Sustaining a Spinal Cord Injury at any point in time is life altering – physically, emotionally, and financially – for all persons affected by the injury, but it can place unique challenges on younger married couples. This study examines the transition to injury for 18 couples (ages 21-55). Data were collected using individual interviews with each partner at three time points following injury, as well as observation in the rehabilitation setting (Creekview). This resulted in 96 individual interviews and 300 hours of observation. Using a combination of the life course perspective and cognitive sociology as guiding theoretical frameworks and grounded theory analysis, I examined how the health care institution influenced the couples’ relationships during their rehabilitation stay and the subsequent transition home. Overall, this study found that Creekview shaped a thought community that emphasizes a return to walking and high levels of physical recovery. Patients who achieved these goals constructed positive narratives about the future while those with lower levels of recovery constructed negative narratives over time. Additionally, because of the dominant medical narrative of wait and see regarding physical recovery, many respondents constructed fuzzy narratives about the future that reflect ambiguity about what life would look like following injury. Additionally, Creekview staff and couples accepted and reinforced the dominant cultural narrative that women are natural caregivers, but larger social structures of class, gender, and the division of paid and unpaid labor work together to push some women into caregiving faster or prevent other women from engaging in caregiving. Expanding on Aneshensel et al.’s (1995) caregiving career, this study examines how younger couples move through the caregiving career when the expected outcome is not long-term care placement or death. This study identified three main types of caregivers, each with their own path of caregiving – Naturalized, Constrained, and Resistant caregivers. Overall, the transition to injury is complex for patients and partners and this study highlights some of the ways the marital relationship is affected by a non-normative, unexpected transition.