On an afternoon in April 2012, Chuck was walking at night near his home base when a car plowed into him, then sped away. The accident left him paralyzed from the waist down.

Their interaction ultimately revealed something that would profoundly change Chuck’s life: He had, in fact, been injured in combat.

“I had accepted the fact I was in a wheelchair because of the accident,” Chuck says, “but other things were taking a toll. I was trying to cling on to who I was before I got hurt.”

That is to say that, after being discharged from Shepherd Center, Chuck struggled to retain information. He got angry easily. Large crowds made him anxious. He describes his life during this period as “a funk I couldn’t get out of.”

Raziano made a point to keep up with Chuck after he left Shepherd. He’d assured her everything was fine, but she recognized his struggles as the potential signs of traumatic brain injury (TBI).

So in fall 2012, Raziano went on a mission: She traveled to Chuck’s home in Charlotte, N.C., and persuaded him to come back to Shepherd Center and enroll in SHARE.

“SHARE is a comprehensive, specialized rehabilitation program for service members who have mild TBI and who may have fallen through the cracks elsewhere,” says Greg Bennett, who manages the program. “We take a holistic approach in helping these service members establish a plan to meet their goals.”

Such goals could range from managing panic attacks to sleeping through the night to returning to work or school, Bennett explains. It’s an outpatient program, but free housing is provided while they are in the program, on average for about 12 weeks.

Chuck is one of more than 160 injured service members who, since 2008, have passed through SHARE, which stands for Shaping Hope and Recovery Excellence. Most sustained mild TBIs, which can cause significant physical, behavioral and cognitive impairments. Symptoms include dizziness, migraine headaches, and problems with mental focus, vision, balance and anger management.

Because of their specialized needs, people in the SHARE Military Initiative are treated separately from Shepherd’s general patient population. The environment is modified to accommodate their individual limitations — no bright flashing lights or incessantly buzzing alarms for service members sensitive to such stimuli, for example.

Chuck says he particularly benefitted from the program’s speech therapy, which helped him with reading comprehension, as well as one-on-one counseling. “In the military, you put everything you’re dealing with in the back of your mind, and it stacks up,” Chuck says. “The counselor started digging and helped me deal with it all. I was able to gain some closure and started feeling better.”

SHARE participants also learn how to plan menus, shop for groceries and cook meals. They take outings to movie theaters, retail malls and sporting events. All of these activities help them learn to function on their own after they return home.

“It’s a one-stop shop for everything,” Raziano says. “We customize it for each person and try to address all of their needs.” Raziano focuses on the time after patients leave the program. She helps them transition and assimilate into the community, serving as a resource as obstacles arise. She also navigates the disability process of the military, helping veterans get the maximum benefits to which they are entitled.

“I am a safety net once they leave the hospital,” she says. “I make sure they continue to progress outside of the SHARE Military Initiative. The fact that we follow them after discharge is what sets us apart.”

Established through a generous 2008 donation from Atlanta philanthropist Bernie Marcus, the SHARE Military Initiative is sustained through private contributions — and is provided at no cost to service members.

“No one gets turned away,” says Jon Roxland, senior major gifts officer in the Shepherd Center Foundation. “Military insurance pays about 38 cents on the dollar for the cost of care. The Foundation must raise about $90,000 a month to keep the program running. So we rely on donations from corporations, foundations and individuals to support the initiative and its clients.”

Today, Chuck is at home living with his mother, but he’s making plans to get a place of his own. He also hopes to go back to school to become a counselor. And he firmly believes that participating in the SHARE Military Initiative turned around his life.

“I lost my job and my career,” he says. “On top of having an injury, not having a purpose or a goal was really difficult. SHARE was the best thing I could have possibly done. It made me a real person again — and a better person.”

“Brookhaven Rotary Club is a key partner in Shepherd Center’s SHARE Military Initiative for service members and veterans who have sustained traumatic brain injuries,” says Scott Sikes, executive director of the Shepherd Center Foundation. “Rotary clubs around the country have the motto ‘Service Above Self,’ and Brookhaven Rotary members exemplify that motto.” SHARE serves military personnel at no cost to them or their families. Their care is covered by military insurance and contributions from the community. But it’s the program’s approach that Ward believes sets Shepherd apart from services offered by other organizations, including the Armed Forces. “The military wants you to be the same person you were when you came in,” he says. “Shepherd teaches you you’ll never be the same person, and that’s OK. They teach you to learn to cope with the new you, giving basic life skills to be successful and help with self-worth.”

Written by Sara Baxter

Photography by Gary Meek

Be alert. Eliminate distractions. Don’t drive after drinking. It’s simple advice — often repeated and often forgotten. But it’s easy to remember for these three former Shepherd Center patients, each of whom was a pedestrian struck by an automobile.

The occurrence of incidents like this is significant. The federal government recorded 4,280 pedestrian fatalities and an estimated 70,000 injuries in 2010.

“When a car hits a pedestrian, you have this huge mass that’s colliding with something a fraction of its weight,” says Shepherd Center physician Anna Elmers, M.D. “So just by sheer physics, the injuries that occur are going to be significant — often multiple trauma, broken bones and brain and spinal cord injuries.”

In fact, the severity of brain and spinal cord injuries may mean that other injuries, such as ligament damage to knees, may not even have been diagnosed by the time patients arrive at Shepherd Center, Dr. Elmers notes.

“It’s difficult to tell in a trauma setting what a patient ultimately will be able to do,” she says. She has learned that some recoveries are surprising.

Patrick’s Story

Patrick Helper-Ferris didn’t use his usual corner to cross Memphis’ Central Avenue on a Saturday morning walk with his two dogs, Hector and Percival, on July 11, 2009. He didn’t like being shielded from the road by the thick hedge on the northeast corner of the intersection.

“But it was a very hot day, and that hedge was providing shade. So my dogs wanted to go to that shade,” Patrick recalls.

When the traffic light changed, he took the dogs briskly into the crosswalk to be sure he could get across the five-lane road.

“I don’t remember being struck,” Patrick says. From the police investigation, he knows a driver unfamiliar with the neighborhood was looking for street signs and didn’t see the traffic light. The car, traveling at 40 to 45 miles an hour, struck a sport utility vehicle “so hard that it spun around 360 degrees and knocked me out of the crosswalk and back onto the sidewalk I had just left,” he explains.

Patrick, now 43, remembers nothing of the next two weeks. It was a frightening time for his wife, Laura Helper-Ferris. She returned home from a tai chi class that Saturday to find one of the dogs, Hector, on the front porch. Soon after, a woman arrived who had found an injured Percival at the accident scene. She had taken the dog to a veterinarian and used the dog collar to find Laura. They went to the accident scene and tracked Patrick to the Regional Medical Center at Memphis.

He had sustained a complete T-2 spinal cord injury, causing paralysis from his chest down. His left wrist and clavicle also were broken, causing severe nerve damage in that arm. His head was hit hard enough to damage his peripheral vision on the left side.

After 10 days with his life in the balance, Patrick had spinal surgery in Memphis. He was on a ventilator when he arrived at Shepherd Center on July 27, 2009. He needed multiple procedures to overcome his lung problems, but finally was able to breathe on his own.

In physical and occupational therapy, Patrick learned to roll, sit up, slide on a board from bed to chair, and use a swing and lift for the toilet and shower. Physical therapy helped restore about 25 percent of the function of his damaged left arm. “The index finger and thumb can close, so that helps,” he says.

“I tried to use my hands as much as I could, especially the left one — practiced working those arms, turning the chair, driving the chair,” he recalls.

Laura stayed in Atlanta throughout Patrick’s four months of treatment, living first in housing provided by Shepherd Center and then with a woman who responded to a call for help from the Quaker community. That host even permitted Hector and the mended Percival to come along. Later, she lived with Patrick in a Shepherd Center apartment when he graduated to Shepherd’s Day Program. Laura recalls that Shepherd Center therapists were “incredible teachers,” training her to help Patrick move in and out of his chair, dress his lower body and even to suction a tracheotomy tube, although the last task proved unnecessary as he recovered.

She described his homecoming on Dec. 5, 2009 as “triumphant.” Friends, neighbors, Quakers, family and coworkers pitched in to help modify the couple’s home for Patrick. They raised money and even helped design and build wheelchair ramps and bathroom and kitchen renovations.

After more therapy and four followup surgeries in Memphis, Patrick resumed the college classes he had begun before the accident with the support of his employer. In January 2011, he returned to his job as an information systems administrator. He expects to receive his college diploma in January 2014.

In 2012, Patrick started working as a volunteer counselor for a Memphis suicide prevention hotline.

“I had been looking for an opportunity to give back,” he says. “Since the accident, I’ve really been humbled by the generosity and kindness of just about everyone in the world — certainly, my family, friends and coworkers. But anywhere I go, strangers hold doors and are very helpful.”

Patrick now drives a customized van, purchased with family support. One of his persistent injuries is a vision “field cut,” like a smudge on the left lens of a pair of glasses. He adds, “When I stop at an intersection, I definitely turn my head around to be sure I’m not missing anyone stepping from a corner, especially on my left side.”

Jay’s Story

Jay O’Neal “woke up” one day in 2006 at Shepherd Center, looking in a bathroom mirror.

The face looking back at him was scarred. His head was shaved.

“I thought, ‘What happened to me?’ I was kind of waking up to the world,” says Jay, now 28. “I’m glad it happened at Shepherd because they were so much better able to explain it to me and handle me.”

Shepherd Center professionals explained that a drunken driver had veered off the road and hit him as he walked toward his car after a church outing at a Columbus, Ga., park, on the night of June 14, 2006.

The impact “completely crushed” his pelvis, requiring major reconstructive surgery at Columbus Regional Hospital. “I’ve got a lot of titanium bolts, screws and that kind of thing,” he says.

“They saved my life,” Jay says. “My family was all excited about it.” Then a doctor told his relatives: “You don’t understand. That’s not his worst injury.”

All four lobes of Jay’s brain had been injured. When doctors let him emerge from a medically induced coma, he was confused and prone to outbursts. His family had been told to consider a nursing home, and then “Shepherd Center found us,” he says. Only after his transfer to Shepherd did Jay regain awareness of what was happening to him.

“What I love about Shepherd Center is they try to build community among patients and staff,” Jay says. He dined with other patients and was expected to keep track of his own treatment schedule.

“They taught me how to be self-reliant and functioning,” Jay says. “Every morning, I had to look at the therapy schedule and see where to be. My recovery was up to me.” He also credits Shepherd with promoting early therapy for patients with brain injury, rather than waiting for the brain to heal itself. The approach worked for him.

“It was a gradual thing,” he recalls. “I’m not going to lie and say there was never a time that I sat there and cried because my life had changed. But there were things that would happen that would make me realize life isn’t all that much different.”

One was an outing with a fellow patient. They got approval one day to go with their mothers to an offsite restaurant — to the horror of their mothers. “They said, ‘You’re not leaving the hospital.’ But we did. It made me realize I’m normal. I thought, ‘Look at me, I’m in public.’”

Jay’s family participated in training at Shepherd Center before he went home, and he continued to improve with physical, speech and cognitive therapy in Columbus.

Jay had been pursuing paramedic training before the accident. But in fall 2007, he transferred to Columbus State University and became a communications major. “I think it is quite ironic,” he says, because his family was told at one point that he would have to relearn how to read, write and talk again. He wrote a paper on patient communication at rehabilitation hospitals, centered on his Shepherd Center experience. The paper was approved for presentation at a national conference.

He expects to receive his diploma in December 2013, but he already is working as executive director of the Contact Disability Resource Center in Columbus.

Now, he works to prevent drunken driving. He is alert in restaurants to patrons stumbling toward the door. “I’ll pay for their taxi, and then I’ll go to the bartender and say you’re overpouring,” Jay says.

He calls his healing “a true gift from God” and says he has no anger toward the driver who hit him.

“She needs her own healing,” Jay says. “It was a mistake. I’m getting better and I hope she’s getting better. I don’t regret the accident. This has made me who I am.”

Von’s Story

Von Fusco, 18, of Orlando, Fla., would still like to have a career in the Air Force, though he knows his career path may have to change. That is the strongest sign of his recovery since he was literally knocked off an Orlando street.

He and a friend got off a city bus on the way to another friend’s home. It was some distance to the nearest crosswalk, but they started across the street while the light for oncoming traffic was red. They started too late.

“I was told the driver was on the phone and hit the gas when the light turned green,” Von says.

The impact broke his legs, shattered his right wrist and severely injured his brain. That was Sept. 3, 2012.

“I don’t remember the two weeks before the accident or anything until my birthday on Oct. 21,” he says. “I woke up with two metal rods in my legs. That’s how I knew something happened.”

In high school JROTC, Von routinely ran 10 miles. But when he regained his faculties on Oct. 21, he needed a helmet to protect his head when he walked.

At Shepherd Center, Von started walking slowly with a therapist close behind for support. But he progressed quickly. He graduated from inpatient care on Nov. 6 and left Shepherd Pathways outpatient care on Dec. 14.

“You need inner strength,” he says. “What gave me the physical strength was the doctors’ and therapists’ work with me. What gave me the spiritual strength was the love of my friends and family.”

Once home, Von got back on track at Colonial High School, doing some classwork at home. He graduated with his class this past June.

By summer, he was “pretty much up to speed” and training to run in a 5K race.

While on disability status, he would like to attend college if he can secure funding. Otherwise, he will work when he is cleared for employment. In either case, he still hopes to join the Air Force when he’s 23. His father is a full-time recruiter in the Air Force Reserve.

Von is able to drive now, and he does so with caution.

“One thing I never do is touch my cell phone while driving. There’s no reason to,” he says. He spreads that message to his friends.

“A majority — not all of them unfortunately — but a majority of them do learn from what happened to me,” he says.

Written By David Simpson
Photography By Jamie Harmon, Louie Favorite and Jacque Brund

Lifelong friends since their youth, the three men share a friendship that feels more like a brotherhood strengthened by their shared commitment to giving back to the communities in which they live and work. “We’ve been so blessed and feel compelled to try and bless others and to give back,” Tom says. Danny concurs, “It’s just rewarding to serve others and to see them grow. Hal feels the same. We wouldn’t be as close as we are if we didn’t all feel the same way.”

Tom, Danny and Hal certainly feel similar admiration for Shepherd Center — a sentiment largely behind their donation of both time and land to the hospital for the inpatient hunting program. It provides staff-led, overnight hunting trips for patients. The idea for the program began in 1991, when Harold Hobbs, the manager of Tom’s father’s plantation, Mossy Dell, approached him about taking his friend, former Shepherd Center patient Chuck Seaton, on a hunting trip. Seeing how much Chuck enjoyed this experience, Tom’s father, Gene, felt encouraged to take other Shepherd Center patients hunting at his plantation each year.

After observing these hunts at Mossy Dell, Tom, Danny and Hal felt they could create the same wonderful experience for Shepherd patients at Tom’s land in Monticello, Ga. They held their first turkey hunt there in 1997. Since that time, they have hosted Shepherd staff, patients and family members at Tom’s Monticello property twice a year (in December for deer hunting and in March
for turkey hunting) and at Mossy Dell Plantation once a year (in January for deer hunting).

With safety as their top concern, Tom, Danny and Hal, in coordination with Chris Ravotti, CTRS, an outdoor specialist at Shepherd Center, do everything they can to make the outings successful and enjoyable for patients. The goal is to help patients practice hunting in a real-world environment and regain hope that, despite their wheelchair, they will be able to participate in outdoor recreational activities again. “Doing everything they can” includes, among other things, clearing roads, readying the cabin, determining the best hunting spots for each patient based on his or her injury, and setting up hunting blinds to prevent detection by animals.

Tom, Danny and Hal thoroughly enjoy getting to know each patient and find it rewarding to serve Shepherd Center. When asked why others should donate their time or resources to the hospital, Tom simply states: “Do it. You get more back than you give. Period. End of story. Try it one time and you’ll be hooked.”

Chris Ravotti finds it equally as rewarding to work with donors like Tom, Danny and Hal. “Whatever I need to make the outings more enjoyable, they will drop whatever they are doing to help,” Chris says. “They’re just a great group of guys I can depend on every year to provide an exceptional experience for the patients.”

Written by Rachel Franco

Photography by Louie Favorite

He was in a coma and had multiple skull fractures, as well as bruises and contusions of the brain and extensive bleeding. He also had collapsed lungs and a ruptured spleen.

Joel Pickett, M.D., a neurosurgeon, operated on Mark’s brain while another surgeon, Deepak Katyal, M.D., treated his lungs and removed his spleen. Their collaboration saved Mark’s life.

Dr. Pickett spoke with Spinal Column about Mark’s injuries and remarkable recovery, and explained why emergency room treatment continues to be a regular part of his practice.

Q: How serious were Mark’s injuries?
A: With a global head injury like he had, the mortality is about 50 percent. Of those who do survive, about one in four has a reasonably good life.

Q: What do you remember about his stay at Huntsville Hospital?
A: He was comatose for a while and actually had a cardiac arrest in intensive care, but he responded to resuscitation. Later, he had pneumonia and was very, very sick. But eventually he was weaned off the ventilator and able to respond to commands.

Q: Why did you recommend that Mark undergo rehabilitation at Shepherd Center?
A: We are very familiar with Shepherd Center and send a lot of our patients there.

Q: Why?
A: The main thing is that the patients and families we have sent to Shepherd Center have all spoken so highly about it when they return.

They felt that the physical therapy and occupational therapy was top-notch. And family members, in particular, indicated that they were very pleased with the treatment. They said how pleased they were that all of their questions were answered.

It’s just the whole package. Families feel like Shepherd Center does everything they possibly can to help the patient. That’s what the family wants, and that’s what they do.

Q: When did you first see Mark after he returned from Shepherd Center?
A: The first time I saw him was at my home, not at my office. Mark and my son, Tyler, are friends, and Tyler brought him by the house.

Q: How was he?
A: Very good. He was actually joking around and very engaging. He told me his father told him when he came home that there would be things he wouldn’t remember, and one of those things was that he used to be a stickler for neatness and always kept his room clean. Mark said he told his father: “I don’t think so, Dad. I’d remember that.”

Q: It’s been 12 years since Mark’s injury. How would you assess his progress?
A: He’s really gotten well. He’ll tell you he struggles sometimes, but you wouldn’t know that if you didn’t talk to him and dig into it. Considering that he had a global head injury, he’s recovered spectacularly.

Q: Finally, unlike many neurosurgeons, you still treat trauma patients in the emergency room just as you did with Mark. Why?
A: Well, it’s time-consuming, it’s hard work and it’s late nights, but I see that as my job as a neurosurgeon. This is my community and my home. These are my neighbors. I want to take care of them if I can.

Written by John Christensen
Photography by Dennis Keim

But because he had a brain injury, Mark remembers little of those life-and-death struggles. He does remember going back to college, becoming an all-conference baseball player, making the dean’s list and getting his degree. And he is grateful today that he has a job and is living independently, but he says he still feels he has much to accomplish.

When Mark arrived at Shepherd Center, he was in a waking coma. He was incoherent and often agitated, and he still had a tube in his chest.

“But that first day,” says Lisa Caprio, Mark’s mother, “the nurse came in and said, ‘OK, you’re going to take a shower.’ And I’m thinking, ‘You can’t do this,’ and she says, ‘Mom, you go over there and relax.’”

Within days, therapists had Mark using a walker and shooting baskets on the basketball court.

“I realized then how much I appreciated Shepherd Center,” Lisa says. “Every day we could see improvement. They had constant activity for him, a schedule. They weren’t going to let the patient decide. They knew what was best and what the patient could do. What a great place it is.”

“Shepherd Center is tremendous,” says Frank Caprio, Mark’s father. “We were lucky to be there.”

“Mark definitely has issues,” his mother says, “but he’s in a good spot. We always comment that when he had his accident, he was an 18-yearold boy. Now he’s becoming more mature and thinking about his future and his career. I do see him evolving and I hope he’s still getting better and learning to cope and strategize on those issues so he can make it on a job.”

“Brain injuries tend to be very humbling,” Kohn says. “When you have a brain injury, people see you at your most vulnerable, and it can be physical, mental, spiritual or behavioral. It’s very humbling to have family, friends and healthcare workers knowing intimate details that you do not recall and most likely will not recall.”

On the other hand, she says people like Mark learn to focus on what is important and appreciate that they’ve been given a second chance. And so have their families.

Frank says that before the accident, he and Mark “used to butt heads.” Now, he says, their relationship is far better than when Mark was going through adolescence.

“I got an opportunity to have a deeper relationship with my son and to tell him what I really feel about him,” Frank says. “Shepherd Center gave us another chance at a good life together.”

Written by John Christensen
Photography by Dennis Keim

“Patients feel good about going home, but when they get there, they often feel lost and overwhelmed,” says Mike Jones, Ph.D., vice president of research and technology at Shepherd Center. “They now have their injury plus the pressures of daily life, and they are hit with the realization that they can’t do everything they used to do.”

In addition, many people with SCI still have acute medical needs that must be managed post-discharge. For example, they might need a feeding tube or catheter, so they need to know how to problem solve and what to watch for to avoid problems.

Patients typically do not lack information or even the skills to care for themselves by the time they are ready to go home, but they may not feel confident making decisions independent of their treatment team, Jones explains. He likens it to the panic that can set in for new parents when bringing a newborn home from the hospital. For the first time, no one is around to help coach them or reinforce their decisions about how to care for this new little life. For people with SCI, feeling ill-prepared can lead to return visits to the hospital (called readmissions) and other problems.

Now, thanks to a new grant from the Patient-Centered Outcomes Research Institute (PCORI), Jones and his team will evaluate the effect of several hospital-wide changes aimed to build patients’ self-efficacy—the belief that they can effectively manage their care.

These include efforts to:

1. Expand Shepherd Center’s peer mentoring program so patients can readily connect with and learn from other people with SCI both at Shepherd and after discharge.
2. Revamp the way patients are educated about SCI and its complications by shifting from passive, lecture-style teaching to a “flippedclassroom” approach in which patients and families review information online and then come to class ready to discuss and apply what they’ve learned with their peers.
3. Develop patient portals that will include personalized medication lists, education and guidance on specific issues (e.g., bladder, skin) and access to peer discussions.

With the near $1.5 million PCORI award, researchers will be able to collect extensive data to determine whether these interventions affect hospital readmissions, medical complications, and compliance with doctor visits and medications post-discharge. Patients included in the study will be evaluated 30, 90 and 100 days post-discharge and again at one year.

“SCI affects all body systems, so when patients go home, there are a lot of ways to get into trouble with their health,” says Sarah Morrison, PT, vice president of clinical services. “Our job is to prevent that from happening.”

The hope is that by offering interactive education sessions, providing individualized online tools and linking them with peers who have faced similar experiences, patients will be better equipped to make health decisions to stay healthy and prevent problems once they are on their own.

“We want to boost their ability to manage their condition,” Jones says. “The way health care is going, the more control and confidence they have to manage their care, the better so they don’t rely on the healthcare system to
meet those needs.”

This work will also help shape Shepherd’s discharge planning and post-discharge supports for patients and families.

Written by Amanda Crowe, MA, MPH
Photography by Louie Favorite

For more than 25 years, she helped students in the Cobb County School District as a special education teacher. And Mary Kay has supported the Georgia Symphony Orchestra in numerous capacities.

It was while teaching that she learned about Shepherd Center through the hospital’s magazine. Impressed with patients’ stories and Shepherd’s work, Mary Kay decided to become a volunteer in 1999.

Inspired by the positive spirits of Shepherd staff members, Mary Kay took a position as a part-time librarian in the hospital’s Noble Learning Resource Center that same year. She worked in the library and helped families and staff with research needs and other tasks until retiring in 2009.

Meanwhile, Mary Kay has continued to volunteer for Shepherd since 1999. A lifetime member of the Shepherd Center Auxiliary, Mary Kay has served as the Auxiliary’s treasurer, in charge of managing the budget and dues collection; membership chair, in charge of current member and new member solicitation efforts; then historian; and, ultimately, president of the Auxiliary.

She has also chaired the Auxiliary’s annual Pecans on Peachtree fundraiser and has participated in many other fundraisers that have resulted in a new suite at the Woodruff Family Residence Center, a new floor in the Livingston Gym, a patient room in the Shepherd Building and other significant renovations.

“Mary Kay has been with us for such a long time that she’s really a part of Shepherd,” says Alex Seblatnigg, CAVS, associate director of Volunteer Services. “She sees where she can contribute and jumps in with both feet. She is one of a kind, and we are really lucky to have her.”

Visitors who pass by the Welcome Desk when they enter the hospital feel lucky to have Mary Kay, too. Volunteering there each Friday morning, Mary Kay serves as the first friendly face that patients, families and others see when they come to Shepherd Center. Not only does Mary Kay answer questions visitors may have, but she also provides great comfort to patients and families who come to the hospital for the first time and who may be feeling anxious.

Gratified by serving Shepherd Center, Mary Kay encourages others to volunteer at the hospital, as well. “If you want to do something that you’ll feel good about doing and that will make someone else feel good,” Mary Kay says, “then volunteer at Shepherd Center.”

Written by Rachel Franco
Photography by Gary Meek

Q:  What first drew your interest to the medical field?
A:  I’d always wanted to be a doctor since I was a little girl, and I never really wavered from that. Looking back, I think in large part that had to do with my father getting sick. When I was six, he had a stroke. So I’m sure that’s what led me toward neurology. But nobody in my family had ever been a doctor, so it seemed out of left field to them.

Q:  What have been some of the biggest differences in your ability to treat MS patients through the years?
A:  When I first started, there weren’t any actual treatments. We were just treating symptoms. We didn’t have what we call disease-modifying treatments – ways to actually change the course of the disease or even the outcomes of the disease. That first treatment was approved in 1993, and then four more in the next 10 years. Now we have three oral treatments – IV therapies – and that doesn’t even include all the possibilities coming down the pipeline in research.

Q:  What is the most common misconception you hear about MS?
A:  Probably the most common is that people think everyone with MS is going to end up disabled in a wheelchair. That’s a big misconception, especially today. With the ability to diagnose early and start treatment early, it’s not the case. Just four years ago, that still might have been the norm. But now we have more disease-modifying treatments than ever.

Q:  What motivates you the most in your work?
A:  I take great pride in the MS Institute. We do a very good job of offering specialized care and we take on challenging cases. We can truly alter lives, improve lives. That’s very exciting. And we get a lot of young patients here who have their whole lives ahead of them. It gives me a big charge to realize what we’re capable of doing.

Q:  Why is research such an important part of your job?
A:  We have a good combination of clinical research and patient-oriented focus. I couldn’t imagine doing just research alone, or research without a direct application. I’m much more of a hands-on person, so I love the patient interaction. Our patients are the reason why we’re doing this research. It’s relevant to what we do day-to-day. So I can’t imagine doing one without the other.

Q:  What attracted you to work at Shepherd Center?
A: I was in Augusta, Ga., before, and Shepherd Center was obviously well known there. I knew how comprehensive the setup was at the MS Institute and the team approach they take. It’s a special place. Once I got here, I started telling people it’s like a very smooth-running ship. I certainly couldn’t do my job here without the talented team around me.

Q:  If you hadn’t become a neurologist, what do you think you’d be doing today?
A:  That’s hard to say because I can’t imagine doing anything else. But I was a chemistry major in college, so maybe I would have gone to grad school in chemistry. Who knows where it would have gone from there, though!

Written by Phillip Jordan
Photography by Gary Meek

CHAPEL HILL, NORTH CAROLINA

Within a three-year span, Michael “Mike” Arneson, 19, of Chapel Hill, N.C., sustained a brain injury in a bicycle accident, was diagnosed with cancer and saw his family’s home burn down when struck by lightning.

“In my family, we like to say we follow the rule of threes, so we’ve completed our trio now,” Mike says. He laughs as he says it and is thankful he can. After his bicycling accident, it took nearly a month before the fog in his mind began dissipating. “My mom described it as ‘The lights were on, but nobody was home,’” Mike recalls.

Nearly two months at Shepherd Center and a stint at Shepherd Pathways helped him recapture his strength and start to regain the use of his hands. “Just walking out of Shepherd Center was a huge accomplishment for me then,” Mike says.

