A Spirit the Waves Couldn't Break

Rehabilitation provided meager progress but progress nonetheless. On a crisp November morning, his mother packed up the calendar and several plastic bags of belongings. A parade of staff members stopped by Room 224 with hugs and farewells and, "Are you happy you're leaving us?" Josh's favorite aide was off, but she called at the last minute, and the phone was held to his ear so he could hear Sharon's pep talk. The rest of his life would commence when he exited the hospital's front door -- a threshold he was terrified to cross.

He was, in ways he wouldn't fathom for months, exceptionally lucky. His family had the financial and intellectual means to provide. A specially outfitted $60,000 minivan was parked at the curb. A $35,000 wheelchair (capable of 8.5-minute miles) was on order. And waiting in Potomac: A custom-built ramp for circumventing the Basiles' front-porch steps; a living room-turned-bedroom and doorways widened to give Josh the breadth of that first floor; plans for an elevator so he could extend his range upstairs and into a redesigned basement; a hired caregiver.

Still, he was a quad.

"Fix my shoulders." He was listing, despite double pillows under his elbows.

"I'm having trouble breathing." Worry clouded his face.

Josh finally came home on Day 101. In the garage, soccer balls, lacrosse sticks and other artifacts of his past remained where he had tossed them more than three months earlier. He was pushed up the ramp and into the kitchen. Within seconds, a sleek feline named Isabel, his favorite, jumped into his lap. She settled contentedly on one of his pillows, in the crook of his right arm. He could not feel her purring.

Primum non nocere. A bedrock medical dictum: First, do no harm. In the desperate aftermath of Josh's accident, this was the only constraint in John Basile's mind. Advances with stem or immune cells might never come in time. Josh needed a breakthrough now.

His father found the rat-and-laser study on the Internet through a chance combination of search words. Just 12 miles away, researchers at the military's medical school in Bethesda had partially severed the spinal cords of 85 female rats and then treated half of them with 810 nanometers of near-infrared light. Basile read on. The results showed that the dosage had penetrated to the spinal lesion. And that the nerves there had regenerated in greater numbers and to greater degree than in the control rodents.

Nine weeks after the knife, the lasered rats walked almost normally. The results, the researchers said, suggested light as a useful therapy for people with spinal cord injury. Basile picked up the phone. He ordered two of the same lasers used on the rats.

So, late at night as Josh slept, the physician began irradiating his son, placing twin circular diodes on the back of the neck, top and bottom of a five-inch zipper of a scar. He tracked the study as best he could. As long as he did no harm, he reasoned.

Against skin, the laser created a luminous red sun. Energy, Josh's father hoped, for healing.

Something was happening.

"Mom, scratch my head," Josh said.

"Scratch it yourself," she retorted, smiling.

Because suddenly, Josh could.

In the early hours of a winter evening, his right hand reached up awkwardly as he lay in bed, past his shoulder, past his ear, above his forehead. It dangled for an instant like a precarious crane boom, swung over and lowered inert fingers toward his scalp -- a performance he gleefully repeated.

He started trying to feed himself, a special wrist splint holding a curved fork worthy of Salvador Dali. He speared the target in front of him, then aimed with slow, obvious effort for his mouth. When the segment of clementine at last hit its mark, Josh stuck it in whole. "Tasty," he declared.

Something was surely happening, accelerated by the daily exercise of Josh's limbs -- the repeated extension and rotation of muscles and joints, the gentle stretching, finger by finger, of his hands. The rehab doctors always expected some improvement; how much, they could not predict.

But something else also was occurring, equally unpredictable and arguably more momentous: Josh was reconnecting with life.

At first, it was mainly in his converted bedroom, where a buck's head ruled over the fireplace. On weekends, friends home from college would hang out, talk sports, play games, watch movies. They overlooked the urine bag hanging beside Josh's leg. He showed off his clementine trick -- "the coolest thing ever," decided E.J. Watkins, a daily visitor -- and after delivery of his Storm TDX5 power chair, Josh demonstrated how its hydraulics could raise the seat 10 inches or more.

