And The Lame Shall Walk
Noted exercise physiologist Gary Dudley conducts research aimed at helping patients with brain and spinal cord injuries walk again. Ironically, it's a battle he's now waging himself.
by Doug Monroe (ABJ '69)
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A large man dangles like a marionette from a harness that supports him so he can exercise his legs with out the burden of his 220 pounds. But he struggles even as a treadmill inches along at only 1.1 miles per hour. He drags his right leg, and his left leg bears a bright red scar where his shattered tibia and fibula pierced the skin. His wife and two of his children—who, with the help of a therapist, have lifted him out of his wheelchair and strapped him into the harness—are standing beside him, cheering as if he were running an Olympic sprint.
This specialized type of treadmill plays an integral part in a muscle study conducted by nationally recognized exercise physiologist Gary Dudley in conjunction with Atlanta’s Shepherd Center, the country’s largest hospital for spinal cord and brain injuries. But the man in the harness is not the subject of a study by Dudley, a fiercely ambitious scientist who wants to find ways to heal spinal cord injuries—and, one day, to help paralyzed people walk again.
The man in the harness is Gary Dudley.
Gary Dudley became fascinated by exercise physiology when he took it as an elective while a math major at Marshall. He earned a Ph.D. in exercise physiology at Ohio State and was passionate about research, but he also had a jock’s interest in exercise. He played basketball as a freshman at Marshall and even as he approached 50, he could lift staggering amounts of weight, bench-pressing up to 415 pounds.
Initially, he went to work for NASA, where he studied the impact of space travel on astronaut’s bodies, specifically muscle atrophy due to lack of use. He arrived at UGA in 1993. A demanding teacher, Dudley employed his own version of the Socratic method: When a student asked him a question, he fired back another. If the student answered correctly, Dudley exclaimed, “Bingo!”
In 1996, a grad student mentioned that she was going to the Shepherd Center for a research project, and Dudley decided to tag along. He had no formal invitation to work with the Shepherd Center staff; he volunteered because he wanted to help patients recovering from life-shattering injuries. Two mornings a week he would accompany Dr. David Apple, the center’s medical director, on rounds, driving over from Athens before dawn.
July 9, 2002, started out warm and sunny. Gary Dudley pulled out of the driveway of his home on 28 acres of Oconee County forest. He reached Colham Ferry Road, then turned north for the 20-mile journey to his office on the UGA campus. He had traveled about five miles when a Honda Civic approaching from the opposite direction ran off the road into a gravel rut. The driver overcorrected to get back on the pavement and in a split second the little car crossed the centerline and ran directly into Dudley’s pickup truck. The Civic was crushed beneath the truck, its roof ripped off, and the pickup was sent careening skyward. Dudley was thrown through the windshield.
State trooper Scott Smith remembers it as the worst accident scene he ever investigated. Dudley landed 150 feet from the crash—after his head smashed into a fence post. The driver of the Civic died on impact, as did her two young children.
Comatose, Dudley was rushed to St. Mary’s Hospital in Athens. He suffered a traumatic brain injury, a pierced and collapsed lung, an injured shoulder, a dislocated ankle and foot. The skin around his right eye was torn and the eye itself was damaged by splinters from the fence post he hit. His right side was paralyzed.
Tammie Dudley clung to one ray of hope: her husband’s iron will. He had survived three episodes of bone cancer, undergoing three hip replacements and the removal of a rib and a vertebra. He had been in a body cast three times. And after each surgery, he had rehabilitated himself, drawing on his extensive knowledge of the human body. On Aug. 5, eight days before he turned 50, Gary Dudley became a patient at the Shepherd Center. Physicians felt he would stay at Shepherd for a while, then be moved to a nursing home for the rest of his life.
Based on the research he had done at Shepherd, Dudley had landed a grant to study changes in cardiorespiratory and muscular health following spinal cord injury. He also had studied MRIs of muscle biopsies, identifying a relationship between fat and the tendency of quadriplegics to develop diabetes. After spinal cord injury, muscle changes from lean to high-fat content (a process akin to the marbleization of meat when cattle are kept inactive). Along with increased fat content comes an increased inability to process sugar, so blood glucose tolerance increases, leading to diabetes.
To counteract this effect, Dudley used electrical stimulation to help injured and paralyzed patients lift weights with their legs. Surface-mounted electrodes were attached to their thighs. The electrical charge was strong enough to make the muscle contract and lift the leg, with a weight attached to the ankle. Dr. Michael Jones, Shepherd’s vice president of research and technology, says Dudley’s work played a fundamental role in the realization that patients need some kind of physical activity to maintain muscle strength and bone density in their legs.
Gary Dudley remained unresponsive until Aug. 17 when his primary physician noted a change. “Patient is awake and alert,” wrote Dr. Donald Leslie on his chart. Dudley’s agitation increased. Infections flared. He began to feel more and more pain. It was the beginning of his recovery.
Dudley remained at the Shepherd Center for four months, heavily medicated, confused about where he was, but gradually improving. On Dec. 5, 2002, he was loaded into the family’s Chevrolet Astro and taken home to Watkinsville. People at Shepherd had tried to explain to Dudley that he had been in a terrible wreck. At home, Tammie finally told him that a woman and two children had died in the crash. “He started crying when I told him that part,” says Tammie.