Two years later, as he continued to improve, a small bump on his neck was diagnosed as Stage II-A Hodgkin’s lymphoma. Six rounds of chemotherapy later, Mike emerged cancer-free and has remained so since.

Those two experiences would put last year’s loss of his family’s home in perspective. “It was tough, especially for my mom, to lose pictures and childhood memorabilia,” he says. “But we know there are worse things.”

The house has been rebuilt, but Mike will soon be on the move again — this time to attend the University of North Carolina at Chapel Hill. This past spring, as he looked forward to college, Mike shared some advice through his high school valedictorian speech.

“Don’t regret the past,” he says. “Sometimes at Shepherd Center, I’d start thinking ‘What if? What if I hadn’t gone biking that day?’ But that doesn’t help anything. Whining or wondering about choices in the past only prevents you from doing what you need to do in the present.”

Josh Lam

MCGAYESVILLE, VIRGINIA

Josh Lam, 28, of McGayesville, Va., lives on a family farm nestled in the Blue Ridge and Appalachian mountains. From his doorstep, he can see the homes of his grandmother, uncle, cousin and parents. Close by is the pond where Josh and his wife Cassie were married two years ago.

It’s a scene he doesn’t take for granted since his injury in September 2010. “All the family support around me helped get me through,” he says.

Josh sustained a C-4 to C-5 incomplete spinal cord injury in a nighttime automobile accident in which he wasn’t wearing a seatbelt. When he came to, he was trapped in his wrecked truck, listening to fuel gurgle out of the punctured gas tank and watching head beams become taillights as cars sped by. “It felt so strange. I don’t know if it was the adrenaline, but I’d broken my neck and I never really felt much pain,” he recalls.

When Josh arrived at Shepherd Center three weeks later, he couldn’t move his legs, fingers or hands. Nine weeks there, followed later by two weeks in Shepherd Center’s Spinal Cord Injury Day Program, brought Josh’s fingers back to life and movement back to his knees and ankles.

“You’ve really gotta put your time in down there,” he recalls. “They work you, but it’s such a great place. I was very lucky to go there.”

Today, Josh gets around most places with only a cane. He doesn’t bale hay anymore, but he’s constructing a new chicken house and can operate most of the farm’s machinery. He’s also gotten a new side job in town at a car dealership.

“I’m a simple, laid-back guy,” Josh says. “Being here with my wife, my family. That’s what meant the most to me.”

Matt Lee

STONE MOUNTAIN, GEORGIA

Matt Lee, 22, of Stone Mountain, Ga., has about a half-dozen teachers in his family. “I think it’s just in my blood,” he says. “As long as I can remember, I’ve wanted to teach.”

When Matt sustained a brain injury in January 2009, it appeared his lifelong plans might be in jeopardy. He had hydroplaned in his car on a foggy night, and Matt wound up in an intensive care unit for a week. His longer-term challenge would be reclaiming his short-term memory.

At Shepherd Center, Matt would forget instructions he’d received only a few minutes before. He couldn’t remember his room number.

“A lot of that period is gone from my memory,” Matt says. “But as time goes on, I do remember music and speech therapy sessions, and how nice and helpful everyone was. I’ve gone back to visit with therapists since I’ve recovered, and it’s been so good to actually have full conversations with them!”

He went on to spend five months at Shepherd Pathways. Halfway through his time in the program, Matt started walking and soon began light running. His balance and coordination improved. Eventually, his memory and attention span improved, as well.

Since then, Matt has earned a degree in religion at Samford University in Birmingham, Ala. This fall, he started classes at Emory University’s Candler School of Theology. Matt’s focus is on Old Testament studies, as well as ancient languages and civilizations. After attaining his master’s degree, his next goal will be to get a doctorate.

“I’d actually started as a music major at Samford,” Matt says, “but I realized pretty quickly that I enjoy music more as a hobby. I’ve always had this interest in religious studies and languages, so I made the switch. This is what I want to teach.”

Meg Throckmorton

WAYNESBURG, PENNSYLVANIA

For the first time in more than a year, Meg Throckmorton, 18, of Waynesburg, Penn., practiced ballet this past summer. “I’m taking it slow, just stretching and exercises on the balls of my feet,” she says. “Even if I can’t dance like I did before, it’s so great to be part of it again.”

“Before” is the time leading up to April 13, 2012, when Meg sustained an incomplete C-1 to C-2 spinal cord injury while practicing for a dance competition. The injury left her in a neck halo for six weeks, and she relied on a ventilator when she came to Shepherd Center. But Meg became one of the youngest people to be approved for a Diaphragmatic Pacing System (DPS), which stimulated her diaphragm a dozen times a minute to assist her breathing.

“It felt like a bee was stinging me!” Meg says. “But I got more comfortable with it, and that helped get me breathing again on my own.”

She and a fellow patient named Montana challenged each other to a vent-weaning competition. “And I beat him by a few days!” Meg says with a laugh. “We were doing it at the same time, so we had fun with it. Really, it was just good to have someone to talk with about it.”

She returned to Shepherd Center this spring to take part in the Beyond Therapy® program and credits it for getting her to the point she’s reached now — able to dance, swim and go out with her friends.

“Shepherd was such a different experience from the first day I was there,” Meg recalls. “They didn’t let me wallow. They got me going right away. Every single nurse, every single therapist was so amazing. I remember telling my mom, ‘Thank you for bringing me here.’ It’s exactly what I needed.”

Written by Phillip Jordan

The fact that he’s wearing a badge again in Palmetto, Ga., is stunning, though. After Lee flew like a bird and landed like a melon on Sept. 12, 2009, the fight was to survive, not work. Quickly after being thrown from a suspect’s car at 80 miles an hour and landing on his head, Lee went into cardiac arrest at Atlanta’s Grady Memorial Hospital. Doctors resuscitated him, but a traumatic brain injury and a shattered face topped a list of injuries.

He couldn’t talk, walk or do much else. Yet, he’s back on the beat in a small town about 25 miles southwest of Atlanta, working full time to the point where he says, “I don’t see myself going anywhere else.”

Not long after transferring to Shepherd Center on Oct. 9, 2009, Lee inquired with Palmetto Deputy Chief John Cooper and other colleagues about work. Here was a 6-foot-2-inch, 250-pound guy who could barely speak. Yet he found a way to ask.

Most amazingly, Lee, now 41, was at work four months after landing in a heap. It was initially just four hours twice a week and working “over property and evidence” – not as intense as his previous duty in the Crime Suppression Unit, but still it had only been four months since his injury.

“It’s beyond reasoning,” Cooper says of the comeback. “The rehabilitation at Shepherd Center did him wonders. I’ve heard it takes years to get over this. It was pretty bad.”

With Lee in a coma for two weeks at Grady, his body underwent reconstruction. He’d sustained a T-7 spine fracture and broken several ribs, lost vision in his left eye and damaged nerves in his right arm. And a massive rebuild was required from the neck up.

“Basically, every bone in his face was broken,” says Lee’s wife, Shelly. The same was true on the inside:  Lee’s palates were wrecked, his tear ducts were crushed and neither eye was in the right place.

On went the rebuild. Upon waking, Lee’s motor skills and cognitive abilities were diminished.

By the time he transferred to Shepherd Center, Lee had undergone many of the 26 surgeries (which have continued) he’s had. At Shepherd Center, physiatrist Gerald Bilsky, M.D., soon discovered that, after adjusting Lee’s medications, Lee was cognitively ahead of where most people are at that point in rehabilitation.

With help from Dr. Bilsky and the rest of his Shepherd Center treatment team, Lee had to relearn how to walk, talk and eat. “I couldn’t even chew,” he recalls. “Food would just fall out.”

Lee has intermittent memory issues, and no recollection of the accident. Fellow officers fill in details. Of that fateful day he does recall that, “my son had his first baseball game,” he says. “Jake was 7.”

A few hours later, Lee and fellow officers were hoping to catch a drug runner.

“We got a tip from the DEA that a guy was going to be coming through with methamphetamine, and I set up a road check because I was sergeant over the Crime Suppression Unit,” he says.

As it was getting dark, officers first stopped another motorist. Lee intervened.

“He had a suspended license and a warrant for his arrest,” he says. “I went over to take it up. Everybody tells me he said, ‘I’m not going back to jail,’ and he reached for something on the floorboard of the car. I reached down through the window to stop him.”

The driver hit the gas, dragging Lee. About 300 yards later, the car hit a brick mailbox. “I went flying and landed on my head,” he says. “They say I went higher than a power line.”

The driver died. The sergeant had his heart restarted at Grady.

Four weeks later, Lee transferred to Shepherd Center to restart his life.

The spinal fracture healed, but Lee’s brain injury required more intense rehabilitation, Dr. Bilsky says. Lee underwent speech, physical, occupational and recreation therapies, including music therapy, and a driver rehabilitation course to teach him how to drive again.

In November 2009, Lee went home to Douglasville, near where he grew up on Atlanta’s west side. He became a Shepherd Pathways outpatient, and the Graggs, now married 20 years with a 17-year-old daughter (Hannah) and 11-year old son (Jake), immersed themselves in Lee’s rehabilitation.

“They’re incredibly good together,” Dr. Bilsky says of the couple. “I tell families there are four parts:  First, the medical side has to do the right things; the therapy and nursing support has to be there; the support of family and friends is critical; and the fourth is out of our control.

“Call it luck, Mother Nature, powers that be, fate,” Dr. Bilsky adds. “There’s got to be something. To a certain extent, he was lucky because it could have easily been a fatal injury.”

On Jan. 12, 2010, Lee returned to work in a limited role. Over the next year, he ramped up to full time. Now, he’s a sergeant in the Criminal Investigations Division and a public information officer.

No doubt, Lee is different now. He forgot the way home from work once, buying a GPS to remedy that. Shelly worries about her husband’s loss of vision to the left.

“I’ve learned to adapt,” he says. “I write notes, even at home, or keep it on my phone. I can tell you about work or music, but I don’t remember getting married. I have headaches pretty bad. That’s probably the main complaint besides memory loss.”

The experience has been an evolution, but some things haven’t changed.

“He’s an extraordinary person, a good one to have on your side,” Deputy Chief Cooper says. “I learned in Vietnam that there are some who, when the going gets tough, they get going harder, and that’s Lee.”

He is a different kind of cop. He’s now a detective in charge of other detectives rather than running a drug task force.

“My days of running after folks, the crime suppression, that’s a done deal,” Lee says. “I still do search warrants, but I let others make entries while I observe and supervise. Stopping cars and doing traffic stops, I’m not going to do that any more.

“I’ve learned that no matter how bad off you may be, there is somebody else worse off. To look at people who didn’t have the opportunity to recover as well as I did – especially if they didn’t have the opportunity to go to Shepherd Center – that puts it in perspective for me.”

Written by Matt Winkeljohn
Photography by Gary Meek

The Indego^® — short for independence and go — is living up to its carefully chosen name and could be available to clinical rehabilitation centers in the United States as early as next year thanks to an innovative partnership among Shepherd Center, Vanderbilt University and Parker Hannifin Corporation, the company that will manufacture the device.

Think of it as a Segway with legs, says device inventor Michael Goldfarb, Ph.D., the H. Fort Flowers Chair in Mechanical Engineering and professor of physical medicine and rehabilitation at Vanderbilt.

The Indego is worn on the outside of the body, helping users move their legs and allowing them to stand and walk. To go, the wearer leans forward. To stop or sit, they stand upright or lean back.

“It’s extremely intuitive and moves in harmony with the body,” says Clare Hartigan, a physical therapist and research coordinator at Shepherd Center. “It’s also the only device that allows the user to transport it completely by themselves. They can wear it in their wheelchair, in a restaurant or car. People have been in the device as long as six hours — sitting, standing and walking.”

The Indego has several other inherent advantages over existing lower-extremity exoskeletons, Hartigan says. It easily snaps apart and is compact and lightweight (27 versus 45 pounds or more for other exoskeletons). It is also the first to allow the wearer to vary the degree of robotic assistance applied based on his or her level of function and muscle control. “This device will adjust in the same way a physical therapist will interact with a patient differently depending on what that patient needs,” Dr. Goldfarb says.

So far, the device has been tested by 10 patients at Shepherd Center — and with great success.

David Carter, 27, of Dallas, Ga., was injured in a 2010 motorcycle accident, which left him with a T-7 complete SCI. After just three sessions with the Indego — only two to three hours each — he was able to walk by himself using a walker for the first time in two years.

“It was amazing to stand side-by-side with someone and look them in the eye rather than always looking up at them,” he says. It is technology that, in Indego’s case, has been developed and refined over several years with real-time feedback from clinicians and patients at Shepherd Center.

There are also secondary benefits associated with the weight-bearing and movement that come with using the device. For example, users report reduced spasticity and pain, improved bowel and bladder function and better skin health.

More recently, clinicians have started testing it on people recovering from stroke. Hartigan says the device has shown such promise that researchers now plan to expand their study from three to 20 people who have experienced a stroke. The device is retraining the way they walk by teaching them to trust their weaker leg, and it seems to be paying off.

Shepherd Center is Parker’s lead clinical partner. It is the only center with access to the device. In 2014, Shepherd and other select clinical centers will receive the generation-two prototype, and multi-site clinical trials will begin. Shepherd is charged with developing the clinical protocols for using the device, training clinicians at other rehabilitation centers and monitoring clinical trials.

For information about the trials at Shepherd Center, visit www.shepherd.org/research and complete the research intake form.

Written by Amanda Crowe, MA, MPH
Photography by Louie Favorite

Not that she wasn’t an athlete – she’d run the race many times before – but her 2013 race signified a remarkable comeback.

Just four months earlier, Marsha was “in bad shape,” as she describes. “I was in pain, taking a lot of medication and trying to manage it all by myself. I was pretty desperate.”

Her condition stemmed from knee replacement surgery and subsequent follow up procedures in November 2012, which limited her mobility and left her in physical agony. Doctors said they could do no more than prescribe narcotics, which were causing terrible side effects.

All that began to change with Marsha’s first visit to Shepherd Pain Institute in February 2013.

There, she met with Erik Shaw, D.O., an interventional pain management specialist and supervising physiatrist at the Institute. “The minute I met with him, I knew I was in good hands,” Marsha recalls. “He clearly understood what I going through and said he could help. It was very reassuring.”

Dr. Shaw immediately switched her medications and also performed a nerve block procedure. Four months later, she was happy to be walking with her husband in the Peachtree, free of medication and treatment.

“I went into my appointment just to thank him,” Marsha says.

Shepherd Pain Institute treats all kinds of pain, from the simple to the complex. Some are current or past Shepherd Center inpatients; others, like Marsha, are referred for pain caused by illness, injury or surgery.

What sets the Shepherd Pain Institute apart from other centers is the staff’s experience in caring for people with catastrophic injuries.

“We see complex pain issues and use a lot of different modalities for diagnosis and treatment,” says J. Tobias Musser, M.D., an interventional pain management specialist and Dr. Shaw’s colleague. “And we have experience in the whole continuum of care for catastrophic injury. As a result, we have a lot of different tools and can offer a large number of options to those that are less complicated.”

The first step in fixing the pain is determining the source. Then the doctors can chart out a course of treatment. “Everyone is at different stages of pain when they come in,” Dr. Shaw says. “We need to determine what part of that pain is medical, what part is psychological and what part is anatomic, or part of the body. We have to figure out how to address the problem in the right order.”

The medical staff at Shepherd Pain Institute ventures beyond narcotics to treat pain. Some examples:

• Nerve blocks – injections of medication into a specific area of the body. These are used to both diagnose and treat pain.
• Neuromodulation – implanted electrodes, or pacemaker-like devices, that stimulate the spinal cord. Dr. Musser calls this “the best option for non-pharmacological pain management.”
• Biofeedback – using thoughts to control the body and relax certain muscles. This is both a treatment option and a coping mechanism.
• Manual (osteopathic) therapy – manual manipulations to bones that can sometimes relieve pain.

Choosing the right approach depends on the patient’s symptoms and circumstances. “We take a personalized approach to each patient,” Dr. Musser emphasizes, “because no two people have the exact same pain experience.”

Both doctors caution that the first course of treatment may not work; sometimes a few options may have to be tried. “Sometimes we’re successful right away, whereas other times, it takes a little longer,” Dr. Shaw adds. “Quite often, the situation is that the longer the patient has suffered from the pain, the longer it takes to figure out what the pieces are.”

If medication is necessary, Drs. Shaw and Musser try to prescribe safer pain medications with fewer side effects. And they point out that while pain doesn’t always disappear, it can at least be made more manageable.

The Institute’s multi-disciplinary approach also distinguishes it from other pain management centers. In addition to the two physicians, the team includes a case worker, two psychologists, a physical therapist and highly trained nurses and technicians. The psychologists are specifically trained in pain management and the issues associated with it, such as depression, anxiety and relationship issues.

“Because we have an integrated team, we can give something to our patients that they can’t get anywhere else,” says Marsha Hanson, the Institute’s nursing manager. “The collaboration with the entire team is one of our greatest strengths. Our doctors are good at what they do, they think outside the box and they are up to date on the latest technology and techniques.”

For more information, see www.shepherdpaininstitute.org.

Written by Sara Baxter
Photos by Gary Meek

Gary Schmitt is an athletic trainer at Atlanta’s St. Pius X Catholic High School, one of the most successful prep athletic programs in Georgia. He’s been a certified athletic trainer for 20 years and has worked at training camp with the Atlanta Falcons.

Jay Shoop, director of sports medicine at the Georgia Institute of Technology, has been in that business for 44 years. He was chief trainer for the Olympic Village in Atlanta for the 1996 Summer Games and was head trainer for the NFL’s Detroit Lions and Tampa Bay Buccaneers.

Schmitt and Shoop agree with Rule No. 1:

• Get ready to play; get in shape. “You can look at studies that show kids who come in better prepared physically suffer far fewer injuries,” Schmitt says. “Kids have gotten better because coaches realize it and make sure with preseason workout programs.”Shoop adds, “A good strength training program is effective in building up your shoulders, trapezoids and neck muscles.”
• Know rules, techniques and guidelines, and abide by them. Be aware of emerging medical knowledge and know that NFL, college and high school officials have put in place new protocols for concussions and blows to the head. In Georgia, for example, a new law requires a doctor’s clearance before K-12 student-athletes suspected of sustaining a concussion can return to practice and play in games. More than 40 other states have similar laws.“People need to make sure they get information from the right people,” Schmitt says. “Go to your state’s high school association website. Ask trainers, even your doctor. We’re so much more educated as far as what damages a person than we were back in the day.”Shoop adds:  “The biggest thing they need to know (in football) is that you never tackle with your head down. You always see what you’re hitting. Keep your face up.”
• Warm-up before and rest afterward. Stretching ahead of activity loosens muscles and reduces the risk of strain. Proper rest decreases the chance that fatigue will impair reaction time or the ability of an athlete to defend oneself next time out.
• Don’t ignore ailments. “A kid with an abrasion that gets infected may miss two or three games just because he didn’t take care of a scratch or abrasive wound,” Shoop says.
• Be tough, but not quiet. This is an extension of the previous tip. There’s a line between playing with bumps and bruises and putting oneself at greater risk by “sucking it up” and trying to impress coaches with your toughness only to compromise your ability to function and make you more susceptible to injury. Speak up when injured.“Anything involving your head and neck should always be reported,” Shoop says. Schmitt adds:  “I always say pain is your guide for most injuries outside of head and neck injuries. If it hurts a little but you’re fully functional and able to defend yourself, keep playing. If it hurts bad enough that you’re not fully functional and unable to defend yourself, come out. We need to look at it.”
• Use proper equipment. “That includes making sure coaches are educated about proper fit. Make sure helmets are properly certified and equipment is properly refurbished,” Schmitt says. “Keep up with it through the season. Things change. Kids get haircuts, or grow or lose weight. Make sure the air is properly fitted in their helmet and shoulder pad straps are properly tightened.”

Written by Matt Winkeljohn

BOISE, IDAHO

Mischa Brady, 31, of Boise, Idaho, served two tours of duty with the U.S. Marines in Iraq in 2003 and 2004. During his second tour, stationed near the Syrian border in Iraq’s dangerous Anbar region, an improvised explosive device (IED) detonated and knocked him unconscious. The improvisation in this case was a 155mm artillery shell packed with C-4 explosives.

“It was early on. Nobody thought much about traumatic brain injuries,” Mischa says. “I wasn’t bleeding, no broken bones. I took some Motrin and drank some water, and continued my patrol. And I finished the rest of my nine-month tour.”

Those months became blurred with migraines, insomnia and abnormal anger. “But when you’re in a pack of people that all have the same problems, you don’t really think twice about it,” he says.

Returning home revealed the depth of Mischa’s problems. Eventually, he found his way to Shepherd Center and its SHARE Military Initiative, which provides comprehensive rehabilitation care for service members with traumatic brain injuries and post-traumatic stress disorder.

“I’d been avoiding a lot of things, and I didn’t want to leave home, frankly,” Mischa says. “But it turned out to be exactly what I needed.”

He received help for physical and mental health issues, and took advantage of volunteer opportunities set up by Shepherd Center, allowing him to find new passions.

Shepherd Center also connected Mischa to the Wounded Warrior Project, another base of support in his recovery. Last fall, Mischa received an associate’s degree from the College of Western Idaho. Now, he’s pursuing a bachelor’s degree in history at Boise State University, where he’s active in a veterans group called the Wyakin Warrior Foundation.

“My time at Shepherd really set the stage for everything I’ve done since,” Mischa says. “They got me out of my comfort zone. That was really the only way I was going to get better.”

Michael Harris

PANAMA CITY, FLORIDA

Michael Harris, 34, of Panama City, Fla., feels like he grew up outdoors. “I was fortunate to have a dad who got me outdoors, and it’s always been my love,” he says.

About eight years ago, Michael and his dad, Johnny, began volunteering with a group that provided outdoor adventures to people with terminal illness or disability.

Eventually, father and son decided to start their own nonprofit organization and expand on the concept.

In 2008, the Harrises founded Seasons of Hope (www.seasonsofhopeinc.org). It offers personalized hunting, fishing, camping and other outdoor opportunities to people with terminal illness or disability, as well as disadvantaged children and wounded veterans.

Less than a year later, on March 30, 2009, Michael was lying under a stack of 23 sheets of plywood that had crashed down on him. He’d been helping a friend organize a warehouse when he sustained a C-5 and C-7 spinal cord injury in the accident. Michael spent a month on a ventilator, in a medically induced coma.

“It was a whole different world when I finally arrived at Shepherd Center,” he recalls. “It’s such a personal place. I can go back there today, and doctors I had will still say hello to me by name.” At Shepherd, he steadily worked to re-establish his independence. He had a goal in mind: to get back outdoors and continue helping others. Today, he is busier than ever — finding new sponsors and organizing outings for Seasons of Hope.

“At first, the vision we had was just to take kids out to hunt and fish, give them a break,” Michael says. “But now we’re moving more toward a full ministry. We want to start a mentoring program. It’s gone above and beyond what we ever thought it would be.”

Josh Inglett

AUGUSTA, GEORGIA

Josh Inglett, 19 of Augusta, Ga., had sustained a T-9 spinal cord injury in a car accident when he arrived at Shepherd Center in November 2012. Josh couldn’t sit up in bed, and a fractured shoulder blade further slowed his physical rehabilitation.

He credits Herndon Murray, M.D., medical director of Shepherd Center’s Spinal Cord Injury Program, as his chief inspiration. “Every time he came in your room, he had you laughing the whole time,” Josh says. “He kept everybody laughing. And he listened. He paid attention to what you needed.”

Josh gradually progressed from sitting up to getting dressed to washing his clothes, cooking and cleaning. He participated in Shepherd Center outings that strengthened his independence. He went to a movie and transferred from his wheelchair toa seat. He went horseback riding.

Josh even became an artist. Sort of. “I’m no artist,” he says with a laugh. But if you enter Shepherd Center’s main foyer, where its “Hall of Fame” busts are located, you will see a sculpture by Josh.

“They have all those bronzed heads in there, and one day I said, ‘Dang, Dr. Murray’s been here since this place started. Why doesn’t he have one?’”

His therapists challenged him to correct the oversight. “They asked me, ‘Why don’t you make him one then?’” Josh recalls.

So he did, crafting a bust of Dr. Murray out of tinsel, clay and bronze-colored spray paint. “It’s crazy,” he says. “That thing started with just a little ball of tinsel. But they got me to do it. It ended up helping my flexibility a lot, too.”

Josh returned to Shepherd Center recently to pass his adapted driving evaluation. On his way in, he passed his bust of Dr. Murray, which still adorns the entryway’s venerable “Hall of Fame.”

Debbie Hochbaum

ATLANTA, GEORGIA

Debbie Hochbaum, 54, of Atlanta, knows she has to be in good shape if she wants to continue seeing ghosts.

Diagnosed with multiple sclerosis in 1994, Debbie has not let her condition inhibit her passion: She and her husband, Tony, are professional ghost-hunters, offering free paranormal investigations of potentially haunted abodes across Georgia and South Carolina.

“Tony had actually organized the group before I ever met him,” Debbie says. “I joined and started going to all the events. Eventually, I started helping him organize the outings. We were friends for a year before he asked me out!”

Today, Debbie and Tony run the Association of Paranormal Explorers (APEX) as relative newlyweds. They married just more than two years ago. “This is just something we both love to do,” she says with a laugh. “And I’m really enjoying my life.”

Debbie credits her vibrant life to good nutrition and physical exercise, which she gets in weekly doses through Shepherd Center’s MS Wellness Center. She participates in cardio, meditation, yoga and core exercise classes.

“I try to grab as many classes as I can!” she says. “The cardio is my favorite because it forces me to move my body the way I need to. It keeps me moving.”

And that’s good. Because Debbie is busy. In addition to her paranormal research, she is a grandmother of eight, teammates with her husband in a bowling league and a new member of Shepherd Center’s Consumer Advisory Board.

Beyond the physical benefits, Debbie says her wellness classes provide her with something else. “Everybody’s so friendly and upbeat there,” she says. “I don’t think I’ve ever seen an angry face. And that’s important. I’m a social person, and I need to be around positive people. That reinforcement helps me as much as anything else.”

The expo featured guest speaker and former patient Duane Morrow sharing his personal story of how Shepherd Center and specifically the Recreation Therapy Program and the sports teams impacted his life after his rugby injury.

The event offered live demonstrations on some of the hospital’s sports and recreational activities, including wheelchair rugby, hand cycling, riflery, scuba diving and water skiing. Art therapy, golfing, fencing and mono snow skiing exhibits were also featured.

“We wanted to host an event that would educate the community on a special program that is an important part of Shepherd Center’s continuum of care,” says Ansley Martin, major and planned gifts officer for the Shepherd Center Foundation. “This was a fun way to teach the community about Recreation Therapy and how vital it is to the recovery of our patients.”

Shepherd’s Recreation Therapy Program helps patients get back into the community by taking them on outings, teaching leisure skills and developing other skills needed in everyday life. With 24 recreational therapists on staff, it’s the largest program of its kind in the country.

“We help them do things they did before, but we also open their eyes to other opportunities and perhaps expose them to things they may never have done,” says Kelly Edens, manager of recreation therapy. “We build their skills and establish a routine before they leave the hospital.”

The Recreation Therapy Program costs $1.6 million annually to operate and is one of the Foundation’s top funding priorities for 2013. The expo was a creative way to raise awareness and hopefully donor support.

“This program goes beyond traditional therapy,” Ansley says. “When patients participate in Shepherd’s Recreation Therapy Program, they realize they will return to an active and fulfilling life.”

These companies include Georgia Power, ERB Industries and Troutman Sanders, companies with a strong Atlanta presence that enthusiastically support local nonprofit organizations, including Shepherd Center, through corporate-level donations and employee giving programs.

Georgia Power, for example, houses the Club of Hearts initiative, a unique employee-giving program founded by employees in 1953 and incorporated in 1954. Through Club of Hearts, Inc., Georgia Power (and Southern Company) employees and retirees in metro Atlanta contribute about $1 million annually to local health and human services organizations.

