On a weekly basis, the staff of the rehab center gathers in the main conference room to discuss patient issues. I attend these meetings religiously, although I feel that my suggestions are only rarely heeded, and always with great reluctance. There is another psychologist on staff at the center, who sees the other half of the patients, and I’ve observed they grant his opinions greater credence than mine. However, he’s been on staff several years longer than I have, so I suppose I must earn their respect over time.

Two of my patients were ready to be discharged home, a fact that pleased me greatly. One of them would even be going home with crutches, despite his poor prognosis on admission, so that was a personal morale booster. By the time we reached Ronnie Herran’s name, I was in favorable spirits and unprepared for the news that Michelle, our social worker, had to give us.

“I’ve placed Ronald,” Michelle informed us.

“You have?” I was rather surprised, considering Ronnie hadn’t been with us for very long and it often takes time for beds to open up. My opinion was that Ronnie could probably use more rehab, but if he had the good fortune to get a bed now, it was to his benefit to take the spot.

“Cabot had a bed open,” Michelle said in her highly efficient way.

“Cabot?” I couldn’t help but react to this piece of news. Sometimes unfortunate things happen, but placing Ronnie in Cabot after he had received so little in terms of rehab... it didn’t seem right. “Can’t we do any better?”

Michelle raised her eyebrows at me. “For your information, Dr. Wilson, it was not easy to get them to take Ronald on such short notice. I had to pull quite a few strings on his behalf.”

I have always hated it when Michelle spoke to me in that tone. “Look, you know Ronnie has no family to help him out,” I said. “If you place him in Cabot, that’s where he’s going to stay, probably for the rest of his life.”

“It’s not my fault that the boy has isolated his parents,” Michelle argued. “Cabot had a spot. God knows how long it’ll be before a spot will open in another home.”

“How would you like to spend your life in Cabot?” I shot back.

Glenn Sherman put his hand on my shoulder. “Ned, come on. Michelle did the best she could for the kid. Cabot’s not that bad.”

“You know it is, Glenn,” I insisted. “I think he should stay here until he gets a bed at a decent home.”

Glenn and Michelle exchanged looks. In fact, everyone at the conference table seemed to be whispering. “Clearly,” Michelle said, “my efforts are unappreciated by Dr. Wilson.”

I wanted to tell Michelle exactly what I thought of her, but I held back. “If it would be a problem, I could take over finding Ronnie a spot in a nursing home.”

Glenn laughed, “Ned, what are you talking about? You have no idea how to deal with these homes. Michelle does this all the time and she knows what she’s doing. If she feels that Cabot is the best that Ronnie can do, I respect her opinion.”

I stared at him. “If my opinion is so meaningless, then why did you hire me?”

“Neddie...” Glenn flashed me a phony smile. “I really think you don’t understand what’s going on here.”

I hated the way Glenn did that to me. He made me feel as though I was too young and inexperienced and I had no choice but to yield. “You think I don’t understand? Really? Because I think I’m the only one here who does fucking understand!”

I looked across the table at the rest of the staff, who was staring at me with surprise plain on their faces. It was true though: I was the only one of them who was disabled. I was the only one who had any idea what it was like to sit in a wheelchair every day for my entire life. They had no right to question my opinion. I couldn’t do my job if I wasn’t allowed to act as an advocate for my patients.

“Glenn?” It was Fran, the physical therapist who was treating Ronnie. “I have to tell you, I agree with Ned. It’s no reflection on Cabot, but I think Ronnie needs a lot more PT work before he gets out of here. Theoretically, he could leave, but we could certainly use this as an excuse to keep him here while we look into finding him a better placement.”

I don’t think anyone expected Fran to take my side. I flashed her a grateful look as Glenn contemplated her offer. Michelle appeared quite unhappy, but she recognized that she was obligated to follow Glenn’s instructions.

“Fine,” Glenn said finally. “We’ll hold off on placing Ronnie in Cabot for now. Maybe we can do a little better.”

Michelle mumbled something under her breath and gave me a terribly dirty look, but she agreed to do what she could. For once, I left our weekly meeting with the feeling that I had done something helpful for one of my patients. As I said, the most important thing in life is knowing at the end of the day that you have made some sort of difference in the world.

I wheeled myself out of the conference room, but Fran caught up with me outside. I was amazed by her selflessness during the meeting and I was glad to have the opportunity to thank her personally. But before I could say the words, Fran beat me to it. “That was a great thing you did for Ronnie in there, Ned,” she told me. “It’s about time someone stood up for those guys.”

“They never would have listened to me if you hadn’t said something,” I pointed out.

“Yeah, but I never would have had the nerve to say something if you hadn’t said it first.”

“It was probably stupid to yell like that,” I admitted. “I could have lost my job.”

“No way,” Fran insisted. “You’re the best shrink this place has ever had and Glenn knows it. You can mouth off all you want. Besides, do you want to work in a place where they fire you for saying what you think?”

