How Far Can You Go

by John Maclean

  Fifty metres out, I heard Matty telling more of my story. People in the stands stood and looked my way. The closer I came, the more of my story he told. “He’s back here, ladies and gentlemen, doing the race for which he was training when he was hit by an eight-ton truck on the M4.” The crowd was now on its feet, cheering.

  Thirty metres away from the grandstand, I noticed Matty wasn’t up in the press box. I saw him up ahead in the middle of the path. He wasn’t just telling my story. He was introducing me to the crowd, all of whom were cheering for me as if I were about to win the event. (I, in fact, finished in 986th position. My sister Marion even beat me, although I smoked her in the swim and bike legs.) When I was fully in front of the grandstands, Matty came over to me, microphone in hand, and interviewed me in front of the crowd, most of whom were there to support other people who ran the triathlon that day.

  “How are you doing, John?” was Matty’s first question. I gave the standard answer about how I felt. I went on to thank all the people who had come out to support us. Then I added, “I have one more lap and I hope to do you proud.”

  “It’s been a long time, twenty-six years,” Matty said. “Just tell us a little bit about what you’ve been up to.”

  “I’ve been learning to walk again,” I replied. The crowd liked that answer. I went on to thank Ken Ware, who was nearby, and added some remarks about redefining what is possible for those in wheelchairs.

  Matty then put his hand on my shoulder and said, “I just can’t believe we’re standing here having this conversation. You said you were going to do this and you are. You have five K to go. Look at all the people behind you. Thank you, John. We will see you when you get back.” The crowd stood and cheered. “John Maclean! Everybody, John Maclean!” People walking with me got excited. A party broke out at the Nepean Triathlon! Everyone was having a great time.

  But I had one more lap to go.

  I pushed myself back up over the bridge. My gait had slowed even more. People kept talking to me, but I replied less and less. Amanda knew I was in great pain. I stopped for breaks a little more frequently. The party atmosphere was still in gear. Everyone around me was in high spirits. It looked like the scene from Forrest Gump where he runs back and forth across the country. I love that movie, and on this day, I guess I was Forrest.

  About halfway down the far side of the lake the pain in my feet finally became more than I could bear. Without announcing I was going to stop, I headed off the path. I lay down on my back and started untying my shoes. One of the guys following along jumped down on the ground right behind me so that I could use him as a pillow. The crowd gathered closer until a wall of people surrounded me. Johnno, David Knight, Steve and Jock came in close. Amanda crouched down, right beside me. I pulled off my shoes and socks and braces to have a look at my feet. The soles looked like I had walked seven kilometres over sharp rocks. A few people gasped. The party was definitely over. It had been for me for a long time.

  “I need some dry socks,” I said. Wally dug around in my backpack that he’d been carrying for me all day, but I hadn’t thought to pack a second pair. David Knight sat down and pulled his socks off. “Here. You can have mine,” he said.

  But I needed more than socks. Darren, who had caught up to me not long before and had been walking quietly to the side observing me, came running up. He took my braces and started making adjustments. He pulled away part of the padding on the bottoms. “I don’t know if it will make your feet feel any better now, but I think this will keep any new blisters from coming up,” he said.

  I pulled David’s socks on, adjusted the braces and pulled on my shoes. I lay there for just a moment longer. I seriously considered calling it quits, when Jock looked at me. “You’ve been lying there long enough, John. Get up. What do you think this is, a bloody holiday? Get off your lazy bum and let’s get going.”

  I needed guys like Jock around me.

  Back on my feet, I still had a full half lap to go—two and a half kilometres, at least. I walked a short while before I needed to stop again. Before long I was back at it, but I needed to stop yet another time. The breaks came more and more frequently now. The temperature had hit the high thirties. I started getting light-headed.

  With a little over one kilometre to go, I had a surprise waiting for me: Jack. “Daddy!” he said, running up to me with a painted sign he’d made with Ashleigh. It said “Go Daddy Go.” Just seeing him up close gave me an extra burst of energy. I sat down on a side rail and gave him a hug.

