At the end of the first week, they moved Austin down one floor to a unit that was just for spinal cord injured patients to undergo rehabilitation. Austin thought it was interesting that they called it rehabilitation, considering they already told him he was never going to walk again. They called his injury T11 complete. “T11” was the name of the vertebrae that he had fractured, where he had severed his spinal cord. As far as Austin could tell, this was around the level where his belly button was. “Complete” meant that below that level, he had no sensation or movement at all.
Heather couldn’t get off from work the day they were moving him. She had already taken several days off that week and she said that she really had to go in. He understood, but he wished she could have found a way to be there. He needed her.
His parents were there at least. His mother held his hand as they pushed his stretcher into the elevator and they made the trip down one floor to the rehab unit. When he got down there, his father was already waiting by his new bed.
Two of the nurses picked him up together and heaved him into his new bed. As she arranged his legs on the bed, a nurse named Kimmy gave him some instructions on his new living quarters in the hospital. She gave him controls for the bed, but warned him not to elevate his back more than thirty degrees without his back brace on. She gave him a mechanical arm that he could use to grasp things out of his reach and told him where the call button for the nurse’s station was located.
“You got all that?” Kimmy asked.
“I think so,” Austin said hesitantly.
“Okay, then I’ll see you for dinner, handsome,” Kimmy said with a wink.
Austin’s mother, Janice Chandler, pulled a chair up at his bedside. She took his hand in hers. “Austin honey,” she said, “your father and I had a talk with Heather last night and we all agreed it would be best if you came to live with us after you leave here.”
Austin nodded, unsurprised. The house he shared with Heather had three stories including the attic and a ridiculous number of stairs. He’d never be able to live in that house and he knew there was no way Heather could sell it in just a month.
“And you can stay as long as you need to,” his father said.
“Thanks,” Austin said, wincing slightly at a sudden pain in his back. It was ironic that he was paralyzed yet he felt so much pain.
“Honey, are you okay?” Janice asked, her brow furrowed. “Do you need a pill for your pain?”
“No, I can get through this,” Austin said, shifting his upper body until the pain subsided.
Austin could see his mother’s eyes misting over and he bit his lip. He didn’t think he could deal with his parents dealing with this. If they were just going to cry all the time, he didn’t want them to stay. He was the one who was paralyzed, for christ’s sake.
“Mr. Chandler?” a female voice he couldn’t see spoke loudly. Austin rolled his head over and saw a woman in a white coat. “Mr. Chandler, I’m Dr. Spector. I’m going to be taking care of you while you’re getting rehab here in the hospital.”
“Nice to meet you, Dr. Spector,” Austin said.
Dr. Spector held out her hand to his father, “You must be the parents. It’s very nice to meet you both.”
After everyone shook Dr. Spector’s hand, Ted Chandler asked her the question Austin didn’t have the nerve to ask: “Doctor, me and my wife were reading on the internet about this and... we read this article about how paraplegics might be able to walk with braces and stuff. Do you think Austin could do that?”
Dr. Spector smiled. “There are devices so that Austin might be able to stand in his own home for short periods, but it would be purely for the sake of exercise. I’m afraid community ambulation is not an option with thoracic spinal cord injuries.”
“Come on, there’s gotta be a way,” Ted said. “Austin’s young and healthy. You can’t tell me he’s going to have to be relying on a wheelchair for the rest of his life. There’s gotta be another way.”
“Austin’s age and his health will be a huge asset,” Dr. Spector said. “He has an excellent chance of being completely independent with his wheelchair. But he will always need a wheelchair.”
“Dad...” Austin said, nearly choking on the word.
Ted Chandler looked like he had more to say, but he kept his mouth shut. Dr. Spector smiled that calm smile at him again. “Would you mind if I examined Austin alone for about half an hour?”
Austin was relieved when his parents reluctantly left the room. He looked up at Dr. Spector. “I’m sorry about them,” he said.
“They’re just worried about you,” Dr. Spector said with a wave of her hand. “Believe me, you’re lucky you have someone here to worry about you. A lot of people don’t. Are you staying with them after you leave here?”
“Yeah, I... guess so. My place isn’t really accessible at all, so if I’m in a wheelchair...”
“You will be in a wheelchair,” Dr. Spector said.
“Right, so I would have to stay with them, I guess.”
“Did you live alone before?”
“No, I lived with my wife,” Austin frowned. “Doesn’t it say that on my forms?”
Dr. Spector shrugged. “I’m sure it does. Where is your wife now?”
“She’s... she’s working. I mean, I’m here for a while... she can’t keep taking off from work...”
“Don’t get defensive, Mr. Chandler,” Dr. Spector said. “I was just asking.”
Austin sighed and closed his eyes. He didn’t want to think about Heather because it made him miss her too much. God knew how much he’d see her if they weren’t even living together anymore. Would she even be willing to cut back her hours to take time to see him?
“I’d like to examine you now,” Dr. Spector said. “You’ve probably had similar exams in the past week, but I have to do it too, so bear with me.”