Whether through a personal connection with Shepherd Center or a general awareness of the Center’s life-restoring work, Georgia Power employees have proudly contributed $140,472 to the hospital since 1978 and are on track to donate more than $7,700 this year.

“At Georgia Power, we’re known for being a citizen wherever we serve,” says Donice Wood, project manager at Club of Hearts, Inc. “Whether it’s with your time or your dollars, we think it’s important to give back to our communities.”

Employees at safety products company ERB Industries feel equally as passionate about supporting Shepherd Center — a passion largely inspired by the company’s founder and longtime Shepherd donor Bill Erb. Ranging from factory workers to executives, ERB employees contribute to Shepherd through weekly or bi-weekly payroll deductions.

Since 1998, employees have given almost $450,000 to Shepherd — initially to the injury prevention program and now to the Dean Stroud Pain Institute, which is named in memory of Bill Erb’s grandson.

“Our employees like knowing their money goes to Shepherd Center and are excited that Shepherd gives hope to those who’ve gone through incredible adversity,” says Sheila Eads, president and CEO of ERB Industries.

The law firm, Troutman Sanders, has supported Shepherd in many ways through the years, including sponsorship of the Center’s annual golf tournament and Derby Day fundraisers. Wanting to find a fun way for its employees to give back, however, the Atlanta office launched its annual Jeans Day fundraiser.

In exchange for a donation, employees can wear jeans the last Friday of each month. Employees enjoy dressing casually in a traditionally formal environment and helping organizations like Shepherd Center, which they supported in 2011 and 2012.

Sallie Adams Daniel, chief development and diversity officer at Troutman Sanders, says: “Shepherd Center is the best facility of its kind in the country. Our employees find it rewarding to support a local organization of this caliber.”

Dean Melcher, director of development operations at the Shepherd Center Foundation, says that while Shepherd appreciates all of its contributors, there is something special about the support that comes from individual employees.

“Having people choose to take money out of their paychecks — money that could make a real difference in their lives — and donate it to Shepherd Center helps demonstrate to us that every dollar makes a difference.”

Companies interested in supporting Shepherd Center through an employee giving campaign should email Dean at Dean_Melcher@shepherd.org.

Here are stories of some former patients with paraplegia who demonstrate healthy outcomes.

Written by John Christensen

People with MS urgently need new treatments to halt the condition, and hope is on the horizon. Shepherd Center is one of 30 sites in the United States and Canada participating in a clinical trial to study whether an investigational therapy using a patient’s own immune cells can help stabilize or stop the progression of secondary progressive multiple sclerosis (SPMS). People with SPMS have moved beyond the initial period of relapsing-remitting MS, and their condition has begun to worsen more steadily.

“This is a group of individuals with MS who have not had many treatment options available, so there is a lot of excitement about this study,” says Carlyn Kappy, RD, LD, CCRP the study coordinator at Shepherd.

Eligible study participants are being randomized to receive either placebo or the investigational T-cell immunotherapy called Tcelna™, which is manufactured by Opexa Therapeutics, Inc. Encouraging results from earlier Tcelna trials in MS patients, including some with SPMS, prompted the U.S. Food and Drug Administration to grant it fast-track designation for SPMS.

To develop the therapy, Opexa isolates the “bad” T-cells (myelin reactive T-cells) from a patient’s blood sample and expands them to generate enough reactive T-cells to treat a patient for one year (five doses). The myelin reactive T-cells are thought to cause the inflammation that is the hallmark sign of MS. During the final dose preparation, the myelin reactive T-cells are modified to make the cells unable to replicate. The modified reactive T- cells are then reintroduced to the patient via an injection, which should stimulate the body’s immune system to reduce the number reactive T-cells.

“We are essentially vaccinating them against their own MS,” explains Ben Thrower, M.D., medical director of the Andrew C. Carlos Multiple Sclerosis Institute at Shepherd Center. “The hope is that the body will recognize these cells and trigger an immune response.”

If this new therapy works, it would give patients a customized therapy from the start.
“The immunology of MS is so different from one person to the next, so it’s a little bit of trial and error to find the right fit,” Dr. Thrower says. “This new approach would allow us to treat an individual based on their unique disease.”

Tcelna is also thought to have a lower risk of side effects because, unlike many other therapies used to treat this type of MS, it does not suppress the immune system. In the early 1990s, doctors believed the best way to manage the overactive immune response typically seen in MS was to crush it with chemotherapy and later with immune modulators, including beta interferons, but there were a lot of side effects.

“Existing medications allow us to treat symptoms of MS, but they may also put the patient at risk for other health problems and conditions,” Dr. Thrower explains. “Newer medications have taken us a step in the right direction, but we still find many patients on immune modulators don’t respond very well.”

So far, six Shepherd Center patients have been screened to take part. Participants must be able to walk to some extent on their own with or without an assistive device be between ages 18 and 60 and will need to stop taking any other treatments to slow disease progression if they decide to pursue the trial. Patients are given just five shots of the treatment or placebo a year. Researchers will evaluate the percentage of brain change at 24 months, disease progression, and changes in disability and annual relapse rates.

Although Linda, a Shepherd Center patient, is not participating in the study, she is hopeful this approach will be effective. “Folks with long-term MS have been waiting a very long time for an effective medication for MS,” she says. “We’re running out of options.”

Dr. Thrower notes a lot of excitement about this study. “People with secondary progressive MS often feel left out [of clinical trials],” he says. “With this study, we are closer than ever to a tailored therapy.”

The National Multiple Sclerosis Society reports more than 2 million people have MS worldwide; of these, an estimated 25 to 35 percent may have SPMS.

An initial analysis of the study results is expected in 2016. For information, contact
Carlyn Kappy, RD, LD, CCRP, at 404-367-2620 or carlyn_kappy@shepherd.org

Written by Amanda Crowe, MA, MPH
Photography by Gary Meek

Q:  You perform tendon transfer surgeries, which have the potential to restore hand and arm function to people with tetraplegia. Do those surgeries still amaze you after doing them for so long?

A:  Oh yes, absolutely. I love doing them, thinking about them. I love the positive effect those surgeries can have for people. It’s one thing I can do that truly can change someone’s life.

What Shepherd Center does is amazing. People go into Shepherd Center with catastrophic injuries, and Shepherd’s doctors and staff teach them that life goes on. What they do is huge. The little part we do at my clinic can help some of those patients become a little more independent, gain a little more confidence.

Q:  What’s the most important thing you learned in medical school? 

A:  To always make sure I pay attention to what patients are actually coming in for, and to listen to what they’re having trouble with. As surgeons, it’s not our job to see a patient and immediately begin to figure out what surgery to do. That’s a lesson I’ve never forgotten.

Q:  What’s the most important thing you’ve learned since medical school? 

A:  That empathy is not the same as feeling sorry or feeling bad for a patient. Empathy is trying to put yourself in their position, to understand where they’re coming from. To put yourself in their frame of mind so that it’s that much easier to relate and help.

Q:  What’s the most difficult part of your job? 

A:  Thankfully, I’m in a specialty where I don’t have to tell someone they’re going to lose their life, or that they’ve just experienced a catastrophic change in their life. But it’s still tough to have to explain to someone why an intervention we’ve tried hasn’t worked. Or why it hasn’t accomplished what they hoped it would do.

We’re trained as surgeons to help people, to make their lives better. So when we fail – or worse, have no solutions to offer – it’s hard to accept. It’s frustrating.

Q:  What makes you most excited to go to work each day? 

A:  I genuinely like what I do. I’m one of those people who actually found in life what I should be doing. I enjoy everything from the most mundane parts of the job to the most complex, challenging parts. Every morning I get up and get to do something I love.

Q:  You have an extra “Lab” assistant when you visit your Shepherd Center patients. What does he do?

A:  Well, my daughter fell in love with this Labradoodle that was trained as a therapy/service dog. I knew then that Murphy was going to join our family. My one condition was that we put him to work.

So my wife, Lori, now brings him to Shepherd Center when I visit my patients here. Murphy’s pretty funny when he visits the hospital. He’s confident. He acts like he lives at Shepherd Center. And it obviously is a fun visit for my patients. He is definitely loved when he’s there.

Q:  From your perspective, what makes Shepherd Center unique? 

A:  It’s just an incredible mission – to take in people who have been thrown these terrible curveballs by life, people who had their lives change so dramatically, who are at a point that the average person can’t fathom.

And Shepherd Center takes these people who are broken physically – and often mentally – and brings them back to life. And not just to a life, but a real quality of life. The hospital helps them get involved in their communities again, helps them find a purpose.

Written by Phillip Jordan
Photography by Louie Favorite

Alan Brown knows this fear all too well. On a rainy day in July 2003 in Cartersville, Ga., his 17-year-old son Joshua drove his truck through standing water. The vehicle hydroplaned and crashed into a tree. Joshua died nine days later.

Looking back, Brown expresses remorse about his son’s inexperience as a driver. “Joshua didn’t take driver’s education,” he says. “We didn’t have access to it, so all he got was what I taught him.”

Experience is the primary factor in producing good teen drivers, says Rob Foss, Ph.D., director of the Center for the Study of Young Drivers at the University of North Carolina at Chapel Hill. “Good drivers have a deeply ingrained understanding of what driving is all about. They know what they need to be doing, and that knowledge can only come from experience.”

In helping their teenagers gain that experience, parents can look to state drivers licensing for the minimum requirements. But experts encourage parents to go much further to help their teens get the experience they need to drive safely.

Most states require supervised driving for at least six months. Many also mandate 50 documented hours of supervised experience and every state grants driving privileges on a “graduated” basis, typically up to age 18. New drivers in Georgia, for example, are prohibited from driving between midnight and 6 a.m., and in the first six months after a driver obtains a license, only immediate family members may ride as passengers.

But Dr. Foss notes that studies show teens need a minimum of 120 hours of driving experience before being licensed to drive independently and safely. Also, he says new drivers should be prohibited from driving after 9 p.m. instead of midnight during the graduated licensing period. That’s because 70 to 80 percent of nighttime crashes among high school-aged drivers occur between 9 p.m. and midnight, and about 85 percent of their nighttime trips occur during that window.

THE PARENT AS COACH
“Graduated licenses help teenagers build up their skills so they master them,” Dr. Foss says. “This gradual experience has helped prevent crashes.” To guide their teenagers through the learning process, he advises parents not try to act as a driver’s education teacher but as a coach during supervised driving.

“Don’t tell them what to do,” Rob cautions. “If you tell them 20 things, you’re wasting your breath on 19 of them. Let them make a mistake if it’s not dangerous. Speak calmly in a mild tone and give helpful advice. Research shows this is more effective.”

Jim Kennedy, a driver rehabilitation specialist at Shepherd Center, suggests that parents emphasize the following process as they supervise their teen’s driving — meanwhile realizing that these actions become intuitive as drivers gain more experience in various conditions:

1. Search the environment, including a check of mirrors.
2. Identify hazards, conditions and situations.
3. Predict what others will do.
4. Decide what to do.
5. Execute that decision.

“The reaction time for teens is quick,” Kennedy says, “but their knowledge base is limited, so they may not react the right way.” Take the case of a car veering off the road. “The instinct is to yank the steering wheel the other way and probably go too far in the other direction,” he says, “but, of course, that can have consequences.”

GOING THE EXTRA MILE
After the death of his son, Alan Brown embarked on a mission to ensure that Georgia teenagers gain experience behind the wheel before receiving a driver’s license.

In 2005, he was instrumental in getting the Georgia General Assembly to pass Joshua’s Law, which requires every 16-year-old in the state to take driver’s education and participate in 40 hours of supervised driving to qualify for a license.

Even still, many experts — and Brown, as well — recommend that teenagers log more than the required number of supervised hours behind the wheel and that they go beyond driver’s education classes to get more hands-on experience.

“If you have completed the minimum requirements in driver training, you are a minimally trained driver,” says Homer Stillwell, founder of Accident Avoidance Workshops, a defensive driving program.“At best, you have been trained in ‘normal’ driving conditions, which means you know how to operate the vehicle and what the lines and signs mean. But there’s more to driving than that.”

The experts agree that the key factor is supervising teen drivers in the many varied conditions they will experience as independent drivers. One tool to help parents with this task is a smartphone app called Time to Drive (timetodriveapp.com). It records the total amount of driving and driving in a variety of conditions, keeps track of hard stops, provides tips for parents, encourages the parent-teen team to meet driving goals and shows a map of past trips. (See the apps sidebar for more ideas.)

And parents can lead by example. “Kids start learning to drive the minute you put them in a car,” Brown says. “If you speed or text, they will think it’s OK.”

In preventing more teen driving crashes, Shepherd Center is making its own contribution. As part of its injury prevention efforts, the hospital has a launched a safe driving campaign themed “Reasons — Big and Small.” It presents a series of answers to a simple question that matters to every driver: “What’s your reason for wanting to arrive at your destination safely?”

As part of the campaign, which kicked off in April, Bridget Metzger, Shepherd’s director of injury prevention and education, is visiting high schools and making community presentations.

“The number one thing kids should know is that they are driving a potentially lethal weapon and should pay attention,” Metzger says. “I’ve worked with a lot of injured teenagers here at Shepherd Center. Their only wish is that they could go back and turn it around. Most car crashes are preventable.”

Written by Sara Baxter
Photography by Louie Favorite

Exercise and diet figure prominently into the treatment plans for every Shepherd Center patient like Mike, who sustained a spinal cord injury, Austin, a brain injury, and Treva, who has MS.

“Every inpatient is assigned an interdisciplinary team to tackle health and wellness issues,” says physical therapist Sarah Morrison, vice president of clinical services. “We like to start as soon as possible, and it is not uncommon for our inpatients to attend classes on nutrition and fitness so they have a wellness regimen to follow when they return home.”

Shepherd Center patients’ goals can vary significantly, says clinical nutritionist Kristy Prox. “Patients who have paraplegia or tetraplegia are going to lose a lot of muscle strength and have decreased energy needs, whereas some of our patients with a brain injury are trying to heal their bodies so their energy needs may be twice as much as a person without an injury. Patients with multiple sclerosis often struggle with fatigue, so we work with them on trying to have smaller meals or snacks more often through the day and convenient healthy foods like pre-cut vegetables.”

The stories of three patients with very different needs show what proper exercise and nutrition can mean for an active lifestyle.

Dramatic Weight Loss

Mike Moberg, 31, of Nashville, Tenn., figures he was at his highest weight ever when he sustained a T-10 to -11 spinal cord injury in an auto accident in January 2009. He carried about 310 pounds on his 6-foot, 1-inch frame.

The ordeal of the injury and surgery at Vanderbilt University Medical Center took off about 10 pounds, but he knew early in his three-month stay at Shepherd Center that he would need to do more.

“As soon as I went from a power wheelchair to a manual chair, I really realized that the less I weigh, the easier it is for me to transfer in and out,” Mike says.

His therapists had him push the chair through the Shepherd parking garage. Back home in Nashville, he found another garage to repeat the training.

“I kept a log on my phone, how many times I went around,” he says. “The pounds started to come off. I also improved my diet.”

He stepped up his efforts dramatically in summer 2012 when Shepherd awarded him a scholarship for an intensive 12-week program in Beyond Therapy®.

“It was really like a boot camp — a mixture of exercise and therapy and using all the equipment, three hours a day and three times a week,” Mike explains. “It made a huge difference.”

“Huge” is not an understatement. Mike reduced from 310 pounds to a range of 155 to 160.

“To lose half your body weight is a big change,” he says. “Being in the chair is definitely a motivator. Every time I do a transfer that I feel like is a little too hard, that’s motivation.”

He continues to work out regularly, trying to fit in three sessions each week around his college classes.

Mike also has jumped into adaptive sports, joining an Achilles International chapter in Nashville. The runners’ group sponsors weekly training sessions open to people of all abilities and even provided a handcycle for Mike.

“I tend to enjoy that more than the gym because I can be outside,” he says. Meanwhile, he has set his sights on wheelchair racing. After participating in 5K races in his “everyday chair,” he received a grant this past spring from a California foundation to get a racing wheelchair. Mike then set his sights on participating in the Wheelchair Division of the Peachtree Road Race in Atlanta. Later goals include downhill skiing on a chair fitted onto a single ski.

“They told me early on at Shepherd to get involved in a sport, but the first couple of years, I wasn’t really open to it. Now, I’m really happy,” Mike says.

Return to Running

Austin Vestal, 25, of Jacksonville, Fla., was in a coma for 15 days after he sustained injuries to his brain and leg in a car crash on June 2, 2012. His mother, Sandy Vestal, says nurses at Shands Jacksonville Medical Center noticed Austin’s left leg and right arm — the only limbs with mobility — thrashing every day around 5:30 p.m.

“The nurses asked, ‘What does he do at this time of day?’” Sandy recalls. She knew the answer. Austin’s mind was taking his daily three-mile run.

Austin started running when he was about 19. From the time he regained consciousness after his injury, Austin was determined to run again.

But first he had to regain the weight and strength he lost during his coma. When he arrived at Shepherd Center in early August 2012, “They told me I had to gain 50 pounds,” Austin recalls. “I was skin and bones. I’m about 205 pounds, 6-foot-2 and I had dropped to 155.”

In addition to getting lots of protein, Austin worked with Shepherd therapists on exercise, which is challenging for a brain that has “forgotten” how to move some muscles.

“It was pretty bad,” Austin says. “My left arm was so immobile. It just didn’t want to move.”

Austin worked with occupational, physical and speech therapists. About two weeks into his Shepherd stay, he took his first steps, wearing a T-shirt from the Gate River Run, a 15K race he ran in Jacksonville in March 2012.

“I told the therapist, ‘I’m running the River Run next year,’” Austin recalls.

By the time he and his mother moved into a Shepherd Center apartment during Austin’s participation in the Shepherd Pathways day program, Austin was insisting on short runs on the lawn.

When he returned to Jacksonville, he heeded the advice to try adaptive sports. He joined a rowing team, and his family took him on bowling and pool outings on Friday nights.

By December 2012, he was running. His mother accompanied him at first. “We would go maybe a block, then another block,” she recalls. “Then he got better, and I had to ride my bicycle. Then he got better, and I had to get my car.”

In March 2013, as promised, Austin ran the Gate River Run — accompanied by his mother and sister, their boyfriends and two step-siblings.

After the family moves south to Boca Raton, Fla., this summer, Austin plans to return to work as a sales account manager, easing in part-time at first to build a daily routine.

Running helps him focus on living well. “When you finish, you’re like, ‘I got it!’ It’s a big confidence booster.”

Steps to Wellness

Treva Turner, 43, of Atlanta was, at first, frightened by her diagnosis of multiple sclerosis in 2003, but Ben Thrower, M.D., medical director of the Andrew C. Carlos MS Institute at Shepherd Center, immediately put her at ease, she says. And she found she could continue to work full-time in sales while managing her MS, including medication and regular doctor visits.

“Then as my MS progressed over the years, I noticed little things I wasn’t able to do as well as I used to,” Treva says. “I was at the point where I could only walk short distances before I got really tired.”

She turned to exercise and was one of the first patients to join Shepherd’s MS Wellness Center when it opened in Summer 2012. The program fills a need for patients who’ve completed medical therapy up to their health insurance limits, says Chris Manella, the center’s therapy manager.

“We wanted to have a way to continue wellness with expert guidance for MS patients,” Manella says. The solution was an enhanced membership to Shepherd’s ProMotion wellness center. For $45 per month (the Georgia chapter of the National MS Society offers some scholarships), patients get access to the pool, ProMotion gym, six exercise classes and two education classes per week.

The classes reflect the special needs of MS patients with appropriate pacing and even cooling vests to prevent overheating. Education topics range from tips on staying mentally active to the latest research on MS. The center tested a group of patients when it opened. Rather than gradually losing ground to MS, 90 percent of the patients have shown actual improvement in metabolic rates and strength, Manella says.

Treva started using the center to work on core strength with Shepherd Center exercise specialist Blake Burdett, who has helped her tremendously.“He knows your limits,” Treva says. “But he doesn’t allow you to use your MS as an excuse to not exercise. It strengthened me in my endurance and leg muscles, so now I am able to do more for longer periods of time without having to rest,” she says.

Treva started a new job as a program coordinator at a local hospital recently. She continues to use the wellness center as often as possible.

“Shepherd Center not only treats my MS, but it also has other resources like the MS Wellness Center for my body and mind,” she says. “That is amazing, and it makes for a quality of life that I wouldn’t have had otherwise.”

Written by David Simpson
Photography by Donn Jones, Kelly Jordan and Louie Favorite

“It was a normal hit, front and back, just a freakish accident,” says the young man who goes by “Q.” “I was face down and about to start panicking about not being able to breathe. I wanted to turn over because I was eating a lot of dirt.” Q couldn’t move. He had sustained a C-5 to -6 spinal cord injury and was paralyzed from the chest down.

As he began rehabilitation at Shepherd Center, Barbara Crane, the grandmother who years earlier adopted Q and his four younger siblings, was in a daze. She didn’t know who would pay the medical bills that could total millions of dollars.

Many medical insurance plans have a $25,000 limit, and much like homeowners are rarely insured against flood damage to homes unless they have flood insurance, those medical plans often don’t provide adequate coverage for catastrophic injuries like Q’s.

Barbara’s answer? In Georgia, high school student-athletes are covered for life-altering injuries sustained in sports by a $5 million catastrophic insurance policy. The state’s governing bodies for athletics — the Georgia High School Association (GHSA) and Georgia Independent School Association (GISA) — purchase the policy from Mutual of Omaha. Crane’s high school, South Gwinnett, is in the GHSA.

“I didn’t know that until (South Gwinnett) coach (John Small) came to the hospital and told me,” Barbara recalls. “At that time, I didn’t realize what it meant.”

The GHSA policy helps Q, now 21, with disability benefits, college tuition, an assistant who accompanies him to class, a power wheelchair, an adapted van and more equipment plus custodial home care. It is only a partial benefit list.

Every high school student-athlete in Georgia must have medical insurance to play, but few, if any, medical or supplemental plans cover expenses like Q’s. And some states do not require schools to purchase catastrophic coverage.

In Illinois, estimates suggest that 5 percent of the state’s student-athletes have catastrophic insurance through their schools. Individual catastrophic policies for young people are rare in the United States.

A bill before the Illinois House of Representatives that would have mandated catastrophic coverage of $7.5 million or 15 years for athletes at every high school failed to pass in fall 2012. A similar bill is before the Illinois Senate this year.

Utah officials may begin charging $3 per student-athlete to defray a rise in catastrophic coverage premiums prompted by recent claims. The alternative may be a hike in game ticket prices.

Meanwhile in Georgia, the GHSA’s policy is funded by a portion of annual dues (ranging from $345 to $985) paid by each of more than 500 member schools. High schools seek to verify that student-athletes have medical insurance through parents or guardians, or that they buy a supplemental plan, before they can participate in sports at school.

Yet few parents seek to understand their insurance coverage limits, nor do they realize these plans may be helpful for a broken ankle or a knee injury, but are not likely to cover a catastrophic spinal cord or brain injury.

Many parents have no idea if there is a statewide, school system-wide or even a school specific catastrophic insurance plan in place to do that.

Why? They don’t ask. Who thinks a catastrophic injury will ever happen to them?

Here are some experts’ suggestions for parents of aspiring school athletes:

• Determine the breadth and depth of your primary insurance coverage and/or supplemental policy.

“Health insurance coverage varies dramatically from family to family,” says Scott Boatright, vice president of BB&T Insurance Services, which has handled the GHSA catastrophic policy for 20 years. “It is important to be aware of the benefits, exclusions and limits within your policy.”

Marilyn Taylor, a Shepherd Center post-acute case manager for spinal cord injury, says: “I spend a lot of time explaining to clients, ‘Yes, you have Blue Cross, but that does not mean you bought the whole pie.’ They only have a piece. A lot of people don’t realize they can call customer service and discuss their benefits.”

• Talk to a school official about insurance coverage available through the school. Find out if they cover ambulance service, emergency room care, outpatient care and, most importantly, whether the school provides catastrophic coverage.

“Ask the school exactly what the policy covers,” says Heddi Silon, director of workers compensation at Shepherd Center. “How much rehabilitation is included? What about durable medical equipment (such as wheelchairs, etc.)? What are the limits? Parents need to know whether there is a policy that covers catastrophic injury.”

Taylor adds: “There are not a lot of (personal) policies that provide catastrophic coverage. Rehabilitation is usually expected to be short term for injuries such as a broken limb or joint replacement, but not injuries that require a $30,000 wheelchair.

• Realize that football is not the only sport in which serious injuries occur. Brain and spinal cord injuries can result from many types of sports.

Mutual of Omaha vice president of special risk Scott Hanson says the company has seen claims for every sport.

For example, at the University of Georgia, baseball player Johnathan Taylor, a former Shepherd Center patient, sustained a C-5 to -6 spinal cord injury in a 2011 game in which he collided with another player in the outfield. Fortunately for Johnathan, UGA has a supplemental policy that paid the bulk of the medical expenses incurred before the NCAA’s catastrophic policy kicked in, says Claude Felton, senior associate athletic director at UGA.

Hanson notes that a catastrophic plan may be the only safeguard to sufficiently care for a catastrophically injured young person and avert financial ruin.

Q Crane is a case in point. Though he has seen increased function in his arms, he must still use an expensive power wheelchair, which his policy covers. It also pays his tuition. As a junior at Georgia Gwinnett College studying political science with a minor in criminology, he wants to attend law school after graduation. Also, he plays billiards and tinkers around in a garage music studio at a home donated to the family.

“I took what I had and never gave up,” Q says. “Keep striving. I’m a competitor.”

Barbara, a disabled former meat packer, has three grandchildren in college (including one on a basketball scholarship) and two in high school. Life is not easy, but her family is getting by with help from the people of Snellville, Ga., and catastrophic care insurance.

“I can really feel for people who don’t have insurance like Arquevious has,” she says. “We try to do what we can, and we’ve been blessed as far as help.”

Written by Matt Winkeljohn
Photography by Gary Meek

Last year, he became the first person with paraplegia to graduate from the U.S. Naval Academy. He then entered Georgetown University’s law school and landed on Forbes magazine’s “30 Under 30: Law and Policy” list.

Ask Kevin what advice he gives to people facing adversity, and you’ll get a long pause. “Well, I don’t know if I have any coherent advice,” he says. “I just think it’s important to take help from the people who are close to you and who are caring about you and willing to offer it. Just be grateful for any opportunity you have and keep your mind on what’s important for you.”

Instead of talking about himself, he will tell you about the people who helped him along the way: Naval Academy buddies who reacted swiftly when a tree fell on him in a wilderness competition; family and Navy officials who worked to get him back into the academy; and Shepherd Center professionals who helped him start his rehabilitation.

He came to Shepherd Center with one goal: “I was just hoping to get back to school at the academy.”

Kevin, who had been a high school distance runner in his hometown of Medway, Mass., was part of an “adventure racing” team at the Naval Academy. Teams navigate with a map and compass through wilderness areas to hit checkpoints while mountain biking, running, and kayaking or canoeing.

On April 16, 2011, Kevin’s team was competing in a storm in the Shenandoah Valley near Front Royal, Va. “I don’t actually remember the accident,” he says. “We were mountain biking down a hill, me and three friends, and a big tree blew over. It hit me on the bike helmet, then rolled down my back and landed on the tire, which stopped the bike. And then I flew over the handlebars. After that, my three buddies took care of me.”

Two classmates used their coats to shelter him. A third spotted a house where he could get an address to guide an emergency airlift crew to their location in the forest.

A spinal cord injury in Kevin’s lower back required surgery at the University of Virginia Medical Center in Charlottesville. For rehabilitation, he came to Shepherd Center in May 2011.

“I just loved the people at Shepherd,” Kevin says. “The nurses and therapists were great. It was a happy place; everybody liked their jobs. That trickled down to the patients and that made it a lot easier for everybody.” Herndon Murray, M.D., Kevin’s physician at Shepherd Center, remembers him as a great patient.

“He’s a very high achiever,” Dr. Murray says. “He works hard and he’s a goal-oriented type person, or otherwise he wouldn’t have been in the Naval Academy. And I think that transferred over into his rehabilitation.”