  I walked a little further, when another special guest greeted me. A young boy with cerebral palsy named Aaryan joined me, pushing his walker. Using the walker is very difficult for Aaryan. He spends most of his time in his wheelchair. The two of us met during a previous foundation event, and we became fast friends. He calls me his hero, but the truth is, he’s mine. Aaryan’s family was with him. He was determined to come out and walk the last few hundred metres with me.

  A new energy came through the crowd once Jack and Aaryan joined our group. I could feel all my friends and supporters willing me to the finish line. The end wasn’t much farther down the path. But the sun beat down and my head grew light. I sat down for a few minutes on a guard rail next to the walking path. Amanda gave me some Gatorade and poured water over my head and back to try to cool me down. “I’m okay,” I said. “Let’s keep going.”

  When I was just over one hundred metres from the finish line, I suddenly knew I wasn’t okay. The heat finally wore me down. “I need to lie down,” I said. I closed my eyes, and everything just sort of went away.

  “Daddy. Daddy. Open your eyes.” Jack’s voice came through the fog that had overtaken me. “Daddy,” he said. I mustered all the strength I had and sat up. Amanda handed me another Gatorade, which I downed.

  “Are you okay, sweet? You’re so close now,” Amanda said.

  “Let’s finish this,” I said.

  I stood. The crowd applauded. I started moving toward the finish line. Right pole, left leg. Left pole, right leg. One step after another. Nothing I had ever done compared to the pain and exhaustion I now felt. Not the Ironman. Not the Channel swim. And certainly not rowing. Nothing compared. The pain grew in intensity. Somewhere in the back of my mind I could hear Johnno’s words from so long ago. The pain won’t last forever, but the memories will. There was a memory I was determined to make, and nothing was going to stop me.

  Thirty metres out from the finish line, I stopped one last time. “Would you carry these for me?” I asked David Knight as I handed him my walking poles. I turned to Amanda. “Ready?”

  “Ready,” she replied. We each held one of Jack’s hands. Then the three of us walked the last thirty metres and crossed the finish line. Together. Every challenge I had ever conquered, every Everest I had ever climbed, all built to this crescendo. Nothing I had ever done can compare, either in its degree of difficulty or in the pure joy I experienced. Amanda, Jack and I crossed the line, not as the finish but as the beginning of a whole new world of possibilities. I cannot wait to see how far we now go, together.

  20

  Afterword

  * * *

  Every time I told my story, I was asked if I considered it to be a miracle. The only way I could truly answer that question was to take a look inside and see if that was indeed the case. For that, I had to have an MRI.

  As strange as it seems now, the first MRI on my spine came twenty-six years after my accident. Although the technology was around in 1988, it was not yet widely available. Not that having it would have made a difference with any of the care I received. My medical team knew my spine was damaged quite severely. An MRI would have given them a visual image whereby they could see the full extent of that damage. Without that, they could only guess how many of the three million nerves that make up the spinal cord were still intact and how many were gone forever.

  60 Minutes arranged for me to have my first MRI as part of the feature they did about me. They did so in part to try to find an expl
anation for exactly what had taken place as I had transitioned to walking again. People who spend twenty-five years in a wheelchair just don’t get up and walk. The 60 Minutes reporter, Georgie Gardner, interviewed the spinal specialist who has taken care of me since my accident, Dr John Yeo, and asked what he thought had happened. A religious man, Dr Yeo did not hesitate to call my recovery of function a miracle. The MRI was part of the search to see if that was truly the case. Dr Yeo and I wanted to know: Had the nerves in my spinal cord regenerated themselves?

  I stood in the back of the room as Dr Yeo and radiologist Dr David Brazier studied my scans on the screens in front of them. Dr Brazier said, “You’ll want to come on over here, John.”

  I walked over. Dr Yeo stepped back to give me space. The room was quite small.

