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the Journal of Neurosurgery; in addition he served a term as director of the American Board of Neurological Surgeons. He has lectured and taught all over the world, from the United States to Taiwan, from Stockholm and Prague to Korea. He has received dozens of awards and grants to investigate cranial injuries and nerve regeneration. The coauthor of several books on the central nervous system, he has also contributed chapters in close to seventy others and published more than 260 articles in prestigious journals. It was just my great good fortune that he was at the hospital when I arrived, that he took control of my care and agreed to operate on me himself.

    Just after I regained consciousness. Dana and I dealt with ICU psychosis and prepared for surgery.
    At the small county hospital in Culpeper, little could be done for me. But fortunately the doctors there had methylprednisolone (MP) on hand and administered it to me immediately. Methylprednisolone is a synthetic steroid, which must be given within eight hours of the injury to have any effect. Doctors discovered in the 1980s that it can help fight the inflammation that occurs immediately after a lesion in the spinal cord. Not only does the victim suffer the damage caused by the initial trauma, but soon afterwards the entire central nervous system starts to fall apart, going down rapidly like a row of dominoes. The inflammation, which in my case extended down to the seventh cervical vertebra, causes the breakdown of fats into unstable compounds called free radicals that are like acid to cell tissues. In other words, healthy nerves below the site of the injury are being eaten alive, causing further loss of sensation and motor function. But in most patients MP can reduce this inflammation by about 20 percent. This 20 percent can mean the difference between patients breathing on their own and spending life hooked up to a ventilator.
    This is why being given the MP was so critical. Afterwards the staff at Culpeper could only wait for the medevac helicopter to airlift me to Charlottesville and the intensive care unit at UVA.
    As soon as I arrived there, Dr. Jane had me stabilized to prevent any more compression in the spine (a result of having landed straight on my head). Compression causes electrical impulses attempting to travel through the injured area to go haywire, which leads to the death of even more nerve cells. As these cells die another wave of destruction radiates out from the damaged site. Immune cells flood in and, in a frenzied attempt to clear away the accumulated debris, begin to chew up damaged and healthy nerves alike.
    So as the victim of a spinal cord injury at the C2 level lies immobilized and unconscious, inflammation is steadily destroying the essential functions of the body: breathing, bladder and bowel control, sexual response, and any motion below the neck. Only the heart and the brain continue to function normally.
    Dr. Jane had me placed on a bed and implanted a metal structure into my head just above the temples. Then he attached a heavy weight behind it to keep me immobile. I was hooked up to machines that monitored my heart rate, pulse, blood pressure, and oxygen saturation levels (SATs). I continued to drift in and out of consciousness. Sometimes I would attempt to flail and jerk my head from side to side, and they would have to sedate me even more.
    My lungs had begun to fill with fluid, making me highly susceptible to pneumonia. In the past doctors had no way of removing liquid from the lungs, and at this stage a patient usually died. I had pneumonia in one lung, but they managed to clear the infection with powerful antibiotics and by repeated suctioning—an extremely unpleasant experience. They stick a tube into your lungs and suck out the liquid. The tube going down your throat can be very painful, and you’re off the ventilator for at least four or five breaths, which can seem like an eternity. I dreaded suctioning more than any other