Sick and Tired

A tragic accident, underpaid, overworked personal-care attendants, and one pissed-off patient

At 9:30 on a Tuesday morning, Mike Marco places a CD on his stereo and hits play. "Gimme All Your Lovin'" punctures the air of his one-bedroom apartment in St. Louis Park. "Working music," he says grimly.

A makeshift collection of well-worn furniture is scattered around the room: wooden chairs without seats; a lumpy, tan two-person couch; a brown recliner. With the exception of the Aiwa stereo and a 19-inch TV set, all of the furniture was acquired from Catholic Charities for $100. As ZZ Top blares, Marco guides his $14,000 electric wheelchair down the hall toward his bedroom. The white walls are streaked with black, the results of navigating the 300-pound vehicle through a narrow space.

Marco positions himself next to his electronic bed. Metal rails run down the sides to keep his six-foot-two-inch frame from falling to the floor while he sleeps. The softball-size hole in the footboard is a reminder of the time he inadvertently smashed his knee through the faux wood. A Sammy Sosa poster is the room's only decorative touch. The air smells of pharmaceutical supplies and is dense and dank with cloistered humanity.

James Jukes

It took Marco more than two years to learn how to get in and out of his twin bed, one of the few morning rituals he can perform by himself. ("You literally can't wipe your butt anymore," he'll tell you. "It takes some getting used to.") After detaching the wheelchair's left footrest and armrest, he wedges a wooden plank under his butt. Bracing himself with his left hand on the bed, Marco awkwardly slides his heavy frame down the board and into bed. Then he reaches back for his legs, which stubbornly cling to the wheelchair. He heaves them onto the bed one at a time, each leg thudding down on the mattress like a dumbbell.

Renada, a personal-care attendant, is assisting Marco this morning. She is somber but agreeable, responding to his constant requests for help with silence. She removes her patient's sweatshirt and sweatpants. He is naked underneath, save for the mass of tubes, bags, and bandages around his waist that pump morphine and a muscle relaxant onto his spinal cord and permit him to perform bodily functions without immediate assistance from others. One of the things he recalls his former wife saying before she left, he relays dryly, was "'Mike, I don't know if I can live with bags.'"

A partial quadriplegic, Marco cannot feel anything below his chest, but his body is a living, breathing medical chart. One wrist is marked by a scar, left by an infected IV line. Bandages cover sores on his toes where the skin has worn away. The right side of his forehead, where he wore a metal halo for seven weeks, is slightly indented. A blue-green, snakelike scar runs down his spinal chord, which doctors fused together five years ago in a five-hour operation.

Renada hands Marco a damp washcloth and squeezes several dollops of soap onto it, and he begins scrubbing his arms, shoulders, and chest. When he's finished she hands him a damp towel to wipe off the soap. Then she performs the same task on the parts of his body that he cannot reach. She scrubs his back, lifts each leg straight up in the air to wash them down. She leaves him one scrap of dignity: Marco cleans his genitals himself. "Nothing's sacred anymore," he mutters. "Nothing."

Renada replaces Marco's Frisbee-size overnight urine bag with one that's slim enough to be concealed by a pant leg. She fortifies his bandages, sprinkles medicated powder along his flaccid thighs to prevent chafing, wrestles socks and sweatpants onto his uncooperative legs. Then Marco reverses the slide along the board from bed back to wheelchair and heads off to the bathroom to wash his hair in the sink, brush his teeth, comb his hair, and shave. The jerky razor-swipes of his crippled hands leave his face speckled with blood. By 11:00 a.m., an hour and a half after beginning his morning routine, Marco is ready to face the day.

This was the easy part.


On July 28, 1995, Mike Marco was leaving his native Chicago for Colorado to study physiology at Red Rocks Community College outside Denver. His Nissan Sentra was packed with everything necessary to make a fresh start in a new state. Stacy, his wife of three years and sweetheart for more than a decade, was to follow in a couple of weeks.

The westward move was designed to get Marco's life back in order. Since dropping out of high school at age 16 and earning his G.E.D., he had worked in print shops and as a personal trainer. More than a decade of lifting weights had transformed him from a gawky teenager into a chiseled, 270-pound man. But in the late 1980s Marco had begun to use his physical strength to cause destruction. Alcohol and drugs were playing a primary role in his life as well. "I used to solve problems with my fists," he says of the bullying and bar fights. "I was a nasty individual at some point there, someone you didn't want to see."

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