Tina Raziano, military coordinator for Shepherd Center’s SHARE Military Initiative, says Kevin’s humble attitude is common among military service members. “Kevin is one of those who has accomplished a lot and done tremendous work but is very modest and doesn’t like a lot of recognition,” she explains. Raziano was among many who helped Kevin, his family and the Naval Academy deal with his first-of-its-kind request to rejoin his classmates.

“That was the most important part, just getting back to all my good friends,” Kevin says. “I have a close bond with my company. I was with a company of 40 kids right from the start, and I’m still friends with all of them today.”

After additional rehabilitation at the U.S. Veterans Affairs Medical Center in West Roxbury, Mass., Kevin went home to Medway, worked out at the YMCA and caught up on his interrupted Naval Academy semester, thanks in part to his family’s season tickets for Navy football.

Before each Saturday home game, he and his parents drove to Annapolis on Thursday so Kevin could take a make-up final exam on Friday. He had piled up extra credits before the accident, so he graduated with his company on May 29, 2012.

His injury precluded a Navy commission, so he decided on law school. He began classes at Georgetown in August 2012.

He lives alone in an apartment near the campus. He hangs out with friends on weekends and smiles politely when people praise his accomplishments, even though he wishes they would talk about something else. His wheelchair is a fact of life, but it’s nowhere near the most important thing about him.

“I just try to live my life normally and don’t focus on disability at all,” Kevin says. “Occasionally, you run into problems. Sometimes you can get around them; other times you can’t. If you can’t get in one restaurant, just go to a different one.”

Kevin hasn’t settled on career goals and doesn’t worry about that. As he says in characteristically few words: “I am very happy where I am.”

Written by David Simpson
Photography by Abby Greenawalt

“They killed me,” he said. “I loved it.”

Nils’ father, John, was standing nearby and allowed himself a smile of his own. “Coming here has been a game-changer for us,” he said.

So much so, in fact, that the Grimleys returned to Shepherd Center to continue Nils’ rehabilitation in May 2013, nearly four years after he was injured in Perth, Australia. Nils’ car was struck by a car going 60 miles an hour when it ran a red light.

His accident horrified his parents – and not just because he sustained a severe brain injury. Their older son, Emrys, was injured in a similar accident in 1992, and he died before they were able to reach him.

The Grimleys immediately closed their small hotel in New Norfolk, Tasmania, after Nils’ accident and flew 1,860 miles to Perth on Australia’s west coast. They devoted the next two and a half years to overseeing their son’s recovery.

Nils spent the first 10 days after his injury in a coma with what John says was among the worst 5 percent of brain injuries. “There were long periods when there was no recognition at all – nothing,” he recalled. “But we kept his body moving and exercising him even through the coma. We talked to him and put on television shows like ‘Planet Earth’ to give him stimulation.”

Eventually, Nils moved a finger, then pointed at letters on a board and finally at letters on a keyboard. But the Grimleys’ unconventional efforts were often discouraged by the very people who were supposed to help, John says. A physiotherapist told Nils he would never make any progress toward recovery. A doctor’s report, John says, “basically said, ‘Shut up and make the best of the situation.’”

They knew better. In 1981, Nils’ mother, Laurelle, was given a medication that left her paralyzed. Nils and Emrys were toddlers, so John stayed home with them while Laurelle traveled to Brisbane for treatment. She regained her ability to walk, but until just a few years ago, she was unable to get out of a chair without using her arms.

“She knew what it was like to learn to walk again,” John says, “so she had ideas about what to do with Nils, and we were assertive in our approach. We pushed the envelope the whole time. We learned to follow our own instincts rather than be directed. We take advice, but we don’t abdicate our responsibility.”

They took Nils to Singapore for intensive physical therapy. They went to San Diego to meet a stem cell researcher. They found a surgeon in Newcastle, Australia, who replaced Nils’ crushed jaw joint, and they traveled to Gainesville, Fla., for an experimental program that helps people with chewing and swallowing problems.

They knew about Shepherd Center from news media and online research, and got further from a medical professional in Florida. After an evaluation by phone, Nils was admitted to Shepherd Pathways’ outpatient program and, later, to Beyond Therapy^®.

The most dramatic change was treating Nils’ muscle tone, which had tightened so dramatically that he was almost incapable of moving. He could speak and swallow only with great difficulty and suffered from nystagmus, the erratic and involuntary movement of his eyes.

Although he was taking a muscle relaxant when he arrived at Pathways, his physician added a second muscle relaxant and administered injections targeting the muscles most affected and dysfunctional.

“Nils is truly inspiring,” says Payal Fadia, M.D., his physician at Shepherd Pathways. “It’s unusual that we see someone three years after their injury make such significant improvement in a short time. But his attitude is so amazing, and it was a pleasure to work with him. We managed to accomplish quite a bit with him.

“Changing his medication combined with the therapy he received here and at Beyond Therapy^® has really helped,” Dr. Fadia adds. “His extremity muscles have relaxed reasonably well, as have the muscles in his face, and his eye movement is much less erratic. It’s translated into some nice changes.”

John says Nils loved the atmosphere at Pathways and in Beyond Therapy^®. “He loved the gym and related to the people.  At some places, the doctors would talk over his head to each other as if he was a log. Here, they kneel on the floor next to him so they’re not speaking down to him.”

Because his injury affected his speech, Nils says, people often treated him “like I was stupid. But here at Shepherd, they gave me hope. They understand biomechanics, and they are friendly and talk to me with respect.”

“They know their stuff, they’re good at it and they take responsibility immediately,” John says of Shepherd’s staff. “In Australia, you sometimes wait months, but here everything goes bang, bang, bang. And another thing: They got Nils up and doing things. They’re very assertive, and they’re also all about getting results.”

Shelley Mitchell, Nils’ case manager at Shepherd Pathways, says: “Nils has done really well. He had stalled out when he got here, and he and his parents had a lot of questions that we were able to address. Now, he has a plan, something that makes sense, where before he didn’t.”

The Grimleys returned to Tasmania at the end of August 2012 and re-opened their hotel in time for spring and summer in the southern hemisphere. Nils, who advocated early release from jail for the young drunk driver who hit him, continued to exercise with the help of an exercise physiologist who trained at Shepherd.

The medication that relieved the tone in his body also left him “looser,” according to his mother, and cost him some of the strength he had regained. “Nils had to go backward before going forward and start over again building strength from the inside out,” she says.

But by March 2013, his strength had returned, his breathing was less labored and the flickering in his eyes diminished. His speech, eating, swallowing and arm movement have all improved significantly.

“Nils’ attitude is that his rehabilitation is his full-time profession,” Laurelle says. “We have set up a gym as his workplace. He starts with 45 minutes of exercises before he gets out of bed and he is still exercising while he watches TV at night.”

The Grimleys were especially heartened by a development that addressed his emotional independence rather than his physical issues. Friends invited Nils to spend a week with them in the North Queensland rainforest. It was his first separation from his parents since his injury, and he had to teach his friends to help him bathe, use the toilet, eat, move around and exercise. He even allowed himself to be strapped into an all-terrain vehicle and bounced about in “the bush.”

“We decided early on that we could not afford Nils’ injury any respect,” Laurelle says. “We take it seriously, and Nils is treated with dignity, but the affliction is derided and laughed at. That’s a ‘very Australian’ approach to adversity, and it has worked for us. Laughter is a powerful tool!”

“Nils and his family have a wonderful attitude,” Dr. Faydia says. They are so positive and motivated, and they’ve seen such great improvement that we are all hopeful that this visit will be even better.”

John says that when they first came to Shepherd they didn’t know what to expect and were thrilled with Shepherd Center’s “marvelous ethos and wonderful culture.”

The results, Laurelle says, speak for themselves.

“Nils is so much ’straighter’ in everything he does, and his movement, though still limited, is more normal,” she says. “He’s taking more and more control of his life. It’s the beginning of a whole new era.”

Written by John Christensen
Photography by Gary Meek

California Beaches
The California coastline stretches 840 miles, and the beaches along the coast are plentiful. Most of the public beaches lend beach wheelchairs free of charge, usually from a lifeguard or the entrance kiosk at a beach. Some may be reserved ahead of time, while others are available on a first-come, first-served basis. Call ahead for availability. For a complete list, check out this link: www.coastal.ca.gov/access/beach-wheelchairs.html. You can click on the map for a specific beach, or choose “text only” for a complete listing.

If you’re headed to the Los Angeles area, download “A Wheelchair Rider’s Guide to Los Angeles and the Orange County Coast” (www.scc.ca.gov/webmaster/ftp/pdf/pub/la_oc_wheel_guidebook.pdf). The comprehensive guide lists every public beach in the area, complete with information on each location and maps to wheelchair-accessible areas at each beach or public park.

Edisto Island, S.C.
General information:  www.edistobeach.comSix public access points for Edisto Island Beach are wheelchair accessible, and the fire department has beach wheelchairs available at no charge. Call 843-869-2505, ext. 217, or visit the fire station to make arrangements. 

Emerald Coast, Fla.
Includes Destin, Ft. Walton Beach and Okaloosa IslandGeneral information: www.emeraldcoastfl.comPark and beach information: www.destin-ation.com/parksandtrails.htm#wcBeach wheelchairs are available at most public beaches. Call the office of Public Beach Safety for more information at 850-259-4131. In addition, beach wheelchairs are available without charge on a first-come, first-served basis for use at all county parks on Okaloosa Island. On weekdays from 8 a.m. to 2:30 p.m., call the parks office at 850-689-5772. On Saturdays, Sundays or holidays, call the park ranger at 850-546-0342.

Fort Myers/Sanibel Island, Fla.
General information:  www.fortmyers-sanibel.com/see-do/beaches-parks-and-nature/The Sanibel Island Police Department (239-472-3111) will make arrangements to have a beach wheelchair available at any of their beach locations. The Lee County Parks and Recreation Department, which oversees the public beaches in Fort Myers, does not provide beach wheelchairs, but can advise visitors on where to find them. Call 239-533-7275.

Hilton Head, S.C.
General information: www.hiltonheadisland.orgA number of Hilton Head’s beaches are equipped with mats that make them wheelchair accessible. A complete listing of those beaches as well as companies that rent wheelchairs is available at www.hiltonheadisland.org/see-and-do/beaches.

Myrtle Beach, S.C.
General information: www.cityofmyrtlebeach.com or www.visitmyrtlebeach.comAccessibility information:  www.cityofmyrtlebeach.com/handicapped.htmlMyrtle Beach has 42 public beach access points (street ends, parks and other access points) that are accessible in varying degrees to people with physical disabilities. The website (listed above) gives a complete list of those public locations. Myrtle Beach has 14 beach-going wheelchairs available for use at no cost on a first-come, first-served basis. From April 15 through Sept. 15, ask at the nearest lifeguard stand, and a chair will be brought to that location. Chairs typically are available in one-hour increments during the summer because of demand. From Sept. 15 to April 15, call 843-918-1382 to arrange for use of a chair for up to one week. The chair will be brought to your residence or hotel lobby during the fall and winter months. Use of the chairs is free, but a photo ID is required.

Outer Banks, N.C.
Includes Duck, Kill Devil Hills, Kitty Hawk, Nags Head, and the beaches at Roanoke and Hatteras islandsGeneral information:  www.outerbanks.orgAccessibility information: www.outerbanks.org/outerbanks-handicap-accessibility/Fire departments loan out beach wheelchairs on a first-come, first-served basis. This website lists all the fire departments in the area. It also has a list of state parks that are wheelchair accessible.

Tybee Island, Ga.
General information: www.tybeevisit.comThere are mobi-mats for beach/water access in seven locations along the four miles of beach at Tybee Island, as well as many other wheelchair-accessible locations along the beach. During the summer months, beach wheelchairs are available for no charge at the lifeguard station and from city hall during the off-season. To get a list of accessible locations, call the Tybee Island Visitor’s Center at 912-786-5444 (toll-free is 800-868-2322), or stop by city hall.

For Shepherd Center's tips on planning a wheelchair-accessible beach vacation, click here.

Written by Sara Baxter
Photography by Steve Jessmore
 

Q:  Why did you decide to become a doctor and then specialize in physical medicine and rehabilitation (PM&R)?

A: I decided to become a doctor because I like to help people, and medicine seemed like a career in which I could contribute. I’ve always thought of being a doctor as a noble profession. When I was a kid, I really liked my general practitioner. He and his wife, who was a nurse in his office, were special people. We had a very nice relationship. They always knew whom we were when we were in the office.

As for specializing in PM&R, I was not sure about this at first. I didn’t know much about it when I started medical school. Then, during my first summer after starting medical school, I did an internship in a rehabilitation unit. I had an incredible mentor there, and I still keep in touch with him today. So that was the turning point. I spent that summer not so much doing clinical work, but getting to know patients. Most of them were there the entire time I was there. It was neat to develop relationships with them. I’m a people person. I thrive on that.

Q: Shepherd Center is known for some distinctive approaches to the practice of rehabilitation medicine. What aspects are most professionally rewarding to you and effective in producing excellent patient outcomes?

A: We do some innovative things at Shepherd Center, but Shepherd is special because of the people who work here. It’s a milieu of caring and teamwork. The staff is incredibly dedicated. There’s a caring aspect here that is different than anyplace I’ve ever seen. The technology and interventions are good, but you could use those same technologies and interventions elsewhere and still not get the outcomes that we get because of the people who work here.

Q: At the core of Shepherd Center’s mission is the goal of helping patients rebuild their lives with hope, independence and dignity, advocating for their full inclusion in all aspects of community life. In a practical sense, what does that mean to you in the way you perform your job?

A:  At Shepherd Center, we work to maximize a patient’s potential and ability, and to rebuild lives in the best possible way whatever the circumstances are. We are honest and open. We don’t promise things we can’t deliver. One of the most important things we do is help people accommodate whatever disability they might have and support them in their efforts to be successful. It’s not our definition of success that guides things, but the patient’s definition of success.

Now, obviously if someone is totally unrealistic with complete quadriplegia and is not going to be able to walk again, it’s not in our best interest to tell them they can go back and do tree trimming, for example.  But we want people to appreciate their talents and abilities and maximize those to be successful. That falls back to us as a group of professionals working with those patients. We have to be passionate and caring to reach out to people and meet them wherever they are in the process of rebuilding their lives.

Q:  How do you offer hope to patients at Shepherd?

A:  Rehabilitation therapy is physically and emotionally challenging and exhausting. We have to acknowledge that, not minimize it. We need to embrace that, but we also have to push people. We have to articulate that there are goals to achieve. As they achieve goals, we add new ones. Part of our role is to be a cheerleader.

We have a lot of former patients who are role models for our current patients.  They show what can be accomplished. We have athletic teams sponsored by the Center and we have former patients who are running businesses. We have role models from all facets of life. They are successful in the community. This is a real advantage. Our alumni are willing to give back. That comes, in part, from this milieu they experienced here at Shepherd Center. They learned that we care, and it fosters caring in them and they reach out to our current patients. You don’t see that everywhere.

Q: What are the most promising areas of research to help people with spinal cord and/or brain injuries?

A:  From a cognitive processing standpoint in brain injury, I believe there will be some better medications in the future – either new drugs or modifications of existing drugs.

For major physical innovations, I think there will be a combination of robotic devices and, ultimately, stem cells will be a big deal. We have political and financial roadblocks at this point, but that type of intervention may be the best hope for a true reversal of deficits. Just basic medication interventions won’t be the cure for spinal cord injury that we’re all hoping for. In robotics, the devices will be external or, ultimately, in a true bionic world, an implantable, programmable chip that can substitute for an injured part of the spinal cord or a focal lesion on the brain.

Q: What is the most frequently asked question you get from patients, and how do you answer it?

A:  The most frequent question from spinal cord injury patients is, “When am I going to walk again?” And I answer it honestly. I don’t know. But it gets back to our job, which is to teach patients to learn about and take care of their bodies, to be as independent and functional as possible, and to be as productive in society as possible. If the patient’s condition changes and improves beyond what we expect, then it gives us more things to work on with them. We’re on a journey together.

The underlying theme of questions we encounter from both spinal cord and brain injury patients is coping and adjustment for both the patient and family. The treatment team – the nursing staff and therapists, in particular, because they help these patients in some intimate settings – gets a lot of questions nobody else hears. In answering, we try to help them come to grips with wherever they are and again be a cheerleader to point them in a positive, forward direction. We try to be there and help them pick up the pieces, especially on the bad days.

Q: What have you learned about yourself and others in the process of treating people with spinal cord and/or brain injuries?

A: Life is fragile. Life can change in an instant, often times through no fault of our own. Personally, I am less of a risk taker than I used to be. There are things I am more cautious about and aware of, in general. In the 30 years or so that I’ve been involved with rehabilitation, I’ve matured and appreciate diversity better than I did in my young days. My definition of what is normal is very different than what I probably thought as a college student. My definition of normalcy is very broad now. We’re all in this together.

Written by Jane M. Sanders
Photography by Gary Meek

“I thought I was crazy,” she says. “I had no one to tell me why I was getting lost, why I couldn’t think of words, why I couldn’t write numbers or cursively. I was lost. I was depressed, anxious and paranoid, and there was no one to hold my hand and explain that I had a brain injury and what I was feeling was normal, and it would get better. That’s why I developed this program.”

The program is the Brain Injury Peer Visitor Association, an organization of volunteers who offer hope, support, education and information to brain injury survivors. In the past three years, peer visitors have made 2,764 hospital visits and spent 2,073 hours counseling brain injury patients at Shepherd Center and Shepherd Pathways. (They also visit patients at more than 20 other healthcare facilities in Georgia.)

Sarah Small, Psy.D., Shepherd’s director of inpatient neuropsychology, originally wasn’t comfortable with the idea of brain injury peers visiting with Shepherd patients.

“I was concerned about what patients and their families would say because even if the visitors have similar brain injuries or stories, the outcomes might not be the same,” she says. “That depends on things like their age, history and family support. I was concerned that people I didn’t know might be giving our patients too much hope or too many negatives.”

She requested that the peer visitors go through Shepherd’s volunteer training program so they would understand Shepherd’s culture.

“I thought I might have to exercise a lot of control over them,” Dr. Small says, “but they’ve proved me wrong. They’re just amazing. When they come on the floor, the peers are very structured about it, and they respond to me when they see something that needs to be addressed. It’s a very collaborative relationship. And that’s huge because families are so fragile.”

Bruce Allen, 58, a peer visitor from Marietta, Ga., says, “Our goal is to encourage and help family members to see that there is life after brain injury, and that the ‘new normal’ can be good.” Ann says that when someone is injured, family members often want to help, but don’t know what to do. Peers offer assurance from their own experience and bring with them information packets that include book lists, websites and other resources.

It also includes a letter written, Ann explains, “as if your brain is talking to you about all the things you’re going through. The more a person knows about their injury, and they know certain things are normal, it makes them feel better. They’ll think, for example, ‘Oh, that’s why I’m sleeping all the time. My brain’s trying to get better.’”

When she was injured in 1998, information about brain injuries was in “the dark ages,” she says, and even when she began gathering information in 2003, there were only a few books about it.

“It was like brain injury was a dirty word,” she says, “as if people had their tongues hanging out and were drooling. Now, she says she’s glad information is abundant.

For more information, be sure to watch a video produced by Shepherd Center in partnership with the Brain Injury Association of America. It’s called “Understanding Brain Injury” and is available online at braininjury101.org.

Although founded by Ann, the peer support program was initially run by a social worker with a grant to work with patients with traumatic brain injuries. But when the grant ended, Ann took over the program and expanded it to include all types of brain injuries.

After training with Ann and as a Shepherd volunteer, peers spend two days accompanying experienced peers on “shadow visits.” Peer visits occur twice during the week and again on Saturdays, and conversations may range from finances and driving to personal care and relationships. Peers also meet one-on-one with patients, and those relationships often continue after patients leave Shepherd.

“When we visit them in the hospital, we don’t just leave it at that,” Ann says. “We give them our business card with our number on it, and we tell them to call us night or day.”

RoseAnn Olson, 50, a peer visitor from Alpharetta, Ga, says: “The peer visitor program has allowed me to meet some amazing patients and their families. I still keep in touch with many of them after they complete their rehabilitation and return home.”

The response has been exceptional, Dr. Small says. Patients and their families are especially grateful to hear from someone who has had a similar experience.

“A lot of patients who have severe disabilities or have been in a coma meet with the peers and want to talk about what that means,” Dr. Small says. “When we check in with families and get their reactions to peer visits, they say, ‘Wow, that was informative and helpful.’”

“Occasionally, a survivor or caregiver will comment that they appreciate the opportunity to talk to someone who has been through the experience of a brain injury,” says Kris Lorenz, 64, a peer visitor from Tucker, Ga. “That makes everything I do worthwhile.”

Like everyone else, Ann is unpaid and has donated a substantial amount of her own money to pay for the information packets. She has also donated 9,811 hours of her time since 2006. She still experiences pain from her own accident, but rather than letting it limit her, she had buttons made that say “I Can.”

“You should see the smile when we give them to people,” she says. “You don’t have to explain; they get it. The point is, don’t ever let anybody tell you, you can’t do things.”

Although she was not treated at Shepherd when she was injured, Ann says Shepherd patients are “the most loyal I’ve ever met. That’s because Shepherd is such a phenomenal place. The staff at Shepherd has the same attitude we have. We believe you can get better and have an even better life. We’re about hope, and giving back is our mission. We’ve been allowed to live and give back to other people. It’s a way of repaying the Shepherd staff for saving our lives, not just physically, but emotionally and for who we are today.”

Bruce Allen
Bruce Allen, 58, of Marietta, Ga., lost his eyesight, speech, executive functions and use of his right side after brain surgery in 2008. Having regained most of his functions and 60 percent of his right side, he shares his experiences in a book he wrote with his wife. The book is Brain Storm: A Journey of Faith Through Brain Injury.

Here is his story in his own words:

On Jan. 7, 2008, I had emergency brain surgery for two abscesses that had rapidly formed in my brain. I lost my eyesight, speech, executive functions and use of my right side.

Now, five years later, I have regained most of these functions and about 60 percent use of my right side. After two years of rehabilitation at Shepherd Center and Shepherd Pathways, I found myself on disability, but wanting to help these family members and care givers.

My wife, Laura, and I are now very active with the Brain Injury Peer Visitor Association. We lead family support groups at Shepherd Center on two Saturdays each month, as well as at Shepherd Pathways during the week. Our goal is to encourage and help these family members to see there is life after brain injury and that the “new normal” can be good.

I am active in my church choir, small group Bible study, MUST Ministries (food distribution to those in need) and Unlimited Possibilities, an area-wide group of 55 or more brain injury survivors and caregivers who have breakfast together once a week and meet monthly. Investing yourself in others who are struggling where you have struggled is very fulfilling. I’m too busy now to work at a job!

Peer visiting led us to recently write a book, Brain Storm: A Journey of Faith Through Brain Injury, which tells our story from the viewpoint of both the survivor and the caregiver. Nine stories of other brain injury survivors are also told to encourage readers. Resources such as books, websites, movies, etc., are listed to help those on the journey to find much-needed and sought-after help. For more information, see www.BrainStormAllen.com.

Kris Lorenz
Kris Lorenz, 64, from Tucker, Ga., sustained a traumatic brain injury in an auto accident in July 2004. Unable to resume her career as an architect, Kris says volunteering with the Brain Injury Peer Visitor Association and helping others has filled a void in her life.

Here is her story in her own words:

In July 2004, while traveling for my employer, I was in a traffic accident that left me with a traumatic brain injury. I am an architect by profession and lived for my work. As a consequence of the accident, I lost my job and my work, leaving me with a feeling of emptiness and even uselessness.

I then decided to volunteer my time to anything that might be constructive, for me and hopefully for others. First, the ACLU and then Shepherd Center offered me the opportunity to contribute some time and effort. Shepherd told me about the Brain Injury Peer Visitor Association, which also presented a full opportunity to put my experience with a brain injury to a positive use.

The volunteer work helps to fill the void left by the loss of my work and gives me the opportunity to make a positive contribution to other people who have experienced a similar life challenge. Occasionally, during a peer visit, a survivor or caregiver will comment that they appreciate the opportunity to talk to someone who has been through the experience of a brain injury. That makes everything I do worthwhile and meaningful.

RoseAnn Olson
RoseAnn Olson, 50, of Alpharetta, Ga., sustained a brain injury after nearly drowning while snorkeling in April 2006. After her recovery, she and her daughter Courtney joined the Brain Injury Peer Visitors Association in gratitude, RoseAnn says, for “getting my life back.”

Here is her story in her own words:

On April 7, 2006, I drowned during a spring break vacation in Grand Cayman. I was snorkeling with my family. To this day, I am not sure why I went under water and cannot remember anything about the accident at all.

Luckily, my son, Zach, who was 19 at the time of the accident, pulled me from the water and two strangers who knew CPR worked tirelessly to resuscitate me. I had no pulse, and my lungs were filled with seawater. I stopped breathing several times in the ambulance, but an ER doctor from Texas rode in the ambulance from the beach to the hospital with me and used life support equipment to keep me alive.

Although there was a hospital on Grand Cayman, it was not equipped to handle my injury effectively, and after a brief stay, the doctors said, “Due to the lack of oxygen to her brain (anoxia), she will likely be a vegetable for the rest of her life”.

My husband, Loyd, arranged to have me transported by an air ambulance to Northside Hospital in Atlanta, where I spent 10 days in intensive care.

On April 19, I was admitted to Shepherd Center. When I arrived, I had a tracheotomy, catheter and I couldn’t walk, feed myself, read or write. It was at Shepherd where I received the necessary speech, physical, recreational and occupational therapy required to help me begin my road back to a normal life.

I walked out of Shepherd unassisted on May 8, 2006 able to talk and feed myself.

After completing Shepherd Center’s inpatient program, I entered Shepherd Pathways outpatient program, where I spent another month working hard to further refine the progress I made at Shepherd.

In August 2006, I passed my driving recertification test, and at that point I realized everything was going to be OK. Today, I continue to improve. I use several tools to work on memory, balance and writing.

The Shepherd Center doctors and therapists, who were dedicated and committed to helping me get my life back, will forever hold a special place in my heart. I will always be grateful to Shepherd Center.

After my recovery, I truly wanted to do something to show my gratitude toward Shepherd. After researching ways to give back, I found Ann Boriskie, director of the Brain Injury Peer Visitor Association. Ann developed an amazing program for brain injury survivors and their families/caregivers. She trains volunteers like me who have been affected by a brain injury to meet with patients/caregivers. Our goal is to offer hope by sharing our stories with the patients and families we meet.

I visit Shepherd’s ABI and Neurospecialty units and The Scottish Rite Children’s Brain Injury Unit once a month. My daughter, Courtney, also wanted to show her gratitude to Shepherd Center, so she went through the Brain Injury Peer Visitor Association training and joins me on my visits when her busy college schedule allows.

The Peer Visitor program has allowed me to meet some amazing patients and their families – many of whom I still keep in touch with after they complete their rehabilitation and return home.

Thanks to Shepherd Center and their optimistic approach to my rehabilitation, along with the support of my family and friends, I was able to get my life back. I volunteer, garden, cook, travel, snorkel, and love being a wife and a mom.

Cole, a 17-year-old former Shepherd Center patient, knows the students are looking at his wheelchair. But he starts by talking about life before his accident – the schools he attended and his many hours of competitive swimming and other sports.

“A lot of them went to the same schools I went to, had the same teachers, the same coaches,” Cole says. “It shows them this (injury) is not a random thing. It happens more than they expect.”

Then he tells them how a guy a lot like them broke his neck diving into the James River on Aug. 11, 2011 – an accident that landed him in the ICU at VCU Medical Center.

“That’s the quietest they’ve ever been,” one group leader told Cole after an appearance. But the respectful students do have questions. For example: What’s the hardest part of life with paralysis?

“The hard part is the dependence,” Cole tells them. “For example, when you go to get a drink that you used to just grab yourself, you have to ask someone for help.”

