fighting the good Fight also inside Teaching children To cope + smart phone, smart apps The winning vows + designed for women + a True reflection

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1 fighting the good Fight also inside Teaching children To cope + smart phone, smart apps The winning vows + designed for women + a True reflection ShepherdCenterMagazine.org Summer 2012

2 Shepherd Center Magazine: Spinal Column Summer 2012 Shepherd Center 2020 Peachtree Road, NW Atlanta, Georgia Editor Jane M. Sanders Dear Friends, Spinal Column A Letter from JAmes shepherd Design Soloflight Design Contributing Writers Sara Baxter, John Christensen, Amanda Crowe, Rachel Franco, Phillip Jordan, Ansley Martin, Florina Newcomb, Cara Puckett, Bill Sanders, Scott Sikes, Midge Tracy, Lauren Tucker Contributing Photographers Leita Cowart, Louie Favorite, Abby Greenawalt, Gary Heatherly, Ross Henderson, Leslie Johnson, Russell Klika, Ted Kostans, Kellye Lewis, Kelvin Ma, Gary Meek, Thomas Wells, Gray Whitley, Jeremy Wilburn Board of Directors James H. Shepherd, Jr., Chairman Gary Ulicny, Ph.D., President and CEO Emory A. Schwall, Vice President William C. Fowler, Treasurer Stephen B. Goot, Corporate Secretary Alana Shepherd, Recording Secretary Members Fred V. Alias, Gregory P. Anderson, David F. Apple, Jr., M.D., C. Duncan Beard, Brock Bowman, M.D. *, Wilma Bunch *, James M. Caswell, Jr., Sara S. Chapman, Clark Dean, John S. Dryman, Mitchell J. Fillhaber *, David H. Flint, Stephen B. Holleman *, Michael L. Jones, Ph.D. *, Tammy King *, Donald Peck Leslie, M.D., Douglas Lindauer, Sarah Morrison *, Julian B. Mohr, Charles T. Nunnally III, Sally D. Nunnally, Clyde Shepherd III, J. Harold Shepherd, Scott H. Sikes *, James E. Stephenson, James D. Thompson, Goodloe H. Yancey III * Ex Officio Emeritus Shepherd Center Magazine: Spinal Column is published quarterly by Shepherd Center, a private, not-for-profit hospital specializing in the treatment of people with spinal cord injury, brain injury and multiple sclerosis. change of address information or request to be removed from our mailing list to magazine@ shepherd.org, or by mail to Shepherd Center, Attn: Shepherd Center Magazine Mailing List, 2020 Peachtree Road, NW, Atlanta, Georgia, Please include mailing label. Shepherd Center Magazine accepts no advertising. Spinal Column is a registered trademark of Shepherd Center. about the cover: Army Sgt. Tom Boone sustained an SCI in Today, he is back on the job in the Special Forces at Fort Bragg, N.C. Photo by Russell Klika This summer, Shepherd Center s campus renovation project comes to a close with the reopening of the updated third floor of the Shepherd Building. Patient rooms are larger and hard-wired for the latest technology. We have eliminated four-person suites in favor of mostly private rooms, a change that helps with infection control and the logistics of admissions. This floor has been updated only once since it originally opened in 1982, so it was time for the update, which was generously funded by our donors. The reopening of the third floor has expanded our total number of beds from 132 to 152, giving us a better opportunity to unplug the bottleneck that sometimes occurs in admitting inpatients for rehabilitation and/or medical services. The renovation also brings the opening of the Billy and Betty Hulse Spinal Cord Injury Research Lab in the former therapy gym on the third floor of the Shepherd Building. This space gives the lab a permanent home for neurorecovery research led by Keith Tansey, M.D., Ph.D., director of spinal cord injury research at Shepherd Center. The Hulse SCI Research Lab also provides state-of-the art therapeutic and research equipment. Funds for the lab were raised in record time less than a year by former spinal cord injury patient Billy Hulse and his wife Betty of Atlanta, along with their close friends, Tommy and Beth Holder, also of Atlanta. Donors requested and we wholeheartedly agreed that the lab be named in honor of Billy and Betty. Now that our renovation phase is completed, we will focus on sharpening all of the edges that distinguish Shepherd Center in the rehabilitation community. We expect to continue to improve patient outcomes through new, as well as tried-and-true, rehabilitation therapies and treatments. We will continue to support our excellent and dedicated staff through professional and educational opportunities that also contribute to improved patient outcomes. And we will sharpen our focus on innovative neurorecovery research that leads to the best and most effective treatments to improve functional outcomes in our brain and spinal cord injury patients. Finally, we remain committed to being a nimble healthcare organization that adapts to changes that will come with healthcare reform. At the same time, we will not waver from our commitment to excellent outcomes that help patients rebuild their lives with hope, independence and dignity. Warm regards, James H. Shepherd, Jr. Chairman of the Board Photo BY ABBY GreenAwAlt

3 summer 2012 shepherd Center Contents Departments short takes Profile Medical Staff: Arthur Simon, M.D. research insights Profile Patient: William Flewellen heard shepherd alums foundation features honorariums & memorials features Fighting the good Fight Two soldiers battle back from spinal cord injuries to return to duty. teaching Children to Cope with life- Changing injury A patient with seven children imparts life lessons to his family and draws strength from them during his recovery. a true reflection Young people with spinal cord injuries share their self-image struggles and triumphs. the winning VowS Former patient and his new wife win a national contest with the wedding vows she penned in just a few minutes. designed For women While female patients make up a small part of Shepherd Center s patient population, the hospital goes the distance to help them adjust to life after injury. SMart phone, SMart apps Wireless RERC at Shepherd Center and Georgia Tech launches App Factory project to develop apps for people with disabilities. Gifts of Generosity If you would like to make a gift to support the work you have read about, please contact Scott H. Sikes at the Shepherd Center Foundation at or visit shepherd.org. shepherd Center magazine online Shepherd Center s Spinal Column magazine is available at ShepherdCenterMagazine.org. Go online to view stories, features, profiles and more with expanded photo galleries and additional content.

