This is the time to stop and explain a very important principle. It’s no accident that an entire ward empties its guts at the same hour each morning. You’ve got to understand that one of the first things spinal-injured individuals lose, after their feelings and movement in their legs and arms, is control of their sphincters. Sometimes it’s like an army base with an open gate, where anything can leave whenever it wants, without permission from anybody. And sometimes it’s the exact opposite. Shutdown. A hermetic sealing of the gate strong enough to lock in the Chief of Staff until the gate opens. Or anything between those extremes. Not only that. Loss of sensation in the lower part of the body can also lead to some very unpleasant situations, with hordes of soldiers exiting the camp gates without anyone taking note of them. Until the smell hits, of course.
That’s why it is necessary to impose iron discipline on the opening and closing hours of the gates. The Daily Bowel Movement Regime is the supreme principle aggressively engraved in ward procedures and based mainly on lots of laxative pills in the evening to stimulate the digestive mechanisms while patients sleep, and suppositories in the morning to assure well-controlled and well-timed opening of the valves at daybreak. How well the ward patients’ bowels obey the orders imposed by the laxatives determines the patients’ standing among the staff: If your movements are orderly, you are great, you are a king. If not — you are on the shit list, pun intended. Word about patients whose movements are not orderly is transmitted through the grapevine to all the staff, old and new. Each patient must fill out a “daily feces report” in which he notes the hour of evacuation, which laxatives were taken, the amount that was evacuated (how do you measure that — by plops? an echometer?), and my favorite column: texture. Was it hard or soft or liquidy? (Guys — how about a little creativity here: velvety with a hint of sandpaper, camembert tending towards cream soda). At the end of the rehab process, the digestive systems of quadriplegics are supposed to be disciplined input-output machines, combination blenders-Trash-Masher-Compacters that collect, process, compact and eject food remnants at the press of a button.

This daily obsession with intake and output, which retrogresses internees to the anal stage of infanthood, disturbs the already shaken souls of those dealing with the sudden loss of their ability to move their limbs, but it fades into insignificance compared to the terror that overcomes you when in the middle of physical therapy, just as the therapist is moving your right leg behind your left ear, you suddenly eject a few odiferous glumps that someone (thank God not you) will have to clean up. And this is closely followed by the humiliating nightmare you suffer when at six in the evening you ask an aide to help you to the toilet. “What? Now??” he says with obvious distaste. Didn’t you just go to the toilet 11 hours ago! And as they take you they’re muttering under their breath that this can’t go on and it has to be taken care of and this is serious. And with every word your heart sinks lower and contracts and you know you’re headed to the shit list and wish you could just disappear.

Some time later — I’ve been in a dreamy haze — the door opens and my guy looks in. “Finished?” he asks. I say yes but there’s always — always — the niggling fear that maybe I’m not, maybe a little more just to be sure, maybe some surviving remnants of yesterday’s intake are getting clear of a bottleneck at a sharp turn just before the exit ramp. Because if all goes well it’ll be another 24 hours before I’ll have a toilet under me again. Just before flushing he peeks into the toilet and lets out a whistle, “Pshshsh… — good consistency today.” I blush. There’s nothing like a compliment to raise a smashed psyche and inject the illusion of control over one’s wayward sphincters.

We move to the shower. My guy turns on an invigorating stream of hot water and his skilled hands act in place of my paralyzed mitts. He scrubs me while I just sit and give orders: a little cooler, a bit more on the head, you missed a spot. The mirror and room are enveloped in a cloud of steam and I wish I could stay another half hour. But my guy is impatient — others kockers in the ward have to be washed and dressed. The water is turned off and he dries me with a towel not much bigger than a washcloth. He wraps a sheet around my back and strategically places the wash cloth towel over my privates so that no passing eyes can revel in my jewels as I am trundled down the hall to the room. I’m clean and fresh, and enjoy the pleasant draft of cool air that washes over me, intermingled with the aromas of excretions generously contributed by my ward mates. In my room he lifts me onto the bed, dresses me in clean clothes, including a bulky diaper for just-in-case, and then retransfers me from bed to wheelchair. Now I am ready to begin the new day.

I roll towards the dining room and another day of life in the rehabilitation ward. The morning shit is behind me. The rest of it is still to come.