  “You can see here,” Dr Brazier said, pointing a pen at what appeared to be a dark bubble along my spinal cord, “the lesion on your cord is clearly visible. Now take a look over here.” He pointed to an image of a white, oblong shape that had a very small spot of dark just off-centre on one side. “This is a cross section of the cord. The white area is the damaged cord, and this tiny bit over here”—he circled a small cluster of dark spots—“is the cord that remains. It is enough, in your case, obviously, for you to have some function. But to be honest with you, I am amazed seeing you walk forward just then, given the scans I have in front of me, because there is quite a lot of damage.” To give you an idea of the ratio of healthy to dead nerves, if the image itself was a map of Australia, the healthy nerves were about the size of Tasmania.

  I nodded and stared at the image on the screen. Finally seeing the actual injury, this leftover from my accident from so long ago, felt more than a little strange. Compared to the abrasions that covered my body, the lesion in my spinal cord was so small.

  Dr Yeo spoke up. “If we had done an MRI back in 1988, John, do you think it would look exactly the same as today?”

  “Yes,” I said. “I don’t think it has changed at all. Many of the things I could not do in 1988, I still cannot do today.”

  “I believe you’re right,” said Dr Yeo.

  I did not need to go into detail for Dr Yeo, but in brief, here are the things that had not changed: I’m still unable to lift my right foot up and down; I still lack the ability to move my legs away from the centre of my body, which is called abduction; I still have very minimal flickers in my right glute; and I still have the same amount of tactile sensations in both legs that I had the day I woke up in the hospital with tubes running out of my body.

  The MRI allowed me to see the enemy I’d been trying to beat for two and a half decades, but it still did not explain why I was now able to do things I had not been able to do for twenty-five years. How could I now walk? Three million nerves make up a healthy spinal cord. At my T12 vertebra, my working nerves number in the thousands, perhaps tens of thousands. Why did they suddenly allow me to walk? Am I a walking miracle? If I am not, does my ability to get up from my chair and leave my wheels behind offer hope and a road map for others with spinal cord injuries?

  I wasn’t the only one with these questions. The reporter from 60 Minutes asked Dr Yeo the same things as my MRI scans hung on light boards on the walls of the room. “Our interpretation of this is that it is not through regeneration that John is getting recovery of function but a re-synapsing, an opening up of pathways.” He later explained this to me. “Medically it appeared to me as miraculous. In analysing your recent improvements, I believe this recent therapeutic approach could well have tapped into a method of loading messages into the spinal cord above, at and possibly even below the injury, which have caused a cumulative effect. In the past a principle similar to this was well known to physiotherapists as ‘proprioceptive neuromuscular facilitation’, or PNF. This means remaining neural pathways ‘wake up’ rather than regenerate.”

  Essentially, what Dr Yeo said was that the specific nerves that carry the signal from my brain to my legs enabling me to walk survived the accident. However, the trauma of the accident and the damage to the nerves around them caused these intact nerves to switch off. Ken’s therapy, then, in some way awakened these nerves and caused them to begin to function once again. Similar results have been observed since the 1930s and 1940s through PNF, which was pioneered by a neurologist named Herman Kabat in his work with children with cerebral palsy and other neurological conditions. By tapping into the proprioceptive system, the sensory processing system that has to do with our awareness of standing, sitting and so forth, Dr Kabat was able to get his patients to move in ways they had not before.I Dr Yeo believes this is what happened to me.

  If this is correct, could the same approach work with others with spinal cord injuries? That’s hard for me to say. I am an athlete, not a doctor. I can only speak of my experience. After my accident, I retained functions below my injury, including sexual function, as well as control of my bowels and urinary tract in addition to about 25 per cent use of my left leg. That percentage has not changed since my therapy with Ken began. I have not been cured in the true sense of the word. I have regained function, in that I can now walk again and spend prolonged periods of time out of my chair with the use of my leg braces. If this can be explained by my synapses awakening, then I suppose others might have the same experience. Every spinal cord injury is unique. With three million nerves to possibly damage, the odds that any two people will damage the exact same combination are astronomical. That is why it is so hard to predict how an injury in the exact same spot as mine, the T12, might affect a person.

