Based on the true story of Mark O'Brien, a polio-stricken poet paralyzed from the neck down who hired a sex surrogate (played by Helen Hunt) to help him lose his virginity, Hawkes went to great lengths to maintain the accurate look of someone suffering from polio. As he told Vulture:
Mark's spine was horribly curved. When you read the script, it says, "I haven't seen my penis since I was 6 years old." And Helen Hunt as his therapist says into a tape recorder, "His spine is so horribly curved that I don't know if intercourse is possible." You need to honor those things. I invented, along with the lovely props people, something called the "torture ball," which was a soccer-sized piece of foam that I would lay onto the left side of my back in order to curve my spine. It turned out to not be very good for me and my chiropractor told me that my organs were migrating. I probably will carry some of that the rest of my life, but it's obviously a minute amount of pain compared to what many disabled people face minute-to-minute.
Hawkes's doctor told him that, in the wake of "The Surrogate," the actor's spine has "not enough movement" -- this despite all the yoga he did during takes. Hawkes might even need to wear a back brace for the foreseeable future. If you don't think that's the type of narrative that gets a well-respected actor an Oscar nomination, you just haven't been paying attention. (Remember George Clooney?) See you at the 85th annual Academy Awards, John!