My first years in the business:

After release from active duty with the United States Air Force and transfer to the reserves in the summer of 1964 I was ready to start a new career in prosthetics. My dad, retired US Army, and now working as a civilian in the Inspectors Generals Office 5th Army, knew someone who knew Jack Armold, PhD, Director of the prosthetics program at Northwestern University. This then was my track into a new pilot program that Northwestern would be starting in a few months for young people wishing to become prosthetists.

Following interviews and aptitude tests I was instructed to find a local apprentice job in prosthetics until classes start in the fall. Being a candidate for the new prosthetist pilot program at Northwestern was a plus in locating a job and I was soon hired by the Bardach-Schone Company located at 106 S. Canal in Chicago. This store font limb shop was two blocks north of Union Station and just a few blocks from Chicago’s skid row where the mass murderer of student nurses, Richard Speck, was found hiding.

The Bardach-Schone Company was owned by Mr. Waldmar Schone, CPO, his partner Mr. Bardach having passed away many years before. Waldmar, a jovial rotund German gentleman with an above the knee amputation who enjoyed making unsociable noises by releasing air from his suction socket prosthesis, did not spend much time at the shop. His nephew Harold, a few years older then I, was working toward his certification as a prosthetist after traditional training at Northwestern but did not have any say in the workings of the company.

My work station (bench) was located at the end of the shop next to the water heater with a window that opened onto a space that permitted steam from the dry cleaners next door to come in. The dry cleaning store was owned by George and his two single sisters from the old country. The sisters dressed and had hair styles straight from the 1940s.

At the bench next to mine was Vula who was from Yugoslavia and had a below the knee amputation. He was a true artist and artisan, and taught me much about the "art" of prosthetics. It was said he did a portrait for King Peter of Yugoslavia at one time. He was single but very active sociality within his church where he had a room for lodging. Vula had the ability to shape a prosthesis so that it was lifelike. I have an example of his work as part of the artificial limb exhibit at the VA Medical Center in Minneapolis.

Vula had no formal training in prosthetics and his education was strictly OJT, but he was able to carve out a full below the knee prosthesis from one piece of wood, and often custom made feet for prostheses.

Next bench over was Pete also from Yugoslavia and an above the knee amputee. Pete was tall, lanky, and had attended one of Northwestern's short term courses for fitting PTB prostheses. For reasons unknown to me and before my time Pete and Vula did not speak to each other, and they would only converse through a third party. Like most prosthetists of the time he wore a prosthesis that was unfinished, but always a work in progress.

Facing Pete’s bench was Carl from Germany who had a deep scar on one arm, but he was not an amputee. He was the shop’s leather man and did the leather work and sewing that was needed to finish a prosthesis. Carl was a bit of a mystery. He had a green card, which authorized him to work in the U.S., but he didn't seem to like Americans.

The shop foreman was Gunter Gehl, CP a certified prosthetist born in Germany but younger than the others. Gunter would later become an instructor of prosthetics at Northwestern after a falling out over the inheritance of the company following the death of Waldmar Schone.

The company was managed day to day by Jack Hensley an above the knee amputee from southern Illinois. I never did know Jack’s background for running the company, but he kept an eagle eye on the front office and did not tolerate any prying eyes - your job is in back stay there.

I recall one time when I saw a copy of the O&P Almanac published by the American Orthotic and Prosthetist Association (AOPA) laying out and started to look through it. It was then that I learned that the publication was for shop owner’s eyes only! For many years the O&P Almanac was a publication that only shop owners had access to. As a prosthetist working in the industry I was not privy to insider news and information relating to the trade I worked in. It was not until 1970 that individual prosthetists and orthotists working in the trade would have a voice in the industry with the founding of the American Academy of Orthotists and Prosthetists.

Next but not least was Carmen the secretary/receptionist, and all around office manager. Carmen was wiser and older beyond her years and ran the office with an iron fist. You would find her before we opened in the morning having a cigarette at the bar on the corner, and by ten she would have a highball on her desk. Her desk had a glass top that covered photos of our artificial limb customers many of them children from the Shiner's Hospital with which we had the contract. Carmen wore billowing dresses and would come in back to adjust her nylons while standing in the middle of the shop rather then using the restroom.

The uniform for the shop was company issued white bakers pants with a button fly front, white T-shirt, and a pair of worn shoes covered with gunk and white glue. Carl and Pete wore a butcher’s apron over top. Not the designer shirts, ties, and lab coats we see today. Of course this was cool in the summer as we did not have air conditioning in the shop, nor did we have a dust collector for the wood dust generated in the making of wooden legs.

I spent time doing odd jobs like cutting and gluing together pieces of coarse sandpaper to make sanding cones for the router, or pulling the stretch out of waxed suspender cords for ropes and rollers suspension systems. I remember watching Carl pouring acetone many times from a five gallon drum into bench top dispensers with a lit pipe in his mouth.

