No American has been able to buy a brand-new Smart Fortwo since the brand departed American shores back in 2019. Just under 100,000 of the city cars were sold in America, and most of the survivors seem to be hoarded by devotees of Smart like me. The ones that I haven’t purchased are living a fascinating second life. They’re no longer vehicles used on the road, as many Smarts are being preserved in medical centers, and help patients relearn a common ability. The reason why makes a lot of sense.
Every once in a while, someone on the Internet finds a seemingly random pristine car just sitting inside or on top of a hospital. For example, one person on X posted photos of a perfect Mitsubishi Galant sitting atop a Jefferson Health facility in Philadelphia, Pennsylvania. On the surface, this is patently silly. Why is a hospital displaying a car that most people found disposable?
Well, it relates to recovery. The human body is like an amazing machine. You can get hurt by injuries or felled any number of conditions, and your body not only has the ability to heal, but adapt. Even if a condition is permanent, you can learn how to retain a good quality of life. These seemingly random cars are important tools for recovery.
Getting You Back On The Road
These cars are used for a multitude of reasons. In many cases, they’re used for what some facilities call “transfer training,” and they teach the patient and possibly the caregiver how to transfer a patient from a wheelchair and into a car. Other times, these cars, as well as car transfer simulators (below), are used to train a patient recovering from a hip or knee surgery in a safe way to get in and out of their car. They’re also used to retrain patients on car entry and egress after an amputation.
Mile Bluff Medical Center of Mauston, Wisconsin, explains further:
Getting in and out of a car is something many individuals take for granted. After a person loses functional mobility due to stroke, brain or spinal cord injury, amputation, joint replacement or other conditions, it is an activity that needs to be practiced and re-learned. It is important for patients to gain confidence in their ability to get in and out of a car, while learning to also safely position themselves during transfer so they protect any surgical wounds they may have.
The car transfer simulator is designed to provide a safe and convenient alternative to parking lot car transfer training sessions. The simulator allows patients to learn and practice car transfer skills in the year-round comfort and safety of an indoor setting.
“In the past, family members would have to bring a vehicle to practice transfers outside with the patient,” commented Marlene Rosenberg, Director of Mile Bluff’s Rehabilitation Services Department. “Sometimes, due to limited family availability, the first opportunity to practice was on the day the patient was scheduled to go home.”
That’s right, for many medical centers, these practice sessions happen outside, which involves getting the patient out and into a live parking lot to practice getting in and out of a car. This method works, but taking your patient outside is a lot more work than just having them get in and out of a car that’s already in the hospital. Then, they can practice getting in and out of a car regardless of what’s going on outside.
One thing to note is that patients will often drive their cars to their therapy appointments, so learning how to get in and out of a vehicle is often a necessary step in recovering from an injury, surgery, or condition.
The Custom Solution
A lot of facilities buy what’s called a car transfer simulator. This device replicates the cabin of a car, complete with seats, a steering wheel, a dashboard, an A-pillar, and a B-pillar. One name-brand product in this space is the Tran-Sit Car Transfer Simulator by Advanced Therapy Products. Here’s a description:
The WT-960 TRAN-SIT® Car Transfer Simulator is designed to provide a safe and convenient alternative to “parking lot” car transfer training. The TRAN-SIT® allows your patients to learn and practice car transfer skills in the year-round comfort and safety of a clinical setting.
It is loaded with features; true-to-life vehicle components like functional doors, reclining bucket seats, tilt steering column, and wheelchair loading space make it look and feel like a real car. The open-back design also makes training easier for both you and your patient.
Quality-constructed to provide years of active use and consistent performance, the TRAN-SIT® is an attractive, functional, and valuable addition to any rehab program. Its life-like appearance also adds to the realism of car transfer training activities.
The Tran-Sit is a neat bit of kit. Clinics can order these things with height-adjustment systems so that the Tran-Sit can be set to the exact height of the patient’s personal vehicle. The device also weighs around 500 pounds and can be ordered with caster wheels so it can be easily moved around.
KPLC 7 News explains how big a deal this is:
It has been one month since a farming accident left Lucas Stewart of Vinton pinned underneath a hay bale. In an instant, Stewart lost the feeling in much of his body and with it, the ability to walk, stand or drive. “When it happened, I knew I broke my back,” he said.
CHRISTUS St. Patrick Hospital occupational therapist Orlando Berlanga has been working with Stewart in the TRAN-SIT Car Transfer Simulator: a safe alternative to practicing in the parking lot of the hospital, which was the only real-time option prior to this equipment. “We would definitely practice on different levels of mat tables and then we would go down to their actual car if they could bring it here and do hands-on with their car,” said Berlanga.
