Today was a big day. Today he would get out of his bed for the first time. Jake looked forward to it as much as he dreaded the thought. Today Murray his physio therapist would take him to the gym instead of doing exercises with him in bed.
A week ago he had sat up for the first time. It wasn't really sitting though. He couldn't sit as such just pull himself up into a seated position with the help of the bar suspended over his bed. At the moment his stomach muscles and the muscles half way up his back were still paralyzed due to the bruising in his spine, but Dr. Lassiter had just given him the latest test results showing that the nerves had started to relay signals again. Now he needed to make his brain send the correct messages and his muscles to regain strength and respond in the way they used to.
It was almost like these parts of his body had been rebooted and now he needed to relearn all the motor skills that he had taken for granted for twenty seven years. As she had told him in the beginning, he couldn't hold his balance, in fact right now he couldn't even sit without any support because his back muscles wouldn't hold him up, but soon, soon, Jake told himself, he would be able to sit again. Once he could sit, he would be able to use the wheelchair.
The thought scared him, though. In his bed he felt safe, contained. While he was lying in his bed he didn't have to deal physically with the fact that he would never walk again. While he was still lying here it was just an abstract thought. Sure, he couldn't feel his legs, nor could he move them, but lying down it was a reality that could be ignored. Once he got out of his bed however, he would have to deal with it. It was unavoidable.
He checked the time. Ten minutes and Murray would walk through the door and confront him with the bleak reality of his situation.
He closed his eyes and like many times before in the last two weeks he made a list in his mind of all the things he used to enjoy that would now be beyond his reach. Running, snowboarding, kite boarding, surfing, riding his Harley, playing soccer and volleyball with his mates, the ninjutsu he used to practice and many other seemingly inconsequential things. He had made plans together with JJ to finally go snowboarding this winter. They had been talking about it for the last four years, as long as they had known each other. Jake had once hoped to become a professional snowboarder, but that had never materialized and now he couldn't even do it for fun anymore.
He thought about all his sports gear and his bike that he had in storage and at JJ's house. He would ask JJ to sell it all the next time he spoke to him. He didn't even want to see his Harley or the boards or rigs again. They were just too many painful reminders of who he used to be. He would call JJ after physio, he could probably use some moral support by then anyway.
The door opened and Murray walked into the room pushing a high-backed padded wheelchair. It almost looked like a dentist chair on wheels. Jake's heart just about jumped out of his chest.
"Hi Jake, how are you today? How's the pain?"
"Under control. Not so bad today."
"So are you up for this?" He stuck his hands into his pockets and kicked the wheelchair with his foot. He grinned encouragingly at Jake.
"To be really honest, I'm scared shitless."
"Just don't expect too much of yourself, yet. It's only been three weeks. You need to be patient. Your body will start responding when it's ready. You can probably look at sitting properly again in about five to six weeks."
Jake sighed. "I have to start somewhere. Okay, let's do this."
Murray pushed the wheelchair parallel to the bed, lowered the rail and raised the head end of the bed more until Jake was almost sitting upright. Then he stood on the other side of the chair so that it was in between them. "Right—lean towards me."
Jake pushed himself sideways until he felt like he was falling over. "I'm about to fall out of bed," he said with alarm.
"Don't worry Jake, I'll catch you." As soon as Jake had said it, Murray had caught him and used the momentum to lift him and pull him sideways into the chair. He took Jake's left leg that was still in the full length brace and released the knee joint. Then he put the leg on the slightly elevated leg rest. Jake took his other leg and pulled it over as well. The atrophy was not yet severe, but clearly noticeable. Murray took the blanket and handed it to Jake.
"Will the atrophy get worse?" Jake asked then draped the blanket over his legs.
"Yes, it will. You could lose more than half of the muscle mass in your legs." Murray pushed Jake out of the room.
"So what if I get my spine fixed. Will it come back?"
"Possibly, but to be honest most people never regain the full strength they had before the SCI."
"SCI?"
"Spinal cord injury."
"Ah."
Neither of the men said anything for a while. They took the elevator down two floors and entered the gym. Instead of staying in the open plan main area of the large gym, Murray took Jake to one of the private, windowless treatment rooms in the back. "I think we'll work in here today," he said.
Jake's expression was stony as he watched the other people working out. There were a few people in wheelchairs, but as far as Jake could see they were amputees.
"Are there any other people here like me?"
"There are two more SCIs at the moment, but they both came in after you and from what I hear, they will both be temporary paralysis cases. Permanent, complete paralysis is a pretty rare prognosis these days."
"Ain't I lucky." Jake sighed.
"You are lucky to be alive. I've never heard of anyone with injuries as severe as yours survive eight hours without any treatment."
"Was it that long until they got me out of there?"
"Yes and then they airlifted you straight here, but you were hanging on by the skin of your teeth. For three days they expected you to kick it. That's why you only had the surgery after five days. Otherwise the operation would have done you in— and even then it was still touch and go, but if they had waited longer the damage would have been even worse."
Murray took a remote and changed the tilt of the chair until Jake was almost lying flat again. Then he lowered it all the way to the ground. The padded section Jake was lying on disconnected from the chair's chassis and Murray pushed it out of the way then knelt down next to him. "All right. Now put your arms around my neck and I'll slide you onto the floor. We'll do some stretching exercises first."
Jake struggled to rid himself of this feeling of confinement. Lying on his back on the mat on the floor, the only thing he could do was lift his arms, head and shoulders off the ground. He worked his elbows under his shoulders to push himself a bit higher while he watched Murray stretch his legs and feet and then the hip joints. Once he finished he moved on to stretch Jake's back gently, but even a minor rotation in his lower back was excruciatingly painful and made Jake's eyes water. He groaned and exhaled sharply with every movement.
