Instantaneous and voluntary was not supposed to be a state of motor control Reeve would ever achieve again not since he fractured his neck at the second cervical vertebra in a horseback-riding accident in 1995. But Reeve's doctors announced last week that a little of what the actor lost that day is coming back. He can move the other fingers of his left hand too, as well as his right wrist. He can straighten his arms and legs and, in a swimming pool, initiate a step and push off against the wall. And he can survive for up to two hours off his respirator. Most satisfying, he has regained a remarkable level of physical sensation. "[My wife] Dana likes to rest her hand on mine when we talk," Reeve says. "Now I don't have to look to see that it's there."
News of his progress has gripped the paralysis community. Experts rightly caution that one patient's improvement hardly guarantees the same for others. Nonetheless, Washington University in St. Louis, Mo.,where Reeve's therapy is overseen, has been flooded with e-mails and phone calls from others with spinal injuries. Doctors there stress that everything from individual anatomy to the extent of the injury to access to rehabilitative care and Reeve has had the best determines one's prognosis.
Yet the fact remains that Reeve is again moving and feeling if slightly making his the first known case in which a so-called C-2 quad has regained so much function so long after injury. And that's big news. Reeve's book describing his improvement, Nothing Is Impossible (Random House), will be published this week. On Wednesday at 10 p.m. E.T., ABC will air a documentary directed by his 22-year-old son Matthew, showing a day in Reeve's life. "I may be an isolated case," Reeve says. "But that shows we no longer know the limits of recovery. If we don't know, why not assume there are none?"
It takes a while inside the Reeves' airy house an hour north of New York City before you notice signs that the place is home to a man who navigates his days in a sip-and-puff wheelchair. But those signs are there: the 31-in. spaces between obstacles; the tall-legged dining-room table, allowing the whole family to pull up to dinner together; the stubbornly fraying seam in the living room carpet ("Tire damage," Reeve says with a laugh). But such easy domesticity was hard won for a man whose body suffered such a catastrophic insult.
Reeve's fight to reclaim his life was joined almost the moment he fell headfirst off his horse. In order to keep his paralyzed muscles from withering, his therapists put him on an exercise bicycle known as a functional electrical stimulus (FES) system, which uses electrodes to jolt leg muscles into a pedaling motion. A session on the bike builds muscle mass and provides a good cardiovascular workout. "My heart rate goes up 40 beats per minute," Reeve says, "and in seven years, I've lost an average of only an inch and a half off my thighs, calves and arms."
Reeve also threw himself into every other available therapy: sessions on a tilt table that allowed him to stand upright and bear weight; workouts to strengthen his neck and shoulders; treadmill training in which he was suspended over a rolling belt to get his legs moving in a rough gait. But while the regimen kept his muscle mass and his spirits up, it had no real effect on function, until one day in September 2000.
Reeve was talking to Dana in a sunny reading room and was trying to make a point emphatically. "Suddenly," says Reeve, "my index finger rose and fell. Dana asked if I was doing it on purpose. I said no, and she said, 'Well, try.'"
Reeve did try, and the finger moved as commanded. Two months later, he was in New Orleans addressing a symposium of neuroscientists when he met with Dr. John McDonald, a professor at the Washington University School of Medicine who was developing a therapy program for paralysis patients that he called activity-based recovery. While the paralysis community McDonald included believes that the road to a cure runs at least partly through the lab (see box), McDonald is convinced that a vigorous program of exercise and electrical muscle stimulation may also help awaken the nervous system. Reeve showed McDonald his finger lift, dismissing it as a "party trick." McDonald saw it as more.
Over the next month, he put Reeve through a battery of tests. Magnetic-resonance imaging showed that the signal commanding the finger originated in the correct region of the brain, meaning that at least one clean circuit was intact. With a little coaxing, Reeve brought more circuits online, learning to move other hand joints, wiggle his toes and push back when resistance was applied to his feet. Though he had noticed some sensation returning, he hadn't realized how much. A standard test with a cotton ball and a safety pin revealed that he was sensitive to a pinprick over 22% of his body and to a light touch over 56%.