On March 30, 1981, Jim Brady, President Reagan's press secretary, was shot in the head. Nine out of 10 people with wounds like that die. But the doctors never gave up on Brady, and he's never given up on himself. JIM BRADY'S AMBULANCE, SIREN SCREAMING, PULLED up to the emergency room door of George Washington University Medical Center. He looked hideous. His entire head had begun to swell, and blood and brain tissue, oozing toothpaste-like from his wound, were dribbling down his face. He was propped up at an incline to help relieve the pressure inside his head, and his head lolled toward his left shoulder.

Carefully and swiftly, orderlies and nurses transferred this mountain of apparently mortally wounded man to the hospital gurney in Bay 5B, only six feet from the one President Reagan was on. The curtain between the two men was partially pulled as nurse Kathy Stevens began cutting all of Jim's clothes away. Dr. Judith Johnson asked him, "Are you getting enough air?" "Yes," said Jim. But he was trying to remove the oxygen mask. "No, you've got to leave that there," she told him. "Okay," said Jim, and he put his hands down.

"His blood pressure was extremely high -- 230 over 180," says Johnson. Through an intravenous line, she gave him sodium pentathol to anesthetize him and quiet the

brain. Then she injected 10 milligrams of Pavulon, a derivative of curare, to paralyze him for the delicate procedure of intubation, which would flood his brain with oxygen, crowding out the carbon dioxide to lower his blood pressure. An extremely uncomfortable procedure on a conscious patient, intubation is the inserting of a plastic tube down the windpipe to the lungs. "It was a frightening situation," says Johnson. "Everything I was doing could make him worse. In the roof of his mouth there was swelling and blood. It was difficult, but I was lucky -- I got it in on the first pass."

"This was perhaps the most important procedure performed on Jim Brady in the emergency room," says neurosurgeon Arthur Kobrine, who would soon assume command of Jim's case. "If she hadn't gotten it in on the first pass, he might have gone several minutes without breathing. Meanwhile, the CO2 was building up. Also, coming in as he did with a full stomach, the procedure could easily have made him vomit, drawing some into his lungs. He could so easily have herniated and died right there in the emergency room. It was a gutsy thing she did. Not all residents could have handled that, and they would be perfectly within their rights to call for an attending physician." But Johnson did it, and pure oxygen began surging into Jim's lungs and from there to his brain. The goal was to get it there quickly. As the priority organ, the brain controls blood flow, and when it received the pure oxygen, it signaled his rapidly beating heart to slow down, reducing the pressure in his brain.

Swelling and the resultant enormous pressure kill most brain-injured patients. "Only one in 10 survives," says Kobrine.

The portable X-ray machine just used to X-ray Reagan's chest was wheeled over, and pictures were taken of Jim's head, front and side. Then they propped him up for a pre-operative chest X-ray.

Kobrine, who was nearby reviewing one of his patient's X-rays, heard the commotion in the emergency room. His beeper was going off as well, and he took off toward the noise. Neurosurgery resident Ed Kornel saw Kobrine coming and told him that the president had been shot. "Are there any head injuries?" Kobrine asked a hospital administrator. "Am I needed in there?" In the confusion, Kobrine was told that there were no head injuries in the ER, and that he and Kornel were not needed. But then Kobrine saw Daniel Ruge, the president's physician, coming out of the ER. Ruge said, "You'd better get in there. Someone has been shot in the head. I think it's the president's press secretary. And, Art, I think you should handle it."

From that moment on, Kobrine would direct Jim's medical care with his neurosurgical residents. By this time, only three or four minutes had passed since Jim's arrival in 5B, but the external swelling of his head was so great that Kobrine was unable to open Jim's eyes. Kobrine lifted the 4-by-4 gauze off the wound. "I have never seen a face on a patient that grotesque and ugly," he says. "Jim's face was purple. His eyes were purple. His left eye was the size of an egg. His nose was swollen and his lips were swollen. He had abrasions all over his forehead and cheeks. He had bruises on his knees. His appearance made me even more pessimistic about his chances than I thought I would be." The entrance wound itself was small, about the size of the eraser on the end of a pencil, just at the middle of his left eyebrow. There was a raised "abrasion collar" around the opening, and injured brain tissue was oozing through the hole.

