D&D Disability – lower-limb prosthetics (continued)

This is part of the series on representing disability in D&D.

In my previous post, I reviewed the mechanics related to disabilities in various editions of D&D, and started to look at some mechanics for prosthetics. It’s time to return to Meurtle and his trip to Domenech’s Ability Restorers.

Meurtle’s story

We left Meurtle having just stumbled through the door of Domenech’s Ability Restorers.

“Well, come on in then and let the door shut. It’s too cold to be leaving it open.”

Meurtle looked around for the source of the deep voice, and found himself facing a strange apparition. Somewhat shorter even than Meurtle’s stooped height and with deep brown, bushy hair and beard over most of the face, except for a large patch around the left cheek and eye which was completely hairless and looked melted. The left eye glittered in a jewelled socket, pinning Meurtle with a piercing gaze which made him feel he was being turned inside out.

Meurtle blushed and dropped his gaze, then looked up again quickly. Gold ankles and feet? What was going on here?

“Good afternoon. I’m Raimon Domenech. You look like you’ve been through the mill, literally, but you’ve come to the right place. Let us look after you, give you a hand and get you back on your feet. Okay, okay, it’s an old joke, but it’s also true – it’s what we do. Now, what’s your budget, and do you have any special requirements, or are you just looking for something simple and effective?”

“Er…”, Meurtle croaked inarticulately.

“No, that’s alright,” the apparition said warmly. “Come over here and have a seat.” He led Meurtle over to a padded chair with soft arms, which raised and tilted forward at the press of a button, then sank down again softly when Meurtle leaned against it, lowering him gracefully until he found himself seated. He closed his eyes and sagged against the support, worn out by his journey across town.

“I take it you’re new to this”, observed the person who had introduced himself as Raimon. “Marlena!”, he called across the shop. Meurtle looked over his shoulder to where Raimon had called and saw someone with long curly blonde hair and a light golden beard, neatly trimmed and curled, doing something with stock on an upper shelf. A faint whirring sound drifted over and she sank back down to ground level before turning and walking over.

“Hello and welcome”, she said, her voice higher pitched but husky as if she had something stuck in her throat. Meurtle found his gaze going to her neck, and noticed it was completely covered in a series of golden rings. “You look beat up. May we look?”

Suddenly Meurtle felt embarrassed. It was the reason he had come, but it still seemed a bit strange and demeaning having someone look at his damaged body. But he had no time to object because she was already sliding his trouser leg up with gentle fingers – gold again, he noticed. He drew in a hissing breath as the cloth, soft though it was, rubbed over the tender skin of his stump in passing, and then it was bunched up sufficiently and the end of his leg was out in the open air.

Raimon raised his hand to his glittering left eye, adjusting something, then bent to look. “Hmmm”, he commented. “This looks recent. Acid?” He looked up briefly at Meurtle, nodded, then went back to his examination. He glanced at Marlena, who reached out with her golden left hand and lightly touched the raw surface, making Meurtle jump. She closed her eyes, and Meurtle got the sense her attention was all in the sensations she was receiving through the touch.

“The flesh is still knitting together”, she observed, “but at least it covers the stub of bone. The acid has cauterised the wound, but it’s stretched tight and tender, and it will start cracking soon.” She lifted her hand off again and opened her eyes to look at him – piercing blue eyes, Meurtle noticed. “We can offer some salve which will ease the tightness, keep it supple and speed the healing process. Above all you want to avoid the skin cracking and letting infection in.”

She turned away briefly, picked up a jar, and returned, scooping out some of the content with her right hand. She gently smoothed it into the raw ending of Meurtle’s leg. His breath caught as contradictory feelings of fire and ice ran through the stump, before giving way to a sense of ease and comfort he hadn’t felt since the fateful expedition. He let out his breath slowly in wonder.

“That’s amazing”, Meurtle said gratefully, realising it was the first proper utterance he had made in the shop.

She smiled at him. “Let’s have a look at that arm”, she said. Meurtle hastily pulled at his left sleeve, hissing again as the cloth slid over the damaged skin of what remained of his arm. She followed the same procedure, lightly resting her golden left hand on the injury, then smoothing some of the salve over the blackened raw end. The same ice and fire sensation ran through the arm then died away, and Meurtle realised that for the first time in weeks the constant background pain had almost dissipated.