Dudley’s support team includes his family and Ron Courson, head athletic trainer for the UGA football team, who sent word that Dudley was welcome to begin his rehabilitation in the same Butts-Mehre facility where injured football players undergo rehab. Dudley’s brain injury was his most significant obstacle because it led to the paralysis. He also spoke haltingly and hoarsely, barely above a whisper. But he did tell Courson about the body-weight-supported treadmill at Shepherd, which Dudley wanted to use for his own recovery.
“To be honest, that was something I hadn’t done before,” says Courson. “Gary gave me articles where he had studied it. Then we found someone to give us a grant to get the system in our training room.”
The harness that came with the treadmill was uncomfortable, so Dudley mentioned the Shepherd harness he had modified. Courson ordered two, and now routinely uses the treadmill to rehab UGA athletes.
“I’ve got a patient giving me therapy advice!” says Courson. “I’m rehabilitating one of the foremost authorities on this particular type of training. He’s one of the top strength-conditioning researchers in the country and also a great weight-lifter—that’s probably one factor in saving his life.”
At first, Dudley was dead weight. It took four people to lift him from his wheelchair and strap him into the harness. He gradually improved to the point where Tammie and daughter Kara could help him onto the treadmill by themselves. He began to lift weights. Student trainers worked with Dudley on a mat as he did sit-ups to the point of exhaustion. They stretched his muscles, with Dudley demanding, “Push more!”
He started working on his home computer as soon as he could, typing e-mail messages with his left hand because his movements were limited in his dominant right hand. In the spring of 2003, Kara started taking him to his office at UGA. Soon he was applying for grants again. He returned to the classroom in the fall of 2003, wearing a microphone headset so his students could hear him. With Tammie’s help, he resumed his laboratory research.
In January 2004, Dudley had to face up to a problem discovered just weeks before the wreck: His bone cancer had returned. He and Tammie flew up to the Mayo Clinic, where doctors removed three ribs, adding more battle scars to his chest and back.
But that same month, Dudley began to use the treadmill without the harness. By March, he was taking smooth, consistent steps while traveling at 1.2 miles per hour for 10 minutes. By April he was up to 1.8 mph. He was curling 40 pounds with his right arm and 60 with his left. He started doing push-ups. He was working as hard as ever on studies and grants.
The joint initiative between UGA and Shepherd, which is now part of UGA’s Biomedical and Health Sciences Institute, has lost momentum since Dudley’s accident. “Regrettably, Gary’s injury slowed things down a bit,” says Michael Jones of Shepherd. Dudley continues to work on his own projects at UGA. With his students, he completed 21 papers in the last year. He has even begun to return to Shepherd, accompanied by Tammie—not as a patient but as a participant in research review meetings.
Just two years after doctors thought he would die, Dudley has overcome much of his paralysis. He still has some spasticity in his right arm and leg and has lost some vision in his right eye. He suffers back pain and speaks hoarsely. He has problems with balance and is reconciling himself to the possibility he may never walk without the aid of a cane. But the fact that he is walking at all amazes his doctors. Jones says Dudley “defies all odds in the extent of recovery he has already achieved.”
Dudley remains ever the maverick. Having pulled off a miracle in his own life, he now wants to do it for others. He believes that science eventually will help people with spinal cord injuries walk again. Exercise is a key, he says, but sooner or later Dudley knows researchers will have to go to the nerves.
Long before his accident, he enlisted Steven Stice, the UGA professor who is one of the world’s leading experts on stem-cell research, to help with his projects. Dudley knew that stem-cell therapy is widely regarded as the scientific key to repairing or even regenerating injured spinal cord tissue.
“I want them to get out of their chairs,” says Dudley. “People say we can’t cure it. B.S.! If they can put a man on the moon, why not?”
On March 31, Dudley was awarded UGA’s prestigious
Creative Research Medal. One of the nomination letters was written by Stice.
“He became one of the people he was trying to help with his research,” Stice wrote. “My analogy of Gary’s creativeness over the last couple of years and his career is that a terrible storm came in and wiped out his house above ground, but not the foundation to build on again. Given Gary’s creative ability, he is building his house back up—and this new house will be better than ever.”
Doug Monroe is an associate editor at Creative Loafing.
This article was adapted from a longer story that ran in Atlanta Magazine, which granted reprint rights.
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PHOTO GALLERY
photos by Robert Newcomb
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| Before the accident, Dudley was working with Shepherd Center patients to help them avoid muscle atrophy and diabetes. Then he became a patient. An inspiration to all, he's now back at Shepherd as a particpant in research meetings- and UGA recently awarded him its prestigious Creative Research Medal. |
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| Expected to die or be confined to a nursing home as a result of an auto accident, Dudley has made a remarkable recovery- thanks to wife Tammie, and iron will, and rehab deviced he customized. |
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| Dudley's recovery is due in part to specialized equipment that allows him to strengthen his muscles through rigorous exercise. |
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