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So it went at Kessler. Some days fear, some peace, some resentment. He had started out at Kessler "with a kind of arrogance and denial," but then began to accept the institute as the locus of his recovery. A nurse named Patty forced him to read a manual on spinal-cord injuries (he had refused at first). He read about the effect of paralysis on respiratory problems, on bowels. He read about sexual activity. He read about the dangers to which he was prone, like dysreflexia, a condition most commonly resulting from a clogged bowel or urinary tract, which the patient cannot feel until too late and which can lead to high blood pressure, heart attack or stroke.
After first wishing to avert his eyes from the population of the disabled, of which he was now a part, he gradually came to accept what was before him. He got rid of his security guards. "I started wheeling into other people's rooms and talking with them. We realized we were no different from one another. Some very nice friendships developed." From time to time, he goes back to Kessler to visit with the people he met there.
He undertook physical therapy with others in a stale-smelling large room. "It was filled with people dealing with their handicaps," he recalls. "The room of sweat, struggle, hope and disappointment," where patients like himself were exercised on blue mats under glaring fluorescent lights in eggbox cases. They were continually shouted at to "do another, try harder, give it another five."
He would be positioned on his side, and would try to move his shoulders. One of the trapezius muscles in his right shoulder could flicker a little. Nothing else. "It would take time for my brain to connect to what muscle to move. I'd have to think, 'My brain to my right shoulder. All right. Let's go. One, two, three.' I learned to will it."
There would be days of no progress or of regression. The worst days had to do with getting off the ventilator. At U.Va. they predicted that he would be able to breathe on his own. They gave him a test called NIF--negative inspiratory force--which measures the effort of the muscles as they try to take in air. He could not move the dial. He thought, "What's wrong with me?" After a long while of trying, he gave up, and the therapists let him. "What they're trying to do," he says, "is get you to take responsibility for your own progress." Then he tried again, took 10 breaths on his own and moved the dial. "I finally said, 'Damn, I'm going to breathe. I've got to make some progress here."
Every day he got a little stronger. "I was sucking for air, my eyes were going up in my head, but eventually I breathed on my own--for 7 1/2 minutes"; 7 1/2 rose to 12, to 15, to 30. Today he can go off the vent for hours.