“Oh”, he sighed, “that’s wonderful!”

“Excellent”, she said. “You will need to do that every few hours for at least a couple of months to ensure it heals fully.”

“Now,” she added, “let’s talk about what’s next. Probably the leg comes first. Of course it will take a bit of time to finish healing and for the swelling to subside, but we can start measuring you up and preparing a replacement. Stand up, please.” She pressed the button on the side of the chair that raised it again, and handed him his crutches. “Now, stand straight and try not to lean on the crutches – just use them for balance.”

As Meurtle stood there, balancing on his remaining good foot, he heard the whirring again and she dropped down lower, her robe pooling on the floor, though he couldn’t see any sign of her bending over or kneeling. As she got out a tape measure with a weight on one end and dangled it next to his leg, he asked “how do you do that?”

She looked up at him. “Sorry?”, she asked.

“How do you do that? That moving up and down?”

“Oh,” she said, “this?” The whirring sound came again and she rose back to her previous height, then kept going until she looked Meurtle directly in the eye. “Extendable legs,” she said. “Very useful in the shop.” She pulled aside one flap of her robe, and he saw that both her legs were segmented metal tubes from her shoes right up into the short skirt she was wearing underneath. She continued to hold the robe open, and he watched as the legs retracted into themselves, lowering her back towards the floor. She stopped when her waist was only a foot off the ground, leaving her with her head about at the level of his waist, and got her tape measure out again.

“It’s a legacy of the same fight that lost me my eye,” Raimon said. “The fool Venerat thought he was clever. Prince Volospin Aendyr had subjected him to 20 lashes for holding his goblet in his left hand at dinner in Castle Silverston, and once he returned to his tower in the Silver Sierras he tried to summon a Balor and send it in to the Principality of Blackhill to take revenge.”

“It turned out he wasn’t as clever and powerful as he thought, but once the Balor had turned him into dragonbait, it decided it liked it here on the Prime Plane, and we were sent to deal with it. Six of us there were, all experienced in battle with fiends, and none of us escaped unscathed. Marlena lost her lower arm to its burning sword, and another massive sweep of it took off both her legs near her body, the lightning bolt that came with it throwing her clear across the clearing. I lost both feet to whip lashes, and Dionis lost his hand, though when the whip pulled him in he used the momentum to slice the Balor through the gut. Cristina used up all her magical arrows, and none of them survived its fiery aura. In the end Aleix’s Ice Storm hurt it enough and distracted it enough that Ginebra could sneak round behind and finish it off, though the blast when it exploded burned all her hair and the side of my face. In a way it was fortunate Marlena had been taken out of the fight so early, as it meant she still had enough healing left to keep us alive through the next few days until we could reach civilisation again.”

“Well, after that, we decided it was time to give up the good fight, and Prince Volospin was sufficiently grateful that we were able to retire in style. As dwarves, we had both always had a joy of crafting tools, and we developed replacements for our missing body parts and those of our friends and colleagues. Word spread, and so now here we are, the foremost specialists at ability restoration and enhancement in Darokin.”

Meurtle realised his mouth was hanging open, and closed it with a snap, then opened it again in a hiss of pain as Marlena wrapped the tape measure around his tender stump.

“Right, all done,” she said.

“Is that all?” Meurtle asked.

“Yes,” she replied, nodding. “Height off the floor, circumference of stump, size of stump in three different directions, distance from knee, circumference of remaining leg at several points. Raimon does a good job of distracting while I measure.”

“So,” said Raimon, “let me see what we’ve got in stock. We’d suggest something simple to start with while you get used to wearing one and while your stump acclimatises and toughens up.” He opened a cupboard, rummaged a bit, then returned with three boxes. “Let’s try these.”

He opened one of the boxes and took out the item inside. It was a simple turned oak pole attached to a cup on the end like a large acorn cup, with strapping coming off the cup. Marlena held a padded cloth over Meurtle’s stump (causing him to draw in another pained breath), while Raimon pressed the cup to it and fastened the strapping up the leg.

“Try taking the weight on that,” he instructed. “How does it feel?”

Meurtle leaned on it, clenching his teeth against the pain until it subsided to an ache. He felt slightly off balance.

