THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Thursday, June 22, 1995 TAG: 9506220071
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: BY MARIE JOYCE, STAFF WRITER
LENGTH: Medium: 89 lines
DR. JOHN JANE is speaking from a phone in an operating room at the University of Virginia Hospital. It's mid-afternoon, and the neurosurgeon has been toiling since early that morning, removing a tumor that covers a woman's brain from the base of her skull to her orbital bone.
Now he gets a short break to talk to a reporter while a few feet away a colleague - an eye surgeon - works on the area around the patient's eye socket.
It's ironic, really. As a neurosurgeon, Jane can put his skilled hands on a patient's brain and perform feats that seem almost miraculous.
But when a patient has broken his spine, as Christopher Reeve did, Jane is like a doctor facing an infection in the days before antibiotics. All he can say is ``I'm sorry.''
It's a ``terrible frustration,'' said Jane, who has been quoted in the newspapers around the world as the doctor attending Reeve. ``The finality is the hardest thing.''
Reeve, the actor best known for his role in the ``Superman'' movies, broke two vertebrae in his neck when he fell from a horse during a riding event in Culpeper.
The 42-year-old has been paralyzed from the neck down since the May 27 accident.
Doctors say it will be months before they know exactly how bad the damage is.
Jane, deferring to the wishes of Reeve's family, refuses to specifically discuss the case of his famous patient. The hospital press office says Reeve's condition is serious, but he ``continues to improve.''
However, Jane will talk about why medicine can do so little to help spinal cord injuries and what choices he believes society must make to find a treatment.
All Jane can do for a patient like Reeve is prevent the damage from getting worse - giving him steroids to reduce the swelling in the spinal cord and operating to fuse and stabilize the vertebrae.
Doctors can't do much because the central nervous system doesn't regenerate and heal itself like other parts of the body. The central nervous system - the brain and spinal cord - is a sort of electrical network that transmits stimuli from and responses to the rest of the body.
Doctors can sew together a severed spine, but the nerves won't regrow connections, Jane said. If the spine is badly damaged but not severed - reportedly the case with Reeve's injury - the damaged fibers regenerate some connections, but not enough to repair the damage.
In cases like Reeve's, the nerves are damaged in two ways. Some strands are cut. Others die when swelling tissue cuts off their blood supply.
Sometimes, the patient regains limited function, maybe because some nerves aren't damaged and start working again when the swelling subsides, said Jane. Or it may be that the nerves have been damaged but are repairing themselves a little bit.
The second possibility offers hope to doctors, he said. Maybe researchers can figure out what substances stimulate the nerves to regrow and use those substances to revive injured spinal cords. It's the subject of research at many medical centers, including UVa's.
Some experiments are under attack, however, from people who claim they are unethical because they involve breaking the spines of animals.
Dr. Peggy Carlson, an emergency medicine specialist who is research director for the Physicians Committee for Responsible Medicine, questioned the usefulness of experimenting on animal's spinal cords when some very basic questions about the nerve cells haven't been answered.
Is there a good reason, she asks, ``to inflict that injury on an animal when, at this stage, there's no reason to think it will help?''
And some animal rights activists have suggested that medicine has failed to find answers because animals' central nervous systems are very different from the human system.
But Jane says the experiments are necessary. ``If you're going to solve the human problem. . . you have to do it with experiments on animals who have spinal cord injuries,'' he said. With human subjects ``you can't take their nervous system out and examine it to understand the process,'' he said.
Someday during the course of his career, he believes, there will be a time when he can do something for spinal cord injuries.
``There's going to be a way. I have no doubt there's going to be a way,'' he said. ILLUSTRATION: Color photo
Christopher Reeve...
The Associated Press color photo
Dr. John Jane, left, explains the surgery that was performed on
Christopher Reeve as Dr. |Christopher Shaffrey looks on.
by CNB