STRUGGLING, NOT GIVING UP
For Marylanders with spinal injuries from violence, financial and emotional costs run high on road to resilience
Walter Smith used to drive fast in his Ford Crown Victoria. Four years ago, the 60-year-old stayed busy working, playing sandlot baseball and spending time with his three granddaughters.
Smith’s life now moves at a slower pace after he was paralyzed in a 2020 shooting in Annapolis. His ability to leave the house in his power chair is weather-dependent — he spends most days sitting by a stop sign in Owings Mills, listening to music and watching as cars zoom down the road.
Smith is among thousands of Americans with spinal cord injuries caused by violence. But annual shooting statistics don’t factor in the experience of survivors with life-altering gunshot injuries who must navigate overwhelming physical, financial and emotional challenges.
“I just want to start my life,” Smith said last winter as cars roared down Painters Mill Road. “I watch the cars go by and wonder where they’re going because I want to go.”
Some new car models are unrecognizable to Smith, who was hospitalized and in nursing facilities for two years before he could find his own wheelchair and
apartment. His ability to sit up and venture outside is the culmination of a threeyear journey.
“Never give up. That’s my motto, even when it’s hard days,” Smith said. “I’ve come a long way. I’ve been in some bad places, bad nursing homes.”
The cascade of difficulties in accessing transportation, housing, employment and a personal wheelchair is daunting, according to disability and medical experts. Continual medical complications and mental health impacts can be particularly tough, which “people don’t really think about,” said Dr. Cristina
“I’ve come a long way. I’ve been in some bad places, bad nursing homes.”
Sadowsky, the clinical director of the Baltimore-based Kennedy Krieger Institute’s International Center for Spinal Cord Injury.
“Paralysis, basically, in one way, kills the previous person that you were and gives birth to a new person,” Sadowsky said. “You have to learn to live your life differently, and not everybody is resilient.”
Acts of violence, mostly from guns, represent about roughly 15% of traumatic spinal cord injuries since 2010, according to the National Spinal Cord Injury Statistical Center. Baltimore, which saw a 20% drop in homicides last year but still has one of the highest rates of gun violence in the country, also has some of the nation’s leading spinal cord injury centers.
Kennedy Krieger, which primarily treats pediatric patients but also some adults, has seen 150 patients injured by gunshot wounds in the past 10 years. At any given time, 5% to 15% of its patients sustained injuries from violence, usually gunshots but occasionally from stabbings.
‘They got me back together’
Death seemed likely for Smith, who was shot nine days before Christmas by the brother of his former girlfriend. Smith, a sanitation engineer, had just gotten off work from Anne Arundel Medical Center and brought his 5-year-old granddaughter to his girlfriend’s apartment at Harbour House public housing community. Smith said he last remembers opening the apartment door.
Rodney Dorsey, 36, is serving a five-year sentence for second-degree assault and narcotics possession. Dorsey’s attorney argued Smith hit Dorsey’s sister during an argument and that the shooting was in defense. Reached by phone, the former girlfriend said she was hit and declined to comment further. Smith denied the allegation.
He was flown to Shock Trauma, where he remained in a coma for three weeks.
In the first year after an injury, the cost of health care and living expenses range from $429,300 to $1.3 million, depending on the severity, according to the National Spinal Cord Injury Statistical Center. Each subsequent year costs from $52,100 to $228,400, and that’s not including indirect loss such as wages, fringe benefits and productivity, which averaged $88,900 per year in 2022 dollars.
Unable to work, Smith lost his employer-sponsored health insurance. While at an inpatient rehab facility in Edgewater, a severe case of COVID-19 landed him back at Anne Arundel Medical Center. He enrolled in an insurance plan and couldn’t return to Edgewater.
The Annapolis hospital sent him to what it said was the closest facility that accepted his new insurance — a nursing home in Clinton, an hour’s drive from his family.
Lying in a dirty, shared room there, he didn’t receive physical or occupational therapy and suffered from bedsores, he said. Two bullet fragments are still lodged in his lower back, threatening lead poisoning.
“In the nursing home,
I was locked up like I was in jail,” Smith said. “We couldn’t even come out of that room because of COVID.”
