When Doug was riding his motorcycle from his boyfriend’s house, he would never have guessed that he would have sustained an injury that would affect him for the rest of his life. Doug’s boyfriend Marc and he had recently had an argument. Doug left Marc’s house in a fit of anger. It was raining outside, and Doug was driving his motorcycle well over the speed limit. This was not an unusual behaviour for Doug, as he often rode his motorcycle to channel his energy. It helped him to think.

That night, Doug turned around a corner. His motorcycle wheels skidded on the wet pavement, and Doug hit a small car head on in the oncoming lane. Doug was thrown from his motorcycle, over the car, and landed on the road behind it. His motorcycle skittered off the road into some trees. Doug laid on the road until the ambulance arrived.

Doug was headed to his mother’s house, where he lived. He was 21, and lived with his mother and his sister, Cheryl. It was the day before mother’s day, and Doug had planned on cooking a special meal for his mother and sister the next day, as he loved to cook. He worked as a construction labourer, and was earning a decent income at the time.

Doug was first treated in an acute care hospital, where it was determined that he had sustained a C6 incomplete SCI. He remained in this hospital for 6 weeks. Following this, he was transferred to a rehabilitation hospital. There, he began to learn adapted skills that would allow him to be independent upon discharge. It was determined that Doug had enough arm and hand function to be able to self-propel in a manual wheelchair, and he had begun to learn to use a wheelchair during his OT sessions. He was also learning methods of transfer and bed mobility. Doug discussed his love of cooking with his OT, Gabrielle, and she had begun to teach him ways to cook independently. As his hand function was affected by the injury, it was especially challenging for Doug to open packets, and use scissors. He found it difficult to stir food in a mixing bowl, and he was worried that when he arrived home, he would not be able to use these skills in his mother’s kitchen. There, the counters were high, and most of the food was kept in cupboards above the counter that would now be out of his reach. He was very worried about becoming a burden to his mother and sister.

Doug’s mother and sister were not in any way worried about Doug’s discharge home. They were extremely supportive of his recovery, and encouraged him strongly. In fact they came to the hospital every day since the injury occurred. They knew that he would walk again one day, and told him this on a regular basis. Doug knew that with hard work and perseverance, he would walk out of the hospital upon discharge.

Two weeks after arriving at the rehabilitation hospital, Doug’s boyfriend Marc arrived to visit for the first time. Doug was glad to see Marc, but was worried about what his reaction would be to his injuries. Marc was so happy to see Doug that he cried, and apologized profusely for not having visited him before. He told Doug that he was afraid of coming beforehand, as he wasn’t sure if he could cope with the stress of losing the person he loved. He was also unsure of what Doug’s reaction would be to his arrival, considering that the accident occurred following an argument with him. He secretly felt responsible for the accident. Marc stayed for one hour that day, and didn’t visit again for another 2 weeks. This worried Doug. He believed that Marc was no longer interested in the relationship because he was now disabled.

Doug became very depressed when he realized that if his nerves did not regenerate, he may never have control of his bladder and bowel again. This prospect was very frightening for him. Also, the realization that his sex life in his current or any future relationships may be affected by his SCI was equally upsetting to him. The good thing was that Marc had been experiencing erections as of late; however he was still worried that he would not have enough motor control to be able to be sexually intimate again.

Doug also realized that he would not be able to return to his job in construction. He had not completed college, and had no other training that he could use to pursue another line of work. The idea of being disabled, dependent on his mother and sister for his care, unemployed, and without Marc was far too much for Doug to cope with. Doug soon began to develop suicidal thoughts. Without the ability to walk, Doug felt that he would be useless and a burden. He simply could not leave the hospital until he was able to walk again. There was no other option. He just needed to try harder. At least he had been communicating with his lawyer, who had recently informed him that he would be receiving a large accident settlement.

Doug soon refused to participate in therapy sessions that involved learning wheelchair use, claiming that he wouldn’t need to learn, as he would be walking soon. Gabrielle encouraged him to try to learn just in case he was unable to regain ambulation, but Doug was not interested, and became short tempered when she tried to persist in teaching him these skills. When Marc visited him at the hospital a second time, he suggested that Doug participate in learning to use his wheelchair, as it would be unknown as to whether he would walk again or not. Doug became extremely angry at this, and swore and yelled at Marc, then told him to leave the hospital. Marc was very hurt by this, and left reluctantly.

Doug’s time in the rehabilitation hospital was interrupted when he developed an iatrogenic staphylococcus infection in his blood after 6 weeks. After 20 weeks of time, Doug was informed that his discharge was being planned. Doug was very upset about this, as his legs were becoming stronger each day, and he continued to be hopeful that he will soon be able to weight bear. Besides, his rehabilitation was interrupted by the time he had taken to recover from the infection. He didn’t believe that the hospital was acting in his best interest, and blamed his physician for his lack of progress toward walking again.

Doug is about to be discharged into the community. He will be discharged with a manual wheelchair into his mother’s home. Marc has been visiting him as of late, providing him with support. Doug’s mom’s house is not accessible for his wheelchair, nor is there an accessible washroom available in the home. Doug has recently been informed that he will be receiving a large accident settlement. He is considering moving into his own home, or building an accessible home. He will initially be required to live in his mother’s home, however. He does not want to be a burden on his family or Marc. He desperately wants to become independent.