Sensible or more worldly people accept the world and its sad decline with more equanimity. I take it personally. Frequently, I cannot take it at all. What I do take is responsibility. Doubtless too much. I certainly take time, frequently too much of this also. In fact way too much on one particular Thursday morning as Jane and I stood with the throngs waiting for taxis in front of the midtown Hilton in New York. The taxi wallah assured us that a wheelchair-accessible cab would drift into the queue on Sixth Avenue within 10 or 15 minutes, but soon half an hour had gone by. I was worried. Stage fright, one might call it. After all, I had a talk to give. Big time speaker that I am, published author and all, this is what I have decided to do with my spare time in New York City. Note that the word ‘spare’ hardly applies. For with the Museum of Modern Art only about 90 seconds away, one would have thought there was enough time for a visit. But no. With our stay short, this was what I wanted to do. Journey north to 98th St. for a chat with the rehabilitation staff at Mount Sinai Hospital. What was I thinking?
Well, I was thinking that I wanted to do this. A friend had connections at the hospital. As a first-time published author, promotional appearances are hard to come by. So why not track down my disabled landsmen, or more precisely, their keepers? Go back to my rehabilitative roots, as it were. It’s a major center for treating the spinal-cord-injured, Mount Sinai. There was even talk of sending me here when I got injured in 1968. My father had a friend on staff.
New York City makes me feel like a California boy. The minute one whooshes through the doors into the baggage claim at Kennedy Airport, here it is. Black-hatted Hasids queuing with Muslim women in their burqas, everyone seemingly from eastern or southern Europe, if not northern Africa. So it’s no surprise after the cab driver deposits us in front of the hospital, we head for a Seattle’s Best coffee outlet and find the entire staff Indian. Literally sparkling with good cheer, they were, so much so that the day-old bran muffin hardly mattered. And then right in front of the hospital someone from the rehab staff asked if we might just be headed her way…and soon we were waiting in the gym.
Somehow I had imagined an old brick gymnasium, a few unused basketball hoops perhaps…but this had slipped my mind, the reality of a physical therapy treatment room. Of course, this sort of gym. Mats and exercise machines and charts on the walls. Waiting for my talk, I could not resist staring at the survey of patient satisfaction. Nothing could be more modern, more out of phase with my 1968 rehabilitation days. It would never have entered anyone’s mind to chronicle the consumer satisfaction among the patient/family ‘market’ for paralysis recovery.
And I would not have recognized these kids, the twentysomethings and a few thirtysomethings who gradually arrayed themselves in rows among the waves, pulleys and treatment tables. Inservice training. Me the trainer. I welcomed them all…the last time I had seen so many rehab center staff I was younger than they were. After hello, I began reading aloud from my new book.
I have done this a few times, grown accustomed to what moves a crowd in, say, a bookstore. This was no bookstore. This was compulsory training, normally of a technical type. And here was this smart-ass writer guy trying to make jokes. In fact, he was trying to shift gears. Again and again. What could I offer them? Anything they would like to know about a partial quadriplegic such as myself…who had been out in ‘the community’ for so many decades? Somehow there wasn’t much to tell them. Mostly because without knowing it, they had much to tell me. I spent half my time coaxing out the latter.
Speaking to this crew proved to be like rousing 20-year-old soldiers from their armored vehicles during a lull in combat. No one was in a reflective mood. Everyone was preparing to return to combat. The casualty rate was high, their victories few. And why? Because in this our nation in freefall, what was left of the social safety net for acute rehabilitation has been finally ripped to shreds.
Consider that in 1968 I was hospitalized for a full six months. In anything short of a total severing of the spinal-cord, the body goes into a period of neurological shock. This was once thought to last about six months. Now, the estimates have been extended. Perhaps six months to 24 months.
Mama said you can’t hurry love. And you also can’t hurry the spinal cord. It does what it does. It has been pinched in an auto wreck, bruised in a diving accident, nicked by a passing bullet. And it is taking its own sweet time to get its neurological act together. No rushing the process, but if one is lucky, supporting it. Matching the body’s own healing stage by stage, amplifying some recovered strength here, encouraging equilibrium there.
But fairly recently, ‘within the last few years’ according to several of the young therapists, our nation’s insurers have decided differently. They have cut what used to be a fairly standard four-month course of treatment for those recently and massively paralyzed – down to four weeks. In other words, to consider my story, at a point when my nervous system was almost completely AWOL and I really did not have a leg to stand on…a finger to flip…or an elbow to grease…these days, I would have gone home.
Actually, this would be a lucky circumstance. If I was a young person living several flights up, as is normal throughout New York City, there would have been no taking my body home except to park it. Mobility? There is no way to get a quadriplegic down steps in a wheelchair. In fact, for most of these four-week discharges, the next destination is usually a nursing home. What happens there, I asked a therapist? Nothing, she said. Patients spend most of their days in bed. The end of rehab.
I told the Mount Sinai therapists…what came to me. That I had spent five months at a Los Angeles County hospital. A place renowned for rehabilitation. And, yes, a public hospital for me, a public patient, and then in Britain under the National Health…. And I could see their young eyes glazing over. I was an old guy, talking about the old days. And they were right in the midst of the new ones. Trained to deliver physical medicine in circumstances that makes a mockery of physical medicine.
I apologized. I apologized to them all. My generation has done this, I said. It seemed feeble, yet it seemed just. Horrifying. A nation of vast wealth, starving its own. Starving itself. But somehow this last part is not yet clear. Not to everyone.
And Jane and I were about to get on a fancy ship and forget all this and everything else. Or so it seemed. Some things pursue us through life. And what is there to do except look over one’s shoulder occasionally and wave? Take the black kids who shot me. In their latest incarnation they are here, of course, on the wards of Mount Sinai. Shot and paralyzed themselves in what has become an institutionalized part of American life. It’s a seasonal thing, the therapists at Mount Sinai told me. The autumn, mostly. The early part when it has been hot all summer, tempers are still frayed and a young man’s fancy turns to thoughts of shooting another young man in the spinal cord. Yes, this is deliberate targeting. It is considered worse punishment than death, living with paralysis. If so, this is a national punishment and a most insidious one. For we don’t know yet how today’s America is punishing us all.