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Abstract
John R., 28 years old, was admitted to Sunny Dale Hospital in the Midwest with a crushed arm from a motorcycle accident. John came through the surgery without complication and was fitted with his prosthetic arm and hand by the end of the first week, post-surgery. John continued outpatient rehab and made steady progress with his prosthesis. Many with his kind of loss never really get over the loss or find trouble adapting to their new reality. In John's case, however, he just picked up where he left off pre-amputation. Physical medicine providers tend to expect that a patient, who has a significant disability as the result of a chronic disease or injury that produces burdensome symptoms, to be seriously and negatively impacted. That is, there is an evidential mismatch between what clinicians predict will happen and what actually happens pertaining to many of their patients' experienced Quality-of-Life (QOL).1-3 These patients represent the disability paradox, i.e., those who report after the disability occurs that the quality of their life is good or excellent, despite the predictions or expectations of their physical medicine providers.4,5
The Editorial Group of the Lynch Center for Ethics
PRESENTATION
John R., 28 years old, was admitted to Sunny Dale Hospital in the Midwest with a crushed arm from a motorcycle accident. The surgeons tried to save John's arm but it was ultimately amputated just below his elbow. To make things worse, it was his right arm, and he is right-handed.
John came through the surgery without complication and was fitted with his prosthetic arm and hand by the end of the first week, post-surgery. Within days of his prosthesis being fitted, he was transferred to Sunny Dale Hospital's Rehabilitation Center.
Because the patient had lost his right hand and lower arm, he had to learn to adapt to activities with only the use of his left hand and, simultaneously, learn to use his prosthesis. His parents, who had been at his bedside since the accident, were concerned that their son would fall into depression and be unwilling to work with the rehab team. But nothing could have been further from being the case.
John's mood had been stable throughout his care. Even when he awoke to find himself having...