A radiology technician brought Jim's X-rays to Kobrine, and they showed, as expected, his fractured skull and multiple fragments from the bullet, but also that the bullet had crossed from the left to the right side of his brain. There is almost no hope for gunshot victims when both sides of the brain have been penetrated.

Ruge, at his post with his hand on the pulse in Reagan's foot, called out to Kobrine, "What do you think about your patient, Art?"

"It's a terrible injury. I don't think he has a chance," said Kobrine. "But I think we should try. He is still breathing and we will operate."

No more than 15 minutes had elapsed since Jim Brady's arrival. Swiftly, Kobrine wheeled him to the CAT scan room. A sophisticated X-ray process, the CAT scan displays horizontal slices through the skull and brain. After several pictures, Kobrine told the radiology technician to stop. "When I saw the track of the bullet, the bone fragments, plus this enormous blood clot, I didn't need to see any more," says Kobrine. "I had seen enough to plan the surgery, and I didn't want to spend another 20 or 30 minutes completing the study."

Kobrine came out to meet Sarah Brady, drew her off to a corner where they could sit and began: "Mrs. Brady, your husband has been shot above the left eye." Sarah closed her eyes; her head dropped forward. "The bullet went through his brain and is lodged in the right hemisphere of his brain. His condition is extremely serious. We are going to operate, and the operation will take four to six hours. It will begin immediately." "May I see him?" asked Sarah. "No," said Kobrine. "We are worried about time. We have got to get started. If the operation is a success, your husband will wake up tomorrow with little use of his left leg and no use of his left arm. Eventually, he may be able to walk. In fact, he may walk out of this hospital someday. However, I want you to know that he could easily succumb to this operation." Kobrine stood up to leave. Sarah looked at him. "You've got to save my husband," she said. "My 2-year-old little boy needs his father."

In Operating Room 4, scrub nurses were already opening the packs of sterile craniotomy tools. They transferred Jim from the cart to the operating table. It would take several minutes of shaving and washing Jim's head to prepare him for surgery. Kobrine had decided that Jim's entire head should be shaved. He didn't know if he might have to open it in more than one place, and he wanted the entire head sterilized so that he could enter it anywhere.

As he changed clothes in the locker room nearby, Kobrine debated with himself how to approach this injury. He could open a window over the entrance area to take care of the damage there, and then make another opening at the site of the bullet above Jim's right ear. Or he could open up the entire front of the head and then open another area only if it became necessary. He decided the second course would give him the most flexibility.

In the OR, an operating headlight strapped to his capped head, Kobrine got down to business. Starting above Jim's left temple, Kobrine guided the scalpel being wielded by Jeff Jacobson, one of his neurosurgical residents. Holding gauze sponges tightly to Jim's scalp to stanch the bleeding, they cut into the half-inch-thick scalp, going straight up over the top of his head, then down to just above his right temple.

At the same moment, ophthalmologist Mansour Armaly began to cut the ligaments on the outer corner of Jim's left eyelid to release the tremendous pressure on the orbit. Kobrine had asked Armaly to take a look at the enormous blood clot that had formed over Jim's left eye. Kobrine knew that, left unrelieved, the pressure would have destroyed Jim's vision in that eye. "It always amazes me," says Sarah, "how clearly Art was thinking. He saw to it if Jim lived his eyes would be fine."

Meanwhile, as Kobrine suctioned the blood away, Jacobson clamped plastic Rainey clips onto both sides of the incision to stop the bleeding of the scalp. Carefully, Kobrine and Jacobson rolled the scalp away to expose the bone, cutting it loose from its attaching fascia and muscle. Along with the scalp, they rolled the skull covering, the periosteum. Kobrine planned to use it later.

