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PERSPECTIVES IN BIOLOGY AND MEDICINE Volume ? · Number 2 · Winter 1974 SITTING ON A BASKETBALL: HOW IT FEELS TO BE A PARAPLEGIC* PAUL C. BUCY, M.D? In all probability you have never sat on a basketball without being able to feel it. Neither have you imagined such an unlikely situation. For the next few minutes let us give free rein to our imaginations and try to put ourselves in the position of people to whom this is a reality. A few years ago a paraplegic was asked what it was like to be a paraplegic . His answer was: "It is like sitting on a basketball that you cannot feel and do not know is there." This was a most incomplete description of the situation which confronts the young men who are paraplegics or quadriplegics. Paralysis is only part of the picture. The loss of all sensation below the level of the lesion and of control over bowel and bladder are equally important. Probably most important of all, for the patient, is the loss of the ability to perform sexually, while sexual desire remains as intense as ever. Also important are a variety of serious complications to which these patients are subject, such as pain, bed sores, infections ofthe bladder and kidneys, the development ofmyositis ossificans , and the ankylosis of their paralyzed joints. Although paraplegia is not uncommon, the existence of this condition is not widely recognized. Because of their disability, because of their sores and the offensive smell of urine and feces which they may have, these patients all too often slink away out of the public eye, either at home or in some nursing facility. How many are they? There are over 10,000 young people paralyzed in this fashion in this country each year, an average of 50 per 1 million people. There are about 125,000 people permanently paralyzed in this manner in the United States at this time. And as our population grows and the causes of the accidents resulting in such paralysis increase, the numbers go up and up.»Revised from a paper delivered before the Chicago Literary Club, April 1973. tP.O. Box 1457, Tryon, North Carolina 28782. Perspectives in Biology and Medicine · Winter 1974 | 151 Who are these people? They are almost all young people between 18 and 25 years of age. Eighty-five percent of them are young men. They are the vigorous, active young people of our society because it is in vigorous activities that they are injured. About 50 percent are injured in automobile accidents. Most of the others are injured in sports accidents, of which diving accidents lead the list. Try to imagine yourself again as a vigorous young man who is rendered paralyzed in the twinkling of an eye. Your future is gone. If you survive, and today most do survive, you are faced with years of battle against your disability and its many complications. Your sex life is gone. But your sexual desires are not. Your eyesight is there, your mind is there, and the accident did not destroy your testicles. Only your ability to perform has been destroyed. If you now have the picture let us review the history of the situation. At the time of World War I most people paralyzed by injury to their spinal cords died in a relatively short time. If they had injured the spinal cord in the neck, they died because of paralysis of the muscles of respiration or because of infection or edema of the lungs. If the injury was below the neck, they died from infection of the bladder and kidneys or infection in their bed sores. By the start of World War II, not quite a quarter of a century later, no paraplegic or quadriplegic from World War I was still alive. Dr. George Riddoch, an English neurologist and a good friend of mine, who had had close contact with the paraplegics of World War I, determined that that was not going to happen again. In the midst of World War II he went to the British government and successfully insisted that a special effort must be made to treat these unfortunate young men better. He recognized...

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