What is the hardest part of spinal cord injury rehabilitation for most people?

The hardest part of rehabilitation for most people is the realization that when they leave the hospital or go out in the world, things aren’t going to work the same way they did before. My best example is the very young healthy paraplegic guy, very muscular, very adept in his wheelchair and he needed to find a place to live. So we sat and went over the newspaper—he learned how to ride the bus, he could get around, he didn’t have a car—got the newspaper went out that weekend to look for apartments, and rode the bus everywhere. That was new for him; he used to be able to drive. And he came into my office and cried. “I used to just jump in my car, and find an apartment, and circle an ad and go out and look at it. I spent all day on the bus, I get there and it wasn’t accessible like they said in this ad, I couldn’t even get into it! They just said it.” And he realized that the world was not as easy as it was before, finding an apartment was hard. He said, “All that stuff with the PT gym where I worked so hard I could stand in braces, that’s the easy part. This is the hard part.”

I think the hardest thing for a patient and a family member of rehabilitation is just how hard it is. It’s the hardest thing they’ve ever been through. They have been through marriages, and divorces, and debts and all kinds of terrible crises in their life, but this is a showstopper. This changes their life indelibly, typically forever. So, in the days, and weeks and months that they spend in rehabilitation—rehabilitation never ends, there’s not an end point. But once they get through the crux, they get through the 101 of rehab, of rehabilitation, they feel how difficult it is. It is the hardest job that they have ever had. And the intelligent person, who understands what they are up against, usually does extremely well. I’ve seen people turn around totally, they’re not the person that they were. They really get serious about their life; they’ve been given another life. They have been given another chance and often times they take it and do very well.