the BRAIN - Shepherd Center

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The Magazine of Shepherd Center: Providing Medical Treatment, Research and Rehabilitation | www.shepherd.org
New
Voice
Technology restores
communication.
Complex
Cases
Shepherd resolves
medical complications.
Patient
Profile
Former patient is
flying the skies.
Breathing
Easier
System helps patients
breathe on their own.
Fall 2009
HEALING
the BRAIN
Shepherd Center brain injury programs
include specialized treatment for young
stroke patients, people in semi-comatose
states and soldiers injured in battle.

Letter from James Shepherd
Dear Friends,
Photo by Gary Meek
As state and federal governments push for improved and more efficient medical
care for citizens, a trend is emerging among a few leading healthcare facilities,
including Shepherd Center. It’s a trend toward transparency – specifically, the
readily available publication of data on patient outcomes and satisfaction at
hospitals and other medical facilities.
Shepherd Center has begun publishing this information on its Web site (see
the Patient Care section of www.shepherd.org) – updating it quarterly – and
is making it available in printed form (see the fold-out attachment on page 21
in this issue of Spinal Column) to referring facilities, case managers, payers, and
patients and their families. A few other facilities are publishing this information,
but generally, hospitals have been slow to take this proactive step. The time has
come, however, for healthcare facilities to make this information directly available
to their customers – not relying solely upon any third party to gather and publish
it. Our customers deserve the opportunity to make good, informed healthcare
decisions based upon solid data.
Organizations that publish their data on patient outcomes and customer
satisfaction – even if it’s not perfect – convey the message that their institution
is one of integrity and progressive thinking. Shepherd Center’s data also lets you
see what an excellent job our staff does in caring for patients and meeting the
needs of their families, as well. For example, the numbers show our low, hospitalacquired
infection rates, which we attribute to our dedicated respiratory therapy
and nursing staffs, as well as rigorous quality control measures. Specifically,
Shepherd has been able to sustain a no-infection rate in ventilator-associated
pneumonia for more than a year. That’s practically unheard of among hospitals.
Another reason Shepherd Center excels across the data measured is our broad
continuum of care. We are one of the few places that can provide true continuity
of care across all levels – from the intensive care unit to inpatient and outpatient
rehabilitation therapy to adaptive driver training to the community reintegration
assistance provided by our Marcus Community Bridge Program.
As our nation engages in a discussion about healthcare reform, it is our hope
that transparency in patient outcomes and customer satisfaction will become the
norm among medical facilities. Shepherd Center is proud to be on the leading
edge of this trend, which will ultimately benefit every American faced with
making decisions about where to obtain healthcare services.
Warm regards,
SpinalColumn
T h e m a g a z i n e o f S h e p h e r d C e n t e r
Fa l l 2 0 0 9
Shepherd Center
2020 Peachtree Road, NW
Atlanta, Georgia 30309
404-352-2020
spinalcolumn@shepherd.org
www.spinalcolumn.org
Editor
Jane M. Sanders
Design
Soloflight Design
Contributing Writers
Lauren Angelo, Sara Baxter, Larry
Bowie, Pete Collman, Amanda Crowe,
Kayla Eubanks, Caroline Hemingway,
Dean Melcher, Anne Pearce, Bill
Sanders, Scott Sikes
Contributing Photographers
Leita Cowart, Jim Fitts, Anthony Orig,
Eric Schultz, Gary Meek, Owen Riley
Board of Directors
James H. Shepherd, Jr., Chairman
Gary Ulicny, Ph.D., President and CEO
Emory A. Schwall, Vice President
William C. Fowler, Treasurer
Stephen B. Goot, Corporate Secretary
Alana Shepherd, Recording Secretary
Members
Fred V. Alias, Gregory P. Anderson,
David F. Apple, Jr., M.D., Brock Bowman,
M.D.*, Wilma Bunch*, James M. Caswell,
Jr., Sara S. Chapman, John S. Dryman,
Mitchell J. Fillhaber*, David H. Flint,
Stephen B. Holleman*, Michael L. Jones,
Ph.D.*, Tammy King*, Donald Peck
Leslie, M.D., Bernie Marcus, Joseph R.
Moderow, Julian B. Mohr, Charles T.
Nunnally III, Sally D. Nunnally, Clyde
Shepherd III, J. Harold Shepherd, Scott
H. Sikes*, James E. Stephenson, James
D. Thompson, Goodloe H. Yancey III
*Ex Officio
Spinal Column is published quarterly by
Shepherd Center, a private, not-for-profit
hospital specializing in the treatment
of people with spinal cord injury and
disease, acquired brain injury, multiple
sclerosis and other neuromuscular
disorders, and urological problems.
E-mail change of address information or
request to be removed from our mailing
list to spinalcolumn@shepherd.org, or
by mail to Shepherd Center, Attn: Spinal
Column Mailing List, 2020 Peachtree
Road, NW, Atlanta, Georgia, 30309.
Please include mailing label. Spinal
Column accepts no advertising. Spinal
Column is a registered trademark of
Shepherd Center.
James H. Shepherd, Jr.
Chairman of the Board

Fall2009Contents
Photo by Leita Cowart
SpinalColumn
The Magazine of Shepherd Center:
Providing Medical Treatment, Research and Rehabilitation
12
14
Features
Breathing Easier:
Pacing system gives ventilator-dependent
patients hope for improved quality of life.
Eye Control:
Shepherd evaluates vision-based
communication system.
15
Building Professional Relationships:
Shepherd Center emphasizes outreach to
referring facilities and physicians.
16
Uncomplicating SCI Complications:
Shepherd has success in resolving associated
health problems in people with SCI.
Cover
Story
19
On the Net:
“Catch Me on ShepherdTV.org” message
debuts during Peachtree Road Race.
