Chapter 11

REHAB, the next morning, 6:00 am

Steve woke to the cheery voice of a young nurse calling his name. For a moment he couldn't remember where he was but as he looked around his new room he remembered yesterday's transfer to REHAB. Obviously he had slept through the rest of yesterday and the night.

"Good morning commander, welcome to REHAB. My name is Sarah, I'm your nurse for the day shift this week and I will get you through everything new for the following days. I'm a special rehab nurse and we will spend lots of time together in the months to come. The first thing for you today is to get introduced to your team of care specialists who will all assess your actual condition to develop an individual care plan for you. We will start with a visit of your physical therapist Christian Turner who will be with you in about 30 minutes. I will give you a sponge bath before and take care of your special needs so you can freshly start your first day. I guess, your period of grace is over."

The nurse smiled softly at Steve and quickly started to adjust the material she would need to take care of her patient.

Steve was surprised by the quick start but was also content that he wouldn't have lots of time to get lost in thoughts.

Exactly 30 minutes later, Steve was resting on top of the sheets, clad in fresh shorts and a t-shirt, the door opened and a mid-thirties blonde man entered the room.

"Good morning, commander McGarrett, my name is Christian Turner, I am your physical therapist during your stay at REHAB. I know, the first day is full of new information and there will be a lot of stuff to be processed, therefore my suggestion is that I will quickly assess your body and then some orders will be placed. Looking at your legs I understand that you will need special compression garments for your lower body to avoid any blood clots. We have specialists who will take measurements later this morning to get the perfect hose for you."

"A hose?" Steve's face flushed, he felt humiliated once again. "You mean I will need to wear a compression hose for the time being? Can't we continue with those stockings they put on me at TAMC? You know, I don't feel either the stockings nor the hose but I would love to keep some dignity."

Christian Turner smiled understandingly at his new patient and assured him that the hose would be the best treatment for Steve. Due to the total immobility of his lower body, Steve was at high risk to develop deep vein thrombosis which could quickly turn into a life threatening situation for him. To minimize any risk he would not only have to wear the special hose but they would apply special inflatable compression garments three to four times a day to treat his general circulatory dysfunction.

Steve wasn't happy but understood that he had to accept all treatments. He was pretty sure that wearing a special hose wouldn't be the most humiliating thing waiting for him. Obviously he had given up his pride and dignity together with his ability to walk. Now he was determined to regain at least pride and dignity.

After Turner had assessed Steve's complete body by testing every joint in his limbs and taking his arms out of the splints to move even the finger joints, he looked at his patient and took a deep breath. There was more work to do than he had thought, but he was optimistic to reach at least some of the patient's goals. That broken man in front of him had been a navy SEAL and an elite task force leader, Turner was sure that he would succeed in motivating that man to train as hard as possible.

"Well, commander, that explosion took a number on you, that is for sure. To be honest, you have a very long and rocky road ahead of you. Our first goal will be to get some use of your arms back. I understand that you have sensation in your shoulders and upper arms and can bend your elbows but don't have any muscle function below, right?"

"Yes, my arms are tingling and from time to time I have a burning sensation shooting through my hands but otherwise my forearms and hands feel totally numb." Steve answered the therapists question honestly.

"Ok, good. We can work with that. The challenge will be to turn your somehow uncontrolled muscle functionality in a well-directed movement. Being able to bend your elbows is a huge advantage. With that you might be able to control the joystick of a power wheelchair in a couple of months. Which leads us to today's second appointment. This afternoon, you will be fitted to a power chair. That chair will need several customized adjustments and we don't want to use any time, so the fitting will take place after lunch. The last appointment of the day for you will be the assessment of your speech and language pathologist who will be with you right after the wheelchair fitting."

"Speech and language pathologist? Sorry, but I don't understand the need of that appointment, I mean, I am able to talk properly." Steve wondered why he should be in need of such a specialist.

Turner explained that the injury level at the cervical spine affected Steve's vocal chords and also the abdominal muscles he needed to breathe. Even if Steve's voice did sound quite normal, maybe a little weaker than usually, the vocal chords were muscles that needed training. The speech pathologist would also go through some intense breathing therapy with Steve.