“I guess not,” I said, although I would have felt devastated losing my job, for the simple reason that I believe my patients need me.

Fran smiled at me, suddenly appearing slightly nervous. “Listen, Ned... do you like opera? You seem like the kind of guy who likes opera.”

“Opera? Why?”

“I’ve got two tickets for this Friday night,” she said. “Two tickets, no date. How would you like to accompany me?”

Fran was a very pretty woman, objectively speaking. She had soft brown hair that she usually pulled back into a ponytail for working purposes. Her body was athletic but rather shapely. I judged her to slightly older than me, maybe early thirties.

“I’m busy Friday,” I said automatically.

“Oh,” Fran said knowingly, “so that’s the way you play it.” When I didn’t respond, she cocked her head. “I bet you’re busy a lot of Fridays, Ned.”

I shrugged, not really sure what to say. I meet few women in my day to day existence and on the rare occasion they ask me out, it is invariably quite awkward.

“I should have realized there was a reason why a nice, cute guy like you is still single,” Fran commented.

“I don’t know what you’re talking about.”

Fran just smiled at me. “You really did a good job in there, Ned. I hope you’re not afraid to speak up again in the future.”


I lost no time in wheeling myself to Ronnie Herran’s room following the meeting. I had no doubt in my mind that his odd mood earlier that day was due to Michelle telling him he would be forced to relocate to Cabot. I was eager to dispel his worries.

Ronnie was not the first patient I’ve had that has exhibited curiosity regarding my stumps and my arm prosthetic. Most of the patients have never met an amputee before, so they find me to be a bit of a novelty. Several of the men have asked me questions about pain or phantom limb sensation or about the functioning of my prosthetic. I have no qualms about answering their questions.

Although some of the patients in this rehab center have a chance of going home with braces, the vast majority will never walk again with any sort of aid or equipment. Several men have told me that it would be easier to accept their disability if they could walk just a little bit. Then they look at my small legs stumps and query as to why I never used leg prosthetics to walk. Why did I stay in my wheelchair if I did not have to?

Aside from the obvious answer that my lack of one arm made it significantly more difficult to maneuver with crutches and the like, the truth of the matter was that I never had any interest in walking. I create a simile for them: it’s like if someone asked if you’d be interested in being fitted with prosthetic wings so you could fly around town. I’m certain there are some individuals who would love aviation with metal wings, but to many people, the idea of flying when it is something you’ve never done before or have any idea how to do is frightening. And consider what would happen if the wings malfunctioned, sending you hurling to the ground below?

I’ve never had legs and I’ve never possessed the ability to walk. I have been using a wheelchair for as long as I can remember. Walking seems “interesting”, I suppose, but it’s not something I long to do. I am much more content in the comfort of my wheelchair.

When I attempt to offer this explanation to my patients, many of them are skeptical. Ronnie, on the other hand, I believe would be understanding of my reasons for wanting to stay in my wheelchair. Most of the patients have a period of “hating the chair” and despising their situation, but as soon as Ronnie broke through his denial, he took pleasure in learning to adapt to his new situation. He was completely comfortable with the realization that he was now severely disabled and required a wheelchair. He never wasted a moment of his time wallowing in self-pity. It was almost as if he had already formed a new identity to match his physical condition.

This was part of the reason that I obliged when Ronnie requested to look at my arm stump. Ordinarily, this is the sort of request I would have denied. It is usually made by men like Lewis Patterson, who have developed a sort of morbid fascination with me and my amputations. Yet in Ronnie’s case, I felt that he had other motives. I believe that he was attempting to relate to me as a disabled person. I had seen him at his most vulnerable: being bathed by a nurse, having his catheter changed. If I was to be his friend, then he should be allowed to witness my own vulnerability. This is why I showed him my stump when I had never showed anyone else before.

By the time I got to Ronnie’s room to tell him about situation with the nursing home, Jason had already dressed him, but he remained in his bed, the power wheelchair by his bedside. The head of his bed was elevated about thirty degrees, but he didn’t seem to be engaging in any activities such as watching television or reading. His hands were in his lap, curled up and badly atrophied. As I grew closer, I could see the puffiness around his light blue eyes and the dampness on his freckled cheeks.

“Ronnie?” I spoke up, concerned. After all I had believed about his progress, I was shocked to see him in tears.

“Hey, Ned.” Ronnie grinned rather crookedly at me. He lifted his right arm and attempted to wipe his face with the back of his forearm. He was largely unsuccessful.

“What’s bothering you?” I asked him. I pulled a tissue from a box on the bedstand and dried Ronnie’s face.

“It’s dumb,” Ronnie said with a sniffle. “I, uh... I just... I mean, I know what my life’s gonna be like now and... it’s okay. I’m a quad now and that’s cool. But...” Ronnie stopped and shook his head. He seemed unable to articulate what he wanted to say next.

I picked up Ronnie’s paralyzed hand and held it in my own. “It’s okay,” I told him. “Just tell me what’s on your mind.”

To be continued....