Medical Marvel

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Possibilities for the Impossible

In 1974, Pat Rummerfield was paralyzed in a car accident. After 17 years of therapy, he regained his ability to walk. Today, Pat serves as a role model and research subject at Baltimore's Kennedy Krieger Institue, where other quadriplegics and paraplegics are undergoing intensive experimental therapies. Medical Marvel, (Post Magazine, Jan. 27, 2008)

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RUMMERFIELD'S TITLE AT KENNEDY KRIEGER IS "PATIENT LIAISON," but in many ways he's a role model without portfolio. Part of his job is just to be Pat Rummerfield -- to serve, literally, as a walking inspiration. There are those who cry upon meeting him, who thank him profusely for providing them with a thin thread of optimism.

Not long ago, Rummerfield got a letter from Alvaro Gomez, a Colombian high school senior who had come to the United States from Bogota for treatment after a horseback-riding accident left him paralyzed. Inside was a photocopy of his yearbook-page dedication: "Patrick, you are like my guardian angel. You give me the strength and hope to keep moving on . . . 'No pain, no gain.'"

Rummerfield is in regular contact with dozens of quadriplegics and paraplegics, counseling them on everything from depression to health problems to insurance hassles. He considers Nate Waters, a 29-year-old accountant with an Oklahoma energy company, "like a little brother." When Waters was a teenager, his mother's boyfriend broke his neck in a vicious beating; then the family abandoned him.

"I didn't know Pat from a hole in the wall," says Waters, who lives in a Tulsa nursing home and comes to Kennedy Krieger for periodic checkups. "Watching him and how focused he is on work and getting things done had a big impact on me . . . I've been paralyzed for 10 years. Sometimes I get burned out going to therapy. After talking to Pat, it's like, 'Okay, I got more juice in me to keep on doing it.'"

Rummerfield doesn't motivate with locker-room-type pep talks. He's by nature low-key. In repose, his face often has a hangdog expression, giving him the air of a softhearted but overextended priest.

"A lot of people that find him are at their wits' end and don't know what to do," says Rummerfield's wife, Barbara, who has watched Pat struggle with being the sounding board for so many sad stories. "It weighs on him. He has said in the past, 'This is just so hard.'"

Yet there are also those who view Rummerfield as a possible purveyor of false hope. Steven Edwards, a quadriplegic and spinal cord injury activist from Charleston, S.C., sees him standing on a distant, perhaps unreachable, mountaintop. While McDonald points to Rummerfield as activity-based therapy's ultimate success story, Edwards is wary. "Ask Dr. McDonald," Edwards says, "who he can drag out besides Pat Rummerfield."

No question, Rummerfield's recovery remains largely a mystery. A howdunnit. About 10 percent of quads and paraplegics spontaneously recover a degree of mobility, specialists say. Others make important, less dramatic gains with therapy, such as moving fingers enough to operate an electric wheelchair or lifting an arm high enough to feed themselves. But Rummerfield's comeback is so extreme that it's off the charts.

"We can't explain it in a scientific way," says Cristina Sadowsky, Kennedy Krieger's clinical director and Rummerfield's personal physician. The best Sadowsky and McDonald can offer are educated guesses of what went incredibly right. Rummerfield's broken neck fortuitously healed in an almost perfect straight line. His car accident may have rattled a part of the brain that controls inhibitions, hence his unusual capacity for pushing himself far beyond the norm. Good genes probably play a role, too.

There's a study underway at Kennedy Krieger in which high-tech, three-dimensional MRIs are being taken of a total of 100 healthy and injured spinal cords. Rummerfield was the first volunteer to be scanned. McDonald and research coordinator Visar Belegu couldn't wait to get a peek at his pictures. Their coolly professional reaction? "We completely flipped out," says Belegu.

They discovered collateral tissue damage above Rummerfield's wound site at vertebrae C3 and C4 that doesn't show up in a standard MRI. Belegu points to a section of the vertical, lateral and dorsal columns within Rummerfield's spinal cord. About two-thirds of it is black. A dead zone.

"He's got no signals coming from those areas," says Belegu. "That's less than Chris Reeve had, and he was completely paralyzed."