Nurse amputee faces climb toward recovery after near-fatal accident

Feb. 22—Even through a lifetime without legs, Harriet Kay never spent much time in a wheelchair.

As a nurse, she's pushed a few. But after a car collision nearly took Kay's life last December, she'll use a wheelchair instead of the artificial limbs she depends on when she's cycling or rock-climbing.

"I never even owned a wheelchair until, get this, last year," Kay said. "When I get back to work I'll be in a wheelchair for a while."

In a career she has dedicated to helping others heal, Kay now finds herself on the other end of recovery — as a patient.

"It's so hard being on the other side because, for one thing, I know a little bit too much sometimes, you know what I mean?" she said. "You have to advocate for yourself sometimes. There are just things you want to make sure happen."

Kay can rattle off her list of fractures with the familiarity of a medical professional. Right humerus. Left radius. Right iliac crest. Sternum. Clavicle. Both femurs.

Rods and plates help keep things together.

"I got a lot of hardware," she said.

It's so much hardware that her friends in the adaptive sports community have declared, tongue in cheek, that Kay can now live up to her nickname: "Titanium Barbie."

"I really like fashion," she said with a laugh, "and for a woman with no feet I really like shoes."

Kay, 52, said she didn't realize until she was in her 30s that walking in those shoes can inspire others. Since the car wreck, she has gotten cards and letters from people she grew up with who remember a little girl in preschool unfazed by not having legs.

"I've had some other people tell me how much they admired that I was just unashamed, that I was just being me, and other things I didn't know at all, honestly," she said. "It wasn't until I was much older that I had any inkling. I had spent so much energy to be ordinary and typical that I didn't realize in actuality I was doing a lot of extraordinary stuff, and that it really inspired a lot of people."

"That Harriet is alive is nothing short of a miracle," said friend Kirby Cates, who started a GoFundMe page to help pay Kay's mounting medical bills. "But for those of us that know Harriet, she has always been a miracle."

Her hometown of Americus, Kay said, "definitely wasn't like some of the other rural places." Growing up there in the 1970s meant growing up in deep Jimmy Carter territory, where media worldwide often flocked to the sitting president's hometown of Plains just a few miles down the road.

Kay was born with amniotic band syndrome, in which strands of the baby's amniotic sac can constrict developing limbs. Initial below-the-knee amputations were performed when she was a baby, and by the time she was 18 months old she was learning to walk on her first prosthetic legs.

Not all her doctors were encouraging.

"They told my parents, 'Well, she'll likely never run,' 'we really don't know if she'll be able to walk without a walker,' 'she definitely won't be able to ride a bike,' and all this kind of stuff," Kay said. Her parents "weren't in denial, but they were just kind of like, 'We'll let her try whatever, as long as it's safe."

"And they did, thank God, because I did everything they said I wouldn't do."

Kay walked. Then she ran. Then she rode a bicycle. She did well enough in swimming lessons to earn a spot on a swim team. She argued on her high school's debate team, sang in the choir and performed in annual one-act plays.

When she left town it sometimes was for summer camp with the Girl Scouts. Other times it was with her parents for follow-up exams in Atlanta, at a facility on Ponce de Leon Avenue that many people called simply "the Crippled Children's Hospital."

"It's funny. I guess I just had this mindset of 'I'm not "crippled," so I'm not really like them,'" Kay said. "I just didn't identify that way at all. I think part of my whole thing of hard-driving is because I really wanted to be like everybody else."

She credits drawing strength and courage from her Christian faith and particularly from her mother.

"We weren't at church every time the doors opened, but we went to a Methodist church and my mom just had a really genuine faith and really believed in prayer, and that translated," Kay said. "She told me when I was born that she just kind of said, 'OK, I can't do this alone. Lord, you're going to have to help me.' To this day, she's 85 years old, she says, 'I pray for you every day.' "

In college, Kay cast about for a career until settling on nursing, graduating in 1993 from Georgia State University. After about six months working in labor and delivery, where she found it difficult to stand for long periods, she sought a specialty.

She worked for the DeKalb County Board of Health in Decatur in the communicable disease clinic, which provided early intervention for HIV near the dawn of the still-deadly AIDS epidemic. In her short stint in public health, Kay said she treated patients other nurses don't always see on regular rounds, such as refugees and tuberculosis patients. She also managed a clinic.

In 2004 she pivoted again, this time to hospice care, working as a palliative care nurse. Several years later Kay returned to school to become a nurse practitioner, specializing in psychiatry.

She also rekindled a hometown friendship. Franky Rachels attended South Georgia Technical College in Americus while Kay's father was the school's dean of students there. Years later, he would visit her in the Atlanta area. She would visit him in Augusta.