  Ken Ware offers a different explanation for why I can now walk. With a scientific background in physics, Ken approaches the body as a complex system that operates according to the basic laws of physics. Because he sees the body through this lens, he believes all of the body’s systems and how they interact can be explained by these laws. Every system is interconnected, with each impacting the others. Ken includes every system, even the emotions. Practically speaking, this means that the responses in the body triggered by our emotions obey and can be explained by the basic laws of physics. The way this plays out in every person is often different and unpredictable. The key for him came when he discovered chaos theory. Chaos is used to study any sort of complex system where there is confusion and unpredictability. Other researchers use it to study things like the weather and the stock market. Ken uses it to study the body.

  What does this mean for me? Ken’s tremor therapy that enabled me to begin using my legs again grew out of his research. First, he observed the tremors I described earlier in the book. Then he set out to understand them. What he found was that the body uses tremors to release a burst of energy that recalibrates the system. Trauma, physical and emotional, basically blocks the body’s system from working properly, and pain is often the result. Repeated patterns emerge that reinforce the blocks, and chronic pain results. When my system recalibrated, my pain levels dropped dramatically. As my pain levels decreased, I was able to focus on the next part of Ken’s research, the part that he uses to explain how and why I am walking.

  When my spinal cord was injured, signals from my brain to my legs could no longer get through. If you think of the spinal cord as a highway, most of mine was blown up, and what was left was so crowded by the traffic of signals trying to squeeze into a small space that nothing could get through. This is an extreme oversimplification, but like I said, I am an athlete, not a doctor or a physicist. Through my twenty-five years of pursuing sports, I constantly and consistently stimulated the neurons—in effect, sending more and more signals down the blocked highway. The neurons, like people on a gridlocked highway, did not like being backed up with nowhere to go. They sought out and finally found a way to get through.

  Ken’s explanation for my recovery of function, then, is that my body’s neurological system adapted and found a way by sending signals through other nerves that run down my back outside of my spinal cord. Like blocked cars and trucks on a highway, they found an alternative route. T
he new paths were not enough in and of themselves. My entire neurological system needed to recalibrate to reset the hierarchy that acts like the traffic cop in the network. Before, neurons could not get through the new paths they created on other nerves because the body’s system gave priority to whatever neurons originally used the road. With the reset, the signals I wanted to get through now got through.

  Again, this is an oversimplification of how all this was explained to me. Ken has written extensively on this topic in research journals.

  The way I see what has happened to me is, through Ken’s work, I’ve been able to tap into the abilities that I have always had. Ken often said to me, “You were always able to do this; you just didn’t have the right tools to unlock your system to allow alternative access.” I do not believe I have experienced a miracle. To me, receiving the use of my legs is the end result of the journey on which I have travelled since immediately after my accident. If I had not constantly pushed myself to see how far I could go in my chair, always open to new challenges in different sports, then I would not be walking today. My ability to focus and challenge my mind and body to go on a journey of multiple sporting disciplines over the past twenty-seven years has assisted in my acceptance and embracing of this new research. On this, both Ken and Dr Yeo agree. I believe Ken has enabled me to tap into increased mobility by inducing managed tremors to recalibrate my system, and quieting the noise of my subconscious thought. On top of this, my life as a professional athlete gave me the freedom to devote hours upon hours every day to the exercise program Ken designed for me.

  I don’t think I have experienced a regeneration of my spinal cord up to this point. I don’t know if I will in the future. I have no control over it either way, but we do now have an MRI that gives us a baseline against which to measure any future changes. This takes me back to my philosophy in all my endeavours in sports. I focus on controlling the controllables and not worrying about that which I cannot control.