As Armaly worked, Jacobson began drilling dime-size holes in Jim's cranium with the "bone-biting" rongeur attachment to the craniotome, which has a pressure clutch to prevent the bit from entering the brain. As Jacobson started the second hole, Kobrine took over. A row of four holes was made, two on top and one on either side of the head. In addition, they drilled off the edges of the bullet hole. It was considered a "dirty wound" -- a possible source of infection.

Armaly finished draining Jim's eye as Kobrine and Jacobson carefully rolled the thick skin flap farther down to just below Jim's brow line. Now the bullet hole in the skull -- about three-eighths of an inch in diameter -- was exposed. They drilled two more holes, one above each eye. With a cranial saw, they connected the holes -- up across the top of his head, then across the brow. The bone flap was free, and they removed it in one piece, setting it aside to be wrapped in wet gauze for its replacement after the operation. "We were in his head within an hour of the shooting," says Kobrine.

Kobrine looked at the dura mater, about as thick and tough as chicken skin, which covered Jim's brain. It was intact except for the ragged hole made by the bullet. "I opened the hole up to expose the left frontal tip of the brain," says Kobrine. "I cautiously debrided {suctioned out} the area of obviously dead and detached brain tissue and several bone fragments. I would estimate that the brain loss from the left frontal tip was, in volume, the equivalent of two walnuts."

Kobrine inspected everything, trying to determine what was viable tissue and what was not, making every effort to be conservative in what he took out. It was important not to be overly aggressive, not to manipulate or even move areas of the brain that he had already judged from the CAT scan to be all right.

"Injured brain gets gooey," says Kobrine. "It loses its integrity as a structure. You have to be very gentle. You touch it or even put a sucker near it and, as the jokes go in neurosurgical circles, 'Whoops, there goes high school. Whoops, there goes college.'

"The right lobe looked normal on the surface, but I knew I had to get inside to the bullet damage. I picked a spot that was avascular {without blood vessels}, and as I was about to make an incision, this huge blood clot burst spontaneously to the surface, like a geyser, sending blood two inches into the air and opening up a cavernous, really, hole for me to work through. It also immediately relieved most of the pressure. It was serendipitously fortunate, to say the least."

Kobrine looked up and saw Ruge watching him from the door. "Dan, you should see this; it's incredible," he said. "No, but thank you very much," replied Ruge. "You carry on."

It was 5 o'clock; they had been operating for an hour and a half. Kobrine was feeling much better about his patient. Jim's heartbeat had slowed down to within a normal range; the sound of it on the monitor was almost soothing. Even more important, Kobrine and his team found themselves saying to one another, "The brain looks good."

Kobrine probed for the main piece of the bullet. He knew where it was, and soon he had his finger on it. Keeping track of it with his left index finger, he reached in with a slender forceps to retrieve the piece of metal. Kobrine then began the delicate, painstaking search for dead brain tissue, bone fragments and more of the bullet.

Plastic surgeon Jack Fisher, Kobrine's friend, stuck his head into the operating room: "Hey, Art, the radio just said your patient is dead." "Well," said Kobrine, "no one has told that to Brady or me."

Kobrine asked his senior resident, Ed Engle, to help now, and Engle gently held the healthy brain back so Kobrine could debride the dead and disconnected tissue. For more than an hour they worked on Jim's right hemisphere, carefully suctioning out dead brain and bone fragments. It was important to get out all the bits of bone that were embedded in the brain; overlooked, they would provide a perfect medium for infection.

Now, Kobrine went back to look at the left frontal lobe. "I still didn't think Jim would survive," he says, "but I knew that if I mucked with it any more, he'd be a vegetable if he did survive. I didn't want any reporter doing independent research and then write an article about how Brady had been lobotomized."

It was almost 8 o'clock; they had been at it for 4 1/2 hours. Kobrine believed he had done everything he could do for now. It was time to close Jim Brady's head and hope for the best. AT 9:30 P.M., SEVEN HOURS AFTER JIM

had been shot, Sarah went up to the intensive care unit to wait for him. The first sight of him frightened her: There were so many lines into him and monitors throbbing. But she went to his side and took his right hand: "Jim, it's the Raccoon. We're all here. Don't be afraid." She turned to Alison Griswold, a senior staff nurse assigned to Jim's care. "I know he's going to be fine. He's squeezing my hand." Griswold was astonished that he was able to respond in any meaningful way. She and Sarah began talking to Jim, asking him to wiggle his hands, his toes. He did everything they asked. They spent most of the rest of the night encouraging him. By dawn, Jim was moving his right arm and his right leg on command and using his right hand to squeeze a wad of gauze Griswold had given him.