"We just reconnected," Rachels said. "We had a lot of the same interests."

"I never really forgot about him," Kay said.

The long-distance relationship got much shorter when they married in 2016 and settled in the Augusta area.

Rachels works at Barrett Turbine Engine Co. in south Augusta. Kay found a job just a few miles away, as a psychiatric nurse practitioner at Bluff Plantation, a clinic on Bennock Mill Road that treats addiction. Their jobs are so close they often ride to work together.

If they had ridden together last Dec. 3, the day might have ended differently.

"He said, 'Do you want to ride together?' and I said, 'No, I want to sleep a little longer,'" Kay said. "Also, there's an outpatient clinic that I cover sometimes. I thought I may have to cover the outpatient clinic, so I'm going to drive myself."

The couple lives in Lincoln County on property where they started building a house. Before she started on her long drive that day to south Augusta, Rachels called to tell her about a heavy blanket of fog. Soon Kay started on what she had told co-workers was, on most days, "a beautiful commute."

She never made it across the Robert W. Pollard Bridge over Kiokee Creek.

"I don't remember any of it. I remember immediately after but I don't remember the impact at all," Kay said. "I just remember waking up and seeing all the broken glass, and I remember realizing that I was hurt really bad."

She doesn't remember the head-on impact, or being cut out of her car, or being rushed to Doctors Hospital. Staff told Kay later that she was urging emergency room personnel to rush her to an operating room because she recognized she was bleeding internally.

The wreck dissected her internal carotid and subclavian arteries, she said. It lacerated her liver and tore her intestine. Her spleen was gone. Doctors told a devastated Rachels that his wife of barely four years likely wouldn't make it.

"I about bled to death basically," Kay said. "I should not have survived that."

When she regained consciousness, she said, her medical knowledge drew her situation into jarring clarity when she saw all the tubes. A tracheotomy tube helped her breathe. A stomach tube fed her. She had a chest tube and surgical drains.

Almost immediately, she said, she began participating in her care.

"I made my sister bring me a Kindle and I typed out questions on the notepad for the doctor because I was terrified, because I know what can happen," Kay said. "I'm writing all these questions, and at that point I was probably driving my husband crazy, because then he got really anxious and hypervigilant about everything."

As she recovers, one particular word keeps coming up among her caregivers.

"They have all told me I'm a miracle, every one of them," Kay said. "I saw my trauma surgeon last week and he said, 'I'm still calling you a miracle.' My vascular doctor said the same thing this morning: 'You are an absolute miracle. I can't believe how well you're doing.' "

Other recovery aspects have been difficult. The seriousness of a femur fracture takes on greater importance for a below-the-leg double amputee who relies on that bone's strength to support a prosthetic leg. Assessments are continuing to determine the extent to which Kay will be able to walk again.

Patients also often feel isolated during hospital recovery, but visiting restrictions prompted by COVID-19 conditions compounded that feeling for Kay. When she first transferred to Walton Rehabilitation Hospital for the last segment of in-patient treatment, by herself in her room, she collapsed into tears. Even today, recuperating at the home of friends, with her husband close by, tears aren't uncommon.

"It's hard to see someone you care about affected that way," Rachels said.

"I used to provide hospice care to adults in long-term-care facilities and skilled nursing facilities, and I've worked in a lot of those places seeing patients," Kay said. Remembering what isolation was like for her during COVID, "I thought to myself, 'I cannot imagine what it's been like for elderly, just quality of life, being so isolated like that.'"

"I don't feel like anyone else would've made it through this beside her because of the strength that shows every day," her friend Kirby Cates said. "She's just one of the most selfless, calm people I know. Even with our patients at work, she just has this thing about her. She truly cares and wants to help other people."

Kay is continuing in-home physical therapy. Ongoing treatment costs surpassed insurance coverage long ago, Rachels said.

Facing unknowns is uncomfortable for someone who describes herself as "a planner." But she said she has a different take on the "everything happens for a reason" cliché: Everything just happens; after all, we're fragile humans.

"But I think the part about the reason is where you really do put your faith in whatever you put your faith in. For me it's Christ. It might be different for someone else," Kay said. "When I put my faith there, I say, 'OK, I can't do this alone' — just like my mom did when I was a baby. I need help, and through that, I find the strength and the courage to keep going."

"And then usually I'll start to move forward. I'll come up with a game plan, and I'll just have this self-determination. Whether it's hard or whether it's painful, I know it's what I have to do."

One of Harriet Kay's friends has started a fundraising page to help pay medical expenses at www.gofundme.com/f/help-harriet-heal.

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