Medicine: Back to Life

"I got this far, honey, I'll get home yet," muttered Roy Campanella to his wife after his car overturned three months ago and landed him in a Long Island hospital with an injured spinal cord. The great Dodger catcher still has a long way to go. He is paralyzed in all four limbs. Whether he will walk again, with or without braces and crutches, is still in doubt. But last week his doctors announced that they will soon move him to one of the few places in the world where anything can be done for him: the Institute of Physical Medicine and Rehabilitation at Manhattan's New York University-Bellevue Medical Center.

Only ten years ago such patients as 36-year-old Campanella had no hope of recovery. Today they can be saved by wonder drugs from the infections that once doomed them. And they can be brought back to productive lives. Reason: rehabilitation, which has grown spectacularly into an entire new "third phase" of medicine—after diagnosis and treatment. More than 2,230,000 disabled Americans, recovering from disease or accidents, sorely need its help in getting back to life. Most in need: paraplegics (both legs disabled), quadriplegics (both arms and legs) and hemiplegics (one side of the body). For them, "rehab" is a stirring technique of hope, sweat and moral grit—and for the majority, it has worked.

"Bed to Job." What happens to Quadriplegic Campanella at the Rehabilitation Institute is mostly up to him. First rule: "Paralysis is a way of life." To teach it—if he has the will to learn—the patient can count on a skilled team of therapists, psychiatrists, vocational counselors, social workers, bracemakers and rehab's own special physicians, the physiatrists. They begin with a precise analysis of how much physical capacity remains, seek out the spine level at which muscles are no longer connected with the brain. Where possible, points of spinal-cord compression have been relieved by neurosurgery; uncontrollable muscle spasms are lessened by various nerve-cutting operations. Once he knows his capacity, the patient is ready to develop it "from bed to job."

The challenge is grim. A person with no sensation in his legs or arms cannot even feel in those limbs the burn of an oven-hot radiator, the pain of a hard fall, the bed sores that breed serious infection—all bad risks that he must be alert to avoid. To stimulate circulation, avoid kidney stones and prevent his joints from locking and his bones from decalcifying, he must somehow rise to a standing position for at least an hour a day, a dizzying feat that is aided at first with a special tilt-table. The patient is also faced with the distressing fact that he cannot control his bladder and bowels. Though he is taught automatic control, the adult must put up with what embarrasses the child: he is going to wet his bed.