Jake wanted to scream. He wished it had been a person who had shot at him and not a computer and he wished for that person to stand in front of him now so that he could have shouted out his frustration or even better beaten the crap out of him. Look at what you've done to me. He wanted someone to blame.
"Murray, please give me a break. It hurts like hell."
"All right. I'll give you a few minutes. I need to go check on something quickly anyway. Let me turn you over onto your stomach."
"Okay." He was used to being turned over by now. The nurses shifted his body every couple of hours, but not often onto his stomach.
"I'll be back just now and then we'll do a few strengthening exercises." He got up and left, closing the door behind him.
Jake brought his arms forward and wiped his eyes. He pushed himself up on his elbows a bit. Not so bad. He pushed higher and pulled himself forward. Yeah. He had just moved on his own for the first time, even if just a few inches. He tried the other elbow. He felt a pinch in his left shoulder, his torn rotator cuff was obviously not entirely healed, but it didn't stop the grin from appearing on Jake's face. He dragged his body forward another two feet to the edge of the mat. Then it hit him. The grin faded from his face. This is it. This is all I'll ever be. Without a wheelchair or other assistive technology, Jake Sully who had been a competitive athlete for nearly two decades of his young life, was reduced to dragging himself across the floor on his elbows and he would never stand up again, never walk, never run, never snowboard; and never was a hell of a long time. He folded his arms under his head and let out a long wailing cry. He felt isolated and lonely, his future inconceivable at this point, his present torn and broken and his past too painful to remember because he had lost so much and worst of all, he had lost himself.
When Murray returned a few minutes later he found an inconsolable Jake. He knelt down next to him and put his hand on Jake's shoulder. "Hey, Jake," he said gently.
After a while Jake turned his head to look at Murray, trying to stifle another sob. He ran his hand over his face. "Murray, I can't do this."
"Yes, you can. I know it's hard for you, but you will get better, I promise."
"Yes, better, but never good enough to be able to stand, let alone walk." Jake's voice was still choked up.
"Walking is overrated. Come let's do just a few exercises to get you fit again. Can I move you?"
Jake sighed. "Sure. I don't want to spend the rest of my life lying here on the floor."
Murray rolled him onto his back again. "Put your arms around my neck." Jake complied. Murray took him back to the center of the mat and put him down again then he got the blanket and put it over Jake's legs. He handed Jake a soft foam ball the size of a basketball. He got up and stood in front of Jake. "Hold the ball in front of your chest. Now I want you to throw the ball to me and every time you throw lift your shoulders and chest as high off the floor as you can." They did several sets of throwing the ball back and forth.
"Okay," Murray said, "one more set," while Jake rested, exhausted from nothing more than throwing a light-weight ball around. "I want to take your gown off. Can you untie it yourself?"
"Sure." Jake undid the gown behind his neck and looked at Murray questioningly. Since Jake was lying on top of the gown, Murray helped him take it off. He adjusted the blanket so that it covered Jake's legs and lower body just below the navel. Then he stood up and threw the ball back at Jake.
"Why are you doing this?" Jake asked curiously.
"I'll show you now." They kept passing the ball back and forth. After a while he said. "I thought so—the next time you throw look at your stomach."
Jake did. "Oh my god!" Jake could see his stomach muscles contract. Not with any strength, but they were definitely moving.
"Five more," Murray said passing the ball back to Jake. Jake kept looking at his stomach and every time he saw the muscles twitch the grin on his face grew wider.
"Okay. I think this is enough for today. Let's end on a high note."
When Jake was back in his bed he rested for a while with his eyes closed, thinking about the session. He was glad he had been able to achieve some tangible progress today and though he still felt utterly depressed about the prospect of having to use a wheelchair for the rest of his life, he decided not to make any rash judgments about how restricted and limited his life would be. He would just take it one day at a time.
He called JJ at his office. JJ answered almost immediately.
"Hi Jake. You have been very quiet. How are things going?"
"Hi JJ. So-so. Sorry, I don't feel much like talking, but I'm making some progress."
"Like?"
"A bit less pain, a bit more movement; today my stomach muscles started to respond again."
"That's good to hear."
"I still can't sit. Maybe another four weeks or so, but I got out of the bed for the first time today."
"And how was that?"
"Devastating to be honest. I just cannot fathom spending the rest of my life in a wheelchair, but that's the long and the short of it." A tear appeared in the corner of his right eye and he let it run down his face.
"I would really like to come visit you."
"Please don't JJ. I can't handle it."
"Okay," JJ sighed, "but I'll keep asking."
"JJ can you please do me a favor?"
"Sure what can I do?"
"Can you please get all my sports gear out of storage and all the equipment that's at your house and either sell it or give it away?"
"If that's what you want?"
"Yes, I never want to see it again."
"Okay, I'll do that."
"And also…"
"Yeah?"
"Sell the Harley." The electric motor cycle was one of Jake's most prized possessions.
"But Jake, the Harley…" JJ wasn't sure what to say.
"JJ please, I can't ride the bike anymore."
"All right."
"You don't have to rush. I'll probably be in hospital for another four months, but please make sure it's gone before I get out."
"No worries. Anything else?"
"No that's it. Thanks JJ—got to go,"
"All right Jake. All the best."
Jake cut the connection and closed his eyes again trying not to think. He felt completely exhausted, mentally as well as physically.
The door opened and Dr. Lassiter walked into the room. "Hi Jake. I spoke to Murray. He said your stomach muscles are responding. That's really good news."
"Yes. Weakly, but they did." He smiled.
"And how was the experience of being out of your bed?"
The smile faded from his face, his eyes started to brim and he shook his head, but he didn't say anything.
She looked at him for a moment. "That bad?" She pulled up a chair and sat down next to him. Then she took his hand and held it until Jake had cried himself to sleep.