4 Sshort takes injury Prevention ProgrAM expands in Metro AtlAntA MiDDle School Shepherd Center staff members will once again conduct a comprehensive injury prevention class at a metro Atlanta middle school in the fall. This time, armed with the results from a 2011 pilot program, the class will be further tailored to meet the needs and answer the questions of 400 seventh graders. The pilot program had one teacher who ran the program within one class, says Shari McDowell, director of Spinal Cord Injury Services at Shepherd Center. This fall, we ll have additional teachers teaching injury prevention at the school. The entire seventh grade will go through this program, which has been modified based on feedback from students last year. Perhaps the most encouraging finding is that students in the pilot program, which was taught at Campbell Middle School in Smyrna, Ga., drastically changed their opinions on how easily they could be injured if they didn t think first before taking risks. We were able to show measureable changes in the students attitudes about risky behaviors, which will hopefully lead to fewer brain injuries or spinal cord injuries, says Bridget Bitterman, a case manager at Shepherd Center. In addition to expanding the program, the Shepherd adolescent treatment team and school faculty are tweaking the content to make an even larger impact. They are expanding the peer intervention component. Students will also hear from Ken Wilson, M.D., a trauma physician from Atlanta s Grady Memorial Hospital, who will describe the physical impact of a spinal cord or brain injury just hours after an accident. The additions to the curriculum for this year are very exciting and add another level of impact for the kids to something they already found fascinating last year, McDowell says. Staff members at Shepherd Center will continue to enhance the injury prevention program in particular with information they are gleaning from two recent patient and family focus groups. Herndon Murray, M.D., the adolescent team physician, conducted the focus groups to gain opinions on how best to reach adolescents and young adults to prevent catastrophic injuries. McDowell is encouraged by the impact the pilot program had. She says she is particularly pleased that students at Campbell Middle School seemed to fully grasp the dangers of two risky behaviors: texting while driving and diving head first into water. Kids picked up on diving the most, she says. We stressed 20 behaviors and perceived risks, and all but two showed statistical differences from the beginning to the end. Diving into a pool or lake was one of the ones that changed the most. For more information, contact McDowell at shari_mcdowell@shepherd.org. q Bill sanders Former Shepherd Center patients and staff spoke about injury prevention to students at a metro Atlanta school in May. Photo this PAGe BY louie FAvorite 2 ShepherdCentermagazine.org

5 BEST HOSPITALS NATIONAL REHABILITATION ShePherD center ranks AMong top 10 in u.s. news & WorlD report S best hospitals Shepherd Center was again named one of the top 10 rehabilitation hospitals in the nation in a U.S. News & World Report survey. The rankings are published online at health.usnews.com/best-hospitals and will be published in U.S. News annual guidebook, Best Hospitals 2013, which will be available in mid-august. Shepherd ranked No. 10 among dozens of hospitals that earned a spot in the magazine s survey of rehabilitation hospitals. Shepherd Center first appeared on the list in Also, U.S. News & World Report announced that Shepherd Center ranked No. 2 in the Atlanta metro area in the magazine s Best Hospitals metro area rankings for and No. 3 in Georgia. These rankings were released simultaneously with the national rankings. Rankings for rehabilitation hospitals are based on nominations among physicians. Physicians are asked to name hospitals they consider the best in their specialty, regardless of location or expense. America s Best Hospitals guide includes rankings of medical centers nationwide in 16 specialties. The ranked specialties are cancer, diabetes and endocrinology, ear, nose and throat, gastroenterology, geriatrics, gynecology, heart and heart surgery, kidney disorders, neurology and neurosurgery, ophthalmology, orthopedics, psychiatry, pulmonology, rehabilitation, rheumatology and urology. All of these hospitals are the kinds of medical centers that should be on your list when you need the best care, says Avery Comarow, health rankings editor. They are where other hospitals send the toughest cases. q Larry Bowie ShePherD center ProMoteS long-time StAFF MeMberS to leadership PoSitionS Shepherd Center named Sarah Morrison, PT, to the newly created position of vice president of clinical services, effective May 1. Morrison is responsible for directing patient care, including Shepherd s spinal cord injury, brain injury, chronic pain and multiple sclerosis programs. She previously served as director of Spinal Cord Injury Services, which serves more than 600 people from across the nation each year. She has been a vital part of the Shepherd Center staff since 1984, serving as a physical therapist, therapy manager and the intensive care unit program director. Shepherd Center recently created the position Morrison has taken because of the hospital s continued growth. This summer, the Center completed a $5.5 million expansion and reconfiguration that will increase the number of beds to 152. Sarah s experience offers a wealth of skills and knowledge, and she is also a great motivator of people, which has prepared her for this integral leadership position, says Gary Ulicny, Ph.D., Shepherd Center president and CEO. In other recent promotions: Shari McDowell, PT, who has served as Shepherd Center s Spinal Cord Injury Program manager for the past six years, was promoted to the position of director of Spinal Cord Injury Services, effective May 1. McDowell has been with Shepherd Center since Shari s strong leadership skills, dedication and impeccable work ethic have been vital to the success of the SCI Program, Morrison says. I look forward to her continued success as director. Deborah Backus, PT, Ph.D., was named to the newly created position of director of multiple sclerosis research in the Andrew C. Carlos MS Institute at Shepherd Center. Formerly the associate director of SCI research, Dr. Backus began her career at Shepherd Center in 1989 as a physical therapist. She was previously involved in the development of the MS outpatient program. In this new position, she is developing a research program that encompasses the entire continuum of MS services. q Jane m. sanders SArAh MorriSon, Pt ShAri MCDowell, Pt DeBorAh BACkuS, Pt, Ph.D. Spinal Column / summer

