Beyond the Wheelchair: The Less Visible Realities of Life After Spinal Injury

There are things that happen after a spinal cord injury that almost nobody prepares you for. Not the physio. Not the muscle work. The other things. The ones that people tend to lower their voices for or skip over entirely in clinical consultations. This episode doesn't skip over them.

The Fart That Got a Round of Applause

Niall McCann did not know, before his paragliding accident, that he would lose control of when he broke wind. Nobody told him. It came as a surprise, and for a while, an uncomfortable one.

Now he gets spontaneous applause for it on stage.

"I was at a big bank here in the UK a little while ago. Broke wind very loudly on stage, got a spontaneous round of applause from all the banking executives." ~ Niall McCann

It's funny but it's also a genuinely useful illustration of how the relationship with the less visible and less discussed realities of living with disability can shift over time. What starts as mortifying can become, with enough time and enough ownership, a light-hearted moment shared with strangers.

The Things That Carry More Shame Than They Should

Steve's experience was rawer. A bowel accident during a therapy session, in front of friends. A catheter bag he desperately didn't want anyone to see. An early education about sexuality that consisted of one 1970s video and no follow-up conversation whatsoever.

"I just felt so small. I felt like a baby. It just didn't seem fair at the time." ~ Steve Kearley

Living with disability means encountering a set of physical realities that our culture has very little language for, and that healthcare often fails to prepare people for adequately. Bowel management. Self-catheterisation. Erectile dysfunction. The fact that these things happen to a huge number of people doesn't make them easier to navigate when nobody is talking about them.

Advocating for Yourself When the System Falls Short

Steve's move from an indwelling catheter to intermittent self-catheterisation is a quiet story of self-advocacy. His doctor said no, he didn't have the dexterity. He said, let me try. If it doesn't work, we put the Foley back in.

"At least let me try. And if it doesn't work, then we'll just put the Foley back in, but at least let me try." ~ Steve Kearley

He figured it out. And now, as a patient advocate, he tells people there is no single catheter that works for everyone. Try options, find what suits you, and know that technology has moved on significantly from what was available in the early years of his injury.

The Invisible Disability Layer

Niall makes an observation in this episode that doesn't get discussed enough. He walks. So when he catheterises at a urinal in a public bar, the context is different from Steve doing the same thing from a wheelchair. People expect certain things from a wheelchair user. They don't expect them from someone whose disability isn't visible.

"Sometimes that invisible disability creates another barrier – different levels of expectation with the general public." ~ Niall McCann

Both men have arrived at the same place, though: a willingness to be open about what they need to do and why. Not performative openness, just matter-of-fact ownership of their own bodies and their own reality. Niall frames it simply: this is mine. I own it.

With 100,000 people in the UK experiencing spinal cord injury every year, that kind of openness isn't just personally liberating. It's necessary.

Listen to the full episode with Niall McCann and Steve Kearley to hear these conversations in full, including what actually shifts when shame starts to lift.

Resources and research discussed here