Toward Independence (1947)

[Music] recent developments in medical management have markedly improved the outlook for patients with spinal cord injuries in years past a spinal cord injury which resulted in paraplegia paralysis below the sight of injury meant at best a sentence to a semi lifee in bed the threat of serious infection was always present new surgical techniques and knowledge of nutrition sulfur drugs penicillin stomy all have greatly increased life expectancy for such patients whatever the medicine the doctor signs the prescription a prescription of Physical Medicine is thoughtfully prepared by a skilled medical specialist a physiatrist the early application of this new and growing branch of medicine brightens the paraplegic outlook for a useful independent life footboards or splints judiciously prescribed IED and applied during early hospitalization helped to prevent contractures a knee joint locked in flexion or an ankle stiffly extended May seriously delay the fitting of braces and prevent maximum Rehabilitation even though lower limbs are completely paralyzed contractures must be prevented if long leg braces are to be worn passive exercise of the affected extremities helps to maintain this so important range of joint motion to maintain range is much easier than to overcome deformities which result when such exercise is neglected mild heat and gentle massage increase circulation nutrition of tissues and help to maintain muscle tone in the affected Parts heat and massage are prescribed with caution for the paraplegic because of impaired sensation and spasticity special apparatus such as the hovered tank provides hydrotherapy for those cases where contractures have already developed after aptitude tests coordination and dexterity in fine movements are developed through carefully prescribed occupational therapy ultraviolet light is administered for General tonic purposes and specifically to assist the healing of the cubitus ulcers Dynamic physical reconditioning activities individual prescribed prevent deconditioning maintain muscle strength and tone and prepare the patient for crutch walking and other functional activities which constitute the highest degree of paraplegic Independence yes modern medicine can do much to Aid such patients yet in the progress of each there comes a point where objective medical measures of LA can do no [Music] more at this point the neurosurgeon urologist orthopedist and all others serving the patient medically must cooperate with deep understanding and free imagination to enlist the patient's whole being in the Grim struggle to free a personality the crushing weight of useless [Music] limbs George Young spine was injured when his Jeep overturned On Maneuvers in Kansas to take full advantage of George's potential for rehabilitation the doctor must know his attitude does George wholeheartedly accept the help offered what is he thinking God grant us the serenity to accept the things we cannot change courage to change the things we can and wisdom to know the difference so what that's what I was thinking so what then the major came in he just glanced at me out of the corner of his eye and went right over to the other fell in the room R Hennessy I knew Ry to speak to from seeing him around the hospital for the past couple of months well Hennessy started to get out of his chair anybody who' spent the time I had in a hospital would have recognized the spasticity that made it hard for Ray to lock the knee joints of his braces but the major didn't try to help him a bit watching him shift his weight and seeing the power of the heave that put him on his feet was to me like watching a high jumper clear a 7t bar and I probably wouldn't even have bothered to look at him if my head hadn't been turned that [Music] way when he did get to his feet he looked well proud like he just pitched a no hit ball game seems funny to think of the way people look at each other can mean something to somebody who's watching him well those looks meant something to me all right I got to know Ray found out his injury was about the same level as mine with those spasms tying his legs up in nuts every once in a while theoretically he was worse off than I but he wasn't he was a whole lot better off he could stand and walk independently Ray paralyzed from the waist down Ry a man with the serenity to accept what he couldn't change the courage to change what he could wisdom to know the difference well that's the doctor's job I let you in on a secret on that day Tuesday the 17th of July I George Young brushed off Dick Tracy and Superman decided to pattern myself after a real man ray [Music] Hennessy the very next day funny thing maybe the major could explain how it happened I was transferred to the same ward as Ray the bed right next to him as a matter of [Music] fact that night I watched him taking off his braces there were nurses and Ward men around plenty of people who would have been glad to help but Ray managed by himself [Music] long leg braces watching Rey with his made me think about the things in a different way instead of being well almost afraid of them I began wanting them they became a sort of a symbol of getting out of bed ah what's the use you have to be able to sit up to put braces on but if you want anything enough I remembered when I was a kid wanting a bike like hoe bassets down the street my dad couldn't get it for me that year I remember I took over Chris wy's paper route and I did get the bike [Music] I did get what I wanted on my own on my own when Ray asked me how long I'd been able to sit up by myself it came to me that this was the first time the physical therapist and doctors have been trying to get me to sit up by myself for a couple of months and now here I was doing it and nobody had urged me on to help me I didn't even know how I'd done it but that didn't make me any less proud of it it was just as if something in me that had been sleeping had awakened being awake inside somehow made it easier for me to go to sleep I dozed off like a kitten that night for the first time and I hate to say how long and I dreamed