6 Sshort takes get into the great outdoors With upcoming therapeutic recreation trips The Shepherd Center Therapeutic Recreation Department is offering two upcoming trips that will allow former patients opportunities to enjoy challenging activities. On Sept , Shepherd therapeutic recreation specialists, in partnership with will lead an adaptive diving trip to Bonaire. This all-inclusive trip includes round-trip airfare from Atlanta, hotel stay, boat dives and airport transfers. It is open to all skill levels and abilities, as well as family and friends of former patients. HSA certification is required. The registration deadline is July 31. For more information, contact Angela Pihera at or Also, former patients, along with their families and friends, may want to make plans to snow ski with Shepherd Center s Therapeutic Recreation Department and SkiMore Tours. A trip planned for March 1-6, 2013 to Steamboat Springs, Colo., will feature private adaptive ski instruction, equipment, lift tickets, accommodations and airport transfers. The trip is open to all skill levels and abilities. Book the trip early for discounts. For more information, contact Katie Murphy at or katie_murphy@shepherd.org. More information is also available online at shepherd.org/tr. q ShePherD center celebrates two big MileStoneS In October 1982, Lesley Hudson walked to the office of Shepherd Center Medical Director David Apple, M.D., and asked him if he had a minute to talk. He waved her in, and she delivered some big news: The U.S. Department of Education s National Institute on Disability and Rehabilitation Research (NIDRR) had selected Shepherd Center as a Spinal Cord Injury Model System (SCIMS) of care. Along with it came a $1.25 million, five-year grant. When I got the call, I couldn t believe it, recalls Hudson, who became the coproject director of the SCIMS, along with Dr. Apple, who is now medical director emeritus. Since Shepherd Center was only seven years old at that point, I didn t know what to expect when we applied. Hudson s words to Dr. Apple were, This is the start of something big. Since that day, Shepherd Center has been renewed as a SCIMS every five years and has remained continuously funded for the past 30 years. The latest grant, received in 2011, is for $2.5 million the maximum any hospital can receive. Being continuously funded has been huge, Hudson says. It has enabled us to make strides in therapeutic recreation, outreach and employment programs. Because the grant has a research component, it laid the foundation for Shepherd s research program, which has grown exponentially through the years. Aside from conducting research, as one of 14 Model System facilities, Shepherd Center is required to collect patient data, both during hospitalization and periodically throughout the patient s lifetime. We collect data every five years, but check in with patients in between to make sure their information is current, Hudson explains. It takes more time and effort to do that, but it dramatically increases our capture rate. The Model System designation has given Shepherd Center national exposure, Hudson notes. The hospital s involvement with the American Spinal Cord Injury Association (ASIA), which is housed at Shepherd Center, also lends credibility to the hospital s mission. ASIA celebrates its 40th anniversary this year. Our relationship with ASIA has been a mutually beneficial situation, says Hudson, who became ASIA s executive director in 2006, when the ASIA office moved to Shepherd Center. It s given us recognition in a national and international arena. q sara Baxter SCiMS staff members are lesley hudson, M.A., David Apple, M.D., Patricia Duncan and keith tansey, M.D., Ph.D. Photo At left BY louie FAvorite 4 ShepherdCentermagazine.org

