So now he is sitting there in a wheelchair with pipes attached to his nose. All of that weight including the oxygen tank hanging on the back of the wheelchair almost makes it too heavy to move. Then again, he is paraplegic. He cannot use anything except one finger on his right hand. So he really doesn't need to move anything anywhere. Even his bowel and bladder do everything whenever needed and wherever.
So now to communicate he uses a bicycle bell. The old kind. Hit it with a finger and it goes ting!. It's the best way of him being noticed and also the best way to get a message across. It is, by far, not the wisest method. Not to mention it isn't the easiest method either. But he loves it. He wants it. Nothing else will do.
You see, the bell has so much more than a ring to it. To him, the bell is something extremely close to the heart. It is more sentimental than anything. He also understands that there are better ways of communicating but chooses to stick with the tacky bell. It is simply because he knows that he would never come across the bell ever again if decided to give it up. The bell would be gone along with all the sentiments it holds.