about being back at my old job at the [Music] plant the next morning when major Fenton and Lieutenant West the physical therapist came into the ward they didn't look in my direction for what seemed like an hour I wanted to well I wanted to show off a little show them the that I could sit up that I didn't have to be cranked up like an old-fashioned clock every morning when they finally did notice me they may believe they weren't surprised but I knew they were surprised and pleased I was just plain pleased this sitting up by myself was something special not that I'd been a difficult patient I didn't have any bed sores and my bladder was well under control but all that had been done by the doctors and nurses sitting up I by myself doing it made me realize that the success of my dream of getting out of bed was all up to me of course people in the hospital could and did test me make out charts and lists of how this nerve worked and what that muscle could do I really put out during the muscle test Lieutenant West gave me that day I didn't want any deformities or weaknesses to show up that it make me less able to walk than Ray during the test she told me that I didn't have any serious limitations of joint motion but that I was stiff and many of my good muscles needed to be either stretched or strengthened to be of real use in getting out of bed by then that idea of getting out of bed was strong in my mind so before the major left the ward I called him back and put it right up to him major when am I going to get out of this bed he didn't answer he just looked at me and threw the problem right back in my [Music] lap my own score sheet I didn't get it at first it looked like one of those test charts except that it was longer but the major explained that this was more than a test was an exercise program too it listed all the main things I'd have to be able to do to get from my bed to a job and Back Again under my own power each exercise was a preparation for the next the first ones were to be done in bed to build strength to get out of [Music] bed I tried number one but now this wasn't just exercise for exercise sake [Music] I could look across at the next bed and see just what I'd be using those muscles for soon maybe being there with Ry seeing how well he managed looking at the chart made me realize that a lot of little things can add up to something big and important to me then the most important thing in the world was getting out of bed under my own power I really wanted to get out of [Music] there I didn't know where Ry was going maybe just to the PX for a tuba toothpaste but wherever it was that's where I wanted to go too within a week I was handling myself in bed pretty well it sit up up turn over even dress myself so then my problem was getting out of bed and onto a wheelchair doing this was two things a test and specific exercise which would help me perform more difficult things later on I'd started on the road toward Independence [Music] when I filled in the little square on my own score sheet I was so excited I nearly poked a hole in the paper being able to get into the wheelchair under my own power made possible another [Music] exercise a real pushup which soon developed the strength needed to perform a very important function from the standpoint of being independent of others there were no special bars or hand grips where I took this part of the test because I was being prepared for life not in the hospital where they have such things but life in the regular world where toilets are toilets and that's that later that same day Ray and I made our first trip at least it was the first trip for me to the gymnasium Ray called it Independence Hall for me when I started it was just a plain sweat [Music] shot just because a fellow isn't strong enough to lift himself out of a wheelchair to the floor and one Fell Swoop there's no reason he can't get from chair to Floor by himself well not exactly by himself the first time Ray helped with advice and some of the other fellas had helped set up the stools to make the rant doing it that way you actually do get out under your own power there's satisfaction in [Music] that then too the floor is firm and from it you get a feeling of confidence Impossible on the soft springy surface of a bed sitting up without or practically without abdominal muscles is quite a trick I couldn't use sandbags in my hands like Ray major Fenton wouldn't let me I didn't ask him why I'd been doing all right leaving the wisdom to know the difference up to him not that he made any mystery about the whys and wherefores of the exercises we did far from it everyone was planned for a special purpose the major prescribed this crawling business to improve my coordination and strengthen my shoulders arms and hands Ray was an expert at it I gave it a good try [Music] anyway they call this the walking on the hand sideways exercise and there's no doubt about it it's walking on the hand sideways and it's exercise they claim that it brings into play the same muscles that are used in getting from the wheelchair to a toilet seat shorties were the first crutches I was allowed to try Ray said they'd been a big help to him in developing control and a feeling of confidence I saw what he meant when I finally got my braces and stood for the first time with the aid of regular crutches boy you need a feeling of confidence that floor looked a mile away a mile away so before I tried walking with a that distance from me I got right down on the mat and practiced walking flat on my back with a wall for a floor got the hang of the thing so I got acquainted with the crutches and strengthen muscles at the same time there were a lot of exercises I had to master before actually trying to walk on crutches parallel bars are much more stable I learned something about posture and got a feeling of balance balance for a fellow with my kind of injury is difficult about the same as an uninjured man balancing on a pair of very high SS with a solid bars for support I practiced the actual gate I'd later be using with the crutches they call this the swing to gate now and