7 Pstaff profile With Arthur simon, m.d., medical director of reconstructive surgery interviewed by jane M. SAnDerS INTERESTING FACTS: arthur simon, m.d., MEDICAL DIRECTOR OF RECONSTRUCTIVE SURGERY PhotoS this PAGe BY louie FAvorite Dr. Simon began practicing reconstructive surgery as a consulting physician at Shepherd Center 23 years ago when he opened his private practice in Atlanta. He provides consultation regarding patients with skin complications, performs surgery on Shepherd patients at the adjacent Piedmont Hospital and sees patients in clinics he holds twice a week at Shepherd. He is board certified in general and plastic surgery. Q: why did you decide to become a physician? A: My mother encouraged me to become a doctor or lawyer. Also, I was strong in math and science. So, to take my skills to a higher level, I chose medicine. In fact, I was the first person in my extended family to graduate from college. Q: why did you specialize in plastic and reconstructive surgery? A: I always wanted to be a general surgeon. As a medical intern, the things I liked about surgery were the immediate results and gratification. The internal medicine physicians always had to order tests and wait for the results. Then as a resident, I applied to some competitive programs where I knew I could get lots of hands-on experience in surgery. At Cook County Hospital in Chicago, I did a plastic surgery rotation in a clinic where we operated on children with cleft lips and palates. I was enthralled to take babies who were missing palates and help make them look almost normal. It was an aha moment for me. I was the first graduate of the University of Illinois to complete a general surgery residency and then go on to complete a plastic surgery residency. In the fourth and fifth year of my general surgery residency, I got to do all kinds of surgeries, and it made me a better surgeon. I learned to make decisions quickly and how to handle complex cases. But I decided to go on to plastic surgery, not for the breast augmentations, facelifts and money, but because of the experience I had in correcting cleft and missing palates. Q: describe your role as medical director of reconstructive surgery at shepherd center. A: I am the go-to guy when complications arise with patients skin. I provide consultations for reconstructive surgery and staff a skin clinic at Shepherd Center twice week in which we see at least 40 patients. I have always considered my work at Shepherd Center to be the most rewarding part of my practice. When a patient has a large pressure sore, which can be fatal, my biggest joy is when I tell patients who are doing well at several months post-operation that I never want to see them again professionally. They laugh and always thank me for helping them. That s the most rewarding part of the job. Also, I consider it part of being a doctor and part of practicing at Shepherd Center that I treat every patient as I would treat them if they were my own family member. Shepherd Center is a remarkable, magic kingdom. People come here with their lives altered so much by injury. With help from their treatment team, they are able to overcome adversity and live productive lives. It is always inspiring to see this happen. The energy this hospital has makes me a better person. So, practicing medicine here is my way to give back. Q: what are some things you ve learned from your interactions with shepherd center patients through the years? A: Never give up hope. That s very important. I ve seen patients using wheelchairs and then six months later, they have walked into my clinic. Always have confidence in yourself. If you lose that confidence, you re not going to progress with your life. I ve seen some patients learn to discover the unexpected blessing of their injury. In time, the injury experience leads them down a different path to a more successful and meaningful life perhaps even more so than if they had remained able-bodied. q 5. experience: Medical Director of Reconstructive Surgery, Shepherd Center, 23 years; also operates a private practice in Atlanta residencies: University of Illinois Medical Center and Medical College of Virginia internship: University of Health Science, Chicago Medical School medical school: Chicago Medical School random facts: For five years, when he was in high school and in college, Dr. Simon worked as a nurse s aid in a Chicago hospital. It taught him to be respectful of nurses and patients and reinforced his interest in becoming a physician, he says. Dr. Simon has participated in several medical mission trips to Haiti, Kenya and the Philippines through the Christian Children s Fund. In his free time, Dr. Simon enjoys writing and creating product lines to promote health and wellness. More story and photos online at ShepherdCenterMagazine.org Spinal Column / summer

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9 fighting the good Fight [ Two soldiers battle back from spinal cord injuries To return To duty. by bill SAnDerS PhotoS of tom boone by russell klika PhotoS of MArcoS MADriD by Abby greenawalt ]

10 8 ShepherdCentermagazine.org When someone such as Tom Boone says rehabilitation for a spinal cord injury at Shepherd Center was one of the physically toughest, but most rewarding, things he s ever done, it means something a little extra. Knowing his title and job helps to explain. It s not Mr. Boone; it s U.S. Army Special Forces Sgt. First Class Tom Boone, 30, a Green Beret soldier stationed at Fort Bragg, N.C. Tom sustained a C-4 to -5 spinal cord injury (SCI) and was diagnosed with central cord syndrome, which limits function in the upper extremities more than the lower ones. He was injured in an all-terrain vehicle (ATV) accident in September 2010 while attending a family reunion near Nashville, Tenn. There s never a good time to flip an ATV and injure your spinal cord. But the timing seemed particularly cruel for Tom. He d been married just six weeks when the injury happened. And he had just finished two years of Special Ops training and was about to deploy as a Green Beret. It s what I had trained for, Tom says. I wanted to get back to kicking down doors and shooting the bad guys. I think I still will get back to the front line and do the job I had trained for. If it were not for Shepherd Center, I know I wouldn t be having a conversation like this, even entertaining thoughts of being able to do things that physical, he adds. I m still in awe at what all I saw and experienced at Shepherd Center. Few can understand Tom s motivation better than Marcos Madrid, 45, of Fairfax, Va., a retired Special Forces soldier and current civilian employee of the U.S. Army. As part of his requirement to stay

