The Art of Replacement

In late 2017, Mick O’Dowd’s life changed in the span of a single Christmas day. What he initially dismissed as a “bad dose of the flu” and a nagging twinge in his glute—something he attributed to getting older—was actually the onset of septic shock. The following eleven months were a grueling odyssey through intensive care, the burns unit, and rehabilitation. Mick emerged as a bilateral upper and lower limb amputee, facing a world that was suddenly, profoundly different.

I recorded a conversation on Saturday with Mick for the podcast I’m working on about limb difference and limb loss, The Limb Shift.

One of the most profound shifts for Mick was internal. When faced with the reality that he could no longer cycle or scuba dive—hobbies that defined his physical identity—he had to lean on advice that became his North Star.

“I think the biggest tip I got from a psychologist was you have to realize what you enjoyed before and find a replacement for it… You’ve got to acknowledge you can’t do them and then work out why did you do them and then try and find a substitute or a replacement.”

For Mick, that replacement was the water. While cycling was gone, swimming offered a new path to fitness; while scuba diving was no longer an option, sailing provided a new way to be on the ocean.

The transition to “finding a substitute” wasn’t immediate. A tracheostomy kept Mick out of the pool for seven months, a period where he literally had to tape his neck at night to prevent air from leaking while he used a CPAP machine. When the hole finally closed, his first stop was Bexley Pool in Sydney.

Mick recalls the initial fear of getting back into the water:

“First time I got in the pool. Yes [I was scared]. And because I had the flotation devices, but it still felt—I mean, it felt great to feel weightless, but, yeah, I was quite nervous.”

He started with polystyrene neck rings, progressing slowly under the guidance of an exercise physiologist (EP). Today, Mick’s routine is anything but simple floating. He swims laps in a 50-metre pool with custom-adapted fins on all four limbs. On Wednesdays, he performs a routine that sounds exhausting even for a non-amputee: swimming laps interspersed with treading water for two minutes while wearing three kilograms of weights around his neck to strengthen his core and open his shoulders.

If swimming provided physical and mental release, regaining his driver’s licence provided literal freedom. However, the process was a bureaucratic and physical marathon that took four years to complete.

Using a Volkswagen Multivan with a lowered floor and complex hand controls, Mick had to rewire his brain to drive. The steering is managed by his right arm, while the brake and accelerator—which work on a “push to brake, pull to accelerate” safety mechanism—are managed by his left.

“The controls are just… it’s not natural. Like it’s not after driving a car—it’s really difficult because the brake accelerator is actually opposite to your wheelchair… My brain would kick back into how I used to drive. So sometimes I’d be going around the corner and I’m still turning. It’s like, ‘Oh, I’ve got to steer out of this.'”

While some amputees use body-powered prosthetics, Mick committed to mastering myoelectric limbs. These devices rely on residual muscle signals to trigger movement, a feat of coordination that Mick describes as one of his greatest achievements.

“That muscle could have moved your wrist previously or it could have been your thumb. That’s what they’re picking up on. And then you have to train your brain to use that muscle to control your prosthetic… It took literally years before I mastered it. It’s like I used to drop things continuously.”

Even now, he admits that when he gets tired, a forkful of dinner might still end up on his shirt. It is a constant reminder of the “patience” he cites as the most important lesson of the last ten years.

Life now is a “good routine” centered largely on his ten and thirteen-year-old children. Mick takes them to school, handles the shopping, and plans family holidays. Last year was Japan; in a few years, they hope to tackle Europe.

For Mick, the planning is exhaustive—checking for wheelchair-accessible taxis in Paris or patient transport services in Tokyo—but the effort is the point. He refuses to spend his days “moping” at home. His message to others facing similar battles is one of grounded optimism:

“It’s not easy to adapt to it, but you just have to keep trying… It might not be what you envisaged at the start, but there will be a solution for you and just keep working towards those goals.”

I really loved chatting with Mick, and look forward to when I can share this conversation in full, later in the year.

https://www.abc.net.au/news/2023-04-10/mick-o-dowd-s-life-without-limbs/102182894