugh. \u201CI don\u2019t know. I mean, I know we\u2019ve done so much to fix it. But I just \u2014\u201D                                She pauses and looks down at the floor.                                Her doctor leans against a table, eyebrows knitted. He runs a hand through his salt-and-pepper beard. He exhales and looks out the window.                                The sound of cars from the nearby highway fills the silence \u2014 horns honk, tires screech. She bites her lip and waits for his response.                                After the Boston Marathon attack on April 15, 2013, doctors thought they could save Rebekah's left leg. One of the bombs shattered it from the knee down, destroying tissues, muscles and half her fibula in a matter of seconds. It ripped her right hand open to the bone and burned her right leg almost entirely.                                At first, she agreed to the 16 reconstructive leg surgeries, sitting through the skin grafts, the pain meds, the weeks of bed rest and therapy. She did it without much question. They know better than I do, she kept telling herself. This might work.                                But a year later, Rebekah, 26, is tired. The medical bills alone are enough to withstand. She's still wheelchair-dependent; walking is nearly impossible. And the pain from her leg is even worse.                                Her fianc\u00E9, Pete DiMartino, 29, and her son from a previous relationship, Noah, 5, were also injured in the bombings. They\u2019ve both recovered well, with wounds far less serious than Rebekah's. Noah sustained only minor injuries (Rebekah\u2019s body shielded him from the majority of the blast).                    \nDr. William McGarvey, Rebekah\u2019s orthopedic surgeon in Houston, removes stitches from her injured leg during an appointment.\n                      But Rebekah feels like she\u2019s slowing her family down. It\u2019s been a year, and the greatest piece of baggage from that day \u2014 a physical, painful reminder of the moment she and her loved ones almost lost their lives \u2014 is still attached to her body.                                Doctors are confident one more surgery could help her walk again, but she\u2019s not convinced. Her wedding is in a few weeks, and as she, Pete and Noah plan to start their new life together, it might finally be time to undergo the life-altering amputation.                                Maybe.                                \u201CI don\u2019t want to disappoint the doctors who have worked on me so far,\u201D she says, \u201Cbut I just don\u2019t know if I can do this anymore.\u201D                                          The explosion knocked Pete off his feet. From the ground, he opened his eyes and could barely see a foot in front of him. The bottom half of his pants had completely disintegrated; a black blanket of smoke enveloped him like a casket. Ash choked any senses that were still intact \u2014 sight, smell, taste.                                Outside the cloud, everyone was screaming.                                He stood up, took a few steps forward, sat down. He didn\u2019t feel any pain at first. \u201CThen I looked down and saw that some of my leg was missing.\u201D                                Rebekah had been standing about 10 feet to Pete\u2019s left, with Noah at her feet.                                \u201CAfter the shock settled, my first thought was him \u2026 my baby,\u201D she says. \u201CMy ears were ringing, I could barely hear. But I could hear him. Screaming. Crying. Mommy! Mommy! And I couldn\u2019t find him. It was so cloudy, and he was so scared. But I couldn\u2019t find him.\u201D                                She tried to stand up, fell, then looked down at her legs. For a second, she thought they were both gone \u2014 she couldn\u2019t see or feel anything.                                Rivers of blood snaked through the charred asphalt from every direction, merging in a dark red pool beneath the black smoke. Bones lay next to her head on the sidewalk. She didn\u2019t know if they were hers.                                She heard Noah scream again. He was behind her. She reached for him with her left hand, but noticed two bones sticking straight out of it, completely exposed and perpendicular to her fingers. Warm blood oozed down her arm, into the nook of her elbow.                                \u201CI laid back down. Then the pain hit. It was the worst pain I\u2019ve ever experienced in my life,\u201D she says. \u201CI couldn\u2019t breathe. I couldn\u2019t see. I honestly thought I was going to die: \u2018God, if this is my time, then take me. But please let me know my baby is okay.\u2019\u201D                    \nNoah, Rebekah\u2019s five-year-old son from a previous relationship, is wheeled away after the explosions on April 15, 2013. Her then-boyfriend, Pete DiMartino, who suffered a 90% tear in his Achilles tendon, appears on a stretcher at left.\nBloomberg via Getty Images\nGod, if this is my time, then take me.But please let me know my baby is okay.                      Seconds later, seemingly out of nowhere, Noah was next to her. He was crying and covered in ash \u2014 but he was okay. Pete\u2019s aunt, who\u2019d been standing near them during the explosion, had picked him up and brought him over to Rebekah.                                \u201CI thought it was a sign,\u201D she says. \u201DI thought, \u2018He\u2019s here, he\u2019s okay. And now I really am going to die.\u2019\u201D                                His aunt embraced her tightly, repeating, \u201CStay with me, okay? Stay with me. Tell me your favorite memory of Noah. We love you so much. We\u2019re here, we\u2019re not leaving you. Stay with me. Tell me about Noah. We love you.