This was familiar territory for Austin now. People had been testing him all week to see what he could feel and couldn’t feel, what he could move and couldn’t move. Dr. Spector took a cue-tip and broke it in half, poking him with the splintered end. She touched him all over his body, asking him if he could feel it. He had normal sensation all through his arms, but as she went down his chest, the prick dulled. Around the level of his belly button, she could stab him all she liked and he felt nothing. She pulled down his underwear and poked him around his genitals, but still nothing. They put tight tan stockings on both his calves, which she removed to test his legs. He knew she was stabbing his legs, his feet, his toes, but he couldn’t feel it at all.
Next she tested the strength in his arms and legs. Of course, his arms were much stronger than hers and he was able to resist her force easily as she pulled against him. But in his legs: nothing. He warned her before she got started that he wasn’t going to be able to move them, but she said she wanted to check just to make absolutely sure. Dr. Spector put her hand on his thigh and said, “Push, Austin!” He tried to do what he remembered doing in the past, but his leg didn’t budge. Not even a twitch.
“I told you, I can’t move them at all,” Austin mumbled.
“Well, you never know,” Dr. Spector said. “Sometimes I get an unexpected twitch in the muscle, but I guess you don’t have that.” She paused. “Now I’m afraid this is the uncomfortable part. I have to do a rectal exam.”
“That’s okay,” Austin said. He had many rectal exams in the last week. “I won’t feel it anyway.”
He needed Dr. Spector’s help just to roll over on his side. She bent one leg for him and then pulled it over the other. Austin grabbed onto the railing of the bed to pull his upper body onto its side and to keep from falling. He was wearing a blue protective undergarment, which Dr. Spector pulled down. Austin hoped he was clean in there and hadn’t had an accident, but either way, she didn’t say anything. “I’m going to poke you in the rectal area,” Dr. Spector said.
She started poking him, but as he expected, he felt nothing. When she inserted her finger into him, she told him to bear down, but he couldn’t do that either. “Try to push, like you’re having a bowel movement,” Dr. Spector said.
“I’m trying,” Austin said through his teeth.
“Okay, I’m not getting anything,” she said. “Now what I’m going to do is I’m going to gently squeeze the head of your penis to check if your rectal tone increases.”
“I can’t feel that either,” Austin said, but it seemed not to matter to her. He looked down and saw her fingers on the tip of his penis, but he felt nothing.
“Okay, I got a squeeze,” she announced.
“Is that good?” Austin asked hopefully.
“It’s... expected.”
Dr. Spector helped him roll onto his back again. She folded her arms as she looked down at him. “Austin, I’m not going to lie to you. The fact that you have no rectal sensation or tone is a very bad prognostic sign in terms of you ever walking again or even getting back any movement or sensation. You most likely won’t get any better than you are now. But you already knew that, right?”
Austin nodded. “Yeah, well... sort of. I mean, you always hope...”
“Let me tell you what we’re going to do for you here,” she went on. “First off, we’re going to give you some blood thinners to make sure you don’t get any clots in your legs. We’re also going to keep an eye on your blood pressure and we’ll need you to let us know if you feel you’re getting dizzy in your wheelchair. But probably the most important thing you want to know is that we’re going to get your upper body in shape so that you can transfer in and out of your chair by yourself, get dressed, and bathe yourself. You have an excellent prognosis in terms of being completely independent.”
“That’s good,” Austin said.
“We’ll also try to get your bladder and bowel under control,” she added. “Now, I see they’ve removed your Foley catheter... the one that was in your bladder. I’m putting you on a schedule of intermittent catheterization every four hours and we’ll work on keeping you dry in that time. We’ll also start a bowel training program where you’ll have a scheduled bowel movement every day with a suppository and stimulation.”
“Okay,” Austin said. He didn’t know what he was supposed to say. Sounds like fun?
“Do you have any questions for me?” Dr. Spector asked.
Austin had a lot of questions but it seemed like the most important question had already been answered for him. He was never going to walk again, not even with leg braces. He was going to need a wheelchair for the rest of his life.
It was a lot to deal with and Austin knew he was still somewhat in denial. He had to be in denial, or else he’d be a lot more upset than he was right now. He couldn’t even begin to think about how being disabled would affect his life. And right now, he didn’t want to think about it.
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Later on that day, Austin had his first intermittent catheterization. His parents were still at his bedside and Kimmy came in with the bag for his urine. Ted Chandler’s eyes widened, “What’s that for?”
“This is an all-in-one catheter,” Kimmy explained. When Ted still looked confused, she elaborated: “It’s for urine.”
“Oh!” Ted said, his face turning red.
Austin felt his own face getting red too. There were some things that his parents didn’t know about yet, such as the help he needed just to go to the bathroom. It probably didn’t occur to them that being paralyzed below the waist included his penis and bladder too. This fact hadn’t been discussed with Heather either, but he was pretty sure she had been told.
