• U.S.

Medicine: Back to Life

6 minute read
TIME

“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.

The results are far from grim. Lying in bed or sitting in his wheelchair, the patient slowly gains strength with constant use of dumbbells and pushups. For those who can eventually stand in their braces, the secrets of confident balance are patiently learned with the aid of low parallel bars, usually under the eye of paraplegic teachers who have already learned. Laboriously, in a never-ending process sparked by the slogan “Keep Moving,” they learn anew 137 separate daily activities, from tying shoelaces to driving a car and developing an employable skill. Their indomitable spirit awes their teachers. Says one therapist: “No All-American’s 80-yard run can compare with a quadriplegic’s heroic efforts to push a button through a buttonhole.”

Fuel & Fire. Rehab’s huge postwar success is due to one man: Dr. Howard Rusk, 57, founder of the Institute, and the rehab apostle whose techniques are now duplicated in 38 countries, from France to Korea. Until he was 40, Missouri-born Dr. Rusk was content with his quiet career as a St. Louis internist and instructor at Washington University School of Medicine. World War II changed everything. At Missouri’s Jefferson Barracks Hospital, Army Air Corps Major Rusk was appalled by a total lack of convalescent conditioning. When still-shaky patients returned to active duty, they quickly slid back to the hospital. Rusk soon got his convalescents into shape so successfully that the Air Corps put him in charge of a program that spread to 253 hospitals and twelve rehab centers, was also adopted by the Army and Navy. With a Distinguished Service Medal for his work at war’s end, Colonel Rusk was “on fire” to do the same job for 20 million handicapped civilians.

Financier Bernard Baruch contributed money and encouragement. Publisher Arthur Hays Sulzberger of the New York Times caught fire too, gave Rusk a platform as an associate editor. The doctor’s bylined reports on the lack of civilian rehab facilities, plus a new medical professorship from New York University, ignited such philanthropists as the Bernard Gimbels and the late Louis Horowitz, builder of Manhattan’s Woolworth Building. In 1951 the $2,500,000 Institute opened its doors, has now trained more than 260 U.S. physicians and 3,000 therapists, plus teams from 28 other countries. Still expanding, it will have beds for 100 adults and 36 children by July, supervises 379 beds in nearby hospitals.

Hunting & Touring. The surface of rehabilitation has really only been scratched. The U.S. now has only about 300 rehab-trained doctors, needs at least 9,300 more. Since the aged are especially vulnerable to disablement, rehab’s job will grow as science stretches longevity. Most disabled people, who now cost the public some $537 million annually, can be readily rehabilitated. Nearly 85% of rehabilitants return to work. In about three years, their income taxes alone match the public funds spent on them during disability.

Roy Campanella will have plenty of inspiring examples of a rehab axiom: if the patient wills it, nothing is too tough. Rusk’s team techniques, 80% usable by individual doctors as well, have returned even quadriplegics to busy lives. A Bolivian boy, born without legs or arms, now paints, plays, walks and attends school with artificial limbs. A leading Southern cotton broker, made quadriplegic in an auto accident, is back running his business twelve hours a day, even goes deer-hunting. In San Diego last week, a group of seven such people emplaned for a precedent-setting tour of Europe, their itinerary mapped by a new organization called Wings for the Disabled. A similar group of 20 will fly from New York to Europe next week. Says ebullient John W. Sharp, 30, a San Diego polio victim who got the idea after wheel-chairing across Europe last summer:”Next year I’d like to see an African safari for the handicapped. I honestly think we could do it.”

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