In the first horrific moments after the Boston bombing, with smoke still billowing around the wounded, I know what is going through the minds of the maimed victims.
They are at once conscious and unconscious. They want to scream, but they cannot scream. They want to wake up from a nightmare, but they are awake.
Overcome with a sense of deja vu, I feel my past converge with the future of those wounded spectators.
I lost my leg in a bomb blast. I know the violent shock of a day that begins well and ends with an amputation, the fog of drugs and surgery, the months of painful rehabilitation.
I know the suffering that lies ahead for these people in Boston. And I know the possibilities, too.
For those who lost a limb or more in the Boston Marathon, Monday, April 15, 2013, was the day their world changed forever.
Mine changed on Tuesday, Aug. 11, 2009. I had been embedded with the U.S. military for two weeks in southern Afghanistan as a photographer for The Associated Press, and this was to have been my last patrol before going home. It had been a long day in the open desert of Kandahar province and I was whipped, barely awake, in fact, when our eight-wheel armored Stryker vehicle hit a roadside bomb and flipped over, knocking me unconscious.
When I came to, I tried to get up but couldn't; my left foot was hanging by a few tendons. I felt brutal pain, like an electric shock, that began in my leg and swept through the rest of my body. Lying inside the vehicle, I thought of my wife, and willed myself to stay alive.
Eventually, a soldier found me and tied on a tourniquet.
In my years as a photojournalist, I'd taken many pictures of wounded soldiers and victims of suicide bombers. I had covered medical evacuations from Afghanistan, Pakistan and the Palestinian territories, and found it odd to suddenly be among those pulled from an inferno and carried on a stretcher — along with two other soldiers and AP Television News videographer Andi Jatmiko.
They loaded me onto a helicopter next to a soldier who had lost both of his legs and we locked hands as the chopper took off for the provincial capital of Kandahar. The solidarity in that moment is the last thing I remember before waking up in a hospital tent to find my left leg had been amputated below the knee. There was no option to save it, doctors told me. Bone and tissue were destroyed by shrapnel. But fortunately my knee was intact, and that would make a substantial difference in my future mobility, they explained.
That offered little comfort as I lay alone and exhausted in a hospital bed in Afghanistan. I had so many questions about life with just one leg but I preferred sleep to thinking about my uncertain future.
The difference between those who lost limbs in Boston and me is that I knew I was taking a risk in a war zone and assumed it willingly, while they had merely gone out to cheer friends and relatives at a family sporting event.
They weren't supposed to be in danger.
I was a photographer documenting soldiers at war and everyday life for civilians under fire. But before violence grabs you, does anyone really believe he will become one of the dead or wounded? No. Nothing had happened to me on dozens of previous patrols with the military through hostile lands. And while I suspected I was playing a kind of Russian roulette, I also told myself that car accidents happen every day and most people don't stop driving because of that.
For months after the explosion I was tortured by so many "what ifs." What if I had stayed back to pack rather than going on patrol that day? What if I had sat a little bit to the right, would the shrapnel have missed my leg? Or if I had sat to the left, would I have lost both legs like the soldier next to me?
I imagine those in Boston whose bodies were torn up by nails or the blasts have similar thoughts: Why didn't I stand at mile 25, go for water, leave earlier, stay home? I would like to tell them that these questions fade as one begins to accept the reality of losing a limb.
The morphine they gave me to dim the pain of my amputation sapped my energy. I wanted off it so I could start my recuperation with all my strength and walk as soon as possible. I am a Spanish citizen, not American, and was lucky that the AP was able to work bureaucratic miracles to get me admitted to the Walter Reed National Military Medical Center, one of the world's best rehab hospitals.
In Afghanistan, I had visited a rehabilitation center run by the Red Cross in Kabul that was considered one of the best in the country. The hospital was one of the few that provided prostheses to patients, including children, who had been blown up by forgotten mines in rural areas.
It's nonsense to compare Walter Reed with the Red Cross center; it is like comparing day and night. However I never stop thinking about those Afghan patients and how they were facing their rehabilitation process even in that calamitous center.
I appreciated even more my luck in Walter Reed and I realized that fate is marked by where you are born.