11 physically fit for his job, Marcos was mountain biking in July 2010 when he wrecked his bike and sustained a C-4 to -5 SCI. He, too, was diagnosed with central cord syndrome. Like Tom, Marcos underwent inpatient rehabilitation at Shepherd Center under the care of physiatrist Anna Elmers, M.D. Also like Tom, Marcos was scheduled to deploy for an overseas mission when he was injured. But as a 45-year-old, he d already seen several overseas tours of duty as a Special Forces soldier. Today, Marcos is 95 percent recovered and has returned to work and to mountain biking. Eventually, I will deploy and support those operations, Marcos says. I ve been deployed before. I ve been there, done that, but I want to go back. I may not be at 100 percent, so not all missions are going to be a good fit for me. But I think there will be a mission where I can serve in deployment again. ToM S ACCIDENT, Rescue and Rehabilitation For Tom, it felt as if his whole life was in front of him on Sept. 10, He had a beautiful new bride, and the rigorous, meticulous training required to become a Green Beret was behind him. His personal and professional life seemed set. Then, on a family reunion weekend in Nashville, Tom s wife, Meredith Boone, went boating with part of the family while Tom went to ride ATVs with his uncle and cousins. For some reason, I had a bad feeling about him going riding that day, Meredith recalls. I kept telling him to be careful and check in with me. When his Uncle Bobby called me, I thought he was joking at first. This couldn t be real. Tom was taken to Vanderbilt University Medical Center. The diagnosis wasn t good at least not at first. I remember them telling me that I d probably never walk again. Tom says. Then this doctor, (orthopedic surgeon) Dr. Clint Devin, who is some kind of superstar doctor, walks in, looks at the MRI and X-rays and said, I think I can fix this guy. Tom had already improved his chances for recovery before he ever got to Vanderbilt. As a trained Army medic, he knew the importance of stabilizing a patient with a spinal cord injury, even if he was the patient. He instructed his cousin and uncle to get the emergency kit out of his truck and to put a neck brace on him and then not to move him. After surgery, Tom regained some sensation in his feet, and everyone believed it was a good sign. Two weeks later, he was taken by ambulance from Nashville to Shepherd Center. As thankful as the Boones are for what Dr. Devin and the Vanderbilt team did, what happened over the next couple of months at Shepherd Center left them almost speechless. Rehabilitation was completely different from the physically taxing things I ve done, Tom says, and I ve done some things that not many would ever think about doing. The rehab was the most difficult thing I ve ever had to do, telling my body to do something and having it not do it, then relearning how to make it happen. Everyone at Shepherd Center was awesome, Tom says. Even on days when I was being pig-headed and wanted to pout, that was not an option. I would throw a little temper tantrum and say I wasn t going to do something that day, but my treatment team always won. It is because of them, that I can run, climb a rope, go to the shooting range and teach my 10 years of military experiences to young privates. Meredith got to witness the spirit of Shepherd Center in a way that only spouses can. In some ways, the spouse gets to see so much more of what is going on around their loved one and in the rest of the hospital. Watching wasn t always easy, Meredith recalls. But the outcome was typically good. It was amazing, she says of her Shepherd experience. At first, you are in shock, then you wonder how all these people are all so happy. You feel like you re the only one in the world this is happening to until you see this great community. At Vanderbilt, they had him standing up before he left there, but his blood pressure was an issue, and he d pass out, Meredith recalls. When he got to Shepherd Center, on the first or second day, they had him walking with a gait belt at the parallel bars. Then, I was the one about to pass out. Meredith adds: When we found out at Vanderbilt that Tom had central cord syndrome, it was heartbreaking. Tom is so strong-willed and self-reliant. Luckily for us, we had Shepherd Center to help. It was extremely hard for him to lose his independence, and when he started to recover, it was just as hard for me to give it back. Dr. Elmers says there was never doubt in her mind that Tom would reach his rehabilitation goals. And she thinks his future goals are certainly attainable. Patients who have gone through military training are often our best patients and have the best outcomes, she says. The training Tom had gone through, it s obviously not easy. I know soldiers go through a lot in training camps, both physically and psychologically. Their attitudes and work ethic pay off in rehabilitation here. u.s. Army Special Forces Sgt. First Class tom Boone, 30, is a Green Beret soldier stationed at Fort Bragg, n.c. he sustained an incomplete C-4 to -5 spinal cord injury in an Atv accident in he was diagnosed with central cord syndrome. today, he has returned to duty as a medic and instructor. MARCoS ACCIDENT, Rescue and Rehabilitation Imagine a tough, veteran Green Beret, and that describes Marcos, Dr. Elmers says. What you see in movies about soldiers, Marcos is that kind of person, she explains. He has a dry wit, but was very serious about his rehabilitation. He s the type of patient that we ll remember 30 years from now. The feeling is mutual. Marcos retired in 2009 after 20 years in the U.S. Army, the last 11 of which were in the Special Spinal Column / summer

12 Marcos Madrid, 45, of Fairfax, va., is a retired Special Forces soldier and current civilian employee of the u.s. Army. Marcos was mountain biking in July 2010 when he wrecked his bike and sustained a C-4 to -5 SCi. he, too, was diagnosed with central cord syndrome. today, he is back at work for the Army. Forces. In 2009, he became a civilian employee in support of Special Ops. He was about to deploy to Afghanistan when he was injured. I was doing some last-minute training before deploying and was riding my mountain bike on a trail I had ridden for eight years, the same route, with the same group, Marcos recalls. Somehow, I went over a log, and it drove my head into the ground. I knew it was bad from the moment it happened, but I also remember thinking I would 10 ShepherdCentermagazine.org overcome it and quickly. I couldn t move anything, couldn t tell where my arms were, what position they were in. Marcos was second to last in his group of 12 bikers on the trails. Had he been last, he s not sure how quickly he could have gotten help. As it was, he was able to get the attention of the last rider, who stopped to help his friend. We were deep in the trail, so it took paramedics about an hour to get to me, Marcos recalls. They dragged me out on a back board, then to a Gator (all-terrain vehicle) and then to an ambulance. This whole time, I m thinking it will go away. I will fight through it like everything else. I had just shocked my system. I thought I d be running again the next day. It didn t get any better in a few hours, and I started to realize that it was not looking good. That s when depression hit. Like Tom, Marcos had central cord syndrome. That meant nothing to Marcos, who just wanted to know whether he d be walking and running again, and when. Basically, it s a crap shoot as to what comes back after the swelling goes down, Marcos says. I needed an answer. Was it 50-50? 75-25? But they didn t know. Twelve weeks later, Marcos left Shepherd Center with most of his questions answered. When I got to Shepherd, I couldn t move, he recalls. As far as I m concerned, I couldn t do anything. Within the first week, my therapists had me standing me up, even though I still couldn t move. I was on a backboard, and they had me support myself. It was a good milestone. The following week, while I couldn t control what I was