Healing the Brain
Shepherd Center brain injury
programs include specialized
treatment for young stroke patients,
people in semi-comatose states and
soldiers injured in battle.
Departments
2 Short Takes
20 Research: Addressing Barriers to a Cure
21 Managed Care Corner
22 Patient Profile: Mal Zackery
24 Ask the Doc Q & A
25 Medical Staff Profile: John Lin, M.D.
26 Shepherd Alums
28 Foundation Features
38 Loving Tributes
About the cover:
Lauren Rushen, 25, of Hartselle, Ala., experienced a
stroke in September 2008. She has made tremendous
progress and continues to work toward a full recovery
with the help of Shepherd Center's Acquired Brain Injury
Program. Photo by Gary Meek
Photo by Credit Here
Photo by Leita Cowart
22
If you would like to make a gift to support the work
you have read about, please contact Scott Sikes at the
Shepherd Center Foundation at 404-350-7305 or visit
shepherd.org.

ShortTakes
Shepherd Snapshots: A Look at News and Other Notes
Dr. Keith Tansey Appointed
to ASIA Board of Directors
Keith Tansey, M.D., Ph.D.,
director of spinal cord injury research
at Shepherd Center, has been
appointed to the prestigious Board
of Directors of the American Spinal
Injury Association (ASIA).
ASIA’s Board of Directors consists
of 11 representatives, each serving
a two-year term. A director is eligible to be reappointed twice
following his/her initial term, for a maximum of six years. This is
Dr. Tansey's first term.
He has been a member of ASIA for some time and recently
served as chairman of the Membership Committee. His primary
board assignment for the next year will be to co-chair an effort to
upgrade the ASIA Web site at www.asia-spinalinjury.org.
Dr. Tansey joins two other Shepherd Center physicians –
David Apple, Jr., M.D., and Bruce G. Green, M.D. – who have
also served as ASIA board members in the past,. The National
Office of ASIA is located within the Crawford Research
Institute at Shepherd Center. — Caroline Hemingway
Photo by Leita Cowart
Shepherd Center Conducts
Inpatient Satisfaction Surveys
Shepherd Center is now conducting inpatient satisfaction surveys
on a regular basis through a company called NRC Picker.
Former patients will receive a call from Discovery Research
Group on behalf of Shepherd Center. The caller will request a
few minutes of time to complete a set of prepared questions.
Discovery Research makes five call attempts starting about
two weeks after the month of the patient’s discharge.
The goal of the survey is to obtain feedback, information
and opinion on the inpatient experience at Shepherd Center,
and to establish and execute improvements and changes
moving forward.
Shepherd Center has taken previous survey results into
consideration, and will implement a number of improvements,
including a comprehensive handbook for the
families of patients, white boards in patients’ rooms
to improve the level of communication, an indepth
injury explanation on Shepherd Center’s
site at www.shepherd.org and a permanent
notebook in each Woodruff Family Residence
Center apartment with information relevant
to housing needs. — Caroline Hemingway
Hurry and register! All Sports Camp
Scheduled for Oct. 16-18
Shepherd Center’s annual All Sports Camp is scheduled for
Oct. 16-18 at Roosevelt Warm Springs Camp Dream in Warm
Springs, Ga. The camp includes hands-on adaptive sports
instruction in wheelchair basketball, quad rugby, swimming,
wheelchair tennis, canoeing and kayaking, handcycling, track,
field, scuba, wheelchair football and wheelchair team handball.
The camp is open to adults ages 18 and up. The cost of $150
includes lodging and meals. For more information, contact
Matt Edens at 404-367-1287 or matt_edens@shepherd.org.
Register online at: www.shepherd.org/allsportscamp.
Shepherd Center File Photo
Shepherd Center Physical
Therapist Named Emerging Leader
Shepherd Center spinal cord injury
physical therapist Joy Bruce recently
received the American
Physical Therapy Association’s
Emerging Leader Award for 2008.
This honor is given to one PT who
demonstrates extraordinary service
and makes exceptional contributions
to APTA and the physical
therapy profession.
Aside from her role as a PT, Bruce conducts clinical
research with Shepherd Center’s new Spinal Cord Injury
Research Laboratory. Studies she’s coordinating include a
project with the Georgia Institute of Technology investigating
the Tongue Drive wheelchair navigation system for people
with quadriplegia and a project with the University of Georgia
on the effects on muscle plasticity and glucose tolerance of
an electrically stimulated strengthening program.
“It is an honor to be recognized by my peers,” Bruce says.
“We cannot overestimate the importance of having strong
leaders to guide research and education, and to advocate for
patients and the profession.”
Bruce praises the mentorship she receives from Shepherd’s
clinicians and managers as a guiding force in her ability to
emerge as a leader in her profession. — Kayla Eubanks
Photo by Kayla Eubanks
2 Spinal Column
w w w. s h e p h e r d . o r g

Newly Integrated Sip-and-Puff System
Gives Patients More Independence
When Shepherd patient James Brown wants a little more light in his
room, it’s as easy as a simple blow into a straw, then a puff, thanks to a
new, integrated sip-and-puff control system developed by Shepherd’s
Assistive Technology Center.
The system gives James the ability to control the lights and other
technology in his room through a single device, which gives quadriplegic
patients like him as much control as possible over their surroundings,
says Assistive Technology Center manager John Anschutz, who
developed the system with help from Jiasheng He, a Georgia Institute
of Technology student who interned at Shepherd this past summer.
“It gives the patient a sense of controlling their environment, which
is important,” John says. “James told us that 16 years ago, when he
was first injured, he had no control and felt stuck, like he couldn’t do
anything. This system takes that away.”
James helped John and his staff test the system, which allows the
user to adjust lights, control a television’s power and channels, make
phone calls and summon a nurse.
