Automail rehabilitation takes three years.
The first barrier to overcome- and arguably, the most difficult- is learning to move the metal limb at all. Wires and steel are completely different to nerves and muscle, after all, and it takes a long time before the automail itself adjusts to the signals it is receiving. The whole of the first year may very well be spent barely even twitching the fingers or toes of the limb.
Once you can move the automail a little, you learn how to make it move the way you want to. When the metal limb is first made, it is a standard limb- it will need constant adjusting before it is properly attuned to its user. This is when those adjustments are made- learning how to connect the nerves to the limb in just the right way so that it moves as the user wants it to move. This period is perhaps the most painful of automail rehab, but thankfully, it is also the quickest period- it can take as little time as a week, with a skilled mechanic.
Then, there is pressure control. With automail, you cannot feel. What was intended to be a comforting hand on someone's shoulder may well be pushing down so hard that the person on the receiving end is being ground into the floor, or a playful punch excruciatingly painful. This is when you learn how to control your automail- from a feather-light brush of the fingers against somebody's cheek to a punch in the jaw. Hours of mind-numbing practice- can you touch this sheet of paper without punching a hole into it? Can you pinch a pillow without creating a permanent crease in the fabric? With a flesh-and-blood hand, you can feel the pressure on your fingertips that tells you to stop- with automail, you have to know exactly how much pressure you want to apply to something, and you have to control that lump of steel muscle and copper nerves that has been firmly bolted to your skeleton. When you walk with a flesh-and-blood leg, you don't have to worry about denting the floor by accident.
Pressure control can take several boring and often accident-prone months.
Then, there is the fine motor control- relearning everything from wiggling your fingers to picking up a pebble, from pointing your toes to pulling your knees up. With patience and practice at this stage you can learn all over again a million tiny tasks made so much more difficult by metal body parts- whether it be using a knife in the kitchen or doing your hair. This is the stage in which you learn to walk before you run- in which you learn all those things that seemed so easy once. Doing up buttons or a zip, curling your fingers into a fist. Unfortunately, there are some things you will never do again- thread a needle, for instance, or use a pencil or pen properly, should the hand you lost be the hand you write with. Small, fiddly tasks will now be infinitely more difficult.
The next part is the most important, especially if you have an automail leg. It is learning to walk again, or to use your arm properly again. No more fiddly tasks and pressure control: now you have to make your automail work in daily life. You have to actually be able to use it- not just do up buttons or curl your toes, but get up and run or tidy the house. Simple, menial tasks maybe; but they will never be quite as easy as they one were.
All of this is a terrible strain on the body- metal is harsher than flesh. It weighs more, it needs more energy to run, it requires constant maintenance, it rusts, it breaks, wires get worn down and things stop working. It clogs up, and it stiffens. In bad weather, it's a nightmare- sure, there is a temperature control installed in it, but it's just not enough. Sooner or later, the place where metal
meets flesh becomes icy cold and starts to ache horribly. Hot weather can be just as bad- have you ever touched something metal at the height of summer, and had to pull your fingers away instantly because of the heat? Well, you can't simply pull away from automail.
Not to mention the slight, constant ache- a dull pain in the automail ports that never truly goes away, where nerves become metal. You can ignore it easily enough, but it's always there.
After the initial pain of having automail installed- and damnit, but that's painful, a chunk of metal wired straight into your nerves without anaesthetic or anything- it can be quite pleasant. To have the limb actually there, metal or not, ache or not, is wonderful, especially if it's well made. A piece of automail that's properly tuned into you, with everything made-to-measure and carefully fitted to suit you, can be a joy. Even a good quality spare limb, not fitted to you or carefully measured, is better than no limb at all.
Automail is completely different to a normal, unmoving prosthetic limb. With a normal prosthetic, you can still feel the missing limb. With automail, there's something there- you might not be able to feel anything you touch with it, but it's there and it's moving. It might be hell to install, but feeling something actually there after having to get used to a missing limb is purely wonderful, no matter how painful it is.
The worst part of installing automail? It's the automail port. It's always bad- horribly so, enough to make a grown man scream, leaving the whole body tingling with pain and agony for hours afterwards, leaving you sweating and grey in the face- when you attach the limb, but that's nothing, absolutely nothing, to getting the port for the limb. Because getting the port installed... that's when they reopen your wound and slice right across the nerves so they can attach it all cleanly, when they bolt steel to your bones and attach your very nerves to wires, string muscles onto metal- and all without any kind of numbing drugs. Automail surgery is hell.
At least that part only happens once.
Often, people don't tend to actually realise what getting automail actually means. It means that you have lost a limb, actually had a part of you physically removed from your being. It means that you have sat on an operating table undergoing unimaginable pain. It means that your body has to support a solid metal limb.
Often, the less physically fit people to have automail installed end up suffering 'Automail Exhaustion' or 'Automail Strain'- nicknamed 'Missing Limb's Revenge'. This is when the body is literally exhausting itself trying to carry the weight and provide the energy for the automail.
It's not the only problem associated with automail either- there are dozens of other problems, from infected automail ports to 'Erratic Limb Disconnection'- when the automail develops a fault which causes it to continually connect and disconnect over and over again, as if you were taking the limb off and putting it on again repeatedly, basically frying your nerves and putting your brain through a vicious cycle of 'limb- no limb- limb – no limb- limb- no limb'. If you want to try and imagine what that's like, imagine your arm kept disappearing, and every time it did, it put your whole body in agony.
You have to be an incredibly strong person, mentally and physically, to be able to cope with automail. It can be truly agonizing- connecting the limb, routine maintenance (which can involve literally poking the wire replacement nerves to see if they are connected properly), the various illnesses and injuries that only came from automail.
Yes, automail was one of the most frustrating, painful and annoying things in the world, for anyone who used it- including Edward Elric.
But, as he got to his feet- metal and flesh- and stretched out his arms- real and fake- he knew that it was worth it to be able to be normal again, to have people stop treating him like a cripple, like a helpless child. To be able to walk again, and dress yourself. Imagine a life without two limbs- unable to do anything without help.
He would pay any price and go to any lengths to be able to stand on his own two feet- to be able to stand alone, proud and whole, for all that he was missing two limbs. And one day, he vowed, he'd get Al standing proud and whole too.