At 6:30 the next morning, Kobrine came by, and Griswold told him what Jim had been doing. He couldn't believe her. "Alison," said Kobrine, "don't get your hopes up too high. This patient's chances are very slim."

Angry that she couldn't convince him, she went to Jim's side and said, "Jim, shake your fist." He raised his right hand in a fist and shook it. "Now, give them the thumbs-up sign," she said, and Jim obliged. Kobrine broke into a broad grin, hardly believing what he had seen. But Kobrine cautioned Griswold that a dangerous road still lay ahead.

At 11:30 that night, when nurse Elizabeth Ann (Betsi) Horwath arrived, she made up a new ball of gauze and tape. An hour or two later, Jim was bouncing the ball on the bed. "Hey, Jim," Horwath said, "throw me the ball." Jim, his eyes still swollen shut, wound up and threw it across the room toward the sound of her voice. Sarah heard Horwath's cheers and joined the game, and the three played ball for two hours.

When Kobrine made his rounds again early the next morning, Horwath told him what Jim had been doing. "Betsi, this isn't funny," Kobrine said. "After that injury, Jim Brady just couldn't be doing anything like that."

"I'm not making a joke," she said, and then called out, "Hey, Jim, throw me the ball." Jim threw it across the room to her. "Oh, my God," said Kobrine. Everyone was crying. Then Kobrine said, "Jim, what do you have there in your hand?" "Ball," said Jim very deliberately, the first word he had spoken since being put under anesthesia. Kobrine asked Jim to stick out his tongue. Jim complied. Kobrine asked Jim to count. "One, two, three," said Jim. Jim's surprising progress "was a mixed blessing because people began to hope he'd be perfect," says Kobrine, "and, of course, I knew he would not be perfect."

The next afternoon Sarah was holding Jim's hand: "Jim, do you know who this is?" "Raccoon," he said quietly but firmly.

"From then on," says Griswold, "if there was a moment of silence, he'd ask for 'Raccoon.' He was one surprise after another. He started speaking one word at a time. He began to ask for 'water' or 'drink.' Also, he was allergic to some of his medications, and he was itching like crazy. He would say 'scratch' and 'feet, feet,' meaning he wanted his feet scratched."

"He did that before he was hurt," says Sarah, "and it used to drive me up the wall. He always wanted me to scratch his feet. But it sounded pretty darned good to me when he said it for the first time in the hospital." MONDAY, APRIL 6, ONE WEEK FROM THE DAY OF THE shooting, physical therapist Cathy Wynne and occupational therapist Susan Marino began to organize the rehabilitation of their 40-year-old patient. At first, Jim was completely exhausted by the simplest activity -- sitting in a chair or holding his head up. Wynne started working on his sitting balance on the edge of the bed, getting him to lean forward, backward and from side to side. "He would work with me," she says, "but he was very quiet. He had a very flat 'affect' -- a blank emotional look -- and I started facial exercises for the paralysis on the left side of his face." Wynne tried without success during that first week simply to get Jim to talk to her. One day during the second week, Wynne mentioned to Sarah that she needed to buy a bottle of wine to take to a dinner party that night. Jim immediately chimed in, "Get Jordan Cabernet Sauvignon, '78. You can get it at Eagle Wine and Liquor." "Sarah and I were so thrilled with this show of memory," Wynne says. "He even told me how to get there."

A few days later, Wynne asked Jim to stick out his tongue. He complied with a cartoon sequence, slapping the back of his head to trigger his tongue out, pulling it to the left by tugging at his left ear, to the right via the right ear, tugging at his throat to pop it back in. "That took a lot of initiative, considering his situation. It let me know there was a lot going on in there."

