Going into the Fourth of July weekend, I got a phone call saying that a police officer had been in an accident. He was a highway patrolman, and he’d been in a funeral procession for a firefighter. You know how the officers bring the motorcycles to block off the intersection? Well, his motorcycle was cut off by a car, and when he swerved, he was hit by a city bus.
When he came in, he had a tube in his throat and couldn’t speak. He looked destroyed. He is six foot five or six foot six, and it was striking to see this hulking man who could barely move. Below the level of his biceps, he wasn’t moving at all, and his biceps were weak. That’s usually the sign of a complete spinal-cord injury, which means the patient will wind up paralyzed.
- My Toughest Case ...
- Treating a Contract Killer
- Removing a Tumor
- Telling a Patient He Has Six Months to Live
- Fixing a Muscle Disorder
- Operating on a Pregnant Woman
- Rebuilding a Police Officer’s Spine
- Saving a Lightning-Strike Victim
- Diagnosing a Friend’s Mystery Illness
- Also: How the Best Doctors Are Chosen
There were brother officers everywhere in the hospital. The patient’s wife was there, as were his father and twin brother, who are also police officers. The dean of the hospital came in with Mayor Bloomberg and Ray Kelly. I thought we were looking at a young man who would be in a wheelchair for the rest of his life. The patient’s wife had just had a child, and my wife was pregnant with our first child. I thought about what would happen to my family if I were in his place. As surgeons, we try to stop ourselves from thinking like that, but in this case I could really identify with the patient.
The officer’s spinal column was broken in two places. Two vertebrae were shattered and the fragments were severely compressing the spinal cord. It was like being called in to fix a collapsed building that has lost a major supporting wall. You have to go in and clean up the collapsed bricks and mortar (the bony fragments), then shore up the building by rebuilding the supporting wall (the spinal column). Eventually the spinal bones will heal just like any other bones in the body, but you want them to heal in the correct position.
I was working together with an orthopedic surgeon. We did what’s called a 360-degree, front-and-back reconstruction. First, we went through the front of the patient’s neck. I was looking down at the bony spine and seeing only chips and pieces where the spine should be. I used a high-speed drill to remove the bone fragments. Because you’re working millimeters from the spinal cord, you have to be delicate or you can cause further paralysis. Once we removed the bone fragments, we needed to rebuild the support structure for the spine. We installed a titanium cage with bolts and screws, then we closed the patient up and essentially did the same thing from the back side. We basically took out the shattered bones and replaced everything with titanium. His spine looked like a ladder of scaffolding.
We were happy with the surgery in terms of stabilizing the spine, but we didn’t think the patient would move again. I told his family that we did the best we could, but were not expecting any recovery. He’d never walk again. They were rightfully devastated.
The next morning, when I came in, my resident told me the officer had wiggled a toe. I didn’t believe him, but when I went in the room the family showed me. And then I knew he had a chance. Later he wiggled a finger, and eventually moved an ankle. He was a strong young guy, and the rehab specialist worked with him for the next few months. He walked out of the hospital. Today he doesn’t walk perfectly, but he plays with his son, and he’s considering trying to get a permit so he can drive for the Fire Department. I’ve never been so happy to be wrong in my whole life.