This system will adjust to the height of your car, truck or SUV and it has hand controls for patients that can no longer use the foot pedals. “Anybody that can’t use their legs, they can use the hand controls for the gas and the brake,” said Berlanga. One of the most important tests to see if it is safe for a patient to once again get behind the wheel looks at the reaction time when starting and stopping. “We know they can get in the car safely and we can do actual practice with their families and make sure everything’s safe,” said Berlanga.
New Life For An Old City Car
A new Tran-Sit simulator costs $15,000 and gets more expensive with options. The funny part is that medical facilities have discovered that there’s something cheaper than a fake car, and it’s a real car. While some facilities will grab any cheap car that they can get their hands on, many facilities are getting one specific cutie, and it’s the Smart Fortwo.
The Smart Fortwo might have been unfavored by the American buying public, but hospitals are finding them to be a cute, practical, and cheap way to help people regain their mobility. A hospital can pick one of these cars up for a few grand and use it for the same purpose that the Tran-Sit serves.
In 2014, the Berkshire Eagle wrote about how the Sweet Brook Nursing Center of Williamstown, Massachusetts, got its new rehabilitation tool:
The skilled nursing facility in Williamstown has commissioned T&M Auto Sales of North Adams to strip-down a used “Smart Car” for use by its occupational and physical therapists. The project stands to be the only tool of its kind in Berkshire County, according to Director of Rehabilitation Jane Edge.
“Driving assessments are something therapists are always keenly involved in,” she said Thursday. “Having our own car in our facility will give us the opportunity to better assess patients’ abilities.”
Edge explained that rehabilitation has grown from just increasing patients’ strength to include enhancing clients’ abilities to carry out functions that are part of a their daily life. Someone who has had a hip replaced could have difficulty moving around and need to practice getting in and out of a vehicle, she said. Someone else could have had a stroke or head injury and need similar practice. The car will also be used to assess patients’ cognitive and perceptional skills, reasoning and their alertness, she said.
T&M Auto Sales reportedly pitched the car as a good fit for rehabilitation because it was a convertible, which means that the care team has easy access to the patient. But also, while Smarts are tiny, they were built with crossover-like high seating positions. This makes entry and egress easier, not unlike the crossovers that the patients are likely to already have at home.
Plus, Smarts are real cars, so they all of the bits and pieces that would normally be an upcharge to make a Tran-Sit simulator emulate a real car.
There are other good reasons to go with a Smart, too. These cars are only a touch wider than five feet, so they can easily slip through a set of commercial double doors. Smarts are also small and light enough to fit in freight elevators, too. Facilities, like the Sweet Brook Nursing Center, have the engine and drivetrain removed, which both make the car lighter and ensure that there will never be a chance of a dirty engine leaking in a hospital. Those parts could also be sold to one of the many Smart owners in need of parts.
Of course, Smarts also make for some pretty cool visuals for clinic websites. Some facilities love their Smarts so much they dedicate entire webpages to them, like this page from the Brentwood Rehabilitation & Healthcare Center.
So, the next time you see a car seemingly randomly parked in a hospital, now you know why. These cars are helping people stay mobile, and that’s awesome. In a weird way, these hospitals are also preserving these cars, because most old Smarts are driven until the wheels fall off.
If anything, I think this is a noble second life for the Smart Fortwo. I remember when stereotypical car enthusiasts mocked the Fortwo and journalists questioned why it existed. Only weirdos like me championed them. In America, sales were good only for one year. Now, I suspect most people don’t even care if Smart came back to America. So, to see these cars help people puts a smile on my face.
(Topshot: Smart/The New Jewish Home)
I never thought about it but a smart is fairly easy to get in and out of the whole thing is basically a door. So many people with mobility issues get elements, xb, and cubes. Soul is kinda getting there too. They always seem to end production of the vehicles people with mobility issues prefer.
Huh, thing I never would have thought of
Those little casters on the simulator are probably hard to roll over carpet, so that’s a win, and it would be easy to install jacks to change the height if necessary.
By the way, there’s this commonly held belief that SUVs are easier for seniors and the disabled to get in and out of, and it’s bulshit. For the last year or two of my mother‘s life, she was terrified of getting out of any car where she couldn’t touch the ground while sitting in the seat. Falling will do that to you. Anything more than about 18-20 inches off the ground is no good. That’s why chairs are that high, except for barstools.
I am confused they buy the custom equipment to customize it for the patients own vehicle but buy the Smartfor two because it is easier to fit into? How does that help the patient get into their personal vehicle unless it is a Smartfortwo?
The Kia Soul would also suit this purpose. Small cars that are higher up than most cars but lower than an SUV or truck.