13 doing, they had me walk in a harness. If I had laid in bed, which is what often happens at other hospitals, I might still be in bed. Two Soldiers Back on Duty Marcos has one regret about joining the Special Forces that he didn t do it sooner. Definitely I would do it again, he says. I wish I had done it earlier. I liked the full-on volunteer nature of enlisting. Everyone is there because they want to be there. No matter what you re doing, everyone is there because they chose to, and that adds some peace of mind. Tom, of course, wants nothing more than to have a shot at what Marcos had 11 years in the Special Forces. I had no intention of making it a career, Tom says. I went into the National Guard right out of high school. It was going to pay for college. While in the Indiana National Guard, I worked with some Green Berets. I thought they are a lot cooler than I am. I want to be one of these guys. Both Marcos and Tom plan on continuing a career that involves deployments. I believe I can do that, Tom says. Physically, I m nowhere near the man I was, but I m getting closer every day, and I do hope to get back to the frontline fight. I m a stubborn guy. No one will tell me what I can t do. Dr. Elmers believes Tom can and will do that before too long. As for Marcos, he might have already gone back to Afghanistan and just isn t saying so. I think he thought he was going soon against doctor s orders, Dr. Elmers adds. But I know that s where his heart is, too, so as his doctor, I m fine with it. q Share Military initiative provides hope and recovery for wounded Military personnel By Bill sanders Patients who have served the u.s. military have long been an important focus of the medical treatment and rehabilitation programs at Shepherd Center. But since early 2008, after philanthropist Bernie Marcus learned about the gap in care for military personnel with brain injuries, the hospital has served more than 124 service members through the ShAre Military initiative. Marcus funded the program initially, but after publicity about its success in helping wounded service members either return to the military or transition back to civilian life, ShAre (Shaping hope and recovery excellence) has garnered financial support locally, as well as nationally. it truly is remarkable that we continue to see the generosity in support of wounded service members so these heroes can receive the much-needed private sector care they deserve until the military health care services ramp up, says Susan Johnson, program director of Brain injury Services. though ShAre initially provided treatment for active-duty military personnel who sustained spinal cord and/or brain injuries either on the battlefield or stateside, the program based on increasing need has evolved, Johnson explains. now, it focuses on comprehensive treatment for military personnel who have sustained mild traumatic brain injury (mtbi) and post-traumatic stress disorder (PtSD) while serving in iraq or Afghanistan. they have suffered from numerous blast injuries with subsequent PtSD and have often have been misdiagnosed or untreated, resulting in a number of other chronic issues, Johnson says. ShAre participants undergo outpatient treatment in a 10- to 12-week program in which they are housed together in apartments close to Shepherd Center. Services provided run the gamut from physical, cognitive, behavioral and psychological treatment, including family and vocational counseling. Since its inception, ShAre has collected a lot of outcome data from the treatment program. the data indicate that clients are improving in cognition, depression, PtSD, headaches, pain and sleep, Johnson notes. once they transition back into the military or civilian life, clients are managed and followed by ShAre s military services transition coordinator for up to a year or more based on their individual needs. the ShAre leadership team has just developed an enhanced transition treatment program that measures the individual success of clients. this model is individualized using a goal attainment scale that the client determines for monitoring his/her success, Johnson explains. Clients can use outlined strategies to cope based on the ups and downs that may occur during their transition. the pilot program has shown a lot of merit, she adds. right now, we know how many go back to work or return to active duty, but we want to learn more about their day-to-day development after they leave, Johnson explains. this new standardized measurement scale will help give us more objective data. Meanwhile, fundraising continues for the ShAre Military initiative. tricare military insurance covers only some of the costs of treatment. So, funds donated to ShAre fill the gap. the program needs about $70,000 a month to sustain its current patient population of 10 to 12 soldiers at any given time, Johnson says. Donors continue to give generously to ShAre, and the program is well on its way to meeting its funding goal in the current fiscal year, she adds. ShAre expects to get a boost later this year from funds raised in the hospital s largest fundraiser of the year the legendary Party. it is scheduled for nov. 3, 2012 at the ritz-carlton, Buckhead. ticket information for the gala event will be available soon at For more information on ShAre, see Sidebar story and photos online 5. at ShepherdCenterMagazine.org Spinal Column / summer

14 A patient with seven children imparts life lessons to his family and draws strength from them during his recovery. by bill SAnDerS 1. To 12-year-old Sylvia Meredith, Shepherd Center was the perfect location for a superhero to do battle with his arch nemesis. Sylvia, and her six siblings, spent weeks in early 2012 living in Shepherd Center s Woodruff Family Residence Center while their dad, Tim Meredith, 42, of Bristol, Tenn., underwent rehabilitation for a stroke. In a story Sylvia wrote during her dad s rehabilitation, Batman became a patient at Shepherd Center after a car crash caused by The Joker. The Joker got so frustrated with Shepherd Center for doing such a thorough job in treating Batman that he set out to destroy the hospital. The Joker foiled his own plan, though, when he fell off the roof of the hospital. The Joker then underwent rehabilitation at Shepherd Center before going to prison. I thought this would be a good way to say thank you to Shepherd Center and make them laugh, says Sylvia, who sent her story to hospital cofounder Alana Shepherd. I figured out a problem and a good solution to the problem. I tried to make Shepherd Center the hero. The Meredith children, ranging in age from 8 months to 12, witnessed the heroics of the Shepherd Center staff on a daily basis. Alison Meredith, Tim s wife, homeschools the children, and after consulting with Tim and counselors at Shepherd Center, she decided to relocate her family to Atlanta for the duration of Tim s rehabilitation. Catherine Rogers, Ph.D., a clinical neuropsychologist at Shepherd Center, says in this case, having the whole family participate in the daily therapeutic process was beneficial not only to Tim, but also to Alison and the children. One thing we recommend for families is to keep as much structure and routine for children as possible, Dr. Rogers says. For the Merediths, with the kids being homeschooled, it would have been more disruptive for them to be apart from their parents when they were so used to being together during the days and evenings. It s amazing, given that they have seven children, how orderly things were and how well they did being on the Acquired Brain Injury Unit. Alison knew the stay in Atlanta would be a 12 ShepherdCentermagazine.org