People with disabilities, even young children, often end up in nursing homes, said Jennifer Johnson, deputy director for the federal Administration on Disabilities at the Administration for Community Living. It’s difficult for people living with a disability to get the services and support they need to integrate back into their communities. The agency provides local organizations with grants and other funding
to help find services such as housing, transportation and employment.
Smith also struggled to afford the Clinton nursing home. In 2022, the median yearly cost of a semi-private nursing home room in the United States was $94,900, according to a cost of care survey by Genworth, a life insurance company. The median yearly rate for a private room in 2022 was $108,405.
It took Smith’s former co-worker constantly calling social services and rehab centers until she found an open bed in Arnold. Even then, Smith had to borrow
a wheelchair and pay $85 for a private transportation service to take him to the rehab center.
By his second day, therapists there helped Smith start to sit up.
In a few weeks, Smith could use a wheelchair. He applied for Medicaid with the help of a social worker. He got an electric wheelchair, priced at $34,000. A local Center for Independent Living, which receives funding from the Administration for Community Living, helped him get a voucher for an apartment in Baltimore County.
“They took care of my
wounds,” Smith said of the Arnold rehab center. “They got me back together.”
Now, the highlight of Smith’s week is when he goes to physical therapy at Kennedy Krieger’s spinal cord injury center.
Keeping up hope
A lavender sign that reads “Hope through motion” hangs over the door of the center at Kennedy Krieger. Sadowsky wears “Hope” earrings with a matching necklace.
“If you lose hope and you don’t have a motivation or a purpose, life is really boring,” she said.
Patients use special exercises and technology, like electric stimulation, to reteach their nervous system to control movement. Activity-based restorative therapies are used for recent injuries and injuries that are decades old.
On a January morning, Terrell Wilson, 23, strapped on leg braces and began to walk for the second time in two years. He was shot in the back during a fight in 2021 in Baltimore.
Physical therapy is a chance to stand up, Wilson said, bringing relief to his long legs after sitting in one position for so long. It’s also an opportunity to prove to himself that he won’t be limited by his injury.
“It’s exciting,” Wilson said. “All I can think about is when I first came here I wasn’t stable enough or strong enough to try to walk with the leg braces.”
Wilson was discouraged about life after his injury. He had hip surgery last year to fix a bone overgrowth that caused months of medical complications. But as he grows stronger, Wilson grows more confident in his ability to reach his goals of having a house and a family.
“There’s no stopping,” he said.
Like Smith, Wilson struggled to navigate insurance after his injury until his parents got him onto their health care plan. Wilson spent three weeks at Johns Hopkins Bayview before moving into his grandmother’s one-story house. His mother, Eshon Hawkins,
moved from Alabama to Essex with Wilson’s younger brothers to be closer to resources like Kennedy Krieger.
“He’s so strong,” Hawkins said, watching Wilson remove his leg braces. “He keeps me going.”
A new road
In Owings Mills, a picture of a younger Smith sitting casually at a friend’s wedding hangs on the wall, a reminder of who he was before the shooting.
Smith tries to put the past behind him and focus on being independent. He has everything he needs, he says, except for his family. The limited supply of accessible and affordable housing resulted in Smith living miles from his relatives who, without reliable transportation, can’t visit.
“I can’t go nowhere unless I catch a Mobility bus, but Mobility buses don’t take me anywhere close to my family,” Smith said.
MobilityLink buses, the state’s public transportation for people with disabilities, frequently drive through his apartment complex, but they are tied to local transit routes and don’t reach Smith’s son’s house.
Smith could visit his family or volunteer if he owned a disability van, he said, but the price of a used one is around $30,000. He would hire private transportation, but his large electric wheelchair doesn’t fit into a regular car.
With few places to go, Smith makes daily trips to the stop sign at the end of his street, where he sits under the sun, like a plant energized by the light. Most days, he zips at 5 mph to a nearby grocery store, at times merging with cars to avoid the risk of being hurt on a bumpy sidewalk.
This life isn’t what Smith expected when he turned 60 in November, but he’s got plans for his future. He hopes to get a job and get strong enough to use a manual wheelchair that fits into a car.
Until then, Smith queued up the Black Eyed Peas’ “Where is the Love?” and set off down the road.