There are some large victories in rehabilitation.
The stroke victims who speak and walk again after retraining.
Gov. George Wallace of Alabama, the spinal cord-injured paraplegic who, confined to a wheelchair, governs a state.
But many of the most important victories are smaller ones. They have to do with helping people live better.
Dr. John Aseff is director of outpatient services at the new National Rehabilitation Hospital. Ten months ago he began treating patients in temporary quarters at the hospital's next-door neighbor and corporate headquarters, the Washington Hospital Center.
"You ask about victories," he said. "Let me tell you about two very interesting women. Both are in their thirties. Both had polio as children. Both came to see me because of increasing weakness and difficulty in walking recently."
One woman was a nun, the other a working mother. Both may have been experiencing what has loosely been called "post-polio syndrome" or "late effects" of polio. Perhaps the strain of the years on affected or weakened muscles, perhaps overuse or misuse of some muscles -- whatever the precise cause or causes, many polio victims are now experiencing these problems.
Both women were dismayed by their new pain and fatigue. Aseff had no miracles for them. But both were thoroughly evaluated to determine just where they were affected and what measures or equipment might help them.
Then in both cases, Aseff said, "We had to treat not just the patient but also the person. They now needed technical help -- bracing -- to walk. I had to tell them this, and it brought tears to one woman's eyes.
"As a child, she said, she had been ostracized by other children when she wore braces. She did not want them again. I had to show her in a mirror how badly she was walking.
"I had to point out how she was contributing to her weakness by putting strains on her muscles, using her body in a way it was not designed to be used. I had to point out that if she continued, there would be increased stresses on her muscles and joints and accelerated arthritis."
Both women are winding up with a simple leg brace, a kind of plastic semi-stocking that hugs the back of the leg, light in weight and far less obtrusive than the old-style steel rods that Franklin D. Roosevelt wore on both legs. One woman will also wear specially designed shoes.
Both have been advised to give themselves daily rest periods so, Aseff said, "they can still perform well and get their work done and walk better than they were walking -- and have more functional time, too, because they won't be so drained by evening."
"I would call both of these successes," he said, "because now they can listen to what their body is saying and use it in a better way. Their medical and physical evaluations, their prescriptions, the human adjustments -- this puts together all the phases of physical medicine and rehabilitation."