"Your days at REHAB will be pretty stuffed with therapy sessions. Your full therapy schedule will consist of at least 3 hours of intense therapy every day plus meetings with the neuropsychologist. Between therapy sessions your rehab nurse will put you on a bladder and bowel program which takes at least 45 to 60 minutes every time it is performed. The rest of the day you will need to rest, but I'm quite sure that we won't have to tell you that twice. The first month in REHAB is usually very exhausting for the patient." Turner smiled sympathetically at Steve and then looked at his watch. "Well, time is flying, we just spend our first 3 hours together, it is already 9:30 am. Do you have any questions for now or can I call for the specialists to take the measurements for your compression garments?"

"Yeah, I'm great." Steve answered sarcastically.

When Danny entered Steve's room three hours later, he found his partner deeply asleep. Steve lay flat on his back, his legs resting in an elevated position on special foam cushions and were wrapped in what looked like some kind of inflatable devices from toes to groin. Danny watched him closely and noticed the dark shadows under Steve`s closed eyes. The man simply looked exhausted.

He had been standing at his friend's bedside for 5 minutes when said friend slowly opened his eyes and looked at Danny.

"Hey," he whispered with a hoarse voice. "You've been here long?"

"No, just arrived a few minutes ago. I was watching you sleep. You look tired, man"

"Thanks for the compliment. What time is it?"

"12:30, lunch time is almost over. How was your morning, or did you sleep through the day?"

"No, the opposite." Steve chuckled and recounted his exhausting morning. He left out what the rehab nurse had taught him about his spastic bowel and bladder, that those organs didn't work as before the injury but did instead spontaneously empty themselves by reflex as soon as they were filled which would lead to accidents. To avoid that, the bladder and bowel would need to be regularly emptied following a strict program which would be performed by Steve's caregivers as long as he had no control of his hands. He found this fact so extremely disgraceful that he couldn't talk about it, not even to Danny.

As he had finished his report, nurse Sarah entered the room with a tray of food.

"Hello commander, I see you have a visitor. Hello, my name is Sarah, I am the commander's rehab nurse."

"Danny Williams, nice to meet you. You brought some food for my lazy partner?"

"Yes, I was here half an hour ago but he was so deeply asleep, I didn't want to wake him up. Commander McGarrett, how do you think about some soup? I would first free you of the inflatable compression garments and then we can get you in a sitting position to feed you. Is that fine with you?"

Before the explosion Steve would have felt more than humiliated if a nurse had announced to feed him some soup but the fact that he couldn't control his forearms and hands had quickly taught him to accept at least that kind of assistance. He smiled at Sarah and agreed on all her suggestions.

Danny stood aside to let the nurse work on Steve's legs and looked out the window. He was surprised how accepting his partner had become during the last weeks.

After Sarah had freed Steve's lower limbs of any devices and adjusted his bed to a somewhat sitting position, she started to feed Steve. Steve signalled her to wait and suggested that Danny could take care of the feeding part. As the rest of his day would be full of appointments, this was probably the only opportunity to talk to his partner in private.

Sarah looked questioningly at Danny who happily agreed to take over and then she left the room.

"Wow, you are making huge progress. I would never have expected you to let me feed you. Minimum assistance, yes. But this? I'm overwhelmed." Danny took the spoon to feed his best friend some of the greenish-looking liquid as Steve continued to talk.

"You know, Danny. I just realized that this is who I am right now. If I don't accept any needed help, I won't be able to make some progress. For the time being I'm physically like a newborn and if I ever want to regain as much abilities as possible, I cannot waste energy by refusing to get fed. It's either someone feeds me or I starve."

Danny was stunned by his partner's matter-of-fact attitude. Whatever kind of therapy they had started on him, it seemed to show immediate success.

Steve had just finished the last drops of the soup as the door once again opened and two new faces entered the room. One of them, a muscular looking young man, was pushing a power wheelchair, and the other one, also an obviously well-trained man in his twenties, had an electric hoist in tow.

"Hello gentlemen, my name is Dennis and this good-looking guy here is my trainee Benedict. We are here to fit you to your new ride, commander McGarrett." The man pushing the power chair friendly announced and stepped close to the bed to get into Steve's field of vision.

Danny receded immediately and took place in his new favourite armchair besides the window. Steve greeted the two men and waited for Dennis to explain the coming procedure.

