Jeremiah Landers has to work for every step he takes.
Twenty-one months have passed since Landers fell asleep at the wheel on a scenic mountain road south of Mount Shasta. He left his home in White City before dawn and nodded off sometime around 7:15 a.m. on California Highway 89 near Burney. The truck he was driving left the pavement and flipped end-over-end before it came to rest.
"I was multitasking," he jokes. "I was trying to master driving and sleeping.
"I was doing a friend a favor," he explains. "He asked me to bring his truck to Carson City."
The crash left Landers with a broken neck. Physicians had to fuse three bones in his cervical spine — the group of seven vertebrae that connect the skull with the rest of the body. At first he couldn't move his hands or legs.
"I had to hand-feed him," says his mother, Josie Landers, who left her home in Jacksonville to be with her son when he was hospitalized in California after the accident.
Jeremiah spent nearly two months in hospitals, learning how to live in a wheelchair, feed himself and transfer his body from the chair to a bed, or a car or a commode. He came back to Southern Oregon in December 2011 to start therapy at Asante Rehabilitation.
The man who came home bore little resemblance to the robust construction worker who crashed two months earlier. His weight had dropped from 220 pounds to 160, and he could not move his legs.
"I had no core muscles," he recalls. "I had to be strapped in my (wheel)chair." Leaving the hospital meant he no longer had nurses and aides to assist him with the activities of daily living. Family members helped as much as they could, but he had to learn how to be on his own in a wheelchair.
"The first winter was tough," he recalls. "Just having to make an appointment (for physical therapy) was work."
Physical therapists assigned to his case could not predict how much mobility he might regain.
"With an injury at that level, you never know what the outcome will be," says Matt McEwan, a physical therapist who has worked with Jeremiah since he came home.
With support from his family, Jeremiah developed a routine. He came to physical therapy three times a week. McEwan gave him specific exercises to retrain his nerves and muscles to relearn the ordinary movements the rest of us do without thinking. After every therapy session, Jeremiah went home and practiced whatever McEwan gave him.
"The first month was the hardest," he recalls. "You try so hard, and you don't feel like you're moving forward. I'd come here and push and push and push, and I didn't excel."
Progress came in fits and starts. One day therapists were delighted to see Jeremiah could move his feet, but he himself could not see them wiggle because he lacked the core body strength to bend over.
"I needed a video to see them," he says.
"It was a slow go till about July 2012," he recalls, "but since then it's been a steady uphill climb."
"He's made tremendous progress," McEwan says. "With his attitude and hard work and a lot of therapy, Jeremiah has surpassed all the goals I set for him at the very beginning.
"I personally have never had a patient with such severe injuries who proceeded so far so quickly," he says.
Therapists have used sophisticated equipment to help Jeremiah get back on his feet. One device allows him to move his legs in a gait while supported from above. The apparatus features a body harness attached to a cable that runs inside a track in the ceiling. Should Jeremiah's legs fail, the cable and harness prevent him from falling.
Without such equipment, a whole team of therapists would have to support someone learning to walk, McEwan says.
"It's like a safety net," he explains, "but it's not only his safety net. It's (the therapists') safety net, too. You can progress so much more quickly when it's a totally safe environment."
The cable and harness have helped Jeremiah gain the strength and coordination to walk on his own with a walker. He recently took himself 82 feet down a corridor at Asante Rehabilitation.
"That machine gives me the freedom to push my limits," he says. "I can do things I couldn't do with five therapists."
At 35, he just wants to go back to work and live an ordinary life.
"Basically everything I've heard is that my will is going to get me out of this," he says, gesturing to his wheelchair. "I'm determined. If my insurance would pay for therapy every day, I'd be here.
"I'll be working within the next two years," he says. "I'll have a normal job like everyone else does. My whole goal is to be independent. I want to go to work. I've been on a 21-month vacation, and I'm ready to retire that chair."
"He will make it," his mother says. "He's gonna get out of that chair. He doesn't care how long it takes."
Bill Kettler is a freelance writer living in Rogue River. Reach him at firstname.lastname@example.org.