The system represents a huge upgrade, James says.
“Controlling your environment is huge,” he explains. “This is really
cutting-edge technology compared to where we were 16 years ago.
When I was first injured, I had to call my mom all the time to do
things for me.”
Ultimately, John and his staff want to provide a cost-effective version
of the integrated sip-and-puff system to patients like James for
use in their homes.
“First, we want to get this system into the hospital rooms of all
patients who need them, and then get systems into their homes,” John
says. “We have some steep hills to climb to get there. We want to keep it
simple and cheap and fill a niche where there isn’t a lot out there that is
inexpensive.” — Bill Sanders
Above: Shepherd Center Assistive Technology Center manager John
Anschutz and Georgia Tech student Jiasheng He developed a new,
integrated sip-and-puff control system with input from patient James
Brown of Conyers, Ga.
Photo by Gary Meek
Shepherd Center and SkiMore Tours
Offer Annual Adaptive Skiing Trip
Shepherd Center and SkiMore Tours have planned
a trip to Breckenridge, Colo., this winter for adaptive
snow skiing for beginners to advanced skiers
with physical disabilities.
The trip, scheduled for Jan. 17-22, 2010,
includes private adaptive skiing lessons, lift tickets,
equipment, hotel accommodations, transportation
from the airport to the hotel and two group dinners.
People of all abilities are welcome, as well as
their families and friends. Advance registration
is required.
For more information, contact Shepherd Center
therapeutic recreation therapist Katie Murphy at
404-350-7488 or katie_murphy@shepherd.org. Or,
go to www.skimoretours.com.
Shepherd Launches
New Web Site
Shepherd Center has a new home on the Internet.
This fall, the Center launched a redesigned Web
site to keep pace with the overwhelming number
of people who visit the site each day to learn more
about the Shepherd experience.
The new site, at www.shepherd.org, features
several new features, including an updated overview
of care programs, patient and program videos, and
new online functions for submitting a referral or
joining a research study.
More and more people are now using the Internet
when choosing a rehabilitation facility for their loved
one. The new site is geared
to helping people who are
considering Shepherd as a
rehabilitation option.
In addition, a number
of other types of visitors
will find something of
interest on the new site,
including people interested
in Shepherd’s research
programs, clinical trials,
volunteering or giving
opportunities. There is
also information available for download on injury
prevention tips and resources related to disabilities.
Shepherd Center expects to continue upgrading
and improving the site. If you have any feedback
about something you’d like to see, please contact
Larry Bowie at larry_bowie@shepherd.org.
Fall 2009 3

CoverStory
Photo by Gary Meek
Lauren Rushen, 25, of Hartselle, Ala.,
experienced a stroke in September 2008. She
completed Shepherd Center's Young Stroke
Rehabilitation Program. Recently, she returned
to visit with several of her therapists, left to right,
Erin Mattingly, Jane Woodward and Lora Harvey.
4 Spinal Column
w w w. s h e p h e r d . o r g

HEALING
the brain
Shepherd Center brain injury programs include specialized treatment for young stroke
patients, people in semi-comatose states and soldiers injured in battle. By Bill Sanders
Twenty-five-year-olds aren’t supposed to have strokes, particularly those in good
health and with few, if any, risk factors.
And neither should 20-year-olds spend five weeks in a coma, nor should 22-
year-olds experience the death and destruction of war.
But, in reality, these things happen, and that’s why Shepherd Center’s Acquired
Brain Injury (ABI) Program has designed three unique, specialized programs
among the many in its broad continuum of care.
Shepherd’s Young Stroke Program treats stroke patients in their 20s, 30s and
40s, helping them with parenting skills, work re-entry or academic skills if they are
still in school.
“For just about all of them, there is a change in lifestyle,” says ABI program director
Susan Johnson, MA, CCC, CCM. “We teach them strategies to live to their highest
level of independence while focusing on re-integrating into their community.”
Shepherd’s Pre-Rehabilitation and Education Program (PREP) admits patients who
are semi-comatose or in a minimally conscious state for a five-week program that
focuses on medical, pharmacological and equipment needs, while optimizing their
recovery for emergence from their coma. The program also focuses on educating
the patient’s family on how to take care of their loved one once he or she goes home.
Patients who emerge from their coma go directly into Shepherd’s intensive rehabilitation
program. Those who do not are discharged to their home or an alternative setting
that supports their ongoing needs until they are ready for more intensive therapy.
“We started PREP nine years ago because managed care policies were forcing
families to take 18- or 19-year-old semi-comatose or minimally conscious patients to
nursing homes because there were little to no other alternatives,” Johnson explains.
Fall 2009 5

“Shepherd brought her
back from the dead.
Had God not led us
to Shepherd, Lauren
wouldn’t have gotten well.”
—Donna Rushen, mother of
patient Lauren Rushen
“Initially, only a few insurance companies agreed to pay for this level
of care. In time, many insurance companies began to see the benefits
with fewer rehospitalizations down the road.”
And Shepherd’s SHARE Initiative, which began in early 2008,
provides additional care to U.S. soldiers who sustain brain and/or
spinal cord injuries while serving in Iraq or Afghanistan. SHARE is a
partnership between Shepherd, the military’s healthcare services provider
and Atlanta philanthropist Bernie Marcus, whose gift started the
program. SHARE funds cover needs and services outside the scope of
benefits provided by the Department of Veterans Affairs and Humana
Military Healthcare Services. Examples include personal support
services, transportation, housing for family members, groceries and
Shepherd’s Beyond Therapy activity-based therapy program.
Photo by Eric Schultz
Above: After more than a year since her
stroke, Lauren Rushen is working part
time and living with her family, enjoying
their horses, dogs and pond that sit on
the family's 40-acre farm southwest
of Huntsville. Her mother, Donna,
thanks God that Lauren came to
Shepherd for rehabilitation.
