If you're still planning to see the Oscar-winning film "Million Dollar Baby" and don't know the ending -- go to the next column now! I'm giving it away. Maggie, played by Hilary Swank, takes a massive blow in the boxing ring and is left a quadriplegic on a respirator. After she repeatedly pleads to her crusty (but loving) aging manager Clint Eastwood to be allowed to die he finally complies both by "pulling the plug" and giving her a lethal dose of adrenaline.
Disability advocates claim the intent was to send a pro-euthanasia message. Certainly by law Swank could have simply asked her doctor to take her off life support. Instead, Eastwood's character breaks the law in bypassing the doctor and changing the action from passive to active. That does sound like a message.
"It was a cheap manipulation of the worst stereotypes of disability to get the audience to sign on to the idea that killing was the only real solution to the problem the disability presented," says research analyst Steven Drake of the disability rights group Not Dead Yet. "Let's face it," says Marcie Roth, executive director of the National Spinal Cord Injury Association, "the message of the movie was: 'Better dead than disabled.'"
It also did not please these people that the best foreign-film Oscar went to The Sea Inside, about a quadriplegic who fought for decades to legally commit suicide. "Both of the best picture awards went to killing cripples," says Drake incredulously.
John Kelly of Boston calls the film "a lie." He's not a film critic, but he knows something about the subject. "When I was 21 I was sledding on a piece of cardboard down a hill and a tree jumped up in front," he told me. He's now paralyzed from the neck down. "I'm everybody's worst nightmare," he says chuckling.
Now 41, Kelly is one of the approximately 11,000 new spinal cord injuries in the U.S. each year. Of these, about a fifth lead to what's medically called "complete tetraplegia" or more commonly "quadriplegia." But technology continually makes it easier for such persons to lead enjoyable and productive lives.
Mobility is vital, and at a single website you can find 55 different models of power wheelchairs, the descriptions of which sound like sports car reviews. They discuss horsepower, speed, turning radius, how high an object they can surmount. One has "Six wheels on the ground [to] provide superior stability and a smoother ride," while another has tank-like treads for off-road driving. The iBOT, from the designer of the Segway Human Transporter, climbs and descends stairs.
Communication is also vital, aided now by tremendously improved voice-activated software. With it you can write books, surf the web, answer or dial the phone, and -- O, joy! -- even pay bills. Voice-activated e-mail allows quadriplegics the same opportunity to read and write letters and receive spam as the rest of us.
All of these technologies were either invented or vastly improved since Christopher Reeve's accident. Moving higher up the tech ladder, new "functional electrical stimulation" (FES) devices implanted in the body can restore some hand movement and allow those with spinal cord injury (SCI) to feed themselves.
Just ten years ago, the chief causes of death of those with SCI were bladder infections and bowel complications. But FES devices can help control the functions of both organs, such that now the major cause of death in SCI persons is heart disease just as with the general population. Maggie could have used one of the new stimulation devices that assist with breathing, freeing many quadriplegics from the ventilator.
We've also greatly improved our knowledge of physical rehabilitation for recently-injured persons. "If I could have talked to Maggie," says Kelly, "I'd say 'We're going to take you to a real rehab center with other people with spinal cord injuries and a gung-ho staff to help with physical therapy as well as being able to treat your depression."
Those who work with the disabled talk guardedly about "a cure." Research showing partial regeneration of injured rodent spines from adult stem cells goes back a decade, and is now undergoing human testing. Others have used mature Schwann cells from the brain to regenerate animal spinal tissue.
Yet for anybody who hasn't been recently injured, even complete spinal regeneration would require tremendous rehabilitation to get atrophied body parts moving again. Roth thinks many SCI patients wouldn't find it worthwhile. "These people have grown accustomed to their lives and many wouldn't want to change them," she says.
After his accident, Kelly got a master's degree in sociology at Brandeis University. "I can do lights, appliances, air conditioning, make phone calls, control the television." He says, "Sometimes I watch TV and work on the computer at one time like any multitasking American and it's fun! I go shopping like anybody else. I really enjoy cooking. I enjoy music and can control my stereo (a jukebox-type variety that holds hundreds of CDs) with my wheelchair."
Adds Kelly, "It's annoying to have to say my life is good in order for people to stop thinking I'd be better off dead. But I love my life and everything in it," he says.
Maggie might have ended up feeling the same way -- if only the script hadn't killed her off.
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