What hurts more; what heals faster?

I am currently doing a neuro-rehab rotation. There are two very striking things about this rotation. First, the duration for which some of these patients have been here and the other; seeing conventional rehab and innovative technologically advanced rehab at work together to enable people to do things which we don't think twice about like walking, eating, voiding, moving one's bowels etc. and fighting fiercely to be as independent as possible wrt their ADLs(activities of daily living). So far, I have essentially seen Motor rehab and not cognitive rehab. Motor rehab is supposedly easier as one might imagine but it is painfully slow, needs a lot of endurance both of the body and spirit not only of the patient but his care-givers as well. There's the SCI (Spinal Cord Injury) unit and there's the TBI (traumatic brain injury) clinic. Since it's at the VAH (Veteran's Affairs Hospital), I know each one of the gentlemen lying in their beds in the SCI unit with paraplegia (paralysis of both legs) or tetraplegia (paralysis of all four limbs) waiting for someone to feed them or dress their pressure ulcers or clean them up, served in the armed forces at some point in their lives. I have always admired people from the armed forces who I feel do selfless service for their countries and have always felt that their sense of pride about their country, their work and their being, their self-sufficiency and their discipline is what makes them who they are. I don't know what hurts these men of honour more, their physical or their psychological dependency on others. Does being a tough guy make it more difficult to come to terms with being dependent on others even for the most mindless, almost reflex things we all do day in day out? And because you're a tough guy, does sharing that pain become more difficult and does the internalization of so much suffering erode your self-esteem paradoxically?

What amazed me last week in my first, brief encounter with the SCI unit was some of these men who seemed to be made up of a different fabric! They were laughing, gleefully sharing their hunting/fishing stories, lifting their arms up (with a lot of effort) triumphantly and telling me how once they're in their motorized wheel-chairs, they can do anything or enjoying a hearty breakfast and actually wishing they could have more bacon! And watching them, brought all those thoughts I mentioned above to my mind again and I felt a sense of regret because here are people who knowing well the limitations of their bodies want to constantly challenge themselves and win; when they don't feel sorry for themselves then why must I feel sad? Then I wondered; if being a tough guy with a strong will-power makes you better-equipped to deal with such physical limitations and inspire people around you and show the world that you're unbeatable no matter what!

And then there were men who lay in bed with the saddest eyes I have ever seen; with tracheostomies, and stubborn non-healing wounds through which bones were playing peek-a-boo; with colostomies; suprapubic catheters and wounded spirits. Some of them have been here in the SCI unit for more than a year. I wonder when their wounds will heal or how much will they scar; I see some scars already with my yet untrained eyes. I can’t help but think which scars are uglier, the ones that show or the ones that don't but completely disfigure your spirit? Does paralysis of the body make you more dependent than the paresis of the mind? Which of these recovers faster and recovers more completely?

Being in the midst of such contrasting patients with similar physical maladies leaves me with more questions than answers, with more inspiration than despair.