Before his motorcycle accident, Travis saw himself becoming a pro football player. Now, paralyzed from the nipple down, he says, "At times it's a pain in the ass-literally and figuratively. But it allows me to not be as threatening to some people [the way I was when] I was still an athlete. Because a lot of times male interaction is done on the basis of pissing contests: I'm bigger, I'm tougher, I'm stronger, I'm smarter. When you're in a chair, they don't look at you like that." At the same time, Travis complains that many people are uncomfortable interacting with him because of his disability. "I would rather you make a mistake and deal with me than not deal with me at all."

Meghan is a high-level quadriplegic, living alone, who uses a power wheelchair and requires daily attendant care. She laments, "There are so many people who think we're asexual, we're not pretty, and we're creeps and weirdoes." To dispel this myth, she envisions a fashion show of women in wheelchairs parading down a runway. Meghan has been involved in a number of sexual relationships since sustaining her injury. While she doesn't think her disability has diminished her sexual pleasure, she feels that it has affected her sexual performance: "Well, you can't move it. You can't, like, bump and grind."

In 32 unusually frank in-depth interviews like these, the men and women in this book freely discuss their sex lives, their beliefs about God, how they want others to treat them, and whether they want to walk again. In each chapter the author presents their complex voices and comprehensive research about different facets of spinal cord injury (SCI).

Wheeling and Dealing explores the extent to which people with spinal cord injury locate their challenges in their physical impairments or in the social environment. Some disagree with those disability activists who focus almost exclusively on the latter, but the author examines this issue in depth.

Topics include:

--Physical health from degrees of loss of function to problems like pressure sores, temperature regulation, and bladder control.

--The stages of psychological adjustment and rehabilitation.

--Obstacles to sexual intimacy, treatment of erectile dysfunction, and new sources of sexual pleasure and emotional intimacy.

--Religion and spirituality.

--Social and political beliefs, with those with SCI weighing in on everything from welfare services to embryonic stem cell research.

--Dating, marriage, and parenting.

--Friendship networks and social supports; concerns about transportation and accessibility; stigma.

--Education, employment, and economic consequences.

This book is the recipient of the 2004 Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best project in the area of medicine.