"... I was fortunate in that no one gave me hope that I would ever walk again. But that wasn't true for some of my fellow patients who were told about promising new research and to "never give up hope". They went home and postponed their lives waiting for the cure. Certainly in the short run hopelessness can be anguish. But as a Native American saying goes: "in hopelessness, we become open channels." Dan Gottlieb, Ph.D., April 2, 2009, "Ask Dan" @ Philly.com.

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How is the dilemma of hope vs. hopelessness resolved in the face of cutting edge research? I received an e-mail today from my physical therapist at the regional rehabilitation outpatient program checking on my progress. I'm fairly certain the real question that went unasked is whether I have reconsidered participating in the locomotor training program. In some ways a complete spinal cord injury is more humane than an incomplete injury. Although today, most people with SCIs are given the possibility of some recovery presented to them, whether it realistically possible or not. Each person has to decide their own path. Margaret Weis, an acclaimed science fiction writer, describes the role of hope in Dragons of Winter Night:

"Hope is the denial of reality. It is the carrot dangled before the draft horse to keep him plodding along in a vain attempt to reach it."

I am not certain how this issue is to be reconciled. Plodding along trying to reach a carrot, like the draft horse, is a reasonable path to take initially. The difficulty arises when one decides to slow down the pursuit and live more in the present. The lure of the possible does not go away, rather it continues like the siren's cry from the Lorelei. I began evaluating the pursuit when I saw video clips of two guys who worked for six years to relearn walking. One guy walked with a cane for balance, the other guy looked like me, walking with a walker for short distances.

I began to consider what my body was telling me. My left knee is difficult to straighten and is painful at times. My left ankle, though healed from the fracture a year and a half ago, still swells and is not stable. It rolls when I try to walk unless I wear the big, bulky AFO, which makes it even more difficult to straighten my left knee.

Conditions have to be perfect for walking or I experience severe abdominal spasms, during which I have to sit down and breathe in tiny, shallow breaths until the spasm relaxes and I can breathe normally. The conditions are that I cannot eat or drink within an hour of walking, I have to be well rested and have no issues with my bowels or bladder. Additionally, my blood pressure must stay in a normal range rather than dropping too low.

These factors, plus the fact that I was older than most at the time of my accident, and have worked continuously for three years to regain my current level of function, have caused me to pause and consider the cost vs. benefit issue. Quite frankly, I don't want to continue the level of physical therapy that I have been doing at the exclusion of other pursuits that are equally important parts of a balanced life for me.

Even though I have made a thoughtful decision, I know I will periodically haunted by the words of H. Ross Perot when he said that, "Most people give up just when they're about to achieve success. They quit on the one yard line. They give up at the last minute of the game one foot from a winning touchdown". As I consider factors, including some that only I am aware of, my decision seems to be the right one for me, for now.

I have progressed much farther than predicted and, even though I can't deny that I have more than just a little doubt at times that I have pushed hard enough and long enough, I am out of energy to keep on doing so. Perhaps part of my issue is also the "never good enough syndrome". I am where I am right now, searching for a way to find meaning for the rest of my life and trying to find balance between my heart, mind, body, and spirit.

My hope is that this is the right decision for me. I choose to operate on that premise now.