A handy feature, he bet, for sidling up to a bar. After all, who would card a guy in a wheelchair?

Those new wheels gave Josh his first measure of independence, though that entailed risk. He worried about the stares he would get or, worse, the pity. Jane Altshuler set him straight. His former Advanced Placement art teacher remembered others' reactions when breast-cancer chemo left her bald.

This is what a spinal cord injury looks like, she told Josh. Deal with it.

He dealt in part by composing poetry. "I've got a lot on my mind," he said. One piece rewound to the accident. Other musings contemplated the present:

My ascent began three months ago

Every day I progress two feet forward

Yet fall back a foot

Because of the boulder attached to my neck.

With Altshuler's encouragement, he enrolled for the spring semester in a weekly poetry course at Montgomery College. She offered to go with him, and Watkins signed up for the same three credits, and there they were, Team Josh.

They arrived a half-hour early that first Wednesday. Josh was more excited than nervous; now he could tell people, I'm back in school . In the classroom, he parked where he could face the other students. He and Watkins traded knowing glances when one particularly attractive woman walked in.

The teacher passed out a short biographical questionnaire. Altshuler filled in Josh's answers.

What do you like to do in your free time? Physical therapy.

What is your major? A question mark.

Any athletics/extracurricular activities? Left blank.

"I loved it," Josh gushed that night, already impatient for the second class. "I felt normal again."

By early April, Josh was thinking more expansively. He had things to say that went beyond poetry.

His alma mater, the private Bullis School, seemed a fitting backdrop for a first speech. He prepped with Altshuler as if he were holding a Capitol Hill news conference, and by the time his small entourage drove onto campus, he had a PowerPoint presentation packed with facts, stats and photos -- an intensely personal public service announcement. "The video's going to make the kids cringe," he predicted.

The presentation flashed on the huge screen behind him in the Bullis theater, with a collective gasp every time the video demonstrated the mechanics of a spinal cord breaking on the ocean floor. Each of its four scenarios, borrowed from a California program called Project Wipeout, was accompanied by an awful cracking sound.

"This is the injury I had," Josh said as compression, scenario No. 3, showed vertebrae piling up on one another like a chain collision on a highway.

Except for Altshuler's younger daughter, beside him to turn the pages of his speech, Josh was alone at stage center. He narrated his story without any hint of bitterness. "I'm fully dependent on others for the most basic things," he said matter of factly.

But he did not elaborate. He did not go step by step through his mother's tedious attending to his bodily functions every morning, or the lesser routine every night, when his aide assembles three buckets of water and drapes him with towels to clean face and teeth.

He didn't mention how often the most ordinary outing must be aborted if a kink in his catheter or a shoe tied too tightly triggers signals his brain can't receive, and his autonomic nervous system sends blood pressure soaring.

He didn't explain how a half-flight of stairs can be as insurmountable as Everest, how quickly in most friends' houses he is blocked, stopped, defeated.

He closed with a dozen beach safety tips and a composition titled "Different But Not Ruined." At which point 700 students spontaneously stood and applauded. For a long time after, he was the center of congratulations.

A week passed, and Josh received an envelope of thank-yous from the third and fifth grades. "Many people would say that Derek Jeter is their idol," a boy named Chris wrote. "But not me, if anyone asked me who my idol is, the answer would always be the same. Josh Basile, my superman!"

No, not ruined at all.

His future is all about connections.

The personal ones Josh makes easily, thanks to his natural gregariousness. At Tysons Corner Center, Josh spotted the Washington Wizards' minority owner in the Nordstrom shoe department and rolled over to introduce himself -- and complain. Getting good seats at MCI Center was tough with a wheelchair, he said. Ted Leonsis listened, asked about the accident. Call me tomorrow, he said, and handed Josh a phone number.