15 PhotoS BY louie FAvorite AnD leita CowArt disruptive time for the children. The question was, Would it be more helpful, in the long run, to have the children with their dad? I asked three of my closest friends, Am I nuts? before bringing the kids, she says. Everyone agreed with what I was thinking. So the kids were packed up and brought down to Atlanta. The kids learned in a real way that family matters, and you drop everything and do what it takes to love Dad. Shortly after experiencing strokes caused by an iliac aneurysm, Tim s chances of survival were poor, according to his doctors in Tennessee. But the Meredith family never lost hope, instead choosing to pray and then to focus on things they could control. Tim, who was discharged from Shepherd Center in late March, says he is proud of his children and thankful for how the hospital staff helped them understand and cope with his injury. For Sylvia and Peter (age 10), this will be a defining part of their childhood, Tim says. It s all been hard on them, but I think it would have been harder for them to stay at home. They got to come together around their dad and saw me take this journey. I think it strengthened them. Dr. Rogers says that being at Shepherd Center was not only good for the kids, but helped in Tim s recovery. It made a big difference with his mood having the contact with his family, she notes. It helped emotionally, but also physically, because he was so motivated to do the work involved with therapy, in large part, because he was surrounded by his family. Dr. Rogers adds that in some other cases, having children at the hospital every day might not be good for the patient. It varies, depending largely on the patient s condition, she says. In this case, it was really good because Tim felt like the same person to them. It s harder for kids when the patient is very disinhibited or acting out verbally or physically. He didn t have that kind of personality change sometimes caused by a brain injury. The Merediths are back home now. Tim wants his children to understand that he may never be 100 percent recovered from his stroke. It s a life lesson that children have to learn at some point. But he also wants them to know how grateful he is for his many blessings mainly, his seven children and a loving, committed wife. q Former patient tim Meredith and his family visit with neuropsychologist Catherine rogers, far right, outside Shepherd Center s woodruff Family residence Center, where the family stayed while he underwent rehabilitation for a brain injury. 2. Amanda Shank and her children meet with Gale eckstein in Shepherd s Family Services Department. Sidebar and photos online at ShepherdCenterMagazine.org Spinal Column / summer

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17 A True Reflection Young people with spinal cord injuries share their self-image struggles and triumphs. by john christensen When 18-year-old Kelsey Sasser was a freshman at Holy Innocents Episcopal School in Atlanta, her English teacher told the class If you re going to talk the talk, you ve got to walk the walk. Kelsey quipped, Are you trying to make fun of me? Her classmates laughed, but the teacher was horrified, thinking he d offended her. He hadn t. That s just the way I roll, she says. Kelsey has been rolling since she was six years old, when she sustained a complete T-3 spinal cord injury in an auto accident. Now a recent high school graduate, she is a poised young woman whose stunning photograph of a smudged, onelegged Barbie doll won a photography contest. She also hit the bull s-eye three times the first time she shot a 9-millimeter pistol, programs the family s electronic devices and English teachers take note was voted by her classmates Most Likely to Make You Laugh. Kelsey describes herself: I m shy to a certain degree a bit reserved until I know what s going on. But once you get to know me, I might not be quiet ever. However, adjusting her self-image to accommodate her disability, as many teen-agers discover, was not easy. Her struggles began in the southwest Georgia town of Blakely, where the family lived when she was injured. Although Kelsey downplays those early years, her mother, Rhonda Sasser says: She had a really hard time. She felt different, and her teacher didn t understand why Kelsey would have to leave the room so much, why it took her so long in the bathroom and why she was sick so often. Her new normal and the lack of understanding she encountered stressed everyone in the family, and things didn t improve when they moved to Dothan, Ala. The teacher left her alone, Rhonda says, and the kids followed suit. But after moving to Atlanta in 2002, Kelsey met other young people like herself in Shepherd Center s Outpatient Services Department and found she was usually accepted wherever she went in the city. In school, it was no big deal, Rhonda says. I think the kids felt, Oh, it s just Kelsey. She becomes Kelsey, not the chair. It was easier for her and for us. Nevertheless, Kelsey, her older sister, Lexa, and Rhonda herself participated in counseling to help them adjust to their new reality. Before the accident, Rhonda says, Kelsey was sassy and very self-confident and independent. For a while after, it was difficult for her. Her self-esteem kelsey Sasser, 18, recently graduated from holy innocents episcopal School in Atlanta. Years after sustaining a spinal cord injury, she is now self-confident and outgoing. She enjoys photography and won a Critics Choice Award for her work in a competition in Atlanta. the photo depicts a damaged, but still beautiful Barbie. Finding the beauty in negative places proves hard to some, but for others, when that nut is cracked, the true beauty shines through more powerful than before, kelsey says. PhotoS BY GArY Meek Spinal Column / summer

18 1., 2. Former patient luke easterwood, 22, of rome, Ga., regained his selfconfidence in time after his injury. he recently graduated from Georgia Southern university and will be entering graduate school at the university of washington this fall. 3., 4. Former patient Schuyler Jenkins, 20, of ellenwood, Ga., right, returns to Shepherd Center to provide peer support to patients, including Brady Conaster, 19, of Cunningham, tenn., left. he keeps in touch with his former therapists, including Cheryl linden and Cathi Dugger. was not very good. But now she s sassy again. She thinks, Yes, I can do it. Sometimes young people are embarrassed at having a disability, says Kathy Mattox, a nurse in Outpatient Services, who has seen Kelsey in the clinic since But we get them out in the community and teach them how to handle people who lack knowledge about people with disabilities. Kelsey grew up in that chair. Kelsey has a good self-image and is proud of her accomplishments. She is a wellrounded teenager and has a bright future. Cheryl Linden, a counselor who works with Shepherd s adolescent inpatients with spinal cord 1. injury, says young people with disabilities worry about how they appear to others, whether they ll be able to do what others do and whether others will want to be around them. They worry about getting around, about complications from bowel and bladder programs, and, naturally, they wonder about dating. One of the best predictors for a good self-image, Cheryl says, is strong support from family and friends. In fact, she says, Some who are more independent physically have a harder time at home than those who are less independent, but are better emotionally because of that support. Another indicator is personality. Everyone has different coping skills, and someone who is highly motivated before their injury may also be motivated to recover from it. It s not just about adjusting to a spinal cord injury, Cheryl says. It s also about taking charge of your life again and how you put yourself out there and perceive yourself rather than how others see you. Others take their cues from you. But what teen-agers seek most is conformity ShepherdCentermagazine.org