We did not have a coffee maker so I would go to the corner bar to get coffee for everyone, sometimes paid for by one of our customers. It was not uncommon for the customer to pay a tip after work had been done on their prosthesis. In the afternoon around three we would have mixed drinks or beer that Carmen would bring back from the corner bar. Carl liked to have a six pack of beer while the rest of us enjoyed mixed drinks. Lunch breaks were time enough to finish a sandwich and then back to work, unless you were smart like Vula and went out for lunch.

Limb shops were not located in modern facilities within suburban medical centers, but in the low rent districts of downtown. Coming to work it was not uncommon to find whiskey or wine bottles in the doorway, and some times the drunk with them. Hanger was located on South Clark Street, and you had to ring a doorbell before someone who knew you would let you in the door of the shop.

Wooden legs were purchased by the customer usually at 50% down and the rest on delivery. There was no Medicare and few insurance companies paid for artificial limbs. Of course an above the knee prosthesis cost around $600. That same identical prosthesis costs thousands of dollars today.

We had amputees come in off the street with no money and would try on an old prosthesis and if it fit close enough give it to them. I recall hauling a bunch of old legs over to the J.F. Rowley building and noticing the stares I got from the people driving by in cars. It was in the old Rowley building that a machine would carve out knee/shin setups that would get shipped out of country for prostheses. This was where Ollie worked finishing knee joints that we used for our wooden socket below knee prostheses. Ollie had an engineering degree from Northwestern University, but was down on his luck and had a bed in a flop house on skid row. We even had a one-legged prostitute customer who worked the bars a few streets west of the shop.

Earning $87 per week take home pay I was able to afford a small room at the YMCA on South Wabash across from a Catholic church. The room had a single bed, desk, chair, and closet. The showers and toilets were a short walk down the hall. This was not the accommodation I had in the Air Force, but would do until I moved into Northwestern's dorm Abbott Hall at 710 North Lake Shore Drive.

I would walk back and forth to work saving money, an on the weekends walk around exploring Chicago, and in the evenings enjoy the Go-Go bars on Rush Street. However, I was able to save enough money to buy my first 35mm SLR camera replacing the viewfinder 35mm I had used in the Air Force. I used The Konica SLR for photos at work, while attending Northwestern, and learning more about photography from RICs official photographer Ed Bonk.

So began my years in the artificial limb trade.

Northwestern prosthetics was a world apart from prosthetics at Bardach-Schone. Not only were they going to teach us modern prosthetics, but they wanted us to be professionals as well. This was the OCS (Officer Candidate School) of prosthetics.

Classmates were Steve, Harold, Wally, and Ernesto. Steve and Wally were both above the knee amputees. Harold’s father owned a prosthetics business and Ernesto was from Argentina. Only Steve, Harold, and I would go on to become Certified Prosthetists practicing in the United States.

The administrators of the program were Jack Armold, PhD and his assistant Don Irish. Our instructors were H. Blair Hanger, CP, Fred Hampton, CP, and Ian Currell, CP. Mr. Hanger, A descendant of J.E. Hanger, had been an Army captain and prosthetist at Walter Reed during WW II. Fred Hampton was an innovator working in prosthetics research at Northwestern. He was instrumental in developing the VA Syme prosthesis, and fitting techniques for hip-disarticulation and hemipelvectomy amputations. Ian Currell a visiting prosthetist from Texas was formerly a prosthetist in the UK. Other visiting prosthetists from time to time were Ronny Snell, Chet Nelson, and Chuck Hennessey. Ronny Snell was one of the founding fathers of the American Academy of Orthotists and Prosthetists. Chuck Hennessey was also on staff for the prosthetics program at UCLA, and co-author of Prosthetic Principles - Above Knee Amputations. Our anatomy instructor was Chuck Fryer, MSPT. Chuck Fryer would become the sixth student in our class, and

in time would replace Jack Armold as the head of the program at Northwestern.

Our course work seemed like anatomy and biomechanics with short periods of prosthetics in between. As Northwestern was still running their short courses experienced prosthetists rotated through, and a number of friendship were made that have lasted throughout the years.

My experience before school at Bardach-Schoene did not provide me with the hands on experience that was really needed so it was like starting from scratch for many of the hand skills. This is still true today in many settings where students and residents are underutilized cheap labor. Years later as mentor I would try not to make the same mistake. I believe the student needs to be given the opportunity to practice what they have leaned under supervision with mentoring as needed to polish their skills.

This was also a time of transition for the prosthetic industry from hand carved wooden sockets to hand casting and laminated plastic sockets. There had already been the change from rawhide finished prostheses to laminated wooden prostheses. Now experienced prosthetists were in school to learn how to fit and fabricate total contact PTB sockets, and quadrilateral total contact suction sockets. As students in this pilot program we still had to learn how to carve and fit wooden above knee sockets. For the experienced prosthetists it was learning how to look at the process in reverse from what it was in making a wooden socket. They now were carving plaster of a positive model of the amputee’s stump.

