My childhood was a village crowded with curious characters, all of them, it seemed, were interested in only one question: "What do you want to do when you grow up?" they asked. It was not too long before I developed a policy whereby I immediately and uniformly responded: "Let me think about it and I will get back to you when I am older." That bought me some respect and eliminated the need for empty conversation, but it didn't make it any easier to really decide what I wanted to be.
It was much easier to decide what I did not want to be. Unlike my peers, I did not yearn to become an action hero. For example, I did not even remotely want to be Superman. I did not care for the blue costume or the red cape, nor for the conspicuous 'S' shield. I did not envy his life as a foreigner (Superman was born on the planet Krypton), his need to lead a double life (with a day-job as a journalist for the Daily Planet), his constant struggles with Lex Luthor, the super villain, or his too broadly-scoped mission statement - to make the world a better place.
I never became Superman, and to tell the truth, I totally forgot all about him, until in 2001 when I arrived in Jackson, Miss., for a fellowship program in reconstructive urology. One of my responsibilities at that time was to make weekly hospital rounds at the Methodist Rehabilitation Center. I checked on these patients on Mondays, which I called: the Mondays of the Unfortunates. Most of my patients were young, some even younger than I was. They all remembered the date on which their spinal cord was injured, for it was that point in their life after which everything changed. Some recalled the moment of injury: jumping into a shallow pool, being hit by a car, or falling from a roof. They were confined to their beds or moved around in wheelchairs. The level of their spinal cord injury determined their degree of disability. The higher their injury along their spinal cord was, the more function they lost. An injury to the cervical (neck) region would result in quadriplegia (paralysis of arms and legs). A lower injury, to the thoracic spine, would spare the torso and the arms but result in paraplegia, or inability to move the legs.
Shahar Madjar, M.D.
When your spine is injured, cells within your spinal cord are severed. These cells are called neurons. The body of each neuron is small. It possesses multiple thin, short extensions called dendrites through which information is received, and an axon-a single, long extension through which information is transmitted from the neuron to its target (other neurons, or muscle cells, for example). The axonal extension of neurons may be as long as 1 meter in humans, or longer if you happen to be a giraffe. Neurons are excitable cells that work somewhat like electrical cords delivering information by creating minute electrochemical pulses. The neurons in your spinal cord deliver motor information from the brain to muscle cells allowing movement of the muscles. They also deliver sensory information (touch and temperature, for example) in the other direction.
When your spinal cord is injured, neurons can no longer transmit information. Unfortunately, neurons are not programmed to regenerate and therefore a neuron lost is a function lost forever. Attempts to surgically connect the severed nerves may prove futile. The neurons in the spinal cord are so small and densely packed that even if they are re-connected, the chance that they will be aligned properly is infinitesimally small.
In those Mondays of the Unfortunates, I looked at my patients, and a flight of associations took off in my mind. In each of my patients I saw Christopher Reeve, the actor that achieved stardom for his role as Superman. In my patients, I saw Christopher Reeve the man whose spine was crushed in a horse-riding accident, the man who became quadriplegic, requiring an electrical wheelchair and a breathing apparatus for the rest of his life. In each of my patients, I saw a man, a man who used to be superman, and ended handicapped.
In each of my patients, I saw the vulnerability that life is, what it is to be human, and what it is to suffer the fate of human pain. In all, I saw the hope for bodily resurrection and the illusion of recovery. They did not wish to become a man of steel, a Superman, just a man who can walk again, hit a baseball, and feel the warm sand between their toes.
Editor's note: Dr. Shahar Madjar is a urologist at Bell Hospital in Ishpeming. Read and comment on prior columns by Dr. Madjar at DrMadjar.com.