Jared Soares | The Roanoke Times

Dr. Bertram Spetzler (right) speaks with Dr. Deborah Mowery at Lewis-Gale Medical Center in Salem during a news event Thursday morning. Spetzler requested that Mowery perform his surgery after an injury that paralyzed him in 2008.

He came to on his back in a creek. The water trickled about his ears. His bicycle was a tangle above him.

A brake failure had sent him careening down his own driveway, across a roadway and into the creek bed. His head hit a rock, snapping it back, bruising his spinal cord.

"It was a beautiful day," Bertram Spetzler remembers. "Remarkably peaceful." If he was dying, "it wouldn't have been bad to go out right there."

But he wasn't dying.

"It was obvious I was paralyzed."

As an orthopedic surgeon, he knew disturbingly well what that meant.

A day before, his gifted hands had performed five knee replacement surgeries. Now, those hands were lifeless.

He had climbed Mount Kilimanjaro and hiked on the Appalachian Trail. Now, he couldn't raise his own body from where it lay.

In an instant, the doctor became the patient. The helper was rendered helpless.

That was nearly two years ago. Since then, Spetzler, 60, has learned to take small achievements in place of great ones: feeding himself, brushing his teeth, driving a specially equipped car, working in the medical arena again, and even walking, albeit with the aid of crutches.

From an electric wheelchair, he looks back upon what he calls a "charmed life," and finds in his personal catastrophe a great reward: When you make yourself part of a community, and try to make it better, it all comes back to you in your time of need.

***

He lay in the creek for an hour before a neighbor found him. He underwent surgery the next day. Doctors inserted three rods and eight screws into his body.

"I'm officially all screwed up," he likes to say.

Then it was off to the Shepherd Center in Atlanta for three months of inpatient physical therapy. At the end of it, he still could not feed or bathe himself and required a canvas sling to be lifted from his chair to a bed. Once a specimen of fitness, he was gaunt, said Dr. Deborah Mowery, his physician at Lewis-Gale Medical Center in Salem.

He continued outpatient therapy at Lewis-Gale Rehabilitation Center, to which, ironically, he was the doctor who referred the first spinal cord injury patient 25 years ago.

With four to five days of therapy a week, his progress continued. Electrical currents were used to stimulate his forearm muscles and allow him to uncoil his fists.

A special bike that uses electrical current to stimulate the leg muscles, like one Spetzler used in Atlanta, was brought in for him.

On Thursday, Spetzler demonstrated how he can how lift a glass on his own and drink from it using a straw. "I can hold a wine glass," he said, grinning.

He rose from his chair and, leaning hard on crutches, walked across the therapy center at Lewis-Gale. It was a halting, robotic gait, but he was on his feet.

"He has a lot of grit," Mowery said.

"You make it work," Spetzler said. "You can't take back the injury."

Rehabilitation "doesn't change the injury," he said, "but it allows you to do the most with what you have left."

***

The doctor isn't always the easiest patient.

For his therapists, it's nice to have a patient with a full understanding of things.

"You have the same lingo," said Chris Berry. "We can be more technical with him."

But the doctor also has his own ideas about his treatment, ideas his doctor and therapists don't always share. They'll try things his way, and if that doesn't work, they do things Mowery's way.

For Spetzler, having a physician's eye view of his own problem can be trying, he said. Hope doesn't come as easily when you know all the rock-hard truths of your predicament.

Yet he seems to spread hope to others. As he walked along Thursday, he looked up at another patient in a wheelchair. "You're next," he said enthusiastically.

"He's always a doctor," Berry said.

With what he's learned as a patient, Spetzler thinks he could be a better doctor than he was. He encountered doctors with atrocious bedside manners, and that "tremendously reinforced" how important communication is for doctors.

"The shame is that what I've learned ... I can't apply back anymore," he said, because he can no longer practice medicine.

He also got a dose of how medical benefits work -- and don't.

"The insurance system is a nightmare," he said. "I don't know how people without resources or education can navigate it."

***

If Spetzler continues to improve, it will likely be in small gains. But he's happy to have won back some of his independence.

The first time he could brush his teeth was a great day for his wife, Clarine, he said.

He and his wife would not be where they are without the support they've enjoyed from friends and the community.

Spetzler went to work in the spring as a medical consultant for Disability Determination Services, a state agency that reviews applications for disability benefits.

He drives himself to work in a specially equipped minivan.

His is not the charmed life that it was, but "I look back, I'm pretty satisfied."

No, he can't bicycle thousands of miles a year, or go ballroom dancing every week with Clarine, but it's nothing to be bitter about.

Now, if he had put off all those things and then been paralyzed? That would be something to be bitter about.