In the book Ethan Frome, he and Mattie take one last ride down the hill on the sled. It was their intention to hit the tree head on and lose their lives, but children were in the way and they had to swerve. They went sideways just enough that they both were severely injured.
Mattie was taken to her friend's home. She was in pain and the doctor had given her medications to quiet her. Zeena went to the house and took care of her. Zeena had her moved to the farm and she cared for both Matti and Ethan. Matti had almost died. Matti is left paralyzed.
Matti's body is described as :
"She sat huddled in an arm-chair near the stove, and when I came in she turned her head quickly toward me, without the least corresponding movement of her body."
"Under her shapeless dress her body kept its limp immobility, and her dark eyes had the bright witch-like stare that disease of the spine sometimes gives."
Ethan broke his back and was left crippled and hunched over. He walks with one arm swinging at his side.
After the wreck Mattie almost succumbed to her painful injuries but she survived with the help of Zenobia taking care of her but she is disfigured, disabled, and paralyzed. Later on in the story Zenobia sends her back to the farm to stay with her and Ethan ( who has a limp). Now Ethan must take care of both of these women until his days are numbred.