Young Stroke Program
Fortunately for Lauren Rushen, 25, of Hartselle, Ala., Shepherd Center
has a subspecialty program designed specifically for patients like her.
On Sept. 17, 2008, Lauren got a bad headache – or toothache, she
thought. She couldn’t specify exactly where the pain originated. But it
was bad. And the timing for it was bad, too. Lauren, a case manager at
the North Central Alabama Mental Retardation Authority in Decatur,
Ala., was preparing for a visit the next day by Medicaid reviewers, who
routinely examine the agency’s files.
“I woke up Sept. 18 and couldn’t go to work,” Lauren recalls. “And on
that day, it was a big deal. I had gone to the dentist the day before, and
he thought maybe I needed a root canal, and he gave me some penicillin
and Percocet. Then on this day, I got up and went to the chiropractor,
thinking it might be TMJ (a jaw condition that causes pain).
“I went to my mom’s house, and she was sick with a stomach virus, and
we were both kind of reclining, her on the couch, me on a chair. I tried to
get up and slid into the floor as my left side just collapsed. I couldn’t get
up. My mom called 911, which we all thought was an overreaction.”
But Lauren’s mom, Donna Rushen, wasn’t overreacting.
Lauren had experienced a stroke that was severe enough for doctors
in Huntsville, Ala., to put her in an induced paralytic state for 12 days
and perform a craniotomy to help relieve the swelling of her brain.
Initially, doctors were unable to offer the Rushen family any hope for
Lauren’s recovery.
But now, a year later, Lauren is home, working part time and living
with her family, enjoying their horses, swimming pool and pond that
sit on their 40-acre farm southwest of Huntsville. Mom and daughter
bicker a bit at one another: “She calls me Attila,” Donna says. But it’s
good-natured ribbing – born from relief and fed by the reality that
they came close to losing one another. Recalling Lauren’s initial prognosis
still brings tears to Donna’s eyes.
“When we left Huntsville for Shepherd Center, I had no idea she’d
be like she is now,” Donna recalls as she makes iced tea in her kitchen.
“We’d never heard of Shepherd, but while we were at the hospital in
Huntsville, we heard from nurses who told us, ‘Don’t go anywhere but
Shepherd.’ God took us there. I’m sure of that.”
6 Spinal Column w w w. s h e p h e r d . o r g

ain injury statistics
Shepherd Center Brain Injury Inpatient
Admissions by Injury Type, Fiscal Year 2009
Shepherd Pathways Post-Acute
Admissions by Injury Type, Fiscal Year 2009 SHARE Initiative Admissions, March 2008-July 2009
144
ATV
Falls
Automobile
Traumatic Brain Injury
Anoxia,
Encephalopathies
21
Traumatic
Brain Injury
Non-Traumatic
25
= 143
Brain Injury
34
Non-Traumatic Brain Injury
Stroke
43
Clinical
Population:
Brain
63%
Spinal Cord
Injury
30%
Pain
Management
7%
For statistics on patient outcomes, see the “Why Shepherd?” tear-out information
attached to page 21 in this issue of Spinal Column.
Patient Military Service Status:
53% = active duty
47% = separated
94
Total
Lauren’s treatment at Shepherd was nothing out of the ordinary
by Shepherd standards. But try telling that to a mom who had visited
a couple of general rehabilitation facilities that were potential
alternatives for her daughter.
“Shepherd – I’m going to start crying now – brought her back
from the dead,” Donna says. “When she got there, her voice wasn’t
even a whisper. She couldn’t swallow, hadn’t sat up in 34 days, and
we walked in there, and on the first day, they had her sitting up. I
was afraid they were hurting her, but they knew what they were
doing. Then they had her standing, and she’d feel lightheaded and
nauseated, and I’d worry. But again, they knew best. Had God not
led us to Shepherd, Lauren wouldn’t have gotten well.”
Trauma doctors told Donna and her family that Lauren was
brain damaged. At Shepherd, the staff told her that Lauren had
a brain injury. Subtle difference? Maybe. But to Donna, it meant
hope versus despair, dignity versus stigma. Even today, saying ‘brain
damaged versus a brain injury’ brings tears to Donna’s eyes.
As for Lauren, she returned to work part time in spring 2009,
and she believes she’s almost 100 percent back to her former life.
In reality, she’s not yet, but she may be soon, Donna says. Young
stroke patients who rehabilitate at Shepherd often continue
recovering for years.
“They say my reaction time is still a bit slow and that my reasoning
and judgment and problem-solving abilities are still affected,”
Lauren says. “I don’t see that, don’t really believe it. But they tell me
that denial is part of it. So maybe it is.”
Today, Lauren walks with a slight limp in her left leg, and she
has perhaps the slightest droop on one side of her mouth. But that
disappears when Lauren smiles, which is often, and in time, it will
probably disappear altogether.
Lauren has not returned to driving or living alone yet, but just
about every other part of her life is back to how it used to be.
Her boss, Earl Brightwell, says it was a delight to have Lauren
return to work and that her responsibilities will increase in time.
“She’s assisting with office chores, and it is great to see how
much recovery she has made,” he adds. “We are looking forward
to her continued recovery. She is a great asset to us as we serve
people with intellectual disabilities. She is an excellent coordinator
and has a sincere interest in the people she serves. They are all very
excited to have her back.”
PREP Program
Joel Rodriguez, 20, of Gulf Breeze, Fla., sustained a traumatic
brain injury in a T-bone automobile crash on April 1, 2009. The
crash, which was caused by a drunk driver, killed one of his best
friends and left Joel in a semi-comatose state. He came to
Shepherd as a PREP patient.