then on good days I'd cheat a little and swing through but it was all good exercise hard work so hard that I don't believe I could have done it if I hadn't had the idea of being independent always with me parallel bars are all right in their place crutches might be called independent portable parallel bars my first step with the crutches wasn't a step at all Lieutenant West taught me to shift my weight from crutch to crutch I had to make sure that I didn't push down on the crutch and at the same time try to raise [Music] it when I first tried lifting my body from the floor I saw how the gym workouts had developed my crutch walking muscles I could lift my body nearly as far as Ray so I was ready to try the first actual gate first one crutch then the other drag the feet forward they call this the alternate tripod gate one crutch then the other drag the feet [Music] forward when I learned to move both crutches at once do the a simultaneous tripod I made more speed but I still couldn't honestly fill in that item 41 on my own score sheet a couple of weeks maybe a month I forget just how much later the chart and I had another speed test ray was the official timekeeper by then I'd mastered the swing two method of walking [Music] it was nip and Tuck all the way but I finally did lick item [Music] 41 then I knew it wouldn't be long before I'd be swinging through just like [Music] Ray but walking is only a small part of crutch management doors are a special problem I knew how to manage them but fallen into the bad habit of letting people help me too much Lieutenant West was all for letting George do George's own work so right then and there she set out to Stage a little practice class for [Music] me swing the door open plant the crutch firmly practice shifting your weight to all sorts of [Music] positions practice balance till you get the habit and I practiced sitting down is another special skill the approach and stance the shift of weight all are important the way the hands grip the chair varies with a patient and with a chair [Music] I had all kinds to try every sort of chair I might meet up with out in the world the world what would it be [Music] like everything designed for men with two good legs wisdom to know the difference but I couldn't let such imaginings interfere with the job I had to do major Fenton didn't leave me much time for idle dreaming he kept me working on that practical dream of Independence stairs he said you you can climb them fella and I kept at it until I [Music] could Ray does the stairs backwards frontways worked out best for me some fellas go up sideways bus steps had to be mastered even though I wasn't intending to be any bus commuter when I got out into the wood [Music] a 15-in lift takes practice and plenty of good solid [Music] beef traffic lights how long would they stay red 18 and 1/2 seconds on cross town streets I waste five seconds getting down the curb so I must get off the curb wait for the light to change and then start [Music] out how wide are city streets 48 ft from Curb to curb cross to can I make 48 ft in 18 1/2 seconds I must be able to in an emergency not that I expect to Buck heavy traffic as a regular thing but I I know I can with Ray 18 and 1/2 seconds might just possibly have gotten stretched to 19 or maybe 20 but with a major 18 and 1/2 was exactly 18 and 1/2 the best piece of equipment in the gym was the one and only postwar dream Chariot shatterproof glassless Windows no wheel brakes that car had everything seriously it was a dream car to me because I knew that an automobile was the real answer to my Transportation [Music] problem getting into your own car may take quite a while but you don't hold up anybody but [Music] yourself yes a car can help a lot on that road toward [Music] Independence I was getting set for a spin along Main Street in the dream car when the major told me in a friendly way to get along down that road but not to forget to stop back in 2 or 3 months for a checkout I didn't forget now I have a real car once back of the wheel with the aid of a few simple gadgets I get along with the best of them especially when I'm on my way to work that's right I have a job been at it for over 2 months tests the employment counselor at the hospital gave me proved I was good at figures so they steered me to a spot where I just fit the hardest work that is the hardest physical labor I do all day is getting out of the car in the parking lot they fixed up a place for me to park right near the rear gate but that's the only special arrangement for the rest of it I'm strictly on my own no they didn't make me a boy executive with seven telephones but miss Neely from the next office has a breezy line that helps pass the time the main thing the boss told me is be there at the desk when you need it for me that's easy keeping the job records right there off the factory floor doesn't take a big brain and the pay won't buy steam Ys but you do get thrown in with all kinds of people and I like him Joe herner's pay voucher doesn't jive with a work slips I can do just as good a job of checking to see if Joe or the pay voucher is right as anybody [Music] can when Joe's right which he usually is I fix up a new slip and that's that of course everybody isn't as agreeable as he is but no pay slips have gone up to the boss to be straightened out since I've been here here a lot of people just seeing me across the desk don't even know I use crutches one fell does though they say he has the makings of the best Precision lathe men on real small stuff in the plant he works on all special jobs practically every part he turns out on that little Jeweler's lathe is an individual order so sometimes his pay voucher really gets bollocked up when it does he clows his top with me keeping the records Ray doesn't stand a chance of losing a nickel he enjoys a healthy grip just to [Music] same it cost me half a day's pay to have a model from the wall of a certain medical Major's office printed on some little cards but it's worth it to see Ray cool off we both still know how to smile we're doing all right [Music] [Applause] [Music]