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a complete paraplegia below TIO/II. He was difficult to manage but eventually made a
satisfactory rehabilitation so that he was given the opportunity to be admitted as a
resident to the Duchess of Gloucester House to take up employment in light industry.
He was full time employed, earned good money but was caught with others pilfering
from his firm and was dismissed. He was given another chance and was re-employed by
a firm producing lighters, but a few months later he was dismissed because ofstealing some
lighters. He left the Duchess of Gloucester House spontaneously, as otherwise he would
have been dismissed as unsuitable for residency at this hostel, and returned to his family.
Only two patients (both with incomplete lesions and able to walk) had to undergo
specialized treatment for chronic alcoholism. Recently one former patient who was full-
time employed for many years died from acute alcohol poisoning.
Several psychotic individuals such as schizophrenics and others suffering from depres
sion had tried to commit suicide by throwing themselves out of a window and sustained
spinal fractures with spinal cord injuries. Sometimes, the traumatic shock may effect a
remission of the mental illness. However, psychotic paraplegics need careful supervision
by the nursing staff, as they may try to make another attempt and may become a danger
to themselves and other patients. One case of schizophrenia who sustained a paraplegia
tried to cut his throat with a knife he demanded from another patient. Fortunately, this
was discovered immediately, and the self-inflicted wound which did not affect the large
vessels of the neck was immediately sutured. Such psychotic patients should be trans
ferred to a psychiatric department at a very early stage to receive specialized treatment.
Psychological treatment
When the paraplegic begins to realize the extent of his disability, it is the immediate
task of both medical and paramedical staff to awake in the patient also the realization
that he has still great forces of readjustment left in his organism which can be utilized
and mobilized to overcome his disability, provided these forces of adaptation and repair
are not counteracted by drugs, such as barbiturates, which interfere with clear thinking.
The patient must be indoctrinated with the idea that spinal paraplegia is not the end but
the beginning of a new scheme of life, which starts once he has come to terms with his
physical defect. In our experience, this is greatly facilitated if the extent of the patient's
definite physical defect and, at the same time, his possibilities of returning to his family
and community as a useful and respected member is explained as soon as possible
to both the patient and his relatives.
As pointed out above, it lies in the nature of such an overwhelming physical defect,
as produced by a spinal cord transection, that the patient is inclined to be passive towards
any treatment. Therefore, the sooner he is directed toward intensive and purposeful
activity the easier his psychological readjustment and social re-integration will be achieved.
In this respect, three measures have proved invaluable towards accomplishing this goal:
active physical exercise, sport and work therapy. They have proved ideal methods to
counteract abnormal reactions resulting in frustration, defeatism, resentment and isola
tionism and have been most invaluable in restoring the will to live with himself and with
others and in developing his self-confidence, self-dignity and, most important of all, to
