Usually it is a car wreck. But there are also wounds from gunshots, plane crashes and falls from horses, bicycles and scaffolding.
Everybody's story is a little different. Kristi Reid recalls nearly every detail of those first few hours, including the name of her emergency room nurse. Sam Barukh did not even know for a month that he was paralyzed.
What they and others in recovery share in common is the lifelong effect of a spinal cord injury. They are among a group of people whose lives changed in seconds and who, on any given day, can spend hours swinging from hope to despair and back.
The plight of those suffering paralysis drew national attention last month when a Los Angeles man, a former marathon runner, disclosed that he was considering suicide withthe assistance of euthanasia practitioner Jack Kevorkian because he did not want to continue living as a quadriplegic.
Talk of suicide is common in the first days after an injury, say patients and counselors at Northridge Hospital Medical Center, a well-known recovery program for paraplegics and quadriplegics. A small number eventually carry out their plan, they say, including a young man who drove his electric chair to a swimming pool in order to drown himself.
Given time, most choose to live. But it is a decision that can sometimes vary from hour to hour and from day to day, say patients and those who assist them.
Helping spinal cord injury patients adjust to the prospect of life in a wheelchair is in most cases as important as their physical recovery. Counseling is a key element of the Northridge program.
"It is the ultimate crisis," said Encino psychologist Sandra Rudnick, who counsels patients at the Northridge hospital. "Your identity is altered forever."
The weightlifter, the stunt woman, the welder, the office manager, the high school kid--none of them gave much thought to the high cost of wheelchairs, or to the availability of handicapped parking, ramps, wide bathroom doors or the hundred other hurdles, small and large, they now face as disabled people.
"Many, many times I've asked God, 'Why me? What did I do?' " said Kristi Reid, 28, who completed the Northridge program last year after being left a quadriplegic by a car crash. "You don't realize, never even think what it would be like until it happens to you."
The first and greatest change for new patients is the almost total dependency on others for the most simple tasks, such as eating, moving and using the bathroom.
"At first, it was like being a baby, an infant. I couldn't even move my arms," said Sam Barukh, a patient who was a Cal State Northridge computer science student and six-day-a-week weightlifter before rolling his truck on the way home from Las Vegas three months ago and breaking his neck and back in five places.
He can now put on his shoes and socks and work at his computer, and in the past two weeks he has started lifting weights again.
"I got that lactic acid burn, and it felt kind of good," he said with pride.
Barukh, 22, said he still plans to create computer software for a living, but his first goal is to learn to care for himself.
"I don't want to sit around and be a couch potato," Barukh said. "But I wasn't always feeling that. The doctors, the therapists have been great. I haven't found one pessimist yet."
Patients in the Northridge program receive physical therapy, as well as help learning tasks such as getting from a wheelchair to a bed and how to drive a car with hand controls.
In the hospital room down the hall, Tova Rimon, who lost one of her two daughters in a car crash last year that put her in a wheelchair, said: "I am dealing with two grief issues. There have been times when I've been feeling really low, and I say, 'Is this worth it?' They will tell me, 'Two years down the road, you'll see it's worth it.' I sometimes don't see that because the progress is so slow."
But last week, Rimon took her first step with leg braces and was released to return to her Studio City home.
"My dream is to walk. I keep telling them, 'I will walk,' " said Rimon, an office manager whose boss wants her to return to work.
The ability to walk is a great dividing line among recovering spinal cord injury patients, but there are many others. Among quadriplegics are those whose injuries are so severe they need machines to help them breathe, while others can sit up and move their arms or hands. Some have partial use of their fingers or their thumb.
The license plate of Bobby Rohan, a quadriplegic who was a junior at El Camino Real High School in the West Valley when he had a bicycle accident nearly three years ago, reads IWILWLK.
While talk of miracle cures surface from time to time, most recently with advances in fetal tissue research, some say they prefer to concentrate on improving their lives with their current abilities, rather than pinning their hopes on a long-shot cure.