Sometimes there was a little more going on than people bargained for. Early on, Jim's brain injury dulled his inhibitions. When cerebrospinal fluid began leaking into the flap that had been rolled down for surgery -- distending his forehead and rolling back and forth as he moved -- his doctors decided to tap the fluid off. "I had to be very careful about inserting the needle," says Dr. Jacobson, "and I told the nurse to hold Jim's head tightly, that she was not to move. Hearing this, Jim reached up and slipped his hand onto her breast. 'What'll I do?' she shrieked. 'What'll I do?' "

"Well, you can enjoy it, or not enjoy it," Jacobson told her, "but don't you move!"

The damage showed itself in other ways. He would perseverate -- repeat things for no reason, an act, a word, a gesture. When eating, for instance, he might continue to fill his mouth with food, and not swallow, until he choked. He had to relearn the complicated act of swallowing food. When given pen and paper, he wrote things like "Racoocoon," or "Bob Woodwardard." He drew a portrait of one of his doctors with 30 buttons down the front of his jacket.

Jim would get lost in time, moving back and forth between the present and the past, sometimes believing he was still on the Reagan campaign plane. "Where are we heading for today?" he would say. In his jottings could be seen the efforts of a mind turned topsy-turvy, desperately trying to impose some order. He drew a self-portrait of himself with the top of his head lopped off. There was a poignant little note to his son: "Dear Scott, Here's your autograph. JSB 1:59 p.m."

Jim remembers very little of the first several weeks of his hospitalization. "I was drifting in and out," he says today. "And I'll tell you if it wasn't for the honor of it, I'd just as soon skip it."

Jim's physical state was pretty well defined almost from the beginning. He had some movement in his left leg quadriceps -- the heavy muscles on the front of the thigh -- but virtually none anywhere else in the leg. He could move his left arm only slightly, and his left hand was useless.

But Jim's sense of humor, his intellect and his interest in the people around him shone through. And Kobrine told Sarah that Jim's brain could very well heal and improve its functioning -- by finding and making new neural pathways -- over the course of the next 7 to 10 years. That knowledge gave her great hope. ON JUNE 2 THE RECOVERED RONALD Reagan came to see Jim in his hospital room, said his job was being held open for him and scolded him, saying, "You've been on your back long enough, Jim, and work is piling up. It's about time you finished up this stuff and got back to the White House." It showed a nicely intuitive sense of what Jim needed to hear -- that he was still needed. As he left, Reagan said, "We're waiting for you to get back. We need you."

While Sarah and Kobrine were pleased overall with the way Jim handled himself during the visit, there were several times when he sounded as though he were crying. This "wailing," as Sarah called it, was a very big problem in his recovery because it alarmed people. Jim might wail while telling a joke or just giving a straightforward answer, and they didn't know what it meant or how to handle it. The truth was, it meant almost nothing. "It's not really crying at all," says Kobrine. "It's a sign of a sort of stress."

Jim's injury caused other problems at the beginning. He would look at his nearly lifeless left arm and not recognize it as his own. Asked how his arm was, he would say, "It's fine, but will you just take this other arm out of my bed and put it on the windowsill?"

Recovery was the byword that summer, however. Problems with wailing, visual perception and mental confusion seemed small and solvable. Every day, Sarah worked on bringing him back to reality, correcting his misimpressions. He didn't know he was taking things in wrong. He didn't want to make mistakes. He just couldn't help it. Sarah firmly and consistently set him straight, but he didn't always accept her coaching. For a long time he didn't understand that he had specific gaps in his brain power. It was only as he got better that he was able to begin to understand that, and then to try to work on the relearning he needed to do.

On the other hand, everything that Jim had learned or experienced before the shooting was still stored, almost perfectly, in his left hemisphere -- although he had considerable trouble retrieving information, especially numbers, dates and times, numerical figuring not being his strong suit in the first place. Most important, his gut political instincts were as sharp as ever. His assessment of what should be done in a public relations sense in any given political situation was usually right on target. His ability to perceive correctly and to store new information -- things that had happened since the shooting -- was impaired. But Jim Brady was the same man with the same personality and wit.