The total contact process for those sockets entailed a process that took a bit of time and material. Not like today when it can be done with the click of a mouse.This was also a time before test sockets and you had to get the definitive socket right the first time.

The total contact process started with the positive model by adding a plaster buildup on the end of the plaster cast before laminating the definitive socket. Once the laminated definitive socket was fitted to the amputee you were ready to make it a total contact socket. The process was that you drilled small holes around the end of the socket and tubular cotton stockinette was taped over the holes for back pressure. Next you pulled a moist PVA bag over the amputees stump and stump socket, taped it down, and then powdered it with talcum powder to make it slippery. Dow Corning Silastic was mixed in a cup to the right density for the total contact pad. An activator was added to the Silastic and the mixture was rapidly poured into the bottom of the socket which the amputee rapidly donned as they stood up. The excess Silastic then percolated through the small holes. Once the Silastic had set the flash was trimmed away and the end pad re-inserted into the socket and then this was the total contact. A process involving venting tubes, a caulking gun and caulking gun tubes was used for total contact in above knee sockets. BK and AK total contact procedures involved both time and materials.

As students we were very fortunate to have received our prosthetic education during this time as we worked hands on with all levels of amputation, WD, BE, AE, FQ, Syme, Chopart, BK, AK, HD and HP. These were not lecture demonstrations, videos, or movies. We actuality fit real amputees with these levels of amputations for a real world experience.

Completing the course of study at Northwestern did not mean graduation. No, now we had to return to work as a prosthetist and fit 5 total contact PTB sockets and 5 total contact AK suction sockets. Now this was a time when most of our below the knee customers wore open ended wood channel sockets with joints and lacer, and our above the knee customers wore wood sockets with suspenders, pelvic belts, or suction sockets with distal air chambers. So fitting 10 of the required sockets took some time, and in between you fit a lot of the old style wooden legs before your official graduation. I was able to return to Bardach-Schone for this internship.

My exposure at Northwestern had influenced my thinking about this business and got me thinking about it as a profession, an idea that was not shared by my co-workers. I even started wearing a white short sleeved shirt over my T-shirt.

My additional duties now that I was back from school were attending the various amputee clinics in Chicago and surrounding suburbs.

A colorful figure was a limb shop owner who would excuse himself during clinic under the pretence of using the men's room. Along the way he would hand out his business cards to the amputees waiting to be seen in the Amputee Clinic. When they were seen many would ask to go to his place of business. He did not care about repeat business as long as he got their first order for a prosthesis. In time things caught up with him and he was forced to sell his business after running afoul of the Veterans Administration.

Another business owner would attend clinics impeccability dressed wearing expensive suits, and he always had a suntan no matter what time of the year. Attendance at clinics was for the purpose of taking orders for prostheses. One need not be an actual prosthetist to attend clinic.

JE Hanger Company

Prosthetist / Management trainee:

Shortly before graduation I accepted a job site unseen in Philadelphia, PA. As I walked up to the old two story building next to the city morgue I was asking myself what have I gotten myself into. The second floor had a dip in the middle and gave a little under your weight as you walked. Being the only other person then the manager on salary, and not punching a time clock did not fit well with the older employees. When asking for help the senior prosthetist would say - you’re the college kid.

Moss Rehabilitation Hospital and Krusen Research Center

Research Orthotist Prosthetist:

As part of a team we used a gait lab to do a biomechanical analysis of the functions of newly developed “plastic” orthoses. I was laughed at by the local orthotists because they all knew that orthoses were made using leather and metal not plastic. The team assembled for this project on orthotics were two occupational therapists and a prosthetist.

A second research project was a multi axial above elbow prosthesis that used pattern recognition from ten muscles to simultaneously operate all axes.

Bardach-Schone second time

Under new ownership:

While at Moss I received a phone call from Harold Schoene asking me to come back to Chicago to help him manage the company he had inherited from his uncle.

The Winkley Company

These were my years of growth.

Otto Bock Orthopedic Industries

These were the most exciting years in my career where I relished going to work, and the company focus was very much on customer service. In later years things started falling apart with the patent expiring on the ball and pyramid design. - The heart of the endoskeletal system, which gave the company a lock on the market and made it a cash rich company. Adding to this secretly setting up a nation wide warehouse system to replace the distributors. A secret that was discovered by one of the distributors accidentally during an unrelated cocktail party. This action alienated many customers leading to a company consolidation, closing of the warehouses, and staff layoffs as market share disappeared.

Department of Veterans Affairs

These have been the most rewarding, invigorating, and interesting years. It was a new and different corporate culture for me as well. - Once again serving my country helping my fellow veterans, and active duty service men and women.

Operations Enduring Freedom and Iraqi Freedom changed the VA With the introduction of the new VA Amputation System of Care program, and is leading the country in the delivery new prosthetics technology to amputees.