Isolation and Its Impact on Rehabilitation After Paralysis

Posted by Michael Collins in Life After Paralysis on March 15, 2016 # Health

Isolation has long played a dual role in society, where it can be seen as either good or bad. For Buddhist monks, isolation creates an atmosphere conducive to the deep meditation necessary to ponder their issues of concern. In order to minimize distractions, many monasteries were built in isolated locations. Months and years spent without the daily discourse with other people that occurs in most of our lives helps those monks achieve their religious goals. Many scholars or students require similar levels of quiet, and even isolation, in order to maximize their ability to study for tests or complete research.

On the negative side, isolation has often been used as a form of punishment. Shunning or banishing someone from a family, church or community was, and probably still is, a very serious penalty in many cultures. Isolating prisoners by placing them in solitary confinement makes incarceration a little less tolerable for those who have been sentenced to a term in prison; in fact, it is the only means of disciplining prisoners who misbehave or fail to follow prison rules.

For me, isolation and the resultant quiet that comes with it have always seemed like a good thing. Before my spinal cord injury in 1988, I spent much of my life living in rural areas, either on a ranch or in very small towns. I was used to peace and quiet. The only night time sounds heard were the yipping of coyotes and occasional hoot of an owl as they went about seeking their nightly meals. It was a very rare occurrence to be awakened by noises during that period of my life.

That all changed once I was injured, as I quickly became exhausted from lack of sleep while in the intensive care unit. In that particular ICU, beds were separated only by curtains. Since I could breathe on my own and was not in excessive pain, pain killers were not needed. Those drugs would have likely helped me sleep, but instead I heard every word of every conversation between the staff about, and with, other patients.

The situation didn't change much when I was moved to a private room across from the nurses' station in the rehab ward. Sleep was an impossibility. At that time I had no idea that I would be spending the next six months in that environment, or that sleep would remain my elusive friend.

Until recently, I had never considered what effect my search for peace, quiet and privacy might have had on my rehabilitation. Because of my preferences, during my time in rehab interactions with others who were also hospitalized to recover from disabling injuries or diseases were usually confined to casual banter during therapy sessions or after-hours discussions in the lounge. A couple of months after being admitted, I was finally able to convince the hospital administration to support (by simply supplying refreshments) a series of Thursday evening peer group meetings that were opened up to former patients with spinal cord injuries.

Being able to find out what was awaiting us in the real world after discharge was invaluable, and our peers seemed to know far more about it than anyone on that rehabilitation ward staff. That pattern has continued since, as much of what I've learned about paralysis has been gained through learning about the experiences of my friends.

I recently learned that I may have missed a lot by being housed in private rooms throughout my half-year in rehab. The reason for my second-guessing is that a friend who sustained a spinal cord injury several years before me shared what he experienced during rehabilitation at Rancho Los Amigos National Rehabilitation Center in Downey, California. While his spinal cord injury was at a lower level than mine, resulting in paraplegia, he spent his time there housed in a six-bed ward with others who were also recuperating from spinal cord injuries.

During a time that always has a big learning curve, those six individuals were gaining an education around the clock. Not only did they share, and compete, in the therapy sessions that would eventually help them regain their independence, they also spent the rest of their time learning about the complications of living with a SCI by discussing common concerns amongst themselves. While I had to negotiate with hospital managers in order to get approval for a few peer group meetings while I was hospitalized, the patients at Rancho Los Amigos were receiving the benefits of a peer feedback session that was continual.

Now that I am able to look back and reflect on lessons learned, I know there is one more difference that points out the value of facing spinal cord injury in a group setting. During the time that I was in rehab, more than two dozen others cycled through the ward and were discharged. We did not keep in touch afterwards, as we came from all backgrounds but did not learn that much about each others' personal lives. I wish I had known them better, and that we had kept in contact.

I now know that those who shared their time in rehab in the same ward became friends, kept in touch, had further adventures together afterward, and are still in contact today. There is a lot of value in that.

If you spent time in a rehab setting following the onset of paralysis, were nights spent in private or shared rooms? Would that be your preference if you had to do it again? In light of the above, I am still unsure about my own choice in that matter.

© 2016 Michael Collins |

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.