In October, Jim was physically well enough to begin walking a few tentative steps and to start speech pathology. Speech pathologist Arlene Pietranton found he slept a great deal during the day but was "consistently alert and responsive" when he was awake. However, his brain was still healing, and when she asked him questions about his personal history, he was confused. He maintained that he lived in his old home town of Centralia, Ill.; he forgot about his previous marriage. "If I asked him what he was doing that day, he said he had an appointment in another part of the country as press secretary. Some confusion was understandable because he was getting visits from the White House staff and hearing about all these travels and events."

He was impulsive in his responses; he needed to relearn how to wait. Such exercises as telling him to "pick up the pen and put it in the cup, but before you do that, turn over the brush" confused him. He wanted to respond to her first words. Pietranton gradually began adding exercises above his level of performance so they would be more and more challenging.

Jim's emotions were unstable. "They came to the surface more easily, showing up in his wailing and loss of pitch control -- a condition triggered by honest emotion," Pietranton says. "His ability to override that was damaged, probably by the rippling effect of one damaged area communicating with another damaged area."

In the area of language skills, he was capable of understanding everything said to him, but, she says, "he had a problem listening long enough to get the full message." And there was that problem with perseveration -- the broken-record syndrome. But as time went on, she says, "he would catch himself and say, 'I perseverated on this one, didn't I?' "

He had the ability to use language appropriately, and his syntax was correct. "Some of his answers weren't appropriate," she says, "but they were stated in good language. His reading comprehension was within normal limits, but it was impaired because of his impulsiveness."

Lastly, Pietranton saw that Jim had trouble getting things in the proper sequence, drawing analogies from a simple set of facts and thinking abstractly.

They began working together an hour a day. "At first I put a tremendous amount of emphasis on his taking initiative. I tried to structure our sessions in order to make him make choices. For instance, if I asked him to write something, I wouldn't give him a pen until he asked for it."

In his moods, Jim could be noncommunicative and depressed, or childish and demanding, or he could be right on target in his analysis and conversation. "When all circuits are wired together correctly," says one surgeon, "he is hilarious." Examining him one day when Jim was being particularly quick and talkative, Kobrine told him, "J.B., you're as sharp as a tack, you know that?" "I'd say more like as sharp as a marble," Jim answered. AT LAST, TOWARD THE END OF NOVEMber, Kobrine gave the word: Jim could go home for good, in time for Thanksgiving.

Before Jim left the hospital, he asked Kobrine to tell him exactly what, medically, had happened to him. "I spent an hour and a half going over everything," says Kobrine, "showing him X-rays, CAT scans, going though his record." After hearing it all, Jim, adopting the current fad of Valley Girl talk, told Kobrine and anyone else who would listen, "This is a totally new head you gave me, A.K., totally."

At home, Sarah uncorked a bottle of champagne first thing upon entering the house. Scott, now 3, was there, as well as Sarah's mother, Frances Kemp, and Sarah's brother Bill Kemp. Jim's 19-year-old daughter Missy would join them for the holiday.

Now the household included round-the-clock nursing staff, too, which proved to be the most difficult part of Jim's homecoming.

"I wasn't accustomed to having live-in help and the complete lack of privacy that comes with it," says Sarah. In addition, she was expected to provide meals for everybody and run what had become a very complicated household. When the washing machine broke down, it loomed as a major catastrophe. "The sheer drudgery of it at first totally exhausted me.

"The RNs, being professionals, tended to want to run our lives, and to run our house like a hospital," says Sarah. "I couldn't convince them we didn't need them right there with us every moment."

The night nurse particularly was a stickler. "She disapproved of our drinking and smoking," says Sarah. "In addition, she was a vegetarian and she spent a good deal of time reading her Bible in the living room.

"She also had the unnerving habit of creeping around the house at all hours of the night. She would come into our bedroom in the middle of the night and reach under the covers for Jim to use the urinal."

"She had the coldest hands," says Jim.