"Commander, we brought a chair that is very similar to the one that will be customized for you. In your current situation you will need several adjustments that can be dismantled according to your progress. We will transfer you to this chair now by the hoist Benedict is pushing. Therefor we will put a harness on your upper body. Don't be afraid, that thing is safe. Are you ready to start?"

Once again, Steve was surprised by the fast pace the caregivers were setting but agreed to start the transfer. Dennis put the bed in a totally flat position and the two men started to wrap Steve's upper body in the harness. At least that was what Steve assumed as he couldn't turn his head to watch what they were doing. After what felt like 20 minutes the bed was changed to a sitting position again and then he was lifted off the mattress very slowly. Each step of the procedure was explained to him and Dennis and Benedict were working extremely deft.

Finally, Steve was lowered in the chair and the harness was disconnected of the hoist. Dennis stood in front of Steve and told him to breathe as the movement had caused some dizziness and nausea. By now, Steve started to get used to feel awfully weak every time he was moved. He blinked several times and told Dennis to continue.

"You don't have the power and stability to hold your upper body in an upright position without assistance. Therefor there are two seatbelts, one at your lower abdomen and one crossing your chest, to hold your torso in a safe spot. Usually, patients with injuries of the upmost spine, your neck, need another strap across the forehead to keep the neck and head secured but as you are in an immobilizing brace up to your head we won't need this fixation. Your file says that you will go through another surgery to repair and stabilize your cervical vertebrae that will let you move your head freely at a later time so we won't have to make preparations for a high headrest. What we have to add in any case are special armrests for your forearms. As you can't control those, we need to put them on customized shells where they can't fall off to the sides. Hopefully you won't need them too long as we hope that you will be able to control the joystick at the end of the right armrest in a couple of months. For now, this joystick will be without function for security reasons. The seat will be padded with a special cushion to avoid pressure sores as you cannot lift your body to relieve the pressure. The legs will also be secured by a belt at the ankles because uncontrolled muscle spasms in paralyzed legs are very common after spinal cord injuries as yours. So, commander, how does it feel?" Dennis smiled expectantly at Steve who was still trying to process the bunch of information he had just been given.

"Ah, wow, I'm speechless. I mean, when I was told that I would be fitted to a power chair so soon, I didn't realize that I would be trussed up like a turkey. To be honest, this feels more like a torture device than as an aid. I don't feel any of the straps but the knowledge alone makes me think at an electric chair, not a power wheelchair."

Dennis was surprised by the commander's reaction but quickly tried to lighten the situation by telling his patient that most of the straps wouldn't be needed for a long time. The only belts that he would definitely need forever, also if he would be able to control a manual wheelchair at some point in the future, were those to keep his legs and lower abdomen in place.

Danny stood up from the armchair at the window and joined the three men. "Look at you, buddy, four weeks ago you could barely breathe independently and now you are sitting in a wheelchair. I think, that's a huge progress. Weren't you the one who told me a couple of hours ago that you need every energy to focus on getting better? Thinking about this lovely chair as a torture device doesn't fit into that strategy of yours, does it?"

Steve thought about what Danny just said and had to admit that his best friend was right. He smiled shyly at the three men in front of him. "Yeah, I guess I'm just a little oversensitive at the moment, I'm sorry."

"No apology needed, commander. We will quickly take the needed measurements for the adjustments and then we will transfer you back to your bed. You look as if you could need a little rest before the next scheduled therapy session." Dennis and Benedict professionally finished their work and then transferred Steve deftly back to his bed by the use of the hoist.

As Steve was finally resting in bed again and the two men had left the room, taking along the power chair but leaving the hoist at Steve's bedside, Steve sighed deeply.

"You know, Danno, this morning when the whole therapy insanity first started, I was so motivated and so determined to accept any help and to go through every treatment, as humiliating as it could be, and to train as hard as possible but now, after this chair thing, I am not sure if I can do all this. I feel so vulnerable and so dependent on the care of people I usually wouldn't share my private life with that I just don't see how I will get used to my new life." Steve's eyes were filled with grief and fear of the future and for a moment Danny felt like there was no hope. But then he reminded himself that his job as a best friend and partner was to support the injured man every step of the journey. He took Steve's hand in his and smiled softly "I hear you brother, I told you once that we are all in this with you and - in case I repeat myself - we still are in this together. It's okay to feel sad from time to time and to struggle but believe me, the days only get better from now on."