I was 40 years old, agile and in good shape from exercise and work as a photographer in rough terrain. I even used to jog in the Afghan capital of Kabul when I lived there. So just a month after the explosion, I threw myself into rehab. Although my wounds were still fresh, I put on my first prosthesis and took my first steps. I was determined.
And I was completely unprepared for the difficulty.
It took tremendous strength to learn to walk again. I needed practice, but practice rubbed my wounds raw. Exercise was essential and exercise produced blisters where the prosthesis was joined to my leg — more hot pain.
I was frustrated and felt useless on the days I couldn't exercise, waiting for the blisters to drain and heal. Then I would put the prosthesis back on and push myself to my limit until the skin broke again.
In those first days, I could only take a few steps. In the first weeks, it took me an hour to walk a mile. I worked out on a bicycle, on a treadmill and with weights. And month by month, I increased my speed so that finally I could walk the 2 1/2 miles from my rented home to the hospital in 25 minutes.
If those maimed in Boston were to ask me what was harder, the physical or psychological recovery, I would say the two go hand-in-hand.
At first I thought it was enough to recover physically, and that learning to walk and work again would naturally produce a psychological recovery.
I was wrong.
The strength of the wounded soldiers at Walter Reed helped me a great deal. Even though many of their injuries were so much worse than mine, I never heard them complain about pain or withdraw in self-pity.
I lost only the lower half of my left leg and came to understand that important distinction alongside soldiers who had lost a leg up to the hip, both legs, or legs and arms. We shared our daily experiences and hardships, often with humor. When a soldier who had lost both arms and legs teasingly called me "Paper Cut" for my lesser wounds, I called him "Trunk" and we laughed.
The soldiers, and some of my Spanish friends with amputations, also taught me the difference between losing a leg and missing a leg. The missing leg can be replaced with a prosthetic, but a loss is permanent. If you don't confront the feelings of loss — the fact that your world has changed — you never fully recover from the amputation.
The support of my family and friends was crucial. My relationship with my wife after the accident changed to a deeper love. I could see that the patients who didn't have as many visitors, as much love and reassurance around them, did not respond to physical therapy as quickly.
And then there was my camera.
The very instrument that had gotten me into this mess, if you will, became my inspiration and part of my salvation. I carried it with me all the time to photograph the recovery of my hospital mates and to test my own. It took a lot of practice to be able to look through the lens and maintain my balance while walking, as I had done before the amputation.
With a prosthetic, you have to watch for bumps and dips in your path because you have no feeling in your false foot. If you take a wrong step, it is easy to fall, and I fell many times before learning to compensate. Running is much harder, as the body struggles to adjust to a prosthetic leg. When I was 15, I ran a marathon. Now, I am running three miles once a week and I am exhausted. My goal is to run again and recapture the runner's high, the feeling of strength that I used to experience.
The new amputees in Boston will discover, as I did, that there is a whole world of prosthetics to choose from. Who would know if you didn't need one? There are feet made for running, walking, climbing, cycling, even for swimming and golfing. But it turns out there's no such thing as an all-terrain prosthesis, so in the end, I accumulated several.
I normally wear a versatile, durable foot, but I also carry a couple of extras in a backpack, one spare foot and a special one for running. I even have one for roller skating, which, after multiple clashes with trees, parked cars and the pavement, is now one of my favorite sports.
In the same way I have always tended to my cameras, I now must care for my prosthetics, making sure they are always in perfect working condition.
Like the amputees in Boston today, 3 ½ years ago I joined a community to which no one wishes to belong. I have changed over the years, as they will.
For better or worse, I am more vulnerable now. If I were to offer advice, it would be that it's possible to accept help without feeling dependent. I would tell them what I tell myself, "Emilio, you're missing a foot so don't be too hard on yourself, and when someone offers you a seat on the bus, take it."
I would tell them the greatest truth I have learned is that I am a man who had a leg amputated, not an amputee.
I am still a whole person.
I have returned to work as a photojournalist with the AP. I have tried to become a better person, sharing my small successes with all the people who have helped me in critical times. I appreciate that I live in a nice house in Barcelona with my wife, who is pregnant. I am looking forward to becoming a father for the first time.
I know they cannot imagine this in Boston now, but I want them to know that while certainly I miss my leg, I feel very fortunate.