“The PREP program helps medically stabilize semi-comatose
or minimally conscious patients and prepare them for the intensity
of a full rehabilitation program,” explains Darryl Kaelin,
M.D., medical director of the Acquired Brain Injury Program.
Fall 2009 7

“Sixty to 70 percent of these patients end up getting into a regular
rehabilitation program.”
PREP also addresses the patient’s family’s concerns about caring
for their loved one. “The physicians and ABI staff involve the family
and educate them about caring for the patient from the beginning,”
Dr. Kaelin says.
“From the first day we got there, I was shocked to see a team
here waiting for us,” recalls Joel’s mom, Nancy Rodriguez. “It was
amazing. They checked him out and started to explain things to me.
It was so calming the way the doctors talked to me, how thorough
they were in giving me test results, telling me everything they were
going to do.”
After about two weeks in the PREP program, Joel emerged
from the semi-comatose state he was in. Then he underwent
therapy in Shepherd’s inpatient program and continued rehabilitation
in the post-acute residential program at Shepherd Pathways.
Joel does not remember much of the first few weeks he spent at
Shepherd. His perception of the time he spent in therapy at
Shepherd is skewed, and just a week or so into his therapy at
Pathways, he felt like he was ready to return home. Like many braininjured
patients, Joel’s lack of insight into his injuries caused him to
doubt his need for continued cognitive therapy, Dr. Kaelin notes.
But Joel’s mom knew it was best for her son to complete the
full continuum of care that Shepherd offers for people with brain
injuries. “I have faith in this place,” Nancy says. “I wanted what was
best for Joel, so we stayed until he was ready to be released. The
people at Shepherd knew there was still healing that needed to
happen inside Joel’s brain.”
At Pathways, Joel attended classes that challenged him to use
cognitive reasoning and problem-solving skills. He also continued
physical, occupational and speech therapy, and participated in
group and individual counseling. Joel worked to regain function
in his paralyzed left arm and leg. He can walk short distances
with some assistance now, but continues to use a wheelchair for
longer walks.
One thing he particularly enjoyed during his therapy was
playing Wii video games that helped improve his eye-hand
coordination. He also kept in touch with his friends back home,
some of whom visited him at Shepherd. And Joel imagined the
things he’ll do as he continues to recover.
“I could dance really good,” Joel says. “I ought to get out of this
chair and show you how good. I could run fast and liked playing
basketball and football. I can’t play those now. Maybe later. I
hope in a year or so. I think I’ll have everything back.”
Sary Newman, a physical therapist at Pathways, believes Joel
will indeed be back to his old self in time.
“From a physical standpoint, his prognosis is good,” she says.
“But he’s not seeing the big picture right now and is frustrated.
That can take a while – maybe a couple of years. But he’s got a
great family who loves him, and he’s getting good care.”
SHARE Initiative
Smiles don’t flow easily from the face of 22-year-old U.S.
Army Specialist Greg Hutchinson – even now, with his whole
life ahead of him. The horrors of war are still very much a part
of him. But thanks to the SHARE Initiative at Shepherd
Center, they are no longer the sole defining statement of who
he is or who he can become.
“Six months ago, I couldn’t make it out to lunch,” Greg says.
“I’m a totally different person now. I have a different outlook.
Six months ago, if you were wearing a jacket, I’d be wondering
Photos by Gary Meek
8 Spinal Column w w w. s h e p h e r d . o r g

what you had underneath the jacket. My physical pain was
through the roof, but I was also hyper-alert, hyper-sensitive,
paranoid, isolated.”
Today, Greg is none of those things. But he knows he’s still
a work in progress. The difficult task of putting his life back
together is not done – not by a long shot. But there is hope
where there once was only fear and despair.
Greg doesn’t talk about his combat experience in Iraq. But
he was injured in a blast explosion in October 2007 – one
that damaged his brain, back and legs. He came back home a
broken and battered man.
“His lingering effects included PTSD (post-traumatic
stress disorder), headaches, memory problems, dizziness,
multiple musculo-skeletal pains and insomnia,” Dr. Kaelin
says. “We look at this kind of patient as an onion with many
layers that you have to peel back one at a time.
“Greg was one of the more affected or impaired patients of
anyone we’d seen,” Dr. Kaelin adds. “But he decided we knew
what we were doing and jumped on board with us and gave it
his all. He’s gotten better control of his pain and his emotional
state – with less medication. He more independently
manages his stressors and is emotionally stable.”
Greg gives all the credit for his improvement to the
SHARE Initiative.
“I’ve been to all the big places that they tend to send
patients like me,” Greg says. “Nothing has come close to this
place. I came here thinking I was weird, that something was
not right with me. What I learned here, through group sessions
and informal talks with other patients, was that what I
was feeling was normal for someone who had gone through
what I had gone through.”
Photo by Gary Meek
“From the first day we got there, I was shocked to see a
team here waiting for us. It was amazing. They checked him
out and started to explain things to me. It was so calming
the way the doctors talked to me”
—Nancy Rodriguez, mother of patient Joel Rodriguez
Far Left: Darryl Kaelin, M.D., is medical director of Shepherd's Acquired Brain Injury Program. Left: Even though
her son Joel Rodriguez thought he was ready to return home after a couple of weeks at Shepherd Pathways,
Nancy Rodriguez decided her son should stay until he completed the full continuum of care Shepherd offers for
brain injury patients.
Above: Sary Newman, right, one of Joel Rodriguez' therapists at Shepherd Pathways, says his physical prognosis
is good, and she thinks he will recover cognitively in time.
Fall 2009 9

Photo by Gary Meek
Photo by Leita Cowart
Below: Greg Hutchinson discharged from the
SHARE Initiative at Shepherd Center this past
summer. His treatment team believes he is
prepared to face the challenges ahead. While
in the program, he participated in equestrian
therapy at Chastain Horse Park in Atlanta.