Patients and former patients, such as Cole, often share their stories in group settings, hoping to have an impact, especially on adolescents. Many of the appearances are coordinated through Shepherd’s injury prevention program, which also uses social media and word of mouth to raise awareness of spinal cord and brain injuries.

And this year, Shepherd Center and the Cobb County School District in suburban Atlanta will expand a program in which Shepherd professionals and several former patients join specially trained science teachers in presenting a two-and-a-half week injury prevention unit to seventh graders.

SPECIAL MOMENTS IN A MIDDLE SCHOOL PROGRAM
Campbell Middle School in metro Atlanta was the first school to implement Shepherd Center’s injury prevention curriculum in 2011 and 2012.

“I was surprised at how well the kids and the patients interacted,” says Thomas Brown, Ph.D., the science curriculum director for Cobb County schools. “The kids seemed to let their guard down, and the patients seemed to be able to be open and frank with them. It was very useful to get to the point that, ‘Hey, you need to be careful and think about what you’re doing. And if you don’t, here’s what can happen.’”

This spring, the program will include Campbell and three additional middle schools: Dodgen, Dickerson and McClure.

The program includes instruction on spine and brain anatomy, medical rehabilitation careers and prevention of injuries caused by distracted driving, diving, unsafe operation of bicycles or all-terrain vehicles, and guns and violence.

Tests of students before and after these lessons in science classes have shown students’ attitudes toward risky behavior changed for the better, says Bridget Metzger, Shepherd Center’s director of injury prevention.

This year, educators also will assess whether the students intend to advocate safer behavior by others.

“If they see Mom texting and driving,” Metzger says, “how likely are they to say: ‘You can’t do that. That’s not safe.’? Or will they speak up if one of their peers is not wearing a seat belt?”

Brown would like to see some students join with patients to find better ways to teach injury prevention.

In the case of distracted driving, he says: “This problem is likely, in the short term, to get worse because kids are so married to their cell phones. Kids are better at technology than we are, so we need them to help find solutions.”

Brown also thinks the program may teach students something intangible.

“We can use this project to help our kids realize that there are lots of people who are struggling in one way or another who need help and encouragement,” he adds.

SEEING THE IMPACT
Like former patients participating in Shepherd’s middle school program in metro Atlanta, Cole shares his story in his own community, hoping to evoke empathy – an important factor in making an impact on the audience.

Asking friends for help can make Cole feel like “a nuisance” sometimes, but he considers how he would feel if the situation were reversed. “It would make me feel good to do that for my friend,” he says.

And he sees his story helping others. One mother reported an emotional warning she gave to her son to stop diving after hearing the details of Cole’s accident at a community prayer service.

“The next time he went out to the river, he went to the same spot, but the tide had gone out, and the water was more shallow than he expected,” Cole says. When the mother received a call that her son had been injured at the river, she feared the worst. But he had broken his tibia, not his spine, because he jumped in feet first.

The boy told his mother, “I thought about Cole, and I didn’t dive.”

Jake Berryhill’s Story

In a way, Jake Berryhill is glad so many of his friends saw him lying in a hospital bed with a spinal cord injury and a battered face. More than any public service announcement could accomplish, he believes the message really hit home when his friends witnessed what could happen when texting while driving.

“That was a pretty frightening thing for them,” says Jake, 26, of Athens, Ga. “I’ve had a lot of them tell me after seeing me like that they just won’t do it.”

He has a message for newer friends. “People will say, ‘Yeah, I look at my phone all the time, and it’s terrible.’ And I’ll be like, ‘Yeah, don’t.’”

And then he tells them his story.

Jake Berryhill, 26, of Athens, Ga., sustained an incomplete C-6 to-7 spinal cord injury in May 2011 when he wrecked because he was texting while driving.

On May 17, 2011, Jake left his parents’ lake house in north Georgia and started back toward Athens. He had fallen into the habit of waiting 10 minutes or so before buckling his seat belt. He was about five minutes into his drive and texting when his car swerved a little bit off the road.

Jake over-corrected and sent the car into a spin. Ultimately, the car crashed into a tree. Jake wound up in the floorboard with a gashed nose and chin, two missing teeth and an injury at the base of his neck that put paralyzing pressure on his spinal cord at the C-6 to -7 level.

After back surgery and a week of intensive care at Atlanta Medical Center, Jake was transferred to Shepherd Center for rehabilitation. He spent four weeks as an inpatient, graduating from bed to wheelchair to walking with a cane. He moved to the Day Program for three more weeks and then went home to Athens to continue his recovery.

“If you saw me today, you’d have no idea that this had ever happened,” Jake says. He returned to work as a business analyst for a software company.

When he drives, his seat belt gets buckled immediately, and his phone goes in the cup holder. “When the car’s in motion, I won’t pick it up.”

He thinks a lot about why people make the mistake he did.

“You get in the car every single day, and so it’s not really a registered thought that you are taking a risk every time you get behind the wheel,” Jake says. “All of us want to think we have the ability to multi-task,” he says. “But something bad could really happen just because you took your eye off the road for a couple of seconds.”

Ali Monckeberg’s Story

When former nursing student Ali Monckeberg, 24, told spinal cord injury patients at Shepherd Center she understood their challenges, she meant it.

At an outing with friends at Myrtle Beach, S.C., on May 24, 2009, Ali went head first over a homemade water slide into the Atlantic Ocean. She slammed into hard sand beneath the shallow water, causing a C-1 spinal cord contusion in her neck. After surgery and acute care at New Hanover Regional Medical Center in Wilmington, N.C., she transferred to Shepherd Center, unable to move anything below her neck except her right wrist.

But over the next two months, she rapidly progressed in Shepherd’s inpatient treatment regimen and then in the day program. After follow-up at home in Cumming, Ga., she regained almost full mobility. By summer 2011, she was back at Shepherd as a nursing extern working with the same team of professionals who had treated her.

“It was really cool to be able to talk to the patients and say, ‘I know what you’re going through,’” Ali says.

Ali Monckeberg, 24, of Cumming, Ga., sustained a C-1 spinal cord contusion in May 2009 after sliding down a homemade water slide into shallow water at Myrtle Beach, S.C.

Her experience can make it difficult for her when she’s with friends who dive into water. “At the pool or in the lake, whenever people start diving in, I just have to look the other way,” she says. ”It’s just hard for people to understand the risk.”

Ali, who describes herself as 90 percent recovered, says she sometimes has a noticeable limp.

“People will say, ‘What’s wrong with your leg?’ Then I explain I had a spinal cord injury, and they don’t understand how a spinal cord injury is interconnected with other issues with your body,” Ali says. “I think people are undereducated about what exactly can happen.”

Ali has friends who tell her it’s safe to dive in some circumstances, and she agrees that it’s better to look into the depth of the water than take no precautions. But she is proof that it’s hard to truly assess the risks.

Her friends had been sliding across a tarp on a sand pile for quite a while before she got up her courage to try it. “I had seen people doing the same exact thing minutes before I did it,” she recalls.

Ali earned her nursing degree from Lynchburg College in 2012. As she embarks on a health care career, she wants people to understand that injuries that seem a remote possibility happen all too often.

“I talked to so many Shepherd Center patients who had gone through accidents that were completely freak accidents,” Ali says. “No one thinks about such little things that can change your life.”

Lino Ortiz’s Story

Lino Ortiz got back on the all-terrain vehicle against his better judgment.

He thought about the two beers he drank at the Fourth of July cookout and how he felt on a friend’s ATV a little earlier that night. That first time, he recalls: “I drove around and parked it. I said, ‘I’m not going to ride it. It doesn’t feel safe.’”

But his friend’s father was late returning from an ATV ride, and she asked Lino to take another ATV and go down a dirt road to look for him. He drove off without a helmet.

Rescuers found Lino in the early morning hours of July 5, 2009, “upside down, bleeding from the nose and the ears.” He doesn’t remember the accident that injured his brain – or any of the next four weeks, including his acute care stay at The Medical Center in Columbus, Ga.

“I remember waking up at Shepherd Center and the doctor telling me, ‘Your life isn’t going to be the same,’” Lino says.

But in what Lino regards as a miracle, he has recovered almost completely. During a month at Shepherd Center, he graduated from a wheelchair to walking around slowly, strengthened his damaged right arm and shoulder, and worked on the brain issues that disrupted his speech. Surprisingly, he was back at work as a computer network engineer less than three months after the accident.

Lino Ortiz, 34, of Columbus, Ga., sustained a brain injury in an ATV accident in July 2009. He was not wearing a helmet.

Today, Ortiz, 34, of Columbus, Ga., experiences only occasional slight hesitations in his speech, which suggest he was injured. But the experience changed him. He appreciates good times, but also regards risk more seriously, he says. He thinks his daughters, ages 13 and 17, also were changed.

On the rare occasion when he drinks a margarita in a restaurant, his younger daughter worries, even though Lino doesn’t drink and drive. If he receives a text message while driving, he asks one of his daughters to respond.

And while the Consumer Product Safety Commission focuses on driver training and preventing children from driving adult-sized ATVs, Lino is flatly against them.

“I’ve gotten to the point that whenever anyone says to me, ‘My son has an ATV,’ I say ‘Whoa, you should keep it away from him.’ I explain my story and they’re like, ‘Wow.’”

He especially wants teen-agers to hear his message.

“Teens think they’re unstoppable,” Lino says. “They want to have a drink on the weekends when mom and dad are away. They want to text and drive. But I learned I’m stoppable. It was a wake-up call. Some people don’t get as lucky as I was.”

Written By David Simpson
Photography By Gark Meek, Tom Stiles and Louie Favorite

His wife, Jan Morgan, M.D., was training for her second Ironman Triathlon^®. She was doing a 70-mile bike ride around her hometown of Starkville, Miss., that morning with her friend Kim. “I knew her pace and I knew how long they were riding,” “It was too early for them to be finished,” David recalls.

It was Kim calling. “She said, ‘Jan’s been hit, and it’s bad.’”

About 50 miles into their ride, a motorist hit Jan from behind. The police report describes the force of the crash launching Jan off her bike, into the air, and then landing on the hood of the motorist’s car, rolling into the windshield. When the driver came to a stop, Jan flew forward on the asphalt.

What happened next seemed unbelievable to onlookers rushing to the scene. The Starkville Daily News quoted the accident report:  “The driver… exited the vehicle and observed the cyclist while talking on the phone. [The driver] then re-entered her vehicle and ran the cyclist over again before being forced from her vehicle by a witness.”

For the first couple of weeks after the accident, doctors at North Mississippi Medical Center focused on keeping Jan alive. Major injuries included collapsed lungs, sternal fractures, a lumbar burst fracture, scalp lacerations, a frontal lobe contusion and hemorrhaging in the temporal lobe of her brain.

“You name it, I had it,” Jan says.

Doctors kept her in a coma and on a ventilator for five weeks. Jan doesn’t remember anything from a couple days before the accident to nearly three months after.

Her husband isn’t so lucky. A radiologist, David says it was difficult knowing all too well how much his wife was suffering. “Seeing it from the patient side was hard,” he says. “It was an emotional rollercoaster. It made me appreciate what patients’ families go through all the time.”

It was two weeks before David knew Jan would live. He immediately began seeking a brain injury rehabilitation hospital and found Shepherd Center. She was still a 4 on the Rancho cognitive-functioning scale when she arrived at Shepherd Center more than five weeks after the collision. “She was confused, agitated, not aware,” David recalls. “It was like talking to a 6-month-old.” Still, staff started Jan on physical, occupational, speech and recreation therapy. For about 10 days, there was little progress.

“The staff kept telling me, ‘She’ll come out of this.’ But it was frustrating,” David says. “Then one day, a nurse came in with pills, and Jan reached to take the pills from her. The nurse and I did a little dance. It was the tiniest, simplest act, but it meant a lot. She had done it on her own. That was the first time I had real hope that she could be herself again.”

Payal Fadia, M.D., medical director of Post-Acute Brain Injury Services, was Jan’s doctor at Shepherd Center. “It was normal for her to be confused and agitated initially with the combination of her fractures and brain trauma,” Dr. Fadia says. “Once we got her settled down, she did well. She really progressed quicker than most, especially considering the depth of her injuries.”

Jan doesn’t remember much from her time at Shepherd Center, but she knows she was a challenging patient. “They had these food monitors, and if you hadn’t eaten enough, they gave you Ensure,” she says, laughing. “For some reason, that made me angry. So I started hiding my food. I thought, ‘How smart I am! I should get extra points from my therapist. I’m problem-solving!’”

“They were so patient with her, but still demanding,” David says. “They made her stay out of bed, made her sit up when she didn’t want to. And there was lots of screaming and resistance from Jan. Believe me! But they were fantastic. It was what she needed.”

David never left Jan’s side during the ordeal. He took showers and naps at the apartment Shepherd Center provided for him, but he didn’t go home until Jan did.

“His support was everything,” Jan says. “I knew he loved me before this happened. But, wow! And he had to live through it all. I didn’t know. When I finally woke up, it was like I missed it – like I read the book or saw the movie about the experience. The more I learned, the more I sobbed for him.”

Jan could walk with assistance by the time she left Shepherd Center. Now, other than short-term memory issues, there’s not much that holds Jan back.

A year after the accident, she was swimming and taking 8-mile Saturday morning walks with her husband. A half-marathon is on the calendar for January 2013, and she’s mountain biking, too.

Of course, it’s hard for the Morgans to escape the cycling world. After Jan retired as an anesthesiologist a few years before the accident, she and David opened their own bicycle shop – Boardtown Bikes.

Jan’s story has provided her with an opportunity to become an even more visible proponent of helmet use and of “Share the Road” laws protecting cyclists on the road. Her story has reached bicycling groups and newspapers throughout the United States. And nobody buys a bike in the Morgans’ shop without the follow-up question:  “Now, do you have a helmet?”

On Sept. 29, 2012, Lee Jenkins, executive director of the Brain Injury Association of Mississippi, presented Jan with the group’s annual “TBI Hope Award.”

“It’s really a miracle that she’s alive, much less doing everything that she’s doing,” Lee says. “We need stricter injury-prevention laws for bikers on roadways. And Mississippi doesn’t have a statewide bike helmet law. Jan’s story is such a good example of why we should.”

In spring 2012, when the driver who hit Jan was found guilty of simple assault with a deadly weapon, the judge initially gave the driver a six-month suspended prison sentence. Jan, however, requested that in lieu of jail time the driver produce a public service announcement (PSA) about safe driving and sharing the road. That PSA is now in production.

“The year before I got hit, Mississippi passed a law that motorists are required to leave at least three feet of space when passing cyclists,” Jan says. “But not enough people know the law. Since my accident, two more riders in Mississippi have been hit, and they died. I want to make people aware so this doesn’t happen anymore.”

Written by Phillip Jordan
Photography by Russ Houston

Growing up in Atlanta, she heard all about Shepherd from her parents, Libby and Gene Pearce, who were both actively involved at the Center. Her sister, Elizabeth, co-chaired Derby Day and is an Advisory Board member. Before she could even walk, Anne played with her toys on Shepherd’s gym floor in 1979 while her mother visited a friend who was one of the first patients at Shepherd.

“Shepherd was a big part of our family life,” Anne says. “I knew that I would get involved in some way when I was older.”

She probably never imagined how involved. Since 2002, Anne has served as an employee, donor and volunteer.

She came to work for Shepherd right out of college, starting in 2002 as a database manager in the Shepherd Center Foundation. She was later promoted to major gifts associate, then moved into event management, where she managed Shepherd’s Derby Day fundraiser and even became one of its sponsors – starting at the $500 level and increasing her commitment each year.

“I helped sponsor every event I ran because I wanted to lead by example,” Anne says, adding that the example was set at home. “My parents taught us that no matter how much money you have, you have to give back. So it was just natural that I would want to give to Shepherd.”

While a Shepherd employee, Anne became well acquainted with Shepherd’s Junior Committee, a group of young professionals ages 23 to 35 who meet monthly and plan Derby Day. For Junior Committee members who rotated off the working group but expressed an interest in finding a way to stay involved, Anne created the Shepherd Center Society, which sponsors several key fundraising events.

“Up until that point, we didn’t really have a place for people in their 30s and 40s who wanted to be as active as they were on the Junior Committee,” she explains. “The new Society represented a way to keep our existing volunteers engaged as well as to pull in new members and create awareness for Shepherd among that age group.”

After getting married in 2011, Anne left Shepherd to focus on new endeavors. But while she left the job, she didn’t vacate the hospital.

“Shepherd will always be a part of my life,” she says, “and I still want to feel like a part of that family.” She’s now a hospital volunteer, helping to support families of patients in a variety of ways. And this year, she’s chairing the organization she founded – the Shepherd Center Society.

Dean Melcher, director of development operations for the Shepherd Center Foundation and Anne’s former supervisor, says she will always be an integral part of Shepherd.

“As an employee, Anne set a great example by volunteering her time with the Junior Committee, financially supporting the event and the Center’s programs, and even including the Center in her estate plans,” he says. “She is a fantastic supporter of our patients and families, through volunteering, donations and advocacy.”

“People ask me, ‘Why should I give to Shepherd over other hospitals?’” Anne says. “I tell them, ‘You hope you never need it, but it’s there if you do.’ And it’s only there because other people believed in it. It’s a place where patients regain their independence and their hope. It rebuilds their lives and their family.”

Originally from Jacksonville, Fla., Bart came to Atlanta in 1963 and worked in real estate until retiring in 2000. Toward the end of his career, in a desire to give back and find new ways to occupy his time post-retirement, he began volunteering.

Bart first volunteered at Project Open Hand, where he delivered meals to those in need until scoliosis prevented him from doing so. He then volunteered at Living Room, which finds affordable housing for homeless individuals living with HIV/AIDS.

After Living Room brought many of its volunteer positions in-house, Bart found himself looking for a new volunteer project. And, thanks to a local interview program, in which two women were discussing volunteering at Shepherd Center, Bart discovered his next opportunity – one that came just when he needed it, when his scoliosis had become more debilitating.

“Shepherd puts everything in perspective,” Bart says. “It has made it possible for me to handle my condition, and the pain that comes with it, with a certain amount of grace that I have learned from the wonderful patients at Shepherd.”

Since coming to Shepherd Center, Bart has volunteered in numerous capacities and has shown such dedication that he received the 2012 Spirit of Excellence Award from the Shepherd Center Auxiliary, a volunteer group whose primary mission is fundraising for the hospital.

In addition to feeding and talking with patients, Bart has assisted Family Support Services in providing aid to patients and families, whether it is answering questions about the hospital or helping with directions, local transportation or other non-medical needs.

Bart has also served as treasurer of the Auxiliary and currently helps sell pecans during the group’s annual Pecans on Peachtree fundraiser. As if these activities were not enough, Bart also co-chairs the Auxiliary’s Special Mailing Committee, which sends out thousands of brochures each year promoting the hospital’s many fundraisers.

Volunteering at the welcome desk (at the parking deck entrance) each Tuesday and Thursday afternoon, however, has been one of Bart’s most fulfilling volunteer positions at Shepherd – something that surprised him.

“When I was first asked to serve at the welcome desk, it seemed like the least important job I’d ever done at Shepherd,” Bart says. “But I was dead wrong. It is a very important job because it is the first, and sometimes the last, impression many have of this marvelous institution.”

As much as Bart has given to Shepherd Center, he believes the hospital has given much to him, especially during Christmas. Bart looks forward to serving patients and families dinner each Christmas and, because his own family is scattered around the country, he feels as though Shepherd is his family that day.

And those at Shepherd feel the same way about Bart. “Bart is just a great advocate for Shepherd Center,” says Midge Tracy, director of Volunteer Services. “He loves his volunteer work, and we love having him here.”

SNELLVILLE, GA.

Samantha Walker, 25, of Snellville, Ga., didn’t hit what she calls “rock bottom” until nearly two years after the car accident that left her with an incomplete C-4 spinal cord injury a week after her 15th birthday. “I became a wild, rebellious teenager after I got my independence back,” Samantha explains. “You’re working through the typical teenager self-image issues, and then add a terrible injury to it.” “At 17, I became pregnant,” she says. Outpatient rehabilitation at Shepherd Center – eight to nine hours a day of “rehab therapy boot camp” as Samantha recalls it – had given the teenager much of her physical independence back a year before. Becoming a mother, Samantha says, “probably saved my life all over again.”

Today, she and her husband, who have been together since she turned 17, cherish two children. Samantha has turned part-time graphic design work into a full-time freelance career, mixing in web design and online marketing for nonprofits and small businesses.

This past Christmas, Samantha connected with friends she had made through a Facebook group of people who sell homemade goods online. She convinced them to donate handmade hats, scarves, wreaths, jewelry, toys and candy for stockings she put together for teens staying at Shepherd Center during the holidays.

“Shepherd gave me my life back, but I still know what it’s like to feel confused and angry as a kid,” Samantha says. “Without going through all that, though, I wouldn’t have my kids, and I wouldn’t have the life I have now.”

Jay Ruckelshaus

INDIANAPOLIS, IND.

Jay Ruckelshaus, 20, of Indianapolis, Ind., says the biggest confidence boost he received post-injury came when he returned to campus at Duke University in fall 2012. “It felt great just to be there,” he says. “It’s really nice to be a student and be treated like anyone else again.”

In July 2011, Jay had broken his fourth and fifth cervical vertebrae in a diving accident. When he arrived at Shepherd Center that September, he could shrug his shoulders. Over the next 11 months, Jay progressed through a variety of Shepherd’s rehabilitation programs. Now, his upper-body strength has returned, and he can move his arms enough to operate an iPad and phone.

In his first semester at Duke, Jay notched a 4.0 GPA and started a mentoring initiative on-campus – pairing students who have successfully returned to campus, post-injury or illness, with students who are still on medical leave. He’s also creating a nonprofit to raise funds and provide scholarships to help students get back to college after a catastrophic injury.

“Family members and friends helped establish a fund for my rehab,” he says. “I want to do the same for others so that they can return to school.”

In the meantime, Jay will return to Shepherd Center for a couple of weeks this summer – for a “tune-up” before traveling to England for a study-abroad program at the University of Oxford. “Navigating a 1,000-year-old castle in a wheelchair for six and a half weeks,” Jay says with a laugh, “should be pretty interesting.”

Joseph G. Leahy

MADISON, ALA.

Joseph G. Leahy, 53, of Madison, Ala., a microbiology professor, entered a conference room at the University of Alabama at Huntsville on Feb. 12, 2010, for a faculty meeting. The routine meeting soon turned tragic as a colleague opened fire on her fellow professors, killing three and wounding three others, including Joseph.

A bullet smashed through his skull, severed the optic nerve in his right eye and splintered his jaw. When he was transferred to Shepherd Center for a six-week stay, therapists worked with Joseph extensively on relearning to swallow. He then remastered all the previously simple tasks – walking, showering, shaving and eating – he needed to know before returning home.

Today, Joseph is back teaching in the same biology department at the University of Alabama at Huntsville. There have been more surgeries and lingering vision problems, and Joseph’s organizational skills are still affected. But most importantly, he is in the classroom again, revealing the world of microbiology to his students.

“I lost three colleagues here, including my boss, who I had great respect and admiration for,” Joseph says. “But I wanted to come back. Coming back the next August, it meant everything in the world to me. I love the students, and it was really difficult to be away from that. I’d been teaching for 13 years before the shooting. A return to normality was critical for me.”

Daren Rodgers

MYRTLE BEACH, S.C.

Daren Rodgers, 42, of Myrtle Beach, S.C., is a building contractor. In summer 2011, he was on a 30-foot ladder, propped up against a building he was inspecting for an estimate. A landscape worker was riding on a lawnmower below. “He thought he could fit between the bottom of the ladder and the building,” Daren says. “Well, guess what? He couldn’t.”

His ensuing fall resulted in a C-6 level spinal cord injury. “I had no arm movement at all,” Daren recalls. “I’d lost all muscle mass. I remember looking at my hands and not being able to raise them.” Occupational and physical therapy at Shepherd Center produced results. Today, with the help of his son and creative solutions, such as video software to help him inspect upper-floor units he can’t access in his wheelchair, Daren is back at work.

“What meant the most to me during all the therapy was that the entire time I was there – and this is from one end of the building to the other end – it seemed everyone at Shepherd truly cared about me as an individual,” Daren says.

Before his injury, Daren bought kits that he used to make unique, wooden ink pens. As he recovered after his accident, Daren figured out how he could use a lathe to hold and turn the wooden pieces, pressing them together to form his pens. He’s made more than 100 since the injury, and while he sells many of them, he has sent several as gifts to his therapists and friends at Shepherd.

But his journey has not been a simple one. While his return to work was relatively quick, Chico’s return to life took some time.

By October 2011, Chico, 30, was back to coaching, albeit via Skype from his room at Shepherd Center, but it took much longer to get back to being himself. Even after the outgoing young man returned to Baton Rouge to work in person with the Tigers, Chico was two people rolled into one body.

The world saw one Chico, but he did not deceive his parents. Syrjala and Pipo Garcia – or Sue and Mr. G as they’re known in the cheerleading community – knew the score.

“He wasn’t fooling me,” Syrjala says of her son’s ability to put on a show. “I knew if he was in the house and the doorbell rang, a switch went on. He would tell people, ‘I’m doing good.’ On the outside, he made it seem he was no different.”

On the inside, Chico suffered long after the accident, where as a passenger in the rear of a boat he was hurtled forward when the craft hit a dock.

As he learned from doctors the extent of his injury – he has movement from the shoulders up – Chico went into a funk. Then, he created a fictional public persona that betrayed his soul but worked well for his job.

“As soon as I came to my senses, I knew I was paralyzed,” says Chico, recalling the accident. “I was trying to pick up my body, and the only thing that would move was my head. Three or four days after getting to Shepherd Center, and them explaining. . . that was the lowest moment of my life. No marriage. No kids. Have to live with someone the rest of my life.

“Coming from an athletic background. . . secretly, I was in that valley,” he says. “I didn’t show it publicly because of my role. I felt it wasn’t appropriate. I was very depressed and I hated my life. I was a very good actor. People would ask, ‘How you doing?’ I’d say, ‘Great.’ In the back of my mind, I was hoping to die.”

This went on for quite a while, and so did Chico – aggressively, yet miserably. Using a sip-and-puff interface to navigate his power wheelchair and assistive technologies to communicate and control his environment, Chico immersed himself in his work. LSU has a well-respected cheer squad that typically fares well in competition.

The New Orleans native cheered from 2002 to 2006 for the Tigers, and before he graduated in December 2006 with a degree in general studies, school officials asked him to remain as an assistant coach.

After about a year, Chico was promoted to head coach. That job included plenty of road trips, not only to football and basketball games but to competitions.

Chico Garcia, 30, of Baton Rouge, La., returned to work as the cheerleading coach at Louisiana State University after completing rehabilitation at Shepherd Center for a C-4 complete spinal cord injury he sustained in a boating accident in August 2011.

He’s curtailed travel to away games, but Chico’s still very involved with big events. He went to China with the squad in December 2012, and in January 2013, he made a 12-hour bus trip to and from Orlando for a major competition.

In the middle of last year, he also returned to his part-time job at the Mall of Louisiana as a creative specialist at the Apple store. He’s still teaching customers how to use Apple’s technology products, he says, “without being able to touch them.”

For a while, Chico’s accident left him wrecked on the inside. Until, that is, he had an epiphany around Thanksgiving 2012.

“I was watching Netflix, sitting in bed and self reflecting: ‘You know what? You’ve lived a great life and can now just live it in a different way. You will not be happy unless you move on from this accident,’” he recalls.

Just like that, Chico overruled his personal sorrow.

“I like that quote from Buddha, I think: ‘Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else. You are the one who gets burned,’” he says. “I actually apologized to my mom and dad that night. I’ve changed my ways as far as being snappy or disrespectful.

“The only thing I can associate it with is like the image we have of (heaven’s) pearly gates . . . when they open up and you see that light come through,” Chico adds. “I don’t know how to put it in words. Happiness just came out and radiated.”

Chico got a jump on his recovery at Shepherd Center through inpatient rehabilitation.

“Unlike other businesses you may encounter, everybody at Shepherd truly loves their jobs,” he says. “And I really liked it when we were in a group of 10 or so people, and we were talking about what we were feeling, although I still had a trach tube at the time.”