After about two weeks of this routine, the Bradys went out in the evening for the first time. "When we got into the van, it seemed like it was the first moment we had been alone together since Jim came home," says Sarah, "and, among other things, I asked Jim what he thought of our night nurse."

" 'You mean Hitler?' Jim said.

"We both decided we couldn't stand her. She had to go."

Jim continued to plug away at his regimen of physical and occupational therapy and speech pathology. There was no doubt in his mind that he was going to recover completely. He and Sarah started accepting some of the many invitations that were coming into his White House office. But their favorite evenings out were with friends for dinner. At first, people were taken aback at his lack of initiating conversation. But in December Jim began to initiate and anticipate things in his therapy.

In January, he and Sarah and Missy attended the annual Washington Press Club congressional dinner. He took his seat at the head table to "thunderous applause," reported The Washington Post, and was besieged by people wanting to shake his hand. The spontaneous and emotional ovation he received that night was the first of many tributes. In late February, at the opening-night performance of the Dance Theatre of Harlem at the Kennedy Center, he was given an "emergence award" by the ballet company. He and Sarah accepted many chores as charity chairmen as well, starting with the D.C. Society for Crippled Children campaign that spring. They became greatly in demand as patrons for charities and fund raisers.

ON VALENTINE'S DAY EVE, JOHN Hinckley made his third attempt at suicide while in custody by taking an overdose of his medication. Over breakfast, Sarah told Jim that Hinckley had tried it again.

"How'd he do?" asked Jim.

"Well, it looks like he flunked again," said Sarah.

"Maybe we should send him a how-to kit," Jim suggested, "with a razor blade in it." WHEN DAVID HARTMAN INTERVIEWED him for ABC-TV's "Good Morning America," he asked, "What does it do to you, mentally and emotionally, Jim, when you were so capable, obviously, not to be able to do the things physically you'd been used to doing all your life?"

Jim paused. "It's humiliating," he said. "That's one word that comes to mind."

Having seizures in public was humiliating. Being barely able to walk was humiliating. Being in a wheelchair most of the time was humiliating. Being dependent on others for almost everything was humiliating.

His body was playing another mean trick that was even worse for his self-esteem. For the first several years of his recovery, Jim wasn't always able to tell when he needed to urinate. Although the accidents became fewer and fewer, the ones in public devastated him. After all, he felt, if you can't control that, what can you control?

As Jim was leaving a restaurant in his wheelchair one night, his bladder suddenly let go. Although no one else was aware of the accident, on the trip home Jim wept and railed at Sarah in helpless frustration over the unfairness of it. But Jim learned to handle even that kind of humiliation with humor, telling his doctor that his soaking of his office carpet "would build character into it."

Little by little, his control improved until it ceased to be a problem -- to Jim's immense relief.

He was increasingly able to put in longer days without tiring as readily. Increasing his endurance was very important to him. But as he worked harder and harder, it started to become painfully clear to him that he could no longer see the light at the end of the tunnel. Until the summer of 1983, he had been positive he was going to beat this thing completely. In a Father's Day interview with CBS' Bill Plante, Jim said, "I will not be a cripple. I will not have it." Intellectually and emotionally he was wrestling with the inevitable -- denying to himself that he was going to have to make major adjustments in his thinking about his condition.

In August that year, it all came crashing down one day in physical therapy. He complained to Cathy Wynne of vague abdominal pain and refused to work on his exercises. Wynne, worried, called Kobrine, who came over to find Jim lying on one of the exercise tables looking very morose. Kobrine checked him over. "It doesn't look like there's anything organically wrong with you, Jim, but it looks like you're pretty down in the dumps."

"Yes, I am," he admitted, tears beginning to roll down his face.

"Well, there's nothing the matter with that. Everybody gets down in the dumps sometimes."

Jim broke into loud sobbing, and between sobs, his sorrow poured out. "Here I am," he said. "Some fucker has shot half my brain away, and maybe he'll be out on the streets someday. Meanwhile, I piss in my pants, I can't remember things, I'm here at the hospital every day. Wouldn't you be depressed?"