19 PhotoS BY JereMY wilburn AnD leita CowArt Image is everything, Cheryl says. They want to be like everyone else; they don t want to be seen as different. They want to fit in, whether that means having long hair or wearing your pants hanging down. They identify with the group. She adds, I can talk about those things, but I m not a teen-ager and haven t been for some time, and I don t have a spinal cord injury. Thus, the need exists for peer supporters teenagers and young adults who have overcome the physical, emotional and psychological challenges of spinal cord injury and are living independently. Take Luke Easterwood, 22, of Rome, Ga., for example. Luke sustained a complete T-5 to -6 spinal cord injury in a motorized scooter accident in November But he graduated from Georgia Southern University this spring in just three years while also working as an intern at a university magazine. He will attend graduate school at the University of Washington this fall. Luke learned to care for himself so well that he bristles when someone holds the door for him. I feel it s almost like telling the other person I can t do it for myself, he says. I don t mind it if I ve got a box in my lap or something, but I like being an activist and being empowered. But he admits that his injury did change his self-image. I can t move around like I did, he says. And things like transferring from a bench to my chair are uncomfortable. But I also know it s important not to worry, to be myself and not attached to the chair. A book he read convinced him that it s not enough to go only places that are accessible, or you re making yourself inaccessible. You re putting yourself in a box if you don t try to go, he says. So he has gone to concerts and soccer games, and wears neon-green laces in his tennis shoes to make people look at the laces instead of the chair. Schuyler Jenkins, 20, a peer supporter from Ellenwood, Ga., sustained an incomplete C-4 to -5 spinal cord injury in an auto accident in November Although he is walking again, he still uses a wheelchair at times and says: I m pretty insecure. I was in tiptop shape for 19 years and could bench press 500 pounds. Now, I can barely lift 100, and I m not able to do as much as I used to. But even though I m battling, it s still worth it to share something that would mean something to someone else. Throughout his ordeal, Schuyler says, his friends were steadfast. It s like I ve got eight mommies, he says. Kelsey says her friends don t see her as being in a wheelchair and haven t changed at all, and that she has an active social life. And, yes, she says, she fits in. Yeah, I stand out, she says, but not in a bad way. I m the only one sitting down. But I m pretty confident. Everyone has insecurities, but I have pretty high self-esteem. And if someone sees only my disability or has a prejudice against me, they haven t spent enough time with me. They d see otherwise. q atlanta School Forms a Special Bond with Shepherd Center By John christensen when rhonda Sasser looked for a high school for daughter kelsey, she called several private schools in the Atlanta area and asked if they would admit a child in a wheelchair. Most of them said no. But holy innocents episcopal School not only enrolled her, it also renovated bathrooms to make them accessible and installed push plates at the doors. that was a big deal, rhonda says. they didn t have to do that. holy innocents makes it a habit to accommodate students and faculty with disabilities and make them feel welcome. in one case a few years ago, a third-grader was temporarily restricted to a wheelchair and unable to get to classrooms on the second floor. the third-grade classes were moved to first-floor classrooms until the student was able to walk again. in another ongoing case, a lower school chaplain has a disability, so students are brought to her for class. holy innocents students also volunteer regularly at Shepherd Center, doing such things as making courage cards, putting up holiday decorations, decorating trays and painting ceiling tiles. Some of their parents also volunteer at Shepherd. Community service is something we value and try to instill, says Associate headmaster rick Betts, and we maintain a relationship with Shepherd Center, where the students can go and serve and build relationships. our community gets a lot out of it, and i know Shepherd Center appreciates what we do. our association with holy innocents is special, says Dean Melcher, the Shepherd Center Foundation s director of annual giving. we ve had a very long and deep relationship. Aside from volunteer activities and individual donations, Betts estimates that fundraisers such as read-a-thons and fun runs have contributed an additional $30,000 to Shepherd Center in the 14 years he s worked at the school. Janet Silvera, who teaches middle school science at holy innocents, was a patient in Shepherd Center s Acquired Brain injury unit following a stroke in early At her request, the holy innocents Parents Association donated more than $14,000 from its 2011 Fun run to Shepherd Pathways, the hospital s post-acute brain injury rehabilitation program. holy innocents has a very strong family relationship among faculty, parents and students, Janet says. And a number of our students and parents have been patients at Shepherd Center. i really wanted to do something to give back because when i walk into that hospital, i get an overwhelming feeling of comfort and appreciation for the ongoing support that Shepherd provides for patients and their family. i am blessed to be able to teach again. Former Shepherd Center patient Janet Silvera teaches at holy innocents episcopal School in Atlanta. Photo BY GArY Meek More story and photos online at ShepherdCenterMagazine.org Spinal Column / summer

20 The Winning Vows former patient and his new wife win a national contest with the wedding vows she penned in just a few minutes. by bill SAnDerS 18 ShepherdCentermagazine.org