Actor Christopher Reeve, 42, will never walk again, he was told this week. And now he has to face spending the rest of his life in an electronic wheelchair - controlled by a mouth or head device.
Reeve was paralyzed from the neck down when he was thrown headfirst from his horse in May.After three months of intensive treatment, he has managed to regain only slight movement and feeling in his shoulders and neck. In June, he underwent surgery to fuse two damaged vertebrae in his neck, but this resulted in only a little improvement.
What are his prospects? Many people with spinal injuries show extraordinary resilience and courage.
"We have to get on with life and live to the full," says Stephen Bradshaw, director of the Spinal Injuries Association in Britain. "The wheelchair is the most amazing, liberating device, without which I would have to drag myself across the floor. I just couldn't begin to lead my internationally active life.
"Christopher Reeve's wheelchair will enable him to travel faster than a person can walk. With computer technology he'll be able to do anything from answering the door to controlling the central heating."
The control panel on Reeve's wheelchair will be designed specifically to meet his needs. A panel could be mounted at chin level and operated by head movements, with the mechanism responding to forwards, backward or sideways pressure.
Alternatively, he might opt for a breath-control device that involves wearing a neck halter. He would suck or blow into two tubes connected to pressure sensors. Sucking on both tubes would make his chair go backward; blowing down both would send it forward. By blowing or sucking on one tube only, he could make a left or right turn.
"It is even possible to carry out all these actions by eye movement - and it won't be long before it can be done by mind over matter," Brad-shaw says.
"Scientists are developing a computer system that can link the brain to a wheelchair's power pack and steering, enabling the user to control its speed and direction."
This prospect has emerged from studies of epilepsy sufferers in Germany, with researchers training them to control fits by altering their brain patterns.
However, Reeve will need intensive care for the rest of his life. Many people with similar injuries require up to five full-time care givers to deal with every bodily function. At night, they need turning frequently to prevent pressure sores and to remain comfortable.
"Caring for someone like Christopher Reeve is very expensive, but technology is reducing the bill," Bradshaw says. "Low air-loss beds are reducing the need for regular turning, and wheelchair cushions are reducing pressure on the bottom by spreading it more evenly.
"Technology is more and more helping us to retain control of our own lives. . . . Perhaps the biggest obstacle Reeve will face is unwitting negative attitudes to disabled people."