In the SHARE program, soldiers are housed
together near Shepherd – much like they would
be when on active duty – and go through the long
process of healing together. The military-like setup
is part of the reason the program is so effective, Dr.
Kaelin says.
“Wounded soldiers tend to be more comfortable if
they are left in a military environment,” he explains.
“So we house the patients together instead of mixing
them into the civilian patient population. They get to
be around other patients who are in similar situations,
and that helps them in therapy – even informally.”
Greg’s healing began once he realized he could
let his guard down around staff and other patients –
including ones who outranked him, he says.
“You had to practice what you were learning, and
that’s hard to do the first few weeks,” Greg recalls.
“When you’re in the Army, you are taught to always
have your dukes up. Once you figure out that you can
let your hands down and trust people, and that there
were no ranks in the groups, then you could start
healing. I’ve been able to help others go through that
process. Most of us don’t have anyone else. I might
have had experiences in combat and working through
those issues that can help someone else. Or they might
have strategies that can help me. The PTSD – and all
of the emotions – is the hardest thing to get fixed.”
Greg discharged from the SHARE Initiative this
past summer – feeling both eager and apprehensive
about leaving the program. He has no long-term
goals yet. Instead, he focuses on the more immediate
future. He expects to be medically discharged from
the Army soon.
“I’m moving to Wisconsin with an Army buddy
and starting life over there,” Greg says. “It’s a
Catch-22 because I want to get out and go on with
my life so badly, but I also know that this part of my
support will be missing, and that’ll be scary. Every
transition is tough, but the transition out of
Shepherd will be very scary. Being on my own,
where I can’t just go knock on someone’s door and
talk, and have them understand what’s going on,
that’s intimidating.”
Terri Kohn, LPC, Greg’s counselor at Shepherd,
knows, maybe even more than Greg does, just how
far he has come. “He has had several bumps in the
road and will continue to face challenges that might
set him back,” Kohn says. “But he definitely makes
use of the strategies he has learned to get through
the more difficult times.”
It’s a challenge Greg appears prepared to take on
and one he is now better equipped to face.
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+
CoverStorySidebar
Praise on
Peachtree
Former Young Stroke Program patient gives thanks for
his recovery during Atlanta’s Peachtree Road Race.
By Bill Sanders
This year, while everyone else celebrated Independence Day on
July 4th, Wes Varda celebrated Thanksgiving.
As he ran up Cardiac Hill in Atlanta’s Peachtree Road Race,
he stopped to thank staff and supporters of Shepherd Center. He
wanted them to know how grateful he was to be alive – much less
running again.
In December 2008, 32-year-old Wes had a stroke so severe
that doctors and Wes’ parents thought he was dying. Taken to
Northside Hospital in Atlanta, Wes was unable to speak or move,
but could see, hear and understand. He knew a priest was coming
to give him Last Rites.
But doctors performed a two-hour, life-saving surgery in which
a catheter carrying a clot-busting chemical was threaded from
Wes’ groin into his brain stem. The chemical worked, the clot
dissolved and Wes was soon admitted to Shepherd Center for
rehabilitation. Staff in the hospital’s Young Stroke Program set
out to help Wes put his life back together.
“When admitted, Wes was weak in all of his extremities,”
recalls Payal Fadia, M.D., Wes’ physician at Shepherd. “His
ability to communicate was limited, and he required a feeding
tube for nutrition due to difficulty swallowing. In addition, he had
difficulty with balance, dizziness and coordination of movements.
The sort of stroke Wes had is life-threatening and can have a very
poor prognosis if not immediately treated.”
Wes did not realize his prognosis when he first came to
Shepherd. But he did sense he was in the right place to get the
help he needed.
“When I got there, I was still wondering what was going on,
but I knew enough to know that it was a great hospital, so my
spirits were a little better because of that,” Wes recalls. “I was out
of the woods as far as living or dying, but I still had some major
health concerns. I couldn’t walk and could barely talk.”
But things soon began to improve for Wes.
“Everyone was so warm and nice there,” he says. “They were
patient with me. I didn’t really have many expectations when I
got there because I was still so dazed. But the recovery has been
much greater than I could have expected. Just nine months
after my stroke, I am almost fully functioning. All of my doctors
are optimistic.”
Wes deserves a lot of the credit for his recovery, says Kendra
Moon, his case manager at Shepherd.
Above: Wes Varda, 32, of Atlanta had a severe
stroke in December 2008. Today, he is back to
running and now volunteers at Shepherd Center.
“Wes was open and willing to acknowledge the differences in his
condition, both physically and cognitively, as a result of his brain
injury,” she explains. “When he got here, he was in a wheelchair
and required physical assistance and supervision with his personal
care. He had visual and speech difficulties, and he had lost a lot of
strength, coordination, and fluidity of movement in his arms and
legs. He required 24-hour supervision and care.”
After completing the inpatient Young Stroke Program at
Shepherd, Wes moved on to the post-acute day program at
Shepherd Pathways. It included physical, occupational, speechlanguage-cognitive
therapies, therapeutic recreation, counseling and
vocational services. After two months, he transitioned to Pathways’
outpatient therapy program, where he participated in rehabilitation
therapy twice a week.
By July 4th, Wes was ready to say thanks publicly. He chose the
Peachtree Road Race for his mission because it takes participants
past Shepherd Center. Patients and staff line the sidewalk to cheer
participants as they pass by, but on this day, Wes cheered them.
“That was truly one of the highlights of my recovery,” Wes recalls.
“Getting to run past Shepherd and talk to patients in wheelchairs
and tell them I was where they are just a few months ago, that made
me very happy. I didn’t get emotional, like fighting back tears, but I
felt very blessed.”
