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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A clinical diagnosis of quadriplegia or paraplegia isn't just a matter of counting inert limbs. It's based on a cumulative score from multiple sensory and motor-skills tests. Robby Beckman, for example, is a quadriplegic who can move his arms but has minimal hand control. Likewise, Rummerfield is still classified as a quad because there are so many residual effects of his spinal cord injury. He chills easily, is prone to kidney stones, can't grip tightly with his right hand and takes catnaps instead of restful sleeps. He's also numb below the knees and has brittle bones.

Beckman couldn't tell Rummerfield was a quadriplegic until Rummerfield told him. There are, however, subtle clues. Lacking feeling in his lower legs, he moves with the deliberateness of an older person. For all intents and purposes, he's walking on knee-high stilts. Block his field of vision, and he's helpless.

"If I try to carry a big box, I can't do it," Rummerfield says. "I fall down because I don't know where my feet are."

Running accentuates those deficiencies. He has a sluggish, unbalanced stride but can hold a steady, 12-minute-per-mile pace. Clearly, Rummerfield's brain and nervous system are compensating in some way. Exactly how, nobody knows. He says he looks and listens to his surroundings for cues. Every step he takes is a conscious decision. Nothing is instinctual. Acute spatial awareness might explain walking, possibly running. But driving race cars?

"So far from normal, it's unbelievable," says Belegu. "It's crazy that he can do that."

"MR. PAT DOESN'T KNOW IT YET, BUT I'M GOING TO BE HIS ASSISTANT WHEN I GRADUATE," teases Beckman, continuing his march on the Hydro Track. He lives with his parents in the Calvert County town of Owings, driving to Kennedy Krieger and to classes at the University of Maryland in a screaming-yellow, lift-equipped Chevy truck he nicknamed "Big Cheddar." Beckman wears his hair in a boyish buzz cut, and there is a mischievous Huck Finn quality about him that therapists love. As Rummerfield notes, Beckman is also "a bundle of energy, full of determination."

When Kennedy Krieger opened its spinal cord injury center 2 1/2 years ago, Beckman, now 24, was one of the first quadriplegics through the door. The center specializes in children but serves adults in search of intensive outpatient therapy. Back then, Beckman could barely roll over on an exercise mat. But here he is, finishing a five-minute workout in the Hydro Track.

"I'm like jelly right now," an exhausted Beckman sputters.

"You're looking good!" exclaims Rummerfield, patting him on the back.

In the hallway outside is another patient, Elliott Farmer, a paraplegic only beginning his journey of recovery. He and Rummerfield talk almost daily. Farmer, who's 19, fractured his neck in a 2006 car crash and lost the use of his legs. He'd just finished his freshman year at the University of Missouri. A few days after the accident, his father read an article in the St. Louis Post-Dispatch about Rummerfield preparing for a grueling endurance race: seven days of running 150 miles across China's Gobi Desert. That inspired Bud Farmer to bring his son to Kennedy Krieger. He and wife Sandy fly with Elliott to Baltimore every few months from their home in Jefferson City, Mo., for two weeks of physical therapy.

According to the National Institute of Neurological Disorders and Stroke, some 250,000 Americans have a debilitating spinal cord injury, and 12,000 new cases are added each year. A spinal injury essentially takes a hammer to the body's delicate circuitry. Messages sent through the central nervous system get garbled or misdelivered. The results can cause terrible discomfort. Farmer dreads taking showers. Every drop of water hitting him seems to have a jagged edge. The bolts of searing neuropathic pain he sometimes feels are worse, like being struck by lightning.

He recently was fitted with a fiberglass body brace. It extends from his ankles to his sternum, with hinges at the knees and hips. Farmer, in effect, is a crustacean, reliant on this external skeleton to keep him upright whenever he gets out of his wheelchair. He's learning to ambulate with crutches, navigating the corridor under the guidance of therapist Mike Lagonera.