Shattered Nerves: How Science Is Solving Modern Medicine's Most Perplexing Problem

6 Giving a Hand

∑ 6 Giving a Hand His real name is Jim Jatich, but he might well be called Mr. Electrode, since he has probably had more electrodes implanted in his body than any human in history—by his count, 150 to 200, with a maximum of 20 at any one time. This has involved approximately ten surgeries over more than twenty-six years, and still counting. And Jatich is almost jovial about it. Rather than an imposition, an inconvenience, or a painful experience, he considers it something of a privilege to serve as a virtual pin cushion for a team that designs, builds, and implants a variety of electrically actuated devices to return movement to people like himself. His most recent count is sixteen electrodes divided between two implanted functional electrical stimulation systems—one in each hand—which until recently enabled him to manipulate both of his paralyzed hands. One of the systems failed after being in place for five years. Jatich could have had it replaced immediately but decided to wait for the next generation. But even with one operational hand, he can feed and groom himself and operate a computer, which has allowed him to run a home-based drafting business utilizing the skills he developed as a junior engineer before his accident. The fateful day that led Jatich to become a champion of functional electrical stimulation was August 28, 1977. Jatich, who was 28 years old at the time, and a few friends had been painting a house in Akron, Ohio, that he was getting ready to sell. They had worked late into a hot, muggy summer night and decided to cool o√ with a swim in a nearby lake after calling it Giving a Hand 87 quits for the day. ‘‘About five of us dove into the lake,’’ said Jatich. ‘‘I was the last one to dive in, and I hit something. It didn’t knock me out; I just was stunned and sank to the bottom, my face in seaweed. I tried holding my breath as long as I could. Luckily some fishermen saw where I went in and didn’t come up, and they told my friends to come help me.’’ After bringing him to the surface, his friends wrapped a towel around his neck and held him as still as they could until the volunteer fire department showed up and took him to a nearby hospital. The diagnosis was not good; Jatich had sustained a compression fracture of the fifth and sixth cervical vertebrae. Typically, individuals with a break at that level are able to move their shoulders slightly, and their elbows, but their hands and legs are completely paralyzed. Such was the case with Jatich. He was put into traction for eight weeks in an attempt to stabilize his condition. ‘‘Slowly I started getting some feeling back down my arms and elbows. I could move my arms, but not my fingers or my hands,’’ he said. Two months after his injury, Jatich was transferred to Highland View Hospital in Cleveland. That is where, in January 1978, he met Hunter Peckham , an FES researcher who was looking for someone willing to have experimental electrodes implanted in his hands. Peckham’s goal was to reverse atrophy, bring back muscle tone, test and improve electrodes, and eventually produce coordinated movement of paralyzed hands. Jatich was a perfect candidate for Peckham’s experiments because he had some shoulder and arm movement—he could raise his arms, but if he tried to extend them over his head, they would fall into his face—and he could flex his left wrist. And he was more than happy to oblige. The plan was to conduct experiments on Jatich for two months. That has turned into a decades-long partnership during which Jatich and Peckham have bonded like brothers. At the outset, a hypodermic needle was used to inject single-strand platinum electrodes into Jatich’s left wrist. Peckham would then manipulate the electrodes under his skin toward the muscles in Jatich’s hand that he wanted to animate. To find the correct location, he would periodically shoot spikes of electricity to the electrode to see which muscles twitched. Once he was assured he had arrived at the right place, he removed the hypodermic needle, leaving the electrode in place, with the lead protruding through 88 Shattered Nerves Jatich’s skin. There were times when as many as ten electrodes...