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.
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.
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.