These days, Chico is working on several business ideas and has devised a few gadgets to aid himself and perhaps others. He has devised ways to mount his iPhone and an iPad to his chair, and improved the stylus he uses to peck at the devices.

“After hours of asking my mother and father to take the stylus out of and put it in my mouth, we went to Lowe’s and bought one-inch PVC and connectors, and I made a mouth tray holder,” he says. “Everybody thinks it came with my chair.”

A motorcylist before his accident, Chico is working with others to create a wheelchair-accessible motorcycle sidecar. He plans to call that company “I Can Ride Teaux,” a tip of the cap to the Cajun influences in his area. Chico is also working on motivational speaking and drafting a proposal to become LSU’s official motivator for all sports.

By mid-season of fall 2012, he was again at Tiger Stadium.

“Initially, LSU was hesitant to let me on the field in case of injury,” he explains. “They were saying to sit in the stands, but my voice doesn’t carry. My diaphragm prevents yelling. They let me on the opposite side of the field. There’s a little bit more space on the east side.”

Though he has not regained any movement since the accident, Chico is evolving – focusing on what he does have. “I can feel temperature and pressure everywhere,” he notes. “That has changed. I can feel my Rottweiler, Tabasceaux, when she sits on me.”

Another Journey Back to Life
Like Chico, Kylie Stephens Guest, 26, of Brunswick, Ga., was into motion. An award-winning dancer for many years, she sustained an L-1 complete spinal cord injury (SCI) in a car accident on Jan. 4, 2008 near Melbourne, Fla. Now, Kylie, who uses a wheelchair, may soon return to the dance field – perhaps as an instructor. She also recently finished her first job – a one-year assignment with the Federal Law Enforcement Training Center near Brunswick.

Her timeline is, like Chico’s, fluid, yet she frequently realizes the benefits from the various forms of therapy she underwent at Shepherd Center.

“Before the accident, my priority was dancing,” she recalls. “I did tap, jazz, lyrical, ballet and modern. We did a lot of competitive dancing, national and all that.”

It has taken Kylie some time to consider what might be her new kind of involvement in dance. She is only now at a point where she believes she would enjoy being a dance instructor, she says.

After the injury, Kylie spent considerable time undergoing rehabilitation at Shepherd Center. “They transferred me (following the accident) the day after my birthday,” Kylie recalls. “It was not a good time for me. But now, I know I’m lucky to be alive and very blessed. I’m able to put on leg braces and I can kind of take steps in leg braces.”

Kylie returned to Shepherd Center in summer 2012 to learn to drive a car adapted with hand controls. She’s been driving independently since then.

“The Day Program is what I remember most,” she says. “I got to stay in an apartment with my mother. I had awesome therapists. They whipped me into shape. It was nice to work with people who were going through the same thing as me. It was like we were fighting the same battle.”

Kylie Stephens Guest, 26, of Brunswick, Ga., made a comeback to a full life after sustaining an L-1 complete spinal cord injury in a car accident in 2008. She married Josh Guest in September 2012 and completed her first full-time job assignment last year, as well.

Now, Kylie is contemplating whether to return to work or resume studies at Coastal Georgia Community College. “I’m kind of in between,” she says. “I’m trying to find out what I want my degree in. It will probably be in some sort of business administration.”

Her life is full, though. She married Josh Guest in a beautiful ceremony on Sept. 22, 2012. Josh has taught her riflery, and she enjoys fishing locally for trout and for kingfish in the ocean.

“I just got a pink pistol for my birthday, and I love to shop, too, like most girls,” she says. “Also, my girlfriends and I get together and go to dinner a lot. They are the same friends I’ve had since I was in daycare. They have stuck by me through thick and thin.”

As she plots her next move, whether it’s a return to school, a move back into the field of dance or perhaps another job, Kylie is developing a new sense of herself, she says.

“I actually still go back to my dance school and all the recitals,” she says, “and that’s something I’d like to get into more.”

Meanwhile, in important ways, Chico is back to being the same.

“Chico has always been the happy-go-lucky, clown-around type,” his mother says. “After the injury, he would listen. Now he’s singing and rocking. He gets happy with it again. He’s joyous.”

Shepherd Center Helps Patients Return to Work
Shepherd Center staff members know the satisfaction and success a job can bring to a person. That’s why the hospital provides vocational rehabilitation counseling to help patients return to a productive work life.

While many patients make a successful return to work, the path to get them there can be a challenge. “One day, they’re out living their life, being active, and the next they’re rehabilitating at Shepherd Center, and they can’t do simple tasks like scratch their nose,” explains vocational rehabilitation specialist Barbara Teague.

“Sometimes, patients say ‘Oh my God. I’m never going to go back to work!, she says.’”

But Shepherd Center staff members set out every day to change the narrative for patients.

More than 92 percent of the patients discharged from Shepherd Center return to their homes and communities while the national average is 72 percent. More than half of patients with spinal cord injury who discharge from Shepherd return to work or school within five years of injury.

Shepherd Center offers a broad continuum of care, ranging from an intensive care unit to inpatient treatment to outpatient therapy to vocational rehabilitation counseling. Vocational rehabilitation specialists assess patients’ job experiences and abilities, counsel them on adjusting, improving or acquiring new skills and/or education, and assist patients in returning to an existing job or pursuing a search to find a new one.

“Most of the patients we see are looking forward to going back to work, but we see patients from different levels of educational and work experience.” Teague explains. “Some are younger and need to return to school for additional education to increase their transferable skills; some have had very physical jobs that they cannot return to, and some have jobs they can return to with the support of job coaching and/or modifications.

“It can take a while because sometimes, it’s just hard for people to think about returning to the workforce when their whole life has changed and they may (initially) be dependent on others for many basic things.” Teague adds. “But we see so much progress. It’s very motivating to hear success stories from former patients”

Vocational rehabilitation specialists help patients understand that physical and cognitive changes need not trigger an end, but rather an evolution.

In 2010, she brought her boyfriend, Jimmy. On that trip, he proposed marriage. The following year, the annual get-together moved to nearby Litchfield Beach for Jaimie and Jimmy’s wedding.

In 2012, when it came time to plan the annual summer trip, life was very different.

Just two months after their wedding, Jimmy was involved in a car accident, sustaining a C-2 spinal cord injury that left him with quadriplegia. He spent two months in the inpatient program at Shepherd Center before transitioning to the day program. He and Jaimie liked Shepherd and found the city of Atlanta agreed with them, so they decided to move from South Carolina.

“About a month after the accident, my friends asked me if Jimmy and I would be able to make the annual trip,” Jaimie says. “I really couldn’t deal with a decision like that right then. But then I thought about it for a while and decided to give it a try.”

The group rented a wheelchair-accessible house equipped with an elevator. “I thought we were golden,” she recalls. One concern: Would a power wheelchair fit in the elevator? Jaimie had a realtor visit the house and measure it. Sure enough, the elevator was smaller than the chair.

Jaimie briefly considered backing out of the trip, but they found a solution: Bring Jimmy’s manual chair. To make it fit in the tiny elevator, they had to remove the handrails and footplates each trip.

The wheelchair was just one item on a long list the Moores had to deal with on their first vacation after the accident.

“I tried so hard to make the vacation how it used to be before the accident,” Jaimie says, “but I know now that it won’t be the same. It was a hard realization.” Nevertheless, she and Jimmy are ready to head back to the beach this summer, armed with the lessons they’ve learned to make it more enjoyable. “Next time I won’t feel as pressured to make it the same as it was, and I’ll be more relaxed.”

Many former Shepherd patients who find themselves adjusting to a new normal share the Moores’ predicament: A simple vacation, once an experience of relaxation, can become an excursion into complexity.

The answer to this change is to adapt, plan and be patient. Like Jimmy, Keith Winchell, of Ocala, Fla., learned to make adjustments and manage expectations for a beach holiday. The onetime New York City police officer was injured on duty in 2007 when a car hit his motorcycle. He sustained an incomplete L-1 spinal cord injury. Two years after his accident, he and his family took their first vacation – to the Outer Banks in North Carolina.

“I was scared,” Keith recalls. “It was the first time I had been away from home after my accident. I was worried that I couldn’t still have a good time on vacation and that it would be difficult on my children.”

Thanks to a lot of planning, Keith’s experience was positive. He reserved a beach wheelchair from the local fire department so he could go all the way down to the water, and then he transferred to a boogie board in the water. He called ahead to all the restaurants and attractions they wanted to visit to make sure they were wheelchair accessible.

“I spent about eight hours on the phone and on the Internet, researching what was out there,” he says. “I wanted it to be as normal as possible, and I didn’t want to put my family out.”

One thing he would do differently is to get a wheelchair-accessible house, as the stairs proved challenging.

“It was a struggle for me to walk up the stairs,” says Keith, who has some movement in his legs and gets around with both a wheelchair and forearm crutches. “But at that time, I had to prove to myself that I could do it. I know now that if I don’t have to struggle, I won’t.”

Keith’s advice to others who might be venturing on vacation for the first time in a wheelchair is to take time to prepare. “Things will go easier if you do your homework,” he says, adding that when he calls places, he asks them everything from the width of the entrance to whether steps lead to the door to the size of the bathrooms. “You just can’t be afraid to ask questions,” he says.

Arthur Booth, M.D., is living proof that beach living is possible – and can still be enjoyable – in a wheelchair.

A retired physician, Arthur sustained a brain injury from a stroke, his second, in 1997. After spending time at Shepherd Center, he relearned how to walk with a cane. But one morning in 2007, Arthur took a fall outside of church, breaking 14 bones throughout his body. He ended up in a wheelchair again – this time for good.

He and his wife had built a house in Kiawah Island, S.C., in 1992, and in a moment of foresight, they’d decided to make it wheelchair accessible, complete with an elevator for their aging parents. Arthur is able to get around the island just fine in his wheelchair, and the nearby Sanctuary Hotel has a boardwalk that gets him very close to the beach.

Arthur knows the restaurants and attractions on the island that are easy to access, and like Keith, he advises to call ahead when travelling and be specific with your questions. “Sometimes, the person who answers the phone thinks the place is handicap accessible, but it’s really not,” he says.

He also suggests calling back a week before your trip to make sure your reservations are still the ones you need.

“I was travelling once and reserved a handicap-accessible room,” he recalls. “When I called a week before my trip to confirm my reservation, they had given it away. I had to find another hotel.”

Visiting a beach or other places outside familiar territory in a wheelchair can be daunting, especially the first time. To help with the transition, Shepherd Center’s Recreation Therapy Department offers a travel class to give patients a better idea of all that is involved when travelling with a disability, including navigating air travel and staying in hotels. A recreation therapy specialist reviews a vacation checklist with patients before they leave on their trip.

“When planning a trip, being assertive is key,” advises Kelly Edens, manager of the recreation therapy at Shepherd Center. “Don’t be afraid to ask questions, and be an advocate for yourself.” She offers these tips for those in a wheelchair who make a beach trip:

• BE AWARE OF THE EFFECTS of sand and water that can’t be felt, but can create skin sores. Wear beach or water shoes.
• SAND AND WATER CAN DAMAGE everyday wheelchairs. Most public beaches have places that rent or loan beach wheelchairs with special tires that can navigate the sand.
• MAKE SURE SHADE IS AVAILABLE to protect both you and the wheelchair from getting too hot.
• FLIP THE SEAT CUSHION of the wheelchair when not in use and/or put the chair in the shade so it doesn’t get too hot and cause burns.
• USE PLENTY OF SUNSCREEN and stay hydrated.
• BE AWARE OF HOW SUN exposure may affect your medications. The combination could cause adverse reactions.
• BRING PLENTY OF SNACKS and water to the beach so you don’t have to come and go.
• BE MINDFUL OF DAILY living routines. The things you need to do at home every day you will still have to do when on vacation.

Brock Johnson, of Myrtle Beach, S.C., used the help and advice of Shepherd Center to help him get back to doing what he loved – surfing. Brock was injured in a diving accident in May 2011, sustaining C-2 and C-6 to -7 spinal cord injuries. Initially paralyzed from the neck down, he has since regained use of his arms.

Before his accident, Brock would be on the beach three to four days a week, surfing and hanging out with his friends. During the five months he spent at Shepherd, he didn’t see any way he could possibly return to that lifestyle. But his recreation therapist introduced him to the Life Rolls On Foundation, a subsidiary of the Christopher & Dana Reeve Foundation, which helps people with a spinal cord injury to stay active through adaptive sports.

“The people at Shepherd helped me identify what I wanted to do and really encouraged me to get back out there,” Brock says.

A year after his accident, Brock participated in a Life Rolls On beach trip to Wilmington, N.C., where he learned how to surf without the use of his legs. He took what he learned back to Myrtle Beach, where he surfs regularly with the help of friends, who help him get out in the water to ride the waves back to shore.

“What I do is more like body boarding, because I can’t stand,” he says, “but it’s so great to be back.” He hopes to get an adaptive surf board that would allow him to be more independent.

Brock’s advice to others is to try new experiences or find new approaches to do old activities. “The biggest thing is knowing you can do it and not being afraid to try,” he says. “It takes a lot of planning and support. But just because you’re paralyzed doesn’t mean you can’t be at the beach and be active.”

For a list of accessible U.S. beaches, click here.

Written by Sara Baxter
Photography by Steve Jessmore

The bill, which was passed in spring 2012, appropriated $400,000 for the University of Alabama at Birmingham (UAB). The university, in turn, created the T.J. Atchison Spinal Cord Injury Research Program and the T.J. Atchison Core Laboratories. The former promotes basic research on spinal cord injury while the latter conducts clinical research.

Having his name on a bill, a program and a laboratory wall couldn’t have been further from his mind when T.J. arrived at Shepherd Center in October 2010. But shortly after he was admitted, researchers invited T.J. to participate in an early-stage clinical research trial to test the safety and efficacy of an embryonic stem cell-based therapy.

A week later, he became the first person with a spinal cord injury in the world to receive the FDA-approved therapy. Later on, T.J. and Tory Minus, a family friend from his hometown of Chatom, Ala., decided to write a book about his experience.

Then in November 2011, Geron, the company that developed the stem cell therapy stopped funding for the research, though T.J. and several other people who received the therapy continue to be followed by doctors and researchers. The findings have been inconclusive.

“I haven’t regained any function so far, but that wasn’t unexpected,” T.J. says. “The point of the surgery was to be sure that it was safe and that there were no after-effects, and so far it’s been successful.”

If anything, the experience made T.J. more determined to help find a cure for spinal cord injury. Through Twitter, Minus introduced T.J. to Roman Reed, a Californian with a spinal cord injury who persuaded the California legislature to appropriate millions of dollars for spinal cord injury research.

Eventually, Reed flew to Alabama and met with T.J., Minus and Sen. Marc Keahey, the state senator whose district in southwest Alabama includes Chatom.

“Roman told us how he got his law passed to fund spinal cord injury research in California,” T.J. says.

Sen. Keahey saw the opportunity to create a program that would help families and, as he wrote in a statement, “serve as an economic engine to the state.” He pointed out that caring for people with spinal cord injury in Alabama costs $515 million a year, and the cost of Medicaid and indigent care was another $143 million.

“T.J.’s Law,” as he called it, would fund research that would benefit people with spinal cord injury and ease the burden on the state’s economy.

His initiative was added to an education bill and passed without opposition. Minus, who is now the educational liaison and program director for the research program at UAB, says such provisions are rarely removed from the budget in subsequent years.

But T.J. isn’t taking any chances. At Reed’s suggestion, he also created the T.J. Atchison Foundation to raise money to support the UAB programs.

“I thought it would be a good idea to use it to raise additional funds so we can keep the research program in case something happens down the road,” T.J. explains.

A golf tournament was planned for April 19, and other fundraising events may include a marathon and a music festival.

To T.J., a senior nursing student at the University of South Alabama in Mobile, the responsibilities he faces are more than a little intimidating. Having his name on legislation, buildings and golf tournaments, he says, “feels surreal, especially when I got to UAB and saw my name on the wall of the research lab. It didn’t seem real to me. I don’t like being the center of attention.”

“T.J. is from a small town,” Minus says. “He’s got core values. He’s an all-American kid, who’s an avid golfer, and loves water sports and hunting. He played football and baseball in high school, and he’s president of the University of South Alabama Student Nurses Association. But he’s very humble. He doesn’t want recognition or fame. He doesn’t care for credit at all.”

But the reality of contemporary fundraising is that potential donors relate more readily to causes with someone’s name on them.

So in November 2012, T.J. presided over an open house for the T.J. Atchison SCI Research Program followed by a meeting of the Foundation’s steering committee. Among those attending were Reed, Sen. Keahey, Minus and Candace Floyd, Ph.D., UAB’s director of research for physical medicine and rehabilitation.

“It was strange to begin with,” T.J. says. “Hopefully I’ll get more comfortable with it. I’m just a college student, and everyone else there has had so much success in their lives.”

Fortunately, T.J. says, his training at Shepherd Center prepared him for something like this. “They educated me so well, and I was prepared after I got out of there,” he says. “I knew I could do everything and live an independent life. And the attitude of everyone working there was one of the best things. You never see anybody without a smile on their face. You never see someone and think they’re having a bad day.”

As for the challenges ahead, T.J. says: “I just think it’s important for us to find a cure, and the only way we can do it is by educating and letting people know what’s going on. When I finish school, I’ll be able to do more with the foundation. That’s my passion: I want to find a cure for spinal cord injuries.”

Q: Let’s start with the good news. What positives might come from this legislation?

A: There are some good things for our patients. First, insurers will no longer be able to deny coverage to someone based on a pre-existing condition. Second, there won’t be lifetime limits on health benefits. For people recovering from something like spinal cord injury (SCI), this is a big deal. In some cases, there are million dollar lifetime caps imposed, and it’s not unusual for people with high-level quadriplegia to use close to half of that on their acute care only. Then they have a lifetime of health needs to contend with. So the ability to keep your insurance and the portability of that, those changes are very positive.

Q: What are some of the challenges or unknowns?

A: The problem with the Affordable Care Act is that it’s not really health care reform; it is about finding ways to provide insurance coverage to more people. Traditionally, insurance carriers try to reduce or minimize their losses by weeding out people who would be high-cost patients. The inability to do this could create some much higher costs.

Although there are a number of alternatives out there, including expansion of Medicaid and the creation of insurance exchanges run by the state or the federal government, these programs may not really provide greater access. For example, they might have a $1,500 limit on durable medical equipment, which won’t even come close to paying for a $15,000 to $18,000 power wheelchair. The lowest-cost health insurance exchange will only pay 60 percent of medical costs. Yet someone’s bill at Shepherd Center could easily total $100,000. What are we going to do? Chase this family that has just gone through a catastrophic injury to get them to pay us $40,000? That’s just crazy, and unfortunately, we may not be able to admit some of those people into our rehabilitation program.

So it goes back to what’s going to be covered. Will the focus be on high-quality care?

Q: In what other ways might the legislation impact Shepherd Center?

A: Depending upon how it is implemented, it could have major effects on how we operate. The biggest change is the move away from fee-for-service reimbursement to value-based purchasing, and we embrace that approach. The issue for us will be whether value-based purchasing – which will more than likely take the form of bundled payments – will be adequate to fully rehabilitate someone with a catastrophic injury. These payments are often based on data from rehabilitation programs caring for 60- to 70-year-old people with a spinal cord injury for an average 18-day stay versus our unique, considerably younger patient population, many of whom are often here for more like 40 days on average.

So, as a specialty hospital that treats a very small minority of acute-care hospital patients, we must figure out how we fit into the overall system and the impact we will experience from the creation of accountable care organizations. How do we improve our value to large and small health care systems so they will include us in their continuum of care?

Q: What is Shepherd Center doing to address these challenges?

A: As always, our focus is on providing the best possible care we can and making sure folks are covered. I have been in Washington, D.C., several times and convened a group of 20 different professional associations, including physical and occupational therapists, and we developed guidelines for essential benefits.

The reality is it’s a bit of a moving target. We are doing everything we can to ensure our programs and services will be covered at an adequate rate. Our strategy is to provide the best possible care we can for the best possible price. We’re working to become more efficient – not by cutting care, but by identifying which care seems to be working the best and doing more of that. So you can look at a patient fee structure in two ways:  You can cut a bunch of costs or identify evidence-based practices that show if you do this, you’re going to get a better outcome. The latter is really our strategy.

The electronic medical record system we are implementing this year will help by allowing us to link the cost of care with outcomes to see what practices really work and in which type of patients.

Q: What, if anything, do you think patients can do in anticipation of these changes?

A: Get involved and be informed.

I saw a bumper sticker that other day that said, “I love ObamaCare.” I thought, “Well that’s great, but no one knows really what ObamaCare is.” House Minority Leader Nancy Pelosi said first we have to pass this bill, and then we’ll see what’s in it, so the majority of people have no idea what it will mean. If you ask the average person on the street, “Do you know that you’re going to be able to buy insurance in this exchange, but you’re going to be responsible for 40 percent of the bill?”, they likely don’t. But they need to educate themselves about what’s out there. There are some good things in this bill, and then there are some things that we just have no idea what the effect will be.

While the community helps Shepherd Center in several ways, two of the most significant include the Perks Partners and Community Reintegration programs. Both play a pivotal role in boosting the spirit and morale of patients and their families, who often spend extended periods of time at Shepherd. And, for patients specifically, these programs often help further their road to independence.

Sometimes the smallest gesture has the biggest impact, especially when the gesture is a win-win for all involved. Such is the case with the Perks Partners Program, says Gale Eckstein, coordinator of Shepherd’s Family Support Services. Launched two years ago, the Perks Partners Program allows Shepherd patients, families and staff to receive discounts and/or special offers from participating Atlanta businesses near Shepherd in exchange for showing their Perks Program card (and employee ID, if applicable).

“Every little thing we do hopefully lightens the load for patients and families,” Gale says. “The Perks Partners Program not only helps them a little financially, but also offers them the comfort of knowing that Shepherd’s community partners will treat them with respect as they (patients) venture out into the community.”

Perks Partners participants include florists, dry cleaners, a hair salon and restaurants such as Another Broken Egg Café (2355 Peachtree Road, NE) owned by Dana and Mignon Percival. While gaining exposure and more foot traffic certainly attracted Mignon to the program, Shepherd’s mission is what really motivated her to offer people from Shepherd a 10 percent discount and to create a culture in which she and her employees go out of their way to make everyone from Shepherd feel comfortable.

“Hearing patients’ stories,” Mignon says, “made me think about how I would want a member of my own family to be treated if he or she experienced this kind of life-changing injury. If a small discount does anything to help patients, families or staff of Shepherd, We think that’s a great thing.”

Vimal Bhakta, franchise owner of Firehouse Subs (2221 Peachtree Road, NE) says he proudly participates in Shepherd’s Community Reintegration Program, which is critical to a patient’s ability to reintegrate back into his or her community. Once a spinal cord or brain injury patient has been deemed medically ready by his or her therapy team, he or she can begin going on community outings. Depending on the severity of injury and space available, a patient usually goes on one or two outings a week.

While community outings may be considered fun, they very much serve as part of a patient’s therapy program by providing patients with real-life scenarios to practice important skills they will need in their own communities. These skills may include maneuvering their wheelchair in a crowd, managing money, feeding themselves and dealing with accessibility issues. Kelly Edens, director of Shepherd Center’s Recreation Therapy Program, says she and other therapists purposefully do not call venues in advance of outings because they want patients to become more comfortable with obstacles they might face in real life.

“Many patients are here for a long time. They love the outings because they help prepare them for when they go home,” Kelly says. “When patients face something at home, they will feel more at ease about it.”

Accompanied by recreation therapists and, occasionally, family members, patients go anywhere an able-bodied person would go – to restaurants, movies, museums, shopping, the airport and other venues around Atlanta. Some popular places they have gone are World of Coke, the High Museum of Art, Turner Field (for a Braves game), the Georgia Aquarium and Firehouse Subs, one of the patients’ favorite restaurants.

Firehouse Subs has been helping Shepherd Center since Vimal (aka Mr. Vee) opened his franchise in 2006 – first by providing sub sandwich platters for the Shepherd Shoot-Out wheelchair basketball tournament and now by providing a welcome setting for patients’ community outings. Whether it’s opening a door, bringing patients menus or moving furniture around to make the restaurant more accessible, Mr. Vee and his staff go above and beyond to make Shepherd patients feel comfortable. But they also understand enough about the process by now to know when not to help.

“We’ve been inspired by Shepherd to go the distance and do what’s right,” Mr. Vee says. “We don’t want to hinder a patient by helping them, however, so we’ve learned when to back off. We feel vested in a patient’s success also and want them to become as independent as possible.”

With programs like Perks Partners and Community Reintegration and participants such as Firehouse Subs, Another Broken Egg Café and many others, Shepherd Center can rest assured that it indeed has a community fully vested in its success.

Many of us take these things for granted. But for people living with a traumatic brain or spinal cord injury, achieving these and other life dreams may seem out of reach. Even figuring out how to access, coordinate and pay for services or equipment beyond the acute rehabilitation period can be challenging. Thankfully, Georgia’s Brain and Spinal Injury Trust Fund Commission is working to change this – all the while helping to lift spirits and enhance lives post-injury.

This unique state agency – one of 23 like it across the country – was founded in 2003 to ensure Georgians with traumatic brain injury (TBI) and spinal cord injury (SCI) are not only valued, but also have equal opportunities when they transition back to their communities. In fact, the Commission’s very existence was driven by a handful of people recovering from these types of injuries who “dreamed of an agency that understood the lifelong needs of people with traumatic injuries – one that was committed to supporting these individuals not just in the critical moments after the injury, but throughout their lives.” Today, that’s exactly what the Commission is doing with the help of experts at Shepherd Center and other partnering organizations.

Granting Financial Support to Bridge the Gap in Services
“Unless people with these type of injuries are well situated financially or have (very good) insurance, their standard of living drops,” says Craig Young, the Commission’s executive director. “We are able to give direct financial assistance to people who need it.”

In particular, the agency helps pay for necessary services and medical equipment not covered by Medicaid, Medicare or private insurance. So far, the Commission has awarded more than $15 million to more than 3,000 Georgians with traumatic injuries who were deemed eligible.

“It could be something as simple as a computer so they can stay connected with family and friends or something more significant like durable medical equipment that can raise someone out of their bed to get to the bathroom,” he says.

People apply for home modifications (e.g., roll-in showers, ceiling lifts), assistive technologies, and additional physical, cognitive, behavioral, speech therapy or personal care support services. But transportation is the most common request – and can open a world of possibilities. “If we can give someone access to a vehicle that may give them the ability to go out, get job training and resume work, that is probably the best possible outcome,” Young says.

That is something a man from Macon, Ga., recently found out. Told he would never walk again after sustaining a C-5 to -6 injury, this former athlete had plans of his own – visions of starting a wellness center that caters to people with and without injuries. Living with his mom, he yearned for his independence. He applied to the Trust Fund for assistance to purchase a van so his family could drive him to appointments and school. But after reviewing his goals, the Fund decided to pay for driver’s evaluation and training with rehabilitation specialists. These efforts helped get this man get back in the driver’s seat – putting him in control of his own transportation and future.

It’s Not All about the Money
In addition to providing grants, the Commission is intensely focused on developing a state action plan to better align services and develop community support to meet patients’ needs. By mandate, the Commission is also charged with tracking and monitoring cases of TBI and SCI to identify what resources are needed.

The Commission has implemented a Statewide Advisory Committee made up of experts from provider organizations and statewide agencies of brain and spinal cord injury services. This group makes recommendations to the Commission about the overall needs of people with brain and spinal cord injuries. Within this group are numerous sub-committees that work on the state action plan to prioritize needs. The Commission is also the lead state agency for traumatic brain injury, as mandated by the TBI Act.

The Commission’s success is due, in large part, to Shepherd Center’s continued leadership and involvement, Young says. The agency relies heavily on clinical counsel from Shepherd’s staff to help evaluate and prioritize Trust Fund applications. Staff members also serve as expert advisors on a number of workgroups, which focus on data collection, program evaluation, and the short-term and long-term needs of children and adults with brain and spinal cord injury.

