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Moment that mattered: A paralysed man is shown walking again

The Nicholls Spinal Injury Foundation event at the Mandarin Hotel, 2-2-15

The Nicholls Spinal Injury Foundation event at the Mandarin Hotel, 2-2-15

“I spent a lifetime trying to persuade people – without too much success – that damage to the brain and spinal cord could be repaired. I started in the mid-1960s and gradually developed my theory that you could do this if you could provide a pathway for nerve fibres to grow along. In 1985 I discovered cells in the olfactory system I thought could provide this pathway. We saw it work in a rat in 1997. At that point I couldn’t know whether it would work in humans, but I knew the principle was there. It wasn’t until we worked with Darek Fidyka that we saw it in action.

Throughout those years I had to stick to my idea when nobody believed in me and no one wanted to support it. When I did talk about it people sometimes became quite hostile. Organisations that have spent huge amounts of money on spinal cord injury and have taken the position that it can’t be cured don’t exactly rejoice when someone working with two people on a shoestring budget gets a patient out of a wheelchair.

The procedure we used on Darek [a 40-year-old Polish man who had been paralysed from the chest down after a 2010 knife attack] involved six months of pre-operative rehabilitation to see if he would improve without surgery, which he didn’t. He had tissue removed from his nose which was cultured. Two weeks later, Polish surgeons transplanted the material into his spinal cord. Since then it has been a continuous process of rehabilitation.

“I said in 1972 that it would be a greater thing to get a man out of a wheelchair than to put a man on the moon, and I maintain it now”

The first thing we saw that indicated that the procedure had worked was a slight increase in the muscle of one leg and an increase in sensation. It gradually built up until he was able to walk again with a walker, about a year after those first very small findings.
Darek is getting slightly better all the time. It still involves an enormous amount of work on his part. I simply produced the idea, the surgeon had to do a lot of work, but none of this is anything compared to what the patient has had to do. He’s doing exercises five hours a day, five days a week. If he didn’t do that I don’t think we would have seen an improvement.

One of the most moving moments was one that won’t matter much to other people. The first time I was introduced to Darek before the operation, he asked me: ‘Why do you suggest I have this operation?’ I said, ‘Because we have scientific evidence that this kind of injury can be cured in this way.’ He looked at me, instantly made up his mind, and said yes to the procedure. That was one of the most important moments for me because it was a person in great difficulties placing his faith in me and taking a risk. It felt close to a miracle.

When I said in 1972 that I thought it would be a greater thing to get a man out of a wheelchair than to put a man on the moon, I was bitterly attacked for ridiculing a great achievement. But I maintain it now. This was just one patient, though. We’ve had a very, very mixed reception from the scientific community. There are many things that might provide alternative explanations for Darek’s recovery. We did try very hard to disprove our own theory and couldn’t. I think we have a 99 percent chance of being right. But that does mean we have a one percent chance of being wrong.

What we need is to give more patients this treatment and prove that it works. We need to work out if there are ways to improve the operative techniques. The procedure involves using cells as bridging materials, so we’re trying to find out if we can get more and better cells for this. It’s hard day-to-day work and much more than my little group of three can possibly take on. We can just hope we see the most important bits and inspire others to take it further. Success, for me, would be if this is taken out of my hands and people all over the world are doing it – when I’m not needed any more.

Professor Geoffrey Raisman is Chair of Neural Regeneration at University College London’s Institute of Neurology. The episode of Panorama that showed Darek Fidyka walking again after undergoing surgery screened on BBC One on 21st October 2014.

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