Wes is not sure what the future holds for him. He is volunteering
at Shepherd – now as a greeter in the cafeteria and later with a peer
volunteer group. Other than that: “The future is wide open,” he says.
And Wes knows he’ll have plenty of support from friends and
family, which is vital in rehabilitation.”
Dr. Fadia says Wes’ recovery has surprised everyone, even at
Shepherd – a place where incredible recoveries often occur.
“His stroke is extremely rare in a person of Wes’ age and good
general health,” Dr. Fadia says. “And as for where he is now, I did
not expect this. Wes has made an unbelievably remarkable recovery
in an extremely short period of time.”
Photo by Gary Meek
Fall 2009 1 1

PacingSystemFeature
Breathing
NeuRx Diaphragmatic Pacing System
gives ventilator-dependent patients hope
for an improved quality of life.
By Bill Sanders
For Jenny Sorenson, not having a voice with which to speak
meant it was hard to have a voice in how she would raise her
children, how she would keep friends informed, and how
she would thank her husband for his faithful support.
Thanks to new technology being implemented at Shepherd
Center, Jenny – and other patients who are dependent upon
a ventilator to make them breathe – can now wean off the
ventilator and instead use an implantable device called the
NeuRx Diaphragmatic Pacing System (DPS). The system
has made all the difference in the world for Jenny, who no
longer has to rely upon her friends and family to read her
lips.“They had gotten pretty good at it,” she says. “But that
wasn’t a solution long-term.”
Now, Jenny uses the NeuRx DPS most of the time, but
still relies upon a ventilator occasionally. Dual dependency is
normal for a while, but eventually, Jenny expects the ventilator
to be a thing of the past in her life.
The NeuRx DPS, which was developed by researchers at
Case Western Reserve University and is licensed by Synapse
Biomedical Inc., works like this: Four small wires are surgically
attached to the diaphragm, the breathing muscle in the
chest. This procedure requires minimally invasive laparoscopic
surgery. These wires exit the chest wall and are attached to an
external stimulator, the NeuRx DPS. The stimulator provides
electrical stimulation through the wires to the diaphragm and
nerves that run through the diaphragm. When stimulated, the
diaphragm contracts, mimicking natural breathing. Air is allowed
to fill the upper and lower parts of the lungs rather than
forcing air in with a mechanical ventilator.
Following clinical trials of NeuRx DPS in patients at
Shepherd Center and elsewhere, the FDA approved the use of
the device in June 2008. After that approval, Jenny was the first
patient in the nation to undergo the procedure and begin using
the pacing system, says Cathy Gragg, the Shepherd program
coordinator for NeuRx DPS. Since then, Shepherd Center
physicians have implanted the device in 10 patients with spinal
cord injury (SCI). Most are now in various stages of weaning
from the ventilator.
Jenny’s success with the NeuRx DPS stems from
determination and hard work on her part, as well as her
caregivers, which include family members. She has come a long
way since the diagnosis of the medical condition that left her a
quadriplegic in early 2008. Doctors at Johns Hopkins Hospital
in Baltimore determined there was an abnormal tangle of
vessels in Jenny’s spinal cord, which cut off blood supply to her
cord. She underwent surgery and transferred to Shepherd for
rehabilitation in May 2008.
While she was undergoing rehabilitation, Andrew Zadoff,
M.D., medical director of Shepherd’s Intensive Care Unit (ICU)
and Pulmonary Services, screened Jenny as a potential candidate
for the NeuRx DPS.
“I had been at Shepherd for two months, and Johns Hopkins
before that, so when they first suggested the pacing system, I just
wanted to go home and see my family,” Jenny recalls. “But after
getting home and clearing my head a little, I realized I really
needed to do this.
“For the first four months on the ventilator, all I did was lie in
bed,” Jenny says. “I didn’t speak clearly with a voice until I got to
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Photo by Owen Riley
Photo by Leita Cowart
“Now, with the pacing system, my voice is much stronger. Even if
I’m not strictly on the pacer, I have it on, and my breathing is a
lot stronger. It’s just easier to breathe.” — Jenny Sorenson
Shepherd. People had learned to read my lips, but trying to communicate
with my kids (twin 10-year-olds and a 7-year old) was
very hard at times.
“Now, with the pacing system, my voice is much stronger,” she
adds. “Even if I’m not strictly on the pacer, I have it on, and my
breathing is a lot stronger. It’s just easier to breathe.”
Dr. Zadoff, who screens all Shepherd ventilator-dependent
SCI inpatients and outpatients to see if they are medically appropriate
for the NeuRx DPS, attributes Jenny’s success with
the device to several factors – most importantly her desire to
make a change that would improve her quality of life.
“First of all, the patient has to have a willingness to get off
the ventilator,” Dr. Zadoff says. “It is hard work that begins
within 24 hours after the procedure. Vent-weaning can then
take up to seven weeks after that. In theory, there’s no reason
why they cannot be completely weaned off the ventilator and use
the pacing system 24 hours a day. But some patients feel more
comfortable continuing to use the ventilator at night, even after
the procedure is done.”
Another requirement for NeuRx DPS patients and caregivers
are pre- and post-operative training sessions. “We want
patients to have a good understanding of how the pacing system
works and what we’re trying to do,” Dr. Zadoff notes.
Once the screening process indicates a patient is a good
candidate for the NeuRx DPS, Shepherd Center consulting
surgeon Saeid Khansarinia, M.D., performs an exploratory
laparoscopy on the patient at neighboring Piedmont Hospital.
In that procedure, he attaches electrodes to the patient’s phrenic
nerve, which helps control breathing, to see if it can cause the
diaphragm to be stimulated. If so, then the surgery is done, and
soon thereafter, the vent-weaning process begins.