“A lot of times, there are specific medical issues, and they need some guidance from us to help them understand what a certain injury does to someone and whether a service or equipment makes sense, or perhaps there is a technology we know would help,” explains Andrew Dennison, M.D., a Shepherd Center physiatrist who was appointed as a Commissioner to the Trust Fund, which is chaired by former patient J.D. Frazier.

“They’ve been such an integral partner,” Young says. “The expertise they bring to the table – caring for these patients, knowing and anticipating what they need to be able to lead meaningful and independent lives – has helped to shape the policies we have to give out grants.”

It’s also given Shepherd yet another way to make a difference and ensure the unique and lifelong needs of these patients are being considered.

“We do an incredible job in the 40 to 60 days they are with us,” says Susan Johnson, M.A., Shepherd’s director of Brain Injury Services, who has been involved with the Commission since its early days. “But there is life after a catastrophic injury. The advocacy work by many volunteers has created much awareness about brain and spinal cord injuries that have resulted in statewide changes that are improving peoples’ lives.”

People with TBI or SCI who are U.S. citizens and Georgia residents are encouraged to learn more about the Commission and whether they are eligible for assistance. Visit www.bsitf.state.ga.us or call 1-888-233-5760.

Written by Amanda Crowe, MA, MPH

FOUNDATIONS

Christopher and Dana Reeve Foundation
www.christopherreeve.org
This foundation does not give grants to individuals, but serves as a great resource for people with paralysis. Click on the “Paralysis Resource Center,” and there is information on every aspect of being paralyzed, as well as a way to find resources in your area.

Dreams of Recovery Foundation
www.dreamsofrecovery.org
When former Shepherd Center patient Cindy Donald discovered that most insurance programs wouldn’t cover the cost of Shepherd’s revolutionary Beyond Therapy® program, she decided to take some of the money that had been donated to her to pay for a friend’s therapy. Out of that gesture, the Dreams of Recovery Foundation was born. The foundation now gives grants of up to $15,000 to pay for therapy programs not covered by insurance, equipment for the improvement of everyday life and grants to institutions for research.

Travis Roy Foundation
www.travisroyfoundation.org
A year after former Shepherd Center patient Travis Roy was paralyzed from the neck down while playing in a collegiate hockey game, he started a foundation to help others with spinal cord injuries improve their quality of life through adaptive equipment. The Foundation raises about $500,000 a year and makes 70 to 100 grants annually, ranging from $1,000 to $7,000 to provide adaptive equipment, such a voice-activated software, ramps and stair platforms.

Brain and Spinal Cord Injury Trust Fund Commission
www.bsitf.state.ga.us 404-651-5112 or 888-233-5760
Created by a Georgia constitutional amendment, the Trust Fund for Brain and Spinal Injury is designed to provide for things that are not covered by private insurance, Medicaid or Medicare, and funds are provided only once all other means of payment have been exhausted or refused. Outstanding medical bills, medical insurance premiums and medication costs are not eligible for a grant, but things like physical, cognitive and behavioral therapy, adaptive equipment, tutoring, caregiving, vehicle modifications and home modifications are eligible. Application guidelines are available on the website.

To get a broader list of foundations that give grants to people with disabilities, visit the listing on the Foundation Center’s website at foundationcenter.org/getstarted/topical/disabilities.html.

FUNDRAISING OUTLETS

HelpHOPELive
www.helphopelive.org or 800-642-8399
Formerly NTAF, works with families and volunteers throughout the United States to start successful fundraising campaigns for people who are facing a transplant or have sustained catastrophic injuries. Funds raised are tax-deductible and are sent to and held by HelpHOPELive in regional restricted funds. Disbursements are then made to the individual to pay for uninsured medically related expenses, such as specially equipped vans and durable medical equipment, home modifications, home health care services, physical therapy and insurance premiums and co-payments.

MedGift
www.medgift.com
Medgift is a combination social networking site and gift registry for patients and people who care about them. Patients can set up a personalized home page, share updates and provide a gift registry of needs. Contributors can pay for hospital expenses and other needs and wishes. Patients can also ask for non-monetary gifts, such as babysitting, prayers, transportation and visits.

Fundly
www.fundly.com
Fundly is an online fundraising management website for political campaigns, nonprofits and individual fundraisers. Like MedGift, individuals can set up a customized fundraising page and promote the campaign through Facebook, Twitter and email. Fees are based on a percentage of the donations.

OTHER RESOURCES

Home Modifications
The Council for Disability Rights lists fundraising sources for home modifications at www.disabilityrights.org/mod3.htm. There is also a downloadable PDF of home modification resources available on the Reeve Foundation website.

Transportation
www.nmeda.org or 800-833-0427
National Mobility Equipment Dealers Association (NMEDA) is a nonprofit trade association of mobility equipment manufacturers, dealers, driver rehabilitation specialists and other professionals dedicated to improving the lives of people with disabilities and assisting with driving independence using wheelchair-accessible vehicles.

Community Trusts
When considering a special needs trust to protect government eligibility, it might be beneficial or necessary to put funds into community or pooled trusts, rather than an individual trust. In many cases, these trusts can provide comprehensive special needs trust services, including service as a trustee, co-trustee or trust administrator. Here are a few that provide those services:

• Georgia Community Trust: www.georgiacommunitytrust.com
• Family Network on Disabilities: www.fndfl.org
• Secured Futures: securedfutures-snt.org
• The National Foundation for Special Needs Integrity: www.specialneedsintegrity.org

Written by Sara Baxter

“That’s when I learned why I was there,” she says.

Victoria, now 24, of White, Ga., was injured in July 2009 when a horse she was bathing reared and yanked a hitching post from the ground. The post struck her in the head, and when she fell, her head struck the concrete floor.

She spent three days in a coma and 10 days in intensive care before transferring to Shepherd Center, where she completed inpatient rehabilitation and two months of outpatient therapy at Shepherd Pathways, the hospital’s post-acute rehabilitation program.

Throughout her therapy, Victoria’s intention was to return to the University of South Carolina, but in her first year of rehabilitation, she attended a college close to her home so she could continue her therapy.

At first, she had a hard time adjusting. She says, “I thought, ‘I can do whatever I want.’”

But she had lost control of her left side and had difficulty walking. She also found she could only run for 15 seconds on a treadmill. But her therapists at Shepherd kept pushing her, and now, she’s grateful for it, she says.

By the time she returned to the University of South Carolina in 2011 and rejoined the equestrian team, her fitness level was much better and so was her ability to adjust to the changes in her life. Although an indifferent student, Victoria thrived upon the support of tutors and academic specialists and the encouragement of her teammates.

“They all wanted me to do well,” Victoria says, “so I wanted to do well for them.”

Victoria was fortunate to be enrolled in a university that supported her transition back to school. Colleges and universities that receive federal funds are required by the Americans with Disabilities Act to accommodate people with disabilities. Michell Temple, interim director of the Office of Disability Services at Georgia State University in Atlanta, says that usually means giving students extended time on tests, allowing them to use note-taking services and books in alternative formats.

“We try to create an environment that is acceptable and inclusive,” Temple says. “We want all students, regardless of background, race, ethnicity or disability to complete college. We want our students judged on their abilities, not their inabilities.”

The key, Temple says, is that the students themselves must be willing to acknowledge their disability and tell the university what they need. Professors are generally receptive to such requests, but sometimes need help understanding.

“Because brain injuries are invisible, there’s usually a learning curve for them,” Temple says. “It’s not that professors resist it. They may not understand. Very rarely does a professor refuse to provide approved accommodations.”

Now graduated with a degree in marketing, Victoria says she has a new perspective on life. “I don’t sweat the trivial things so much,” she says. “I wanted to figure out who I was, and I’m very happy with who I am today.”

Victoria even used her injury as an asset after graduation, telling prospective employers: “I can work hard and here’s proof: I’ve been to hell and back.”

Written by John Christensen
Photography by Gary Meek

“It was heartbreaking,” says Tim, the chief of the Statesboro Fire Department. “I honestly didn’t think we were gonna get him back. My first thought was, ‘He’ll never be able to come back to fightin’ fire.’”

That was in May 2011, shortly after Lamar sustained a traumatic brain injury in a traffic accident while in New Jersey. But over the next several months, the city, Tim and Lamar’s fellow firefighters went out of their way to support him. Tim and three other firefighters drove to New Jersey to help, and while Lamar was undergoing rehabilitation at Shepherd Center, his co-workers donated their sick time so he could continue to receive paychecks. They also paid for a wheelchair and hotel rooms, and constantly supported Lamar and his family.

The questions were: Would Lamar learn to walk again and process information and be fit enough to return to a job that demands a high level of fitness, clear thinking and the ability to act quickly? Could he be relied upon when his life and the lives of others were at risk?

Returning to work from a brain injury isn’t always an option, and it’s seldom easy even when it is possible. Debbie Page, a vocational rehabilitation case manager at the post-acute rehabilitation program Shepherd Pathways, says Shepherd Center is the only hospital she knows of that has a vocational rehabilitation program, which actually manages the patient’s return to work.

And it’s been remarkably successful. Of 267 recent Shepherd patients who were employed or in school before their brain injury, 128 returned to work or school within a year.

“We’ve been successful with police officers, firefighters, physicians, CEOs and almost any other occupation you can think of,” Page says.

In many cases, Shepherd Center therapists even accompanied clients back to work to help with their transition.

“Most people are left to work it out with their employers themselves,” Page says. “But it’s very difficult to get back to work without help. Employers don’t know what to do, and they are so relieved that someone is coordinating a person’s return to work.”

Lamar’s initial challenges included loss of strength in his legs, poor balance, slow reaction time, anxiety and high blood pressure.

Medication calmed him, and Shepherd’s therapists, he says, “inspired me to do so much work so I could have a full, normal life with my family and two active boys. They’re awesome. Their whole setup is awesome. I really appreciate what they did. It was one of the most humbling experiences of my life to go from the active life of a firefighter to being almost helpless. I thought I would never return to work or be even close to where I am now. I am truly blessed.”

Lamar returned to work in spring 2012 beginning with a half-day of administrative duties. His schedule gradually increased until he was back working a full week, but not yet fighting fires. After a final visit to Shepherd Center, however, he was cleared to climb ladders and fight fires without restrictions. And shortly after his return, he and another firefighter rescued a man from a burning building.

“That made me feel good about my job,” he says. “I knew I was as good as before.”

Written by John Christensen
Photography by Jeremy Wilburn and Gary Meek

Q: Why did you decide to become a doctor and then specialize in physical medicine and rehabilitation (PM&R)?

A: My interest in medicine began due to my interest in science. I thought about becoming a physician, but I also wanted to be an English professor. I kind of view myself as more of a humanistic person. I was always interested in arts and letters. As an undergraduate, I took a lot of science classes, but also took philosophy and political science classes. I’ve always had broad interests and maintained that throughout my career.

After college, I went into medical school not knowing what specialty I wanted to pursue. Then I was referred to a PM&R doctor about some back pain I was having, and that was a good experience. I thought about becoming a PM&R physician who treats back pain, but then I got some early experience with inpatient rehabilitation. That patient population was very compelling to me. There is a lot of dire need. It is very rewarding to be able to help patients who need neurologic rehabilitation.

I am drawn toward the brain injury patient population in particular because I grew up with an older sister with a mental disability. I was always protective of her. There were some difficult situations in which people made fun of her in school.

In addition, I am drawn to brain injury rehabilitation because brain science is one of the most interesting areas in medicine today. So much remains to be known, and I hope I can contribute to the field. There is a lot of uncharted territory in the practice of brain injury rehabilitation. A lot of what we do is more experimental in nature in the sense that each patient is treated based on his or her own unique constellation of injuries.

At Shepherd Center, we get a lot of complex brain injuries with effects that are sometimes unpredictable. Typically, there are a handful of diagnoses yet to be made once a patient arrives here. I appreciate the educational aspect of my job in terms of explaining the neuropathology of the injury to the patient and the family, and to provide them with advice for how to cope. I have a body of expertise because I’ve seen so many of these patients, and I enjoy relying on that experience to offer the best available treatments to my patients.

Q: From the patient’s standpoint, what qualities make you an excellent physician?

A: By nature, rehabilitation physicians see their patients for weeks or several months. We care for them during the entire course. It’s a unique field of medicine that makes it possible to treat patients at a high level for such an extended time.

I rely on this time with my patients and their families as my number one advantage. I focus on building therapeutic relationships with patients and families. That is key in rehabilitation. There has to be a sense of trust on both sides, and I work to build that.

Also, I try to stay open-minded in my patients’ treatment plans. As you become an expert in treating a particular condition, it’s easy to start seeing your way as the only right way and neglect other ways. But I remain open to the input of families and therapists. Sometimes, the families are effectively additional nurses for the patient. I appreciate that rather than push back from it.

Q: Shepherd Center is known for some distinctive approaches to the practice of rehabilitation medicine. What aspects are most professionally rewarding to you and effective in producing excellent patient outcomes?

A: Shepherd Center has so many more additional resources than the average rehabilitation hospital, which is trying to make do on insurance payments alone. Those resources include our dynamic therapeutic recreation program and our well-integrated psychological services, which are very important to patients and families. Also, I really appreciate that our nurses are only following four to five patients versus the six or seven that is common elsewhere. This level of nursing attention, which is a big investment for the Center, allows our nurses to know their patients and families better and serve them better.

As an attending physician at Shepherd, I have relationships with a wide array of consulting specialists that allow me to expand the services I can offer to my patients during their rehabilitation course. It allows for more continuity of care and more comprehensive care. For example, at most freestanding rehabilitation hospitals, a patient would have to be transferred back to an acute care hospital for surgery. But here, because of Shepherd Center’s relationship with Piedmont Hospital and other facilities, we can get an expert opinion, determine an intervention and often get a procedure done the same day. Then the patient comes right back to Shepherd Center for post-op care, in our ICU if necessary. Keeping more of our patients admitted here continuously, no matter what has to be done, allows us to capitalize on the limited time we have for inpatient rehabilitation.

Q: How do you offer hope to patients at Shepherd?

A: By now, I’ve seen most every type of injury before. I’ve seen people of different ages and levels of injury severity and they have come through it. I am able to see through what seems like insurmountable challenges at the time. I’ve seen patients in follow-up appointments one or two years after the injury, and they are continuing to make remarkable gains. I’ve seen people who were in a vegetative state for several months, and they have recovered to the point of returning to college. Of course, we cannot guarantee that, but it does offer grounds for giving hope to patients and families.

Q: What should brain injury patients and their families keep in mind as they start their recovery journey?

A: One of the most important factors for success is not seen on a brain scan. It’s really the family structure and the strength of the patient’s relationships with family and friends. Frankly, brain injuries strain people to a breaking point. And just as an injury damages parts of the body, it can damage relationships – if not in the beginning, sometimes months or years later. People need to be prepared as much as possible that this will be the most trying period of their lives in terms of their relationships with their loved ones.

Their loved one’s perception of the world and aspects of their personality may change. Families and friends need to be as forgiving as possible as the patient recovers. Sometimes, it may seem too much to ask, but typically the turbulence calms at some point. Still, families and friends must recognize the storm they’re going through may last for months or years. The people who are most successful in the end are those who have made a commitment to stick by their loved one at all costs.

Q: What have you learned about yourself and others in the process of treating people with brain and/or spinal cord injuries?

A: My work provides a daily reminder of what’s important in life, which is other people. I’ve seen people struck down in the midst of high-powered careers. They were young and healthy. As someone who is dedicated to his career and is relatively young, this experience keeps my head screwed on straight. I view my profession as a calling, but I must still recognize that it’s just one aspect of who I am. The most important thing is the people who love me.

Q: What promise does the future hold for improved treatments for people with brain injuries?

A: While I frequently use neurostimulant medications to help my brain injury patients move forward during the rehabilitation process, as a physical medicine doctor, I am always particularly interested in physical treatments. Those include the range of treatments like, heat, cold, electricity, bracing and prosthetics that rehabilitation medicine began with back in the 1940s.

It’s actually in this rather old-fashioned area of physical medicine where we are seeing the beginning of a new way to rehabilitate the brain – by selectively stimulating its injured and uninjured parts with electric current. We’ve moved a long way from electroconvulsive therapy thanks to advancements in technology.

The most promising treatment, which we are learning more about through waves of studies coming from labs all over the world, is repetitive transcranial magnetic stimulation (TMS). This is an already FDA-approved technology being used now by psychiatrists for treatment-resistant depression. With TMS, we can selectively target fairly discrete areas of cortex. In rehabilitation studies, we are finding that inhibitory frequencies of TMS applied to undamaged brain areas opposite of damaged brain areas allow the damaged brain to function better.

For example, aphasic patients (those who have speech disorders because of brain injury) have been shown to communicate better when the area corresponding to the speech zone on the opposite side of the brain is stimulated with inhibitory frequencies of TMS. I and the other brain injury specialists at Shepherd Center are paying close attention to technologies like this, and as soon as we believe they are safe and effective for our patient populations, I am certain we will be among the first centers employing them clinically.

Q: Describe your interest and involvement in medical journalism.

A: I’ve enjoyed writing really ever since I learned how to type! Given my interest in science, medical journalism is a career path I considered in college, and it occurred to me back then that I might have better access to my subject matter, and better stories to tell, if I was a doctor myself.

I can also recall a speaker at a college career day sharing his frank views about how competitive science writing had become at that time. The idea of writing about medicine from the inside perspective certainly ranked low down there on my overall list of reasons to become a doctor, but I was aware of the advantage I’d probably have in terms of scoring writing gigs and getting published.

All of my early suppositions have proved to be true, so I have to thank the 19- or 20-year-old me, and that career day speaker, for the swell advice to my future self. Today, I have relationships with several national outlets for my science writing, most especially The Atlantic, where I am a correspondent for TheAtlantic.com.

Written by Jane M. Sanders

The sad truth is that most families are unprepared for the harsh financial consequences of such an injury. Insurance policies typically cover several weeks of rehabilitation care, but the average stay at Shepherd Center is nearly six weeks.

“Generally speaking, there is a mismatch between the costs of catastrophic care and the insurance coverage people have to cover those costs,” says Mitch Fillhaber, Shepherd’s vice president of managed care and marketing. “As a result, people are surprised to find out what catastrophic care costs.”

Further complicating the issue is the gap in coverage for related costs such as caregiving, ongoing therapy, adaptive technology, home modifications and transportation. So patients and families have to think creatively about how best to generate funds to help cover costs – and how to make sure every available dollar is spent in the smartest way possible.

Creative fundraising often begins at the local level – with patients and their families and friends organizing community support. Former Shepherd patients tell stories of receiving funds from golf tournaments, bike rides, carnivals and other fundraising events held in their honor. Contributions take the form of cash or equipment. Several nonprofit organizations and social networking sites exist to help people generate and accept donations (see sidebar article).

Foundations and nonprofit organizations can also be a resource to help cover expenses. Former Shepherd patients Cindy Donald and Travis Roy have set up foundations that provide grants for equipment and therapy. Other foundations around the country do the same. The challenge is to conduct thorough research to identify a match between a foundation’s focus and the patient’s need.

Finally, government assistance can add support in the form of Supplemental Security Income (SSI) and Social Security Disability Income (SSDI), and through Medicaid and Medicare. People with disabilities who have very minimal income and resources may qualify for Medicaid and SSI, and those who have been gainfully employed and paid into the Social Security system may qualify for Medicare and SSDI.

In most cases of catastrophic care, patients must rely on some combination of public assistance and help from other sources, such as personal income, donations or grants. The added irony: One can cancel the other out. For example, if a patient’s assets from any source – grants, donations, settlements, inheritance or other – exceed $2,000, then Medicaid and SSI benefits can be lost.

This means that if a person is on Medicaid and SSI and receives an outright distribution of settlement money from a lawsuit or from a fundraiser or grant, he or she loses SSI and Medicaid government benefits. The same is not true for Medicare and SSDI, however. Those benefits are not “means tested,” meaning they are not constrained by income thresholds.

Thus, identifying techniques that maximize the value of every dollar is crucial. One way to protect means-tested government benefits is to set up a special needs trust (SNT), which provides financial support to individuals with disabilities while allowing them to remain eligible for public benefits. Funds placed into the trust aren’t counted as an eligible resource and can be used to cover medical costs and other quality-of-life expenses.

“Patients who become eligible for Medicaid and were injured because of the fault of someone else, or those who have community support, should consider asset protection through a special needs trust,” says Liz Schoen, Shepherd Center’s former general counsel. SNT funds can generally be used for everything except food and some shelter items. “That could include Shepherd’s Beyond Therapy^® program, recreational therapy, a modified vehicle, even a trip for the patient and a caregiver,” Schoen explains. “The trust supplements what government programs won’t pay for.”

Special needs trusts generally fall into two categories depending on whether the trust is funded with assets of the trust beneficiary or someone else. First party SNTs are funded with assets that legally belong to the beneficiary. The trust is irrevocable, meaning it can’t be revoked or terminated, and the beneficiary must be under the age of 65 and classified as “disabled” under the Social Security Administration definition. If funds remain in the SNT after the death of the beneficiary, they must first be used to reimburse Medicaid for all benefits paid out during the beneficiary’s lifetime.

A third party SNT is funded by assets that don’t belong to the beneficiary, such as those from a family member, friend or money raised through fundraisers. Also irrevocable, third party SNTs do not give Medicaid any claim to remaining trust assets upon the death of the beneficiary.

While SNTs help protect funds, they can be complex. “Many lawyers don’t know how to set these up,” says Kristen Lewis, an attorney at Atlanta firm Smith, Gambrell & Russell who specializes in estate planning and SNTs. “It is imperative to find counsel who is experienced in this complex area and who knows the proper language to include in the trust document.” The trust document, she explains, details how the SNT assets can and cannot be used, and it must adhere to ever-changing Social Security Administration regulations.

A trustee, appointed in the trust document, is needed to administer and manage an SNT. “A trustee can be an individual, attorney or corporation, such as a bank,” explains Bill Frazier, senior vice president of SunTrust Bank, who oversees a national division handling SNTs. “When choosing a trustee, you need to make sure it’s a good fit from an economic, investment and skill set standpoint. Trustees need to be knowledgeable in special needs trusts.”

Another option for those whose assets may be more modest is a pooled SNT trust. (See the sidebar article for a list of those types of trusts.)

Georgia’s Department of Community Health (DCH) must approve each SNT application in the state, and the DCH turns to HMS Government Services, a private firm, to review applications. William Overman, who directs Georgia’s trust unit for HMS, says once the trust is established, his office tracks the accounting, making sure all disbursements are within the law.

“We look at every single SNT application to make sure all the legal requirements are met when the trust is set up,” Overman says, “and then we review it each year.”

Because closing the gap between cost and care affects the quality of life for patients, Shepherd Center is working to become a greater resource in this area.

“Right now, the legal team at Shepherd can help patients with powers of attorney and advance directives,” Schoen says, “but the hospital wants to do more to help protect our patients. In the future, Shepherd Center hopes to bring in experts such as Kristen Lewis, Bill Frazier and Bill Overman, who can explain special needs trusts and direct patients and their families to people who can help.”

Written by Sara Baxter
Illustration by Justine Beckett

Their son, Bruce Stein, M.D., sustained an incomplete C-3 spinal cord injury in December 2011, and the family has spent countless hours at the facility since as he has undergone rehabilitation for quadriplegia.

The Steins made a contribution to Shepherd not only to honor the work done with their injured son, but also out of respect for the hospital’s rehabilitation professionals as human beings.

“We had knowledge of Shepherd Center for many years,” Howard says. “The staff members are wonderful people, and now we feel very close to them. These are people we would like to know better. They run a wonderful institution in helping others.”

Howard and Irene have made multiple charitable donations to Atlanta institutions since moving to Atlanta in 1976. The Brooklyn natives are very involved at the High Museum of Art, where Howard is a life member of the Board of Trustees.

They have admired the passion of Shepherd Center staff members in working with their son, who recently progressed to using a walker.

“They integrate all of the needs of the patient so they can get back to as close to normal as possible,” Bruce says of Shepherd Center. “I go five days a week for neurorecovery work. My hands are getting better use. I can use an iPhone and feed myself in a limited fashion. I hope to get back to my practice, although I won’t do surgery again.”

Howard and Irene, who will celebrate their 65th wedding anniversary in February, enjoy traveling and collecting art. They’ve added friends at Shepherd.

“Bruce had the most serious type of damage to his spine,” Howard says. “He was a very athletic type, and he’s doing everything in his power. He has made progress. Not every day is a good day; that goes without saying. We take care of Bruce. He needs help. He still has his office, and hopefully one day he will return to work.

“We’ve got to pray and hope,” Howard adds. “We have a strong relationship with the High Museum, and we hope that we can build the same with Shepherd.”

“I don’t even think I’m going to take it out,” says Albert, 31, of Washington, D.C. “It’s just something that happened. I don’t look at it as a bad thing. I just look at it as a life-changer.”

Life changed for Albert on April 13, 2012 at the Rite-Aid drug store he managed in D.C. He complied with an intruder’s demand that he open the cash drawer, but Albert was shot anyway. The bullet ruptured his spleen, nicked a kidney and sprayed bone debris into his spinal cord. (The robbery was caught on video, and police arrested a suspect soon afterward.)

A T-11 incomplete spinal cord injury paralyzed Albert from the waist down. After receiving acute care at Washington Hospital Center, Albert’s workers’ compensation carrier referred him to Shepherd Center. He was admitted on April 25, and attentive care started within minutes of his arrival, he recalls.

“I met doctors, nurses, therapists, the counselor who then saw me every day,” Albert says. “I’m lying in the bed, and I’ve got probably eight to 10 people in my room with me. Everybody introduced themselves and put their name on the board. That stuck with me right there because it let me know I was in a caring facility.”

His treatment began with therapists stretching his legs. He couldn’t feel anything, but on the third or fourth day, there was a “flicker” in his right thigh.

“I didn’t see it, but my occupational therapist saw it, and my aunt saw it,” Albert says. “I was like ‘What happened?’ and I looked down and saw it. I was like ‘Wow!’ That put a smile on my face.”

He learned to use a wheelchair, but he was determined to walk. He tackled that goal in Shepherd’s day program, moving to an apartment in the adjacent Woodruff Family Residence Center with his mother just a month after arriving at the hospital.

Before long, Albert was on the parallel bars doing what he calls “the Frankenstein walk.” He started walking slowly and stiff-legged like the movie monster because of long braces to help support his weight. And like the monster, he got an electrical boost from an electrical stimulation device called the Bioness L300 Plus.

“I have electrodes connected to my right leg – two attached to my thigh and a sensor in my left foot,” he explains. “So when I take a step with my left foot, it knows my right foot is back. It knows to trigger the electrode to tense the muscle.”

With the mechanical and electrical help, plus a therapist behind him to help move his legs, he made quick progress. In three weeks, he graduated again to Shepherd Center’s Beyond Therapy^® program, commuting from an apartment he shares with his mother less than a mile from the hospital.

His fianceé, Elysia Morgan, is in graduate school in California, so he has had to rely on two visits and many video chats with her and their 1-year-old daughter, Aaliyah.

“I was at first very apprehensive about being so far away from him,” Elysia says, “but the staff at Shepherd Center has been an extended family to him. They’ve embraced us and our daughter.”

Albert got a boost in the summer when his 11-year-old son, Jeline, and 10-year-old nephew, Daevian Grinnage, arrived from Washington for a long visit. The family went to Six Flags Over Georgia to celebrate Albert’s 31st birthday in July 2012. At Shepherd, the boys helped Albert do his exercises.

He could see constant progress. When he entered Beyond Therapy^®, he could use a walker for “maybe seven or eight steps, and I was done.” By October 2012, he was using a walker with no hands-on assistance from a therapist. The electrical stimulus continued, but he estimated “the quads on my left are pretty much 100 percent, and the quads on my right are probably 70 percent.”

He was thrilled on the day he could walk from one end of the Shepherd Center basketball court to the other, he recalls.

Albert misses home and family, but he is determined to stay in Beyond Therapy^® as long as his improvement continues. He says Rite-Aid has promised a job when he can return. And he has started looking at coursework to finish his college degree.