The next day, four special playoff tickets were waiting.

The other connections, the nerve couplings crucial to Josh's future, are being made, too. All spring, he reported tiny, invisible changes in sensation deep in his abs. He gained strength through his torso and by late April, capitalizing on his right arm's greater control, he could sit on a matted bench and hold himself upright. "I discourage him from pursuing a miracle cure," said Trish Esposito, a physical therapist at the rehabilitation hospital. "I don't discourage him from dreaming."

In late May, he suddenly could move his left arm, curling it through the bicep. He hid it from his mother for 12 hours -- to show her as a present on her birthday.

Watkins sees his friend as constantly inspiring. Every so often, though, he hears Josh lash out in frustration: "God, I wish I could do that." Or confess: "I feel like such a nuisance." Altshuler, whose counsel and commitment have become indispensable in his life, comforts Josh in the rare moments of tears.

Josh insists that he doesn't dwell on the what-ifs. The biggest one: What if he never walks again? "You push it away. It's in my closet, my attic, way above." He has concluded that he simply was unlucky that summer afternoon last year. "Wrong place, wrong time, wrong beach, wrong piece of sand."

Last month, he became one of the Kennedy Krieger Institute's first patients at its new International Center for Spinal Cord Injury. The director is neurologist John McDonald, whose research helped Christopher Reeve regain sensation and movement. Even after major damage, McDonald said, more neural circuits remain than doctors had presumed. And even long after injury, he believes, their function can be restored through exercise and patterned, repetitive activity.

During a head-to-toe assessment, Josh went over everything he had done since Aug. 1. He listed the vitamins and supplements his father had prescribed to nourish nerves and tissue -- 22 at last count. He ticked off how many hours a day he wore the EMS units that electrically stimulate dormant muscles. He talked about his acupuncture treatments. He recapped a trip to Shriners Hospital in Philadelphia for evaluation for tendon-transfer surgery on his arms.

"It's really critical that you dedicate the next two years to this," McDonald told him. Initially, four hours a day, five days a week at the center in Baltimore. Plus more time at home. A level of training that a former tennis jock had not achieved.

"I'm with you," Josh said.

By week two at Kennedy Krieger, he is going strong.

"Oh, God, I love this machine," he says. He is sitting in his wheelchair with his hands Velcroed onto a set of miniature bicycle pedals mounted on a table top. His arms are pumping, pushing, pulling the pedals -- absolutely on their own.

"I'm feeling a lot of delts," Josh tells a therapist.

"A lot of traps." She nods.

"I'm feeling, I think, a little triceps." That's C6 to C7, just maybe the edge of real recovery.

"And there are pecs, definitely a little pecs."

Josh breathes heavily, happily, remembering what a sweat-producing workout can be. It gives him hope that soon he'll feel a familiar twinge, a tiny jerk of a finger or toe, that will mean a signal has made it. Beyond the C7 level, beyond C8, even lower. Down, and all the way back.

He's closer to figuring how a future as a quadriplegic can matter. But his new schedule complicates his planning. He has too little time for other projects. He wants to give free chess lessons in his neighborhood because that is something he can do for others instead of others doing for him. He's launching a foundation to benefit new spinal injury patients and their families, which will be named Determined2Heal because, "That's what I am."

People see his mother in the grocery store in the neighborhood and ask, "How's Josh?"

"How do you answer that in one sentence?" she wonders. How does she say, "My son is a better person than he was a year ago"?

He has given speeches since Bullis, the points about beach safety increasingly honed. This fall, Josh intends to take a public speaking class. "We have such a powerful message to get out," he urged the other quads he met during his visit to Shriners. Few of them had ever thought of their paralysis that way. "They never thought they could make a difference."

He is a long way from Bethany Beach. A long way toward appreciating that his life can be -- he searches for the right words -- "a fully contributing life."