“Hmmm. Slightly too short,” Raimon commented. He unstrapped it, put it back in the box, and took one out of the next box, a slightly darker wood this time but in much the same style. Meurtle couldn’t see much difference, but once it was strapped on he noticed the improved balance.

“That’s better,” observed Raimon. “Try a few steps. I recommend you keep your crutches for now.”

Meurtle cautiously took a small step forward onto the new leg, then tried to put his weight on it and take a step with his good leg. He wobbled, and would have fallen if Marlena hadn’t put out a hand to steady him. “Gently does it,” she said.

He took a few more cautious, shuffling steps across the floor, then a few back again, before sinking gratefully into the support of the chair, and rubbing the edge where his leg met the wood. His stump felt like it was on fire.

“You’ll need to take it gently to start with,” Marlena advised. “Practice a bit more here when you’re ready.”

“How much is this?” Meurtle asked.

“This model, the basic peg, comes in at 30 daros complete with fitting, strapping and pad, and we’ll throw in a week’s supply of the salve. I wouldn’t recommend anything more fancy until you get used to this – even one with a foot would catch and trip you until you get used to controlling a leg. It’s not like a real foot where you can flex it and move it to the right place, and you won’t feel it catch until you’re already falling.”

“Once you do get the hang of it, there are all sorts of specialist options – springs to help you jump, flippers to help you swim, blades to help you run, grippers to help you climb – and you can get more ornate versions for when you want to impress. But for now I’d suggest just the basic wooden peg.”

“Will it always hurt this much?” he asked, plaintively.

“Your stump is incredibly sensitive right now so soon after the injury, but it will toughen up,” Marlena assured him. “You can help by rubbing it with different grades of cloth – start with a fine, soft wool or silk, then when it’s used to that, progress to gradually coarser cotton, linen, and even sackcloth as it adjusts. Regular application of the salve will also help. As well as soothing, it has some ingredients which help toughen the skin. As I said, we’ll give you your first week’s supply, and more than that costs 3 daros per week.”

“I didn’t realise it would cost this much,” Meurtle complained.

“Well, you have come to the best,” Raimon replied. “You could probably find someone in the docks who could sell you a peg leg for 15 daros if you haggle, but it wouldn’t be so carefully fitted or finished – you really don’t want splinters in your stump!”

“I don’t have that much on me,” Meurtle said.

“Who do you bank with?” Raimon asked. “We’re just round the corner from Graggs. We could nip over now if you want to get started. Or you could always come back.”

Notes

Of course, Meurtle, Raimon and Marlena are figments of my imagination. But from my readings, several things have come out.

  • The stump is very sensitive to start with – the desensitising procedure is lifted almost verbatim from Jamie Andrew’s “Life and Limb”.
  • Wearing a prosthetic never gets completely comfortable in a “never think about it” kind of way. It takes time to put it on and take it off, and the tiniest bit of grit in the cup will just grind.
  • Even if everything is perfect, there will be good days and bad days, and if you wear your prosthetic for too long, or jar it, it will hurt and your stump will complain.
  • Even the best prosthetic isn’t as good as a real leg, and there are always tradeoffs. You see the blade runners in the Paralympics, but most prosthetics aren’t like that, and the blades gain springiness at the cost of stability – it’s harder to balance on them. If you haven’t got a blade, then jumping, or even doing things balanced on your prosthetic, will be much harder.

Key reading which has informed this:

  • Jamie Andrew’s “Life and Limb” (as mentioned above). Jamie lost part of both arms and legs to frostbite in a storm when mountain climbing.
  • Harry Parker’s “Hybrid Humans”. Harry is a former soldier who lost part of his leg to an IED in Afghanistan. He looks into both the history and the latest advances in robotics, tech and implants, and also talks about the impact on his life. It was his description of the Cybathlon at a trade show which brought home to me how underwhelming even the most advanced prosthetics are compared to real legs (see pp107-108 in the chapter “Freedom is expensive”).
  • The Cormoran Strike series. Cormoran is a former solider who lost part of his leg in Afghanistan, and the author has done a lot of research talking to similar veterans to make his life with a prosthetic realistic. He is always pushing beyond what is sensible for his leg, and then having to live with the dull ache and aftermath.

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