\u201D                                What happened next was a blur. Noah was released from the hospital after five days. He\u2019d suffered only minor injuries to his legs and lower back.                                She and Pete were in and out of surgery for the next few weeks. They talked via FaceTime about a week after the attack. \u201CWe were so out of it, though. I don\u2019t really remember what we talked about,\u201D she remembers.                                Pete was released from Massachusetts General Hospital after 17 days. The bomb tore off 90% of his right Achilles tendon. Second-degree burns covered more than 10% of his body. He went to a rehabilitation center in Boston until the end of May, then moved back to Rochester, N.Y., to stay with his parents and continue therapy. Now, despite the black scars that run up and down his legs like burst veins, he\u2019s able to walk without a limp \u2014 without much struggle, too.                                Rebekah remained at Beth Israel Deaconess Medical Center in Boston for 39 days undergoing various reconstructive surgeries, then transferred to Memorial Hermann-Texas Medical Center in Houston for three weeks. There, she developed osteomyelitis, an infection of the bone marrow. She recovered, then moved in with her mother and stepfather in Katy, Texas, where a home health nurse watched over her for the next eight weeks.                                \u201CIt just dragged on and on,\u201D she says. \u201CAll of it, for me and Pete, just felt like this ongoing movie that we couldn\u2019t get out of. It never ended. It still hasn\u2019t.\u201D                    \nRebekah's left leg has undergone 16 reconstructive surgeries over the past year. It still hurts, \u2018like an 11 on a scale of 1 to 10,\u2019 she says. She\u2019s considering amputation.\n\nAll of it just felt like this ongoing movie that we couldn\u2019t get out of. It never ended. It still hasn\u2019t.                      In the appointment room today, Dr. William McGarvey, Rebekah\u2019s orthopedic surgeon, looks away from the window and asks her to stand. Reluctantly, slowly, she does. Tears spring to the corners of her eyes; her body begins to shake. The skin on her leg, between the scars and stitches, turns purple. She sits back down.                                 Resting, standing and sleeping \u2014 it doesn\u2019t matter, she says. Everything hurts, \u201Clike an 11 on a scale of one to 10.\u201D                                She\u2019s been taking pain medications regularly \u2014 Tylenol 3, Cymbalta and Celebrex \u2014 but admits they\u2019ve only been temporary solutions. Minor distractions, at best, from the seemingly endless pain.                                The main problem is Rebekah's foot is drifting inward. The bomb destroyed tissues and bones, and because of where they\u2019re missing, the tendons have nowhere to attach. As a result, they're pulling from the inside of her ankle.                                There\u2019s still shrapnel from the bomb inside her leg. Sometimes, she says, a small piece of metal or BB will lodge out of her calf while she\u2019s sleeping.                                Dr. McGarvey\u2019s hope is that one more surgery will stabilize her foot and help it stay flat on the ground. Still, there\u2019s no guarantee it will mitigate the pain.                                \u201CYou\u2019re the one living through this difficult situation,\u201D he concedes. \u201CIt\u2019s your decision to make.\u201D                                He stands. \u201CLet\u2019s talk amputation.\u201D                                          In total, 16 survivors had one or both legs amputated after the bombing. Most were treated in the first day or two following the attacks, and the rest shortly afterward.                                Heather Abbott, 39, a human resources executive from Newport, R.I., lost her left heel in the second explosion. Doctors immediately admitted her to surgery, but by the following Friday told her the leg likely wasn\u2019t salvageable. It would be shorter than her right leg, and probably mangled. She'd never be able to walk, much less run. They suggested amputation.                                After some thought, she agreed. \u201CIt would have just been a burden to keep it.\u201D                                Another survivor, Adriane Haslet-Davis, 33, a dance instructor from Boston, made good on her vow to dance again after she lost the bottom half of her left leg during the bombing. At a TED Conference in Vancouver in March 2014, she performed on stage with a prosthetic limb. Soon, she hopes to appear on Dancing with the Stars.                                Erika Brannock, 30, a preschool teacher from Baltimore, Md., had her left leg amputated the day after the bombing. \u201CIf I\u2019d kept my leg the way it was, everything now would be even harder,\u201D she says.                                She and Rebekah were the last two survivors to leave Beth Israel. Even back then, she remembers, Rebekah was considering the amputation that still haunts her today.                                \u201CAt some point, you just need to move on with your life,\u201D Erika tells me over the phone. \u201CIf your body\u2019s telling you that you can\u2019t try anymore, that you\u2019re just too tired, then you need to listen to it ... If she feels deep down that it\u2019s the right move, then it probably is.\u201D                    \nThe bomb tore open Rebekah\u2019s left hand and exposed two of her finger bones. The scars are still visible.\n\nAt some point, you just need to move on with your life.                      Most of the survivors meet every few months back in the Boston area, to socialize, to share how they\u2019re coping with their new lifestyles. Rebekah has kept in touch with some via email and Facebook.                                