Dr. Khansarinia says the NeuRx DPS can make a significant
and dramatic change in patients’ lives. He looks forward
to future generations of the device that may make it entirely
implantable, thus eliminating the need for any external wires
and machines, he adds.
Inpatients who are interested in the NeuRx DPS can
initiate the screening process by simply asking their doctor.
Outpatients are asked to contact Shepherd Center case manager
Brenna Blocker at 404-367-1253 or brenna_blocker@shepherd.
org. More information is available at www.shepherd.org/dps.
For Jenny, the decision to get the NeuRx DPS was a good
one, she says. Though she’s not sure when, if ever, things will get
back to normal for her, she’s thrilled to have a voice again and to
have a family that loves her so much.
“My husband has been wonderful,” Jenny says. “I couldn’t get
through it without him. My kids want the old mom back, but
we’ve adapted how we do things, such as hugs and going places.
They put their hand on my hand when we’re out. It’s not by any
means normal for them, but they like it that I can come to their
swim practices, can go out to eat and not just be in a bed. So
that’s some normalcy.”
Above: Jenny Sorenson, her husband Scott and their children are
returning to some normalcy in their lives in Irmo, S.C., since Jenny
started using the NeuRx DPS system to help her breathe.
Andrew Zadoff, M.D., screens all ventilator-dependent SCI patients
to see if they are appropriate for the pacing system.
Fall 2009 1 3

AssistiveTechnologyFeature
Photo by Gary Meek
Edge with appropriate Shepherd patients to see how it can
help them and then determine if it’s an affordable solution
for them. Results elsewhere indicate there is reason to be
optimistic, John notes.
Eyegaze Edge appears to be a promising piece of
technology for improving patients’ quality
of life and restoring some of their independence.
Eye Control
Shepherd’s Assistive Technology Center evaluates
vision-based communication and control system
for patients who cannot speak.
By Bill Sanders
Shepherd Center patient Julius Singleton struggled a bit the
first time he stared at a computer screen and tried to type out
his name, using nothing but his eyes.
But, with a little practice using a vision-based communication and
control technology called Eyegaze Edge, Julius, a college professor from
Burnsville, W.Va., made progress.
“This technology has the potential to transform the lives of quadriplegics
whose high-level injuries make it difficult for them to speak and
communicate,” says John Anschutz, director of the Assistive Technology
Center at Shepherd Center.
The technology, developed by LC Technologies Inc., gives users numerous
functions including: speech generation, environmental control
(lights, appliances), typing, and running both mouse- and keyboardcontrolled
applications on the company’s Edge screen. Also, the Edge
can serve as a keyboard and mouse interface for a user’s own computer.
Users make selections by looking at boxes or “keys” displayed on the
Edge screen. The system uses a pupil-center/corneal-reflection method
to determine where a user is looking on the screen. An infrared-sensitive
video camera, mounted beneath the system’s screen, takes 60 pictures per
second of the user’s eye. The Edge calculates the person’s gazepoint (i.e.,
the coordinates of where he is looking on the screen) based on the relative
positions of the pupil center and corneal reflection within the video
image of the eye.
The technology isn’t new to the market, but it’s new to Shepherd
Center and its patient population. Ruth Fierman, an occupational
therapist in the Assistive Technology Center, is testing the Eyegaze
If Ruth determines there is potential for the Eyegaze Edge
system to be a good match for a patient, one of Shepherd’s
speech and language pathology therapists determines if the
system will provide efficient communication for the patient.
As a technology demonstration with Julius shows, Eyegaze
requires practice. Users must learn how to focus on a letter or
statement, such as “I am thirsty,” for the right amount of time.
“It can be intimidating until you are familiar with it,” John
says. “Once they get the hang of it, though, they want us to
speed it up.”
Physicians expect Julius to regain his voice, but some
other high-level quadriplegics do not regain that function.
And if they are unable to use a mouse stick in their mouth,
they have virtually no ability to communicate, John notes.
So Eyegaze Edge appears to be a promising technology for
improving patients’ quality of life and restoring some of their
independence.
“If someone can’t communicate at all, it is amazingly
frustrating for that person,” John explains. “So, once we finish
evaluating the Eyegaze Edge system we have at Shepherd
now, we hope to get some funding through grants to help
more people. The price of these units has come down from
about $18,000 to $9,000, so we hope, in time, that we can get
them into some homes of people who need them.”
Above: Ruth Fierman, center, an occupational therapist
in Shepherd Center's Assistive Technology Center (ATC),
evaluates whether the Eyegaze Edge system is appropriate for
quadriplegics who have lost use of their voice. John Anschutz,
manager of the ATC, assists with a demonstration for patient
Julius Singleton of Burnsville, W. Va.
Photo by Gary Meek
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OutreachFeature
Building
Professional
Relationships
Shepherd Center emphasizes outreach to referring
facilities and physicians.
By Kayla Eubanks
The Shepherd Center Marketing and Public Relations
departments have teamed up to create a special outreach
plan to the hundreds of referring facilities and physicians
who work with the hospital each year.
To build better relationships and improve communications,
the team created new strategies to effectively communicate
news at Shepherd and update referring physicians on how their
patients are doing in rehabilitation, explains Mitch Fillhaber, vice
president of marketing and managed care. The goal is to improve
access to Shepherd Center physicians for the trauma physicians
and neurosurgeons who initiate life-saving interventions at the
facilities that refer patients to Shepherd.
Fillhaber outlines the details of the plan:
MD-to-MD Communication
As part of the new plan, Shepherd Center doctors call referring
physicians to provide insight into their patient’s transition and rehabilitation
plan following admission. Although most physicians
already call the referring hospital or physician once a patient has
arrived, Shepherd created an internal standard to ensure that this
happens regularly.
If a patient is admitted to the ICU, the admitting physician