Amputation; Artificial limbs; Orthopedics; Surgery, Military
It is very difficult to make the layman understand this. He invariably
takes for granted the good will of the patient, with all of whose
complaints he sympathises, without for a moment realising that they
sometimes degenerate into jeremiads, often with an ulterior motive.
An examination by a doctor--and an experienced doctor--is therefore
necessary in order to determine under what physical and mental
conditions an amputation case can be re-educated; so that he may
understand that it is entirely to his interest to work as quickly and
as well as possible, that begging is degrading, and above all that
private charity is temporary and exhaustible; and that in consequence
he must as quickly as possible put himself into a condition to
supplement by a salary justly earned the pension or gratuity which is
certain to be insufficient for his maintenance.
It can never be sufficiently insisted upon in dealing with the maimed
that by resuming work, and on account of the functional improvement
resulting from doing so, they need have no anxiety that their pension
will be reduced, because the amount of this is based on the extent of
the injury itself and on the man's rank, and not on his profession
before he became a soldier. In the same rank the pension is the same
for a surgeon or a lawyer, if both have lost a hand.
It is a deep-seated notion, instilled into the minds of injured
workmen by the often suspicious folk who advise them, that if they
begin work before their case has been settled their pension will be
less.
It must be acknowledged on the other hand that the civil expert
is often faced with a difficulty. As our law stands--and it is
unfair--work cannot be resumed partially with provisional half-pay
followed later by whole-time work with permanent salary. This
difference is important to our wounded soldiers, who have everything
to gain by a rapid and complete re-education and whose duty it is
to do whole or part-time work while their legal position is being
arranged and before the wound, in legal phraseology, has become
"consolidated," that is to say, before the completion of treatment.
It is only fair to add that the patients are not alone to blame and
that the administration has for long been guilty of an error against
which reaction is growing, viz. delaying re-education until the time
when the local condition has become permanent and the patient has been
discharged and has received his prosthetic apparatus.
This delay is deplorable, on both medical and social grounds. On
medical grounds because in very many cases before treatment is quite
complete the addition of carefully graduated and supervised work is
an important part of the treatment. On social grounds because it is
necessary to fight in every possible way against the common tendency
of the patient to fall into habits of laziness and intemperance.
Public-domain text, read in full here on John Shaqi.
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