Ultimately, Rebekah feels she\u2019s playing catchup to everyone else \u2014 people like Erika, Heather and Adriane who have spent the year successfully adjusting to their new prosthetics and moving on.                                At her home in Texas, she only feels more alienated. And still, she's not convinced.                                          Katy, Texas, some 20 minutes outside of Houston, sits in the center of suburban sprawl that seems to reach hundreds of miles. Strip malls, hotels and chain restaurants line the endless stretches of intersecting highways, some stacked four or five high like bunk beds.                                Rebekah and Pete\u2019s house is a handsome, two-story brick complex. It\u2019s a newly developed area. Most of the houses in the neighborhood have been built within the past 10 years.                                Inside, their home still smells like fresh paint. The living room glows with afternoon sunlight that seeps through the patio door to the backyard. It houses a beige rug and a pair of leather couches over dark-stained, hardwood floors. A sign on the mantel above the fireplace reads \u201CWelcome, Y\u2019all.\u201D                                Rebekah lies on one of the couches. She\u2019s not feeling well today, but still greets me with a smile.                                \u201CI\u2019m just a little exhausted, I guess. I\u2019m always so out of it lately.\u201D                                She\u2019s had nightmares for the past year. Every two nights, almost on cue, they creep into her dreams. The theme is always the same: Someone is trying to kill her and her family.                                The night before, she dreamed Pete was carrying her through a barren field as bombs exploded on the ground behind them. Noah ran alongside them, grasping for her hand as the fiery eruptions and violent debris traced their every turn, getting closer, louder, with each blast.                                \u201CIt\u2019s always the three of us,\u201D she says. \u201CAnd there are always explosions \u2026 Sometimes we\u2019re back in Boston, sometimes we\u2019re in a random field or desert. But there are always bombs. Every time, I wake up thinking I\u2019m going to die.\u201D                                It\u2019s March 18, just a few weeks before the wedding. Rebekah\u2019s gown arrives in the mail. We\u2019re at her mother\u2019s house, just a few doors down from hers, and the two are eagerly unwrapping the box.                    \nRebekah and mother, Tina, admire Rebekah\u2019s wedding dress at home in Katy.\n                      The subtle white floral patterns of the dress flow into a long train at the bottom. She grabs her crutches and walks into the bathroom to try it on. A minute later, she opens the door to show us.                                \u201CIt\u2019s a little big, but there\u2019s still time to make adjustments,\u201D she says with a shrug.                                She pauses in thought: \u201CI still don\u2019t even know how I\u2019ll be getting down the aisle. These crutches, maybe. Or one of those carts. I have no idea.\u201D                                As her mother helps her hang the dress back up against the closet door, Rebekah stops to look at it one last time, before it goes upstairs. Her eyes fixate on the patterns as she leans back in her wheelchair. Her shoulders relax; she exhales softly.                                For a moment, her leg is the last thing on her mind.                    \nPete drove from Rochester, N.Y., to Katy, Texas, in October 2013 to surprise Rebekah with his proposal.\n                      Back at the hospital, Rebekah is overwhelmed. \u201CAnd tired. I\u2019m so tired.\u201D                                Dr. McGarvey nods. There\u2019s no rush on making a decision about the amputation. With the wedding approaching, he tells her to put it on the back burner \u2014 for now, at least.                                \u201CThis is your life. Your leg,\u201D he says, smiling for the first time during the appointment. \u201CYou know what you want to do. But for now, just take a break from thinking about it and start your new life.\u201D                                As she leaves the hospital, a handful of nurses stops her in the hallway and congratulates her on the upcoming wedding. She smiles and thanks them, wiping the remaining tears from the corners of her eyes. Her face brightens up as she tells them about Noah and Pete.                                During a phone conversation the next week, she tells me Noah broke down when she mentioned her possible leg amputation.                                \u201CI try to explain to him that I\u2019d still be the same person with a prosthetic,\u201D she says. \u201CThat I\u2019d be able to walk and run, to play with him again. But he\u2019s so scared just thinking about it.\u201D                                Noah and Pete may have healed physically, but Rebekah still carries the burden of their full recovery. Especially Noah hinders on her well-being, or so she thinks. Until she\u2019s back on her feet, either with the help of another surgery or a new prosthetic, the family won\u2019t fully be able to move on.                                Over the phone, she sighs and repeats Dr. McGarvey\u2019s advice out loud: \u201CTake a break. Focus on starting your new life with Noah and Pete.\u201D                                For now, she will. And so will they.                          The 17th Surgery            by Eric Larson                                              Share              Tweet                                                                              "^^<http://www.w3.org/2001/XMLSchema#string>
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