"You're right, goddamit," Kobrine came back at him. "That fucker oughta be taken out behind the barn and shot. I agree with you. But that's the fact of it. You're shot in the brain. You're never going to be as good as you were. You've just got to be tough."

"I know, I know," sobbed Jim. "The Bear is tough," he said, invoking his nickname, "but you're not the one whose back aches, and who can't get out of your chair."

"But you've got to be tough, Jim," Kobrine repeated. "You've got to be tough."

"North American brown bears are tough," said Jim, his sobs subsiding. "The Bear is tough. The Bear is tough."

"Soon he was over it and was joking and throwing off his one-liners," says Kobrine. But Jim had hit rock bottom. At last he had faced his tragedy and knew that only small victories lay ahead, not the complete recovery he had dreamed about.

The loss of his mobility was almost unbearable. He began to talk about levitating. In the interview with Plante, Jim announced that he'd been working on trying to levitate. "Are you going to levitate on the air for us?" asked Plante. "No. I'm saving it for NBC," said Jim. "NBC {in 1983} is in third place and dropping quickly. My levitating would put it over the top."

Someone has to be the first one to levitate, he always said. "Why shouldn't it be me?" Consciously, he was kidding, of course, but levitating was an idea he loved. He sat in his "Bear Chair" at home, hardly able to move, and imagined himself levitating out to the kitchen, to the refrigerator, to the deck out back, to the swing in the yard to play with Scott. AFTER SIX YEARS, JIM HAS NEARLY

beaten his wailing problem. "When he's laid back and with friends, he doesn't wail," says Kobrine. "I have seen it on his face when he just starts to wail, and then I can see him consciously suppress that. That's learned behavior. Jim's way of diffusing tension is to crack jokes. It is a very deep-rooted way of his to cope with his stress."

He continues in his therapies and continues to make progress. By mid-1984 he had made most of the significant progress he was expected to make. Now he is making small, subtle but important refinements of his mental skills. His physical condition has not changed much, nor is it expected to. While Jim can walk when he absolutely has to, he spends most of his day in his wheelchair. However, he can become stronger, increase his endurance and his flexibility, as long as he continues to work at it.

He is still dealing with lingering vestiges of his problems with perseveration, short-term memory, organization and lack of initiating. "But," says vocational rehabilitation counselor Cynthia Potesta, "you also see the sheer force of Jim Brady's personality coming out of all of that. And his kindness. I was totally unprepared for the depth of his kindness to people."

Tom Welsh, the man Jim calls his "physical terrorist," says that since 1984 he has seen "dramatic differences in the way he handles things. He is so quick-witted." He remembers private jokes he has shared with almost everybody he has met at the hospital, says Welsh, "and he is even quicker to make them laugh now."

"Physically, Jim is doing different things, including dancing {swaying to the music}. His endurance has improved as well as his balance and coordination. And he will be able to gain more strength in his leg and develop new skills. I can see him getting out of that wheelchair more and more.

"Jim still has pain in his contracted left hand and entire left leg. All pain is in the brain, and it is possible that the pain he feels is misperceived. But it is real to him. The chances that there will be any return of function in his hand are very poor, and Jim still takes it very hard. I've seen him break into tears about it." (Sometimes Jim speaks sorrowfully of it. "It's my little dead hand," he will say, patting it protectively. "It just lies there. Don't hurt my paw.")

"Mentally, he's made leaps and bounds," says Welsh. "He is better motivated now and is much more receptive to doing new things. He has a schedule, more places to go. He's not out in limbo anymore. He has a purpose.

"Jim Brady is a pretty gritty guy, still a real brainy guy. I can just imagine how he must have been before. He must have been so exceptional. He must have just had it all at his fingertips." :: FROM THE FORTHCOMING BOOK "THUMBS UP: THE LIFE AND COURAGEOUS COMEBACK OF WHITE HOUSE PRESS SECRETARY JIM BRADY BY MOLLIE DICKENSON. COPYRIGHT

1987 BY MOLLY DICKENSON. TO BE PUBLISHED BY WILLIAM MORROW AND CO, INC.