Career goals and motivation are important in tailoring each client’s therapy, says Heddi Silon, director of workers’ compensation care at Shepherd Center.

“He’s a strong, very motivated, independent man,” Silon says of Albert.

He has kept the resolution he made to be strong when he saw the shocked expressions of family and co-workers in the intensive care unit on the day of the shooting.

“My whole outlook was, I’m still here, I’m still alive. I’ll beat this. I’ll be back 100 percent, no doubt,’” Albert adds.

Written by David Simpson
Photos by Louie Favorite

“I remember when I was an attending at the VA, I had to amputate a diabetic patient’s gangrenous leg below the knee,” he recalls. “I met with the family prior to the procedure, and they could see I was tearing up. It wasn’t something I wanted to do, but it ultimately would save his life.”

Dr. Cuppels faced his own tragedy in 2010 when he sustained a complete T-10 spinal cord injury (SCI) in a fall. Paralyzed from the waist down, he suddenly found himself a patient.

After completing his rehabilitation at Shepherd Center, Dr. Cuppels was eager to return to work. But, even though he had full use of his upper body, he says the orthopedic practice that hired him told him they could not keep him on after his injury.

“When I was recovering, I assumed my job would be waiting for me, but they didn’t accept me back,” says Dr. Cuppels. “I told them ‘My hands and my head still work,’ but they had already decided, so I had to start looking for a job.”

At a crossroads, Dr. Cuppels not only faced the challenges of adjusting to everyday life, but his life’s work and passion suddenly seemed beyond his reach. However, the kindness and ingenuity of a few strangers soon would help change this.

In the doctor’s quest for job prospects, a team of biomedical engineering students at the University of Wisconsin-Madison heard about his story. They decided to take on Dr. Cuppels’ case and build what they call a standing paraplegic, omni-directional transport, or SPOT device.

“We are trying to give Dr. Cuppels his life back,” says researcher James Madsen. “Getting him back into the operating room will make a huge difference for his wellbeing and sense of independence.”

They believe their one-of-a-kind design will allow Dr. Cuppels to safely and comfortably maintain a standing position so he can again move quickly and precisely during surgical procedures.

How it Works
Commercially available standing chairs either have a front wheel, mid-wheel or back wheel design, so there is no way to move sideways – something that would hinder Dr. Cuppels’ ability to move swiftly and smoothly in the OR. With this new system, the students say he will be able to move in any direction. That’s because it is outfitted with four wheels controlled by four independent motors, giving him full range of motion.

“He can move forward, on a diagonal, sideways. He can rotate in place. Nearly every movement you can think of is possible,” says Bret Olson, an undergraduate student, and design team member.

There is a standing mechanism that will allow Dr. Cuppels to transfer from his wheelchair and a hydraulic pump to move him into the standing position. He will be able to control his movements with a joystick and a computer interface that will allow him steady use of both hands during procedures.

The team has spent much of the past year making sure the device fits Dr. Cuppels’ needs and integrates safety features. For example, the researchers are making sure the platform doesn’t tip over as Dr. Cuppels leans over. An in-person test session in Wisconsin in November 2012 allowed the team to make further modifications, but they otherwise talk during a weekly session on Skype – something that continually reenergizes the researchers, they say.

The Importance of Technology
“We know technology is hugely important at different stages of SCI rehabilitation,” says John Anschutz, manager of the Assistive Technology Center at Shepherd Center. “Individual patient needs are often what inspire the most innovative and creative technology.”

Dr. Cuppels’ desire to get back to the operating room and care for patients has inspired the team.

“They have taken such care with this project. It’s really amazing,” Dr. Cuppels says. “It renews my faith in people. I feel lucky and blessed.”

And, as Anschutz adds, it’s not just creating a device that moves. The prototype needs to be fashioned to Dr. Cuppels, remain stable as he leans over the operating table and support the fine precision of a surgeon’s hand. Of course, making sure the platform fits the operating room presents its own set of challenges.

The team has tried to anticipate these challenges. For example, they have asked: Will it fit through doorways, is it the right height and will other OR equipment get in the way? They have examined whether the device follows FDA regulations and can be easily sanitized in between cases.

Of course, other issues are bound to arise as the prototype is tested in the OR. Madsen says that, as with other bumps along the way, they will persevere. He and the team are hopeful their creation will eventually help people with paraplegia in other jobs, as well.

“They have done a phenomenal job,” Dr. Cuppels says. “They’ve talked to people in ORs to ensure the device will comply with strict regulations. They have called companies to secure donations. Even if this doesn’t become the first paraplegic robotic surgeon per se and I’m at square one, I think these guys have created something that crosses a lot of boundaries. I hope it will encourage others with SCI to consider medical school and even surgical careers. The device may also benefit people in other occupations where they need this level of precision.”

The prototype costs around $13,000, which has been partly supported by donations from companies.

For the students, the project lets them apply what they have learned to a real-world setting and know they are helping someone. For Dr. Cuppels, it provides hope that he will return to work.

For more information, view this University of Wisconsin-Madison video on the project.

Written By Amanda Crowe, MA, MPH
Photography By MARK RIECHERS, UW-MADISON COLLEGE OF ENGINEERING

MADISON, ALA.

Arash Iranmanesh, 25, of Madison, Ala., had fainted a few times before Halloween 2008. “I had a few episodes before, but they weren’t a big deal,” he says. “A little confusion, but nothing else. I just got back up.”

On Oct. 31, 2008, Arash passed out again – this time after playing basketball with friends at the University of Alabama’s recreation center in Tuscaloosa. He slipped into a coma after falling when he passed out. The prolonged period of time without oxygen led to an anoxic brain injury.

“I don’t remember anything from that night until Nov. 25,” Arash says. “Halloween to Thanksgiving.”

After receiving several weeks of acute care, he entered Shepherd Center’s inpatient brain injury rehabilitation program. “I was learning how to walk, how to talk, how to eat,” Arash says. “I was really starting over.”

He continued his recovery in Shepherd Pathways’ outpatient rehabilitation program before returning home. Adjusting to a slower pace to allow his brain to continue to heal at home was difficult. “I had been in college where you’re doing stuff all the time,” Arash says. “Class, sports, going out with friends. Even at Shepherd, you’re doing stuff every day, working to get back. Once you’re released, it’s a lot of downtime. A lot of sitting around, waiting as you continue to heal.”

Arash feels like he finally returned to his life in January 2012, when he enrolled in a biology course at the University of Alabama at Huntsville. Having lost his ability to read because of his brain injury – “it’s like a type of dyslexia that keeps me from putting letters into words and words into sentences” – Arash uses auditory textbooks now. This past fall, he took two classes and decided to major in biology.

“Going back to school has been great,” he says. “Being active again. Simply going from doing nothing to doing something just makes your whole life more meaningful.”

Michael Toyryla

SPENCER, N.Y.

Michael Toyryla (pictured below at left), 36, of Spencer, N.Y., never felt the chilly water of Cayuga Lake the day he nearly died. Mike’s grandfather had passed away Easter weekend 2010, and relatives had gathered at an Ithaca, N.Y., lakehouse to celebrate his life.

It was unseasonably warm, and Mike’s wife suggested a leap in the cold lake one day. “I didn’t realize the lake level was so low before I dove in,” Mike says. The impact “turned everything off, like a light switch,” he recalls. He couldn’t breathe or move. Family members rushed in, keeping him stable in the numbing water until a medical helicopter arrived. The cold kept his swelling down, but he sustained an incomplete C-5 to -6 spinal cord injury, leaving him with quadriplegia.

Mike’s rehabilitation brought him to Shepherd Center for three months. “When they opened the doors, I knew I was in good hands,” he says. “It seemed like they were asking the impossible some days, but as you start seeing results, you start trusting them more.”

Mike was a working musician before the accident, performing in a pair of bands. He doesn’t have the finger dexterity to play guitar as he did before. Mike’s oldest son has inherited most of his guitar gear. “He’s got my amps, my guitar collection,” he says with a laugh. “It’s worked out pretty well for him.”

Two things Mike can still do well are writing music and singing. He can stand for a two-hour show again and can sing what he writes for his pop project, the Tijuana Danger Dogs. The band recently released a five-song EP on iTunes and is promoting it through their band’s Facebook page (www.facebook. com/49dogs).

“The energy and response from the crowd in that first show after the injury was such a rush,” Mike says. “I’ve been a musician since I was a kid, and it was the coolest thing to feel that sensation again.”

Deborah Krupp

ROSWELL, GA.

Deborah Krupp, 56, of Roswell, Ga., knew she wasn’t going crazy. She’d begun having seizures after switching medicine for diabetes. Doctors told Deborah she was epileptic. Deborah’s eyes became so light-sensitive that she wore multiple pairs of sunglasses and a hat outside. She lost her job.

“I started seeing a psychologist. I knew something was wrong, but I couldn’t figure it out,” Deborah says. “Am I going nuts? Am I sick, or what?”

A neurologist referred Deborah to Shepherd Center. She was diagnosed with hemiplegic migraines, trigeminal nerve damage and impaired speech due to aphasia. She had also experienced a mild stroke. Proper medication helped Deborah manage her migraines. Blue-tinted glasses provided eye relief.

“The Shepherd staff called me their Humpty Dumpty and said they were putting me back together again!” she says. “Nobody else took the time to examine me the way they did at Shepherd. They really saved my life.”

She did biofeedback therapy and acupuncture. Today, Deborah goes to the Shepherd Pain Institute for weekly pain-management classes for breathing techniques, yoga and meditation.

During rehabilitation, Deborah began designing jewelry. With the help of her husband and friends, Deborah opened a jewelry business called GemAssist (www.gemassist.org). Part of her profits goes to Shepherd Center to support brain and spinal cord injury research.

“I wanted to create something that would educate people,” she says. “So I made a brain-injury awareness pendant.” Deborah gave one to Shepherd’s co-founder, Alana Shepherd, who provided space in the Shepherd Apothecary, where Deborah could sell them.

“Wearing this is like the pink ribbon is to breast-cancer awareness,” she says. “I want to make this a national symbol of hope for people with brain injuries.”

Michael Leitson

ACWORTH, GA.

Michael Leitson, 23, of Acworth, Ga., didn’t understand what was happening. A mild headache had turned into something more. Blurred vision. His right arm felt asleep. When his speech began slurring, Michael’s dad took him to the hospital.

“I had no idea what a stroke was, or even the symptoms of a stroke,” Michael says. “I thought strokes only happened to people my grandparents’ age.” It took about 25 hours for the entirety of his stroke to take place – the cerebral cavernous malformation slowly but methodically paralyzing his right side.

Movement came back slowly in the months that followed. Learning to walk again was Michael’s greatest challenge while at Shepherd Center. “I could not walk for 10 feet without sitting down due to exhaustion,” he recalls. “I couldn’t believe that I had to completely relearn something that I’ve done my whole life.” By the time he left Shepherd after a month’s stay, he was no longer dependent on a wheelchair.

Michael’s right arm remains a work in progress, but his body is back in motion. Exactly three years after his stroke, Michael completed his first half-marathon. It was exhausting, and the last mile was just plain cruel, “but crossing the finish line was truly one of the greatest feelings I received in my entire life.”

Michael recently graduated Magna Cum Laude from Kennesaw State University with a bachelor of science degree in mathematics. He’s proud that he earned his degree in four years, despite time lost to his stroke and rehabilitation. His next challenge: a master of science degree in applied statistics.

“Every day that has passed since my stroke, I am more and more thankful to be alive,” Michael says. “My favorite quote is from Eleanor Roosevelt: ‘Life is what you make it. Always has been, always will be.’”

When he returned to the United States, David spent 13 months doing inpatient and outpatient rehabilitation in New England and three more years undergoing day program and outpatient therapy at Shepherd Pathways, Shepherd Center’s post-acute rehabilitation program for people with a brain injury. Now, he says: “Things are very different. I’m learning to live a new life.”

David, who lives in Atlanta, is one of more than 5 million people in the United States who have a brain injury, the leading cause of death and injury for people under the age of 45. Brain injuries are notable, in part, because unlike most injuries, which are visible – a broken leg requires a cast, a wound needs stitches – brain injuries are often invisible.

David looks normal, and in many ways, he is normal. But the lingering effects of his injury include struggles with processing speed, confusion and memory loss. Going back to his old job is not feasible for David, but he is volunteering at his children’s school. He has some difficulty with tasks that were easier for him before his injury, but he says he finds fulfillment in being involved at the school.

The disconnect between appearance and reality is confounding not only to those who have a brain injury, but also to people around them. Where people with visible disabilities often get the benefit of the doubt, those with brain injuries often do not.

“The assumption is that when people with brain injuries get out of the hospital, they should be OK,” says Terri Kohn, a licensed professional counselor at Shepherd Pathways. “If you look as good as before, the expectation is for you to be the person you were before. But that’s not the case, and friends and family may think you’re lazy, selfish and disinterested. The brain-injured person may not initiate tasks or participate in the family as before, and it can cause anger and frustration for other family members.”

Some people have a full recovery while others have lingering effects physically, emotionally and cognitively. The goal of rehabilitation is to optimize a patient’s independence and quality of life in the home and community.

“Brain injuries are very complex, and simply getting someone who’s been in a coma to walk again, and feed, bathe and take care of their self is a huge step forward,” says Debbie Page, a vocational rehabilitation case manager at Shepherd Pathways.

Kohn and Page are part of a rehabilitation team that includes a physician, speech, physical and occupational therapists, therapeutic recreation specialists, nurses and case managers. The team also includes the patient, family and others close to the patient.

“It is always a challenge to get everyone on the same page,” Page says. “We work hard to help patients and families move through their understanding of brain injury and adjustment to changes in their lives as they transition back to school or work.”

Kaela Matthews-Webb of Statesboro, Ga., says that when her firefighter husband, Lamar Matthews-Webb (see sidebar), was treated at Shepherd Center for a traumatic brain injury (TBI), the education and counseling she received – individually and in groups – was invaluable.

“They broke down the science of the brain and explained what had happened,” she says, “and they told me the plan, where they wanted to go. It helped me manage it all and understand that when he got frustrated as he progressed, it was normal and would get better. And it did. Shepherd’s whole approach put me more at peace. They were just awesome.”

For people who are unable to return to work or school, Kohn conducts support groups that provide a comfortable and supportive environment where they can come to terms with the changes in their lives.

“Their issues are the typical ones we see with brain injury – things like a lack of insight into their condition,” Kohn says. “They think, ‘I’m fine.’ But by the time they get to a group, they’re more aware of what’s involved. They have already been home and found that things that used to be easy are challenging. They go through a grieving process and learn how to cope with anger, sadness and anxiety.”

One such group meets weekly for two hours with Kohn in a conference room at Shepherd Pathways. This past fall, nine of them talked about their frustrations and the importance of the group to them.

Bonnie Short, 64 of Alpharetta, Ga., was injured in a motorcycle accident, then treated and released. After six months of cognitive problems and losing her job, she was diagnosed with a brain injury and referred to Shepherd Pathways. Although unable to find another job, working with a therapist and attending the group have given her hope.

“This is the only place where people understand what I’m going through,” Bonnie says. “It’s a beautiful thing where we share and we can laugh. We’re not isolated and alone.”

Seated next to her is Kim Guest, 50 of Roswell, Ga., who sustained a brain injury after a fall in 2010. Two years later, she still had recurring headaches and inner ear problems that made it difficult to think, talk and keep her balance. Her impairments required her to make a list to remind her what to do in the shower: Wash hair, rinse hair; wash body, rinse body; etc. Even now, watching television makes her nauseous. A trip to Walmart is so disorienting that Kim’s husband must wear a bright orange shirt so she can find him.

“My career was about people,” Kim says. “I was a hotel and restaurant administrator, but now it’s difficult to go to a restaurant and have dinner.”

Like some brain injury survivors, Kim finds social settings difficult. “I can’t keep up with all the people,” she says. “If I go to a wedding, I sit in a corner facing the wall so I can only see one or two people. Otherwise, it’s overwhelming.”

Keith Wilson, 53, of Atlanta, was hit by a car while vacationing in the Cayman Islands in 2001 and has been a member of the group since. Although he looks fit and healthy, he is unable to return to work and has had to deal with the suspicion that he is malingering.

“I was like a child and had to relearn things all over again,” he says. “I wanted to take leaps and get back to where I was, but I kept climbing that hill and sliding back down again. That hurts. That’s the hardest thing.”

Randy Nguyen, 20, of Norcross, Ga., was beaten in 2011 by five inmates while he was in jail. He spent seven weeks in a coma and a year later still experienced short-term memory loss.

“I’ll pack a lunch the night before I’m going out and put it in the refrigerator,” he says, “and five minutes later, I’ll get up and check to see if I’ve got everything. When I check it, everything’s there, but I keep checking like it’s going to disappear.”

Despite his experience as an executive before his injury, David Aschmann says his memory loss and lag in processing speed prevent him from taking on tasks that require leadership.

“I forget certain aspects and may not comprehend something until the next day,” he says. “Other times, I’ll sit there listening to people talk and I have no idea what they’re saying. It takes my brain a while to catch up. Some days, I’m quicker than others. People get confused when they see that. They have no clue what brain injury is about.”

Bonnie’s injury so affected her cognitive skills that she found it difficult to respond to things such as a simple, two-sentence email.

“What I think it says is never what it really means,” she says. “I get the words, but I’m not comprehending them right. And I can’t trust what I hear, either. It may not be what people are actually saying.”

The problem, Kohn tells them, is that their brains are not properly processing visual and auditory cues. “With these cognitive problems say ‘I’ll get back to you,’” she suggests, “but you’ve got to remember to get back to them. Jot it down, and after you process the information, then respond.”

Atlantan Michael Kaplan, 68, sustained a stroke during an operation that caused his brain injury. He has learned to repeat what people say to him. “And they say ‘correct,’” he says. “Otherwise, I lose it.”

One of the most confounding aspects of brain injury is that it can cause opposite reactions in different people. Shawn Webb, 24 of Carrollton, Ga., for example, sustained a TBI after being electrocuted at a construction site. Once easy-going, Shawn says that now: “Certain things set me off. My temper is worse than it used to be.”

Bonnie has had a similar experience. Before her injury, she says, “I had no highs and no lows. I never had any anger. Now, anger is the only thing I feel on a regular basis.”

On the other hand, Randy says he used to get mad easily. “But since my injury, it’s totally changed.”

The changed behavior– whether anger, confusion, memory loss or something else – caused by brain injury is often as hard on the family as it is on the person with the injury.

“The family may be aware of the problem long before the person is,” Kohn says. “But patients don’t have that awareness at first, and it takes them a while to catch up. And the family wonders what to do with them.”

“Sometimes they don’t want to have much to do with you,” Keith says.

His relationship with his wife was so difficult that he suggested they separate. “I hurt her more in six months than I had in nine years,” Keith says. “I told her I didn’t feel like I was a good husband. She says I’m the best husband in the world, but I don’t feel that way. My pride’s been taken away.”

Kim explains: “When someone says something to me, a lot of times I’m not sure what I heard or that I understood it, and I ask them to say it again. And if I still don’t understand, they look at me like, ‘What the hell’s wrong with you?’ I know my daughter is frustrated with me, because I used to be the mother with all the balls in the air. Now, most of the balls are on the floor, and she doesn’t understand that.”

Shawn adds: “I get emotional and speak my mind, and it usually hurts people’s feelings. My family says I’ve changed, and I have. I come across as being an (expletive). I don’t mean to, but it’s the first thing that comes to mind. I don’t filter it.”

Bonnie says: “I used to be a sweet, soft-spoken doormat kind of person.. Now I’m temperamental and outspoken. Things come out of my mouth before I can stop them, and I’m tired of my husband telling me to control what I say.”

Kohn reassures them that their emotions are part of the process of grieving the loss of their old way of life. Reclaiming a sense of self and security in a world where everything seems upside down can be terrifying.

“Those feelings come up, and you may be angry or sad for a minute or 20 minutes, and then for three hours everything’s OK,” Kohn says. “It’s an emotional roller coaster. As you recover, the hills of the roller coaster are not as dramatic, but that doesn’t mean they’re not there. Brain injury can happen to anyone any time. It doesn’t matter how old you are, what sex you are, your race or financial status. In that moment, your life changes dramatically, and the road to recovery is exhausting cognitively, physically and emotionally.”

As one client told Kohn, “Brain injury isn’t for sissies.”

The good news, David says, is “the emotional roller coaster levels out. You have to give it some time. It takes a whole lot of adjustments that will eventually become normal to you. At first, it seems like you’re in hell, but in time, it becomes normal, and you become comfortable with that type of life. It gets better.”

Indeed, in time, some not only adjust to their new normal, but are actually grateful for the new direction their lives have taken.

Kim says one of the casualties of her new life is perfectionism. “I used to be surrounded by needy people, and I did all the giving,” she explains. “Now, I’m the one who’s needy, and I have to be OK with the way things are. It doesn’t matter if things are perfect as long as they happen. That’s change, and that’s good.”

Randy says before his injury, “I was either gonna end up in a grave or prison. Luckily, someone was watching over me and said, ‘That’s not where I want you to be.’”

The stress of his job caused Keith to drink heavily, and his injury was “a godsend that got me off that bad road and on a very good road,” he says. “The way I look at life now is totally opposite. I know who truly loves me and who my true family is.”

Michael adds: “I can’t really point to where it happens but you finally accept that what you were before was a different person. Someone said God has us starting over, and that previous life wasn’t all that great. Actually, mine was pretty bad. I was doing a lot of things I didn’t want to do. This group made me realize that I didn’t like all that. I’ve gone through this brain injury, and now I’m human.”

David says the anger and confusion he felt in the first few years after his injury is gone. “I’ve gotten comfortable with the way things are,” he says. “I might be slow, but before, I was in a miserable marriage, and my sons were in foster care. Now, I’ve got custody of my sons, and we’re a happy family.”

Written By John Christensen
Photography By Louie Favorite

Just ask Kellie Cosby, an animal-assisted therapy provider and owner of Cosby’s Therapy Animals. Kellie, along with her late partner, Bill Reynolds, largely initiated an animal-assisted therapy program at Shepherd Center in 1991. Funded by generous donors, Shepherd’s animal-assisted therapy program pairs specially trained animals with spinal cord and brain injury patients to assist in their rehabilitation.

Animal-assisted therapy is effective because it disguises therapy as play, Kellie explains. It is enjoyable for both the patient and the animal – not to mention Shepherd’s employees, including therapists Kati Vines and Nate Schurman.

Therapists and patients see the animals every Wednesday, when Kellie brings her therapy dogs to the Acquired Brain Injury (ABI) and Spinal Cord Injury (SCI) units. Cosby’s Therapy Animals is an asset to these units because of Kellie’s vast knowledge of different breeds and their capabilities; the extensive training she provides her dogs from puppyhood throughout adulthood; and her outgoing and calming demeanor that brings out the best in both patient and dog, therapists say.

“Kellie makes everyone feel very comfortable,” says Kati Vines, a physical therapist in the SCI Unit. “She’s great at using the dogs to get someone who may be a bit timid at first to open up. Working with the dogs gives patients joy, and they look forward to seeing Kellie and her dogs each week.”

Kellie works closely with each therapist to match the right dog with the right patient to ensure each patient’s therapy goals are met. In the SCI Unit, for example, Kellie has patients groom the dog, play tug of war with him or walk the dog as they roll along in their wheelchair. These activities help patients improve balance, upper-arm endurance and range of motion.

In the ABI Unit, in addition to participating in the above-mentioned activities, patients also work on bolstering their speech and tactile stimulation by issuing commands to the dogs, petting them or visually tracking the dogs. Patients also experience a sense of calm when they are around the animals.

“Some ABI patients can demonstrate agitated behavior, which interferes with their ability to participate in structured therapy sessions,” says Nate Schurman, a recreation therapist in the ABI Unit. “After we pair them with the dog, they just completely relax. It’s awesome to see that change happen.”

Kellie enjoys seeing these positive changes happen, too, and is thrilled that she and her dogs can contribute to patients’ rehabilitation. “Shepherd Center is such an amazing place, where the doctors, therapists and other staff never give up on the patient,” Kellie says. “I’m honored to be part of the program after all of these years.”

She looks forward to serving Shepherd Center in the future and, in doing so, she says, honoring the legacy of her late partner, Bill, who also gave so much to the animal-assisted therapy program before he passed away in late 2011.

Written By Rachel Franco
Photography By Gary Meek

Nick fell asleep at the wheel and crashed his car on his 23rd birthday – March 28, 2012. He sustained an incomplete T-8 spinal cord injury, multiple fractures and wounds to his left arm and hand. The resulting paralysis in his legs seemed a secondary issue to him when he arrived at Shepherd Center on April 18. For a country music singer-songwriter who used a guitar like an extension of his body, the severe tissue damage to his arm represented a crisis.

When he was 12, Nick picked up a guitar at a friend’s house. His parents gave him one of his own at Christmas. At 13, he saw his friend’s band perform in Macon. That clinched it. “I started playing bars at 15,” he recalls.

Nick had a full calendar of bookings through summer 2012. Working in country music means long hours on the road. He was coming off trips to Alabama and Atlanta and operating on two hours’ sleep when he played a show in Macon the night of his crash.

On the way home, fatigue got the better of him. He doesn’t remember his car hitting the tree, the six hours pinned inside until he was discovered or his first weeks of surgery and intensive care at the Medical Center of Central Georgia (MCCG). For rehabilitation, MCCG referred Nick to Shepherd Center, where Lisa Gerdes, RN, was his admitting nurse.

Macon television news anchorman Frank Malloy, Nick’s father, recalls: “I was scared to death, and I know Nick was, too. Lisa was just wonderful from the first moment – her manner, her smile. We met so many people like that, just so encouraging. As parents, that meant the world to us.” Gerdes says Nick couldn’t bear to look at his heavily scarred arm, which was an obstacle to the painful rehabilitation it needed. And then there was his appetite.

“He would sometimes go a whole day and eat a forkful of rice, and that was it,” she says. Getting Nick to eat became a group project.

Nurses shopped for food to entice him. Family members brought old favorites from home. It took a month or more, but Nick’s appetite slowly returned. Meanwhile, he was coping with his paralysis. He recalls a tough two months when he thought he wasn’t making progress. “Everybody said they could see it I,” he recalls. “I couldn’t.”

Feeling frustrated and unwilling to even look at his arm, Nick and the therapists had to break up the “really severe and intensive scar tissue” in his arm with painful massage and stretching, Gerdes says. “Slowly, as the weeks went by, I worked with Nick to help him be OK with looking at his arm,” Gerdes recalls. “A lot of the process was not forcing him too much.” Nick remembers turning the corner emotionally in his last two weeks of inpatient therapy. Nick graduated from inpatient care to day program rehabilitation on June 14. During that program, he began living with his mother in the Woodruff Family Residence Center adjacent to Shepherd Center.

His left arm improved, and the splint came off his hand. But he still had not held a guitar since the accident when his friends in Macon staged a benefit concern for him on June 1. At country music star Dierks Bentley’s request, C.F. Martin & Co. donated a guitar to be auctioned off. “Those are the best guitars in the world,” Nick says. But he didn’t expect his friends to plop it into his arms.

“They were like, ‘Play it,’” he recalls. “And I thought, ‘I don’t know if I can, but it is a Martin guitar. I’ve got to play it.’” So as his friends cheered, Nick started strumming, first some easy chords. Then the tough ones like B minor. All of them came back to him – and his left hand – like old friends. “I was kind of tearing up,” he says. “I thought I could never play guitar again.”

Nick played a concert in July 2012 for fellow patients, family and staff at Shepherd Center. He went home on Aug. 10, but played Sept. 8 at a Nashville fundraiser for Shepherd Center’s Beyond Therapy^®-Tennessee.

Back at home, Nick looks ahead. His spinal cord injury was incomplete, meaning “there’s a 75 percent chance of regaining some function in my lower extremities,” he explains. He plays guitar and thinks about writing new songs. “I’ve definitely got a lot more emotions going on than before the wreck,” Nick adds. “I think some good stuff will come out of this, for sure.”