His parents left so that he had some privacy. Austin grabbed onto the headboard to pull himself higher up on the bed, and Kimmy pulled down his shorts. He was still wearing that blue plastic protective undergarment, but he was happy to see that it appeared to be clean. “No accidents,” Austin commented.
Kimmy smiled at him. She lubricated the tip of the catheter and held his penis with her other hand. As Austin watched, he was surprised to see his penis growing larger. His eyes widened, “Oh shit, I’m sorry...”
Kimmy shrugged, “That’s all right... it happens all the time. Makes it easier to get the cath in, actually. Sometimes guys rub it a little bit before they cath themselves.” She squinted at him, “This your first erection since the accident?”
“Yeah, I guess so,” Austin said.
“Congratulations, then,” Kimmy said, causing his color to redden further. “Lots of paras get hard from physical stimulation. And like I said, it helps to get the catheter in.”
Austin felt mild disappointment as his penis quickly shrunk back down again. Not long enough for sex. The question he badly wanted to ask was if sex would be possible for him now. Before he got this erection, he had assumed that he’d never have one again, so sex would just be a memory. But now it seemed like maybe there was some hope. Even if he couldn’t feel it, it would be nice to know he was capable of giving Heather some pleasure. And maybe they could even still have kids...
As the catheter entered Austin’s bladder, he watched the clear yellow fluid filling the bag attached to it. “Um, should I be doing the caths myself?” Austin asked Kimmy.
Kimmy smiled, “My, you’re very eager. Don’t worry... you’ll get there soon enough. For now, just work on staying dry in between. Deal?”
As if he had any control over it. Austin smiled at Kimmy, “Deal.”
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An hour later, Austin was given a wheelchair to use while he was in rehab. It was “his wheelchair.” It would stay by his bed all the time and eventually, he’d learn how to get into it by himself.
Austin had never sat in a wheelchair before in his life. He wasn’t even sure how they worked, except it looked like you turned the outer wheels to get them to move. It was hard for him to believe that the only way he could get around from now on was with that chair.
The physical therapist Jeannie came in with the chair. She talked to him and his parents about the workout routine he was going to have over the next month. Then she asked him: “Ready to try out the chair?”
Austin glanced over at his parents and smiled a little crookedly. “I guess so.”
It wasn’t such an easy thing to get into the wheelchair. Austin wasn’t even allowed to sit up more than thirty degrees without a back brace. First he had to put a binder (sort of like a medical corset) around his chest. He grabbed onto the headboard to pull himself off the bed and allow Jeannie to slide the binder underneath his chest. She closed the Velcro tightly, which made his broken ribs feel a little better. Then he had to put on this large, awkward back brace. It looked a little like a tortoise shell, with one hard plastic piece that went on his back and one that when on his front, and it was very uncomfortable. It took Austin and Jeannie about fifteen minutes between the two of them to get the damn thing on.
“Are you all right, dear?” Janice asked him.
Austin had broken out in a sweat. It was partially from the struggle of getting the brace on and partially because he was scared about getting in the wheelchair. “I’m fine,” he assured her, as he used his controls to elevate the head of the bed.
Jeannie had a sliding board to help him. She put one end of the board in the seat of the chair and one end on the bed. Before getting started, she pulled his legs over the side of the bed so that his toes grazed the floor. Jeannie was a small girl but she was surprisingly strong—she practically lifted him across the length of the board and his legs were pulled along with the rest of him. Austin tried to help, but he couldn’t do all that much yet.
Once he was in the chair, Jeannie attached the legrests, which seemed to snap right on. Austin wondered if he’d be able to do that on his own. When she was done, Jeannie, lifted his limp legs one at a time into the rests.
Austin looked up and saw that his mother was crying. What was worse was that she was clearly trying not to cry and failing miserably. She finally had to run out of the room.
His father was a little more supportive. “Well, that’s not so bad, is it?” he said. “I can see using that all the time.”
One good thing about wearing this uncomfortable brace was that it allowed Austin to sit up by himself. He had tried to sit up earlier and found that the muscles that used to keep him erect no longer seemed to function. But the brace provided him with the support he needed to sit up on his own.
Austin tried out the wheels a little bit. He attempted to move forward and slammed right into the bed. “Oops,” he said.
“Don’t worry, you’ll get better at it,” Jeannie assured him. “By the end of the month, you’ll be an expert.”
Austin’s back pain, which was using a low throbbing, had upgraded itself to a sharp jabbing. He was able to tolerate it for a few minutes of wheeling around, but then it got to be too much for him. “I think I should get back in bed,” he told Jeannie. “My back really hurts.”
“With your injury, you’re going to have some pain,” Jeannie said knowingly.
It was discouraging. How was he going to use the wheelchair all the time if he couldn’t even sit in it for fifteen minutes? He guessed he’d get better at it though. He suddenly realized there was something a whole lot worse than being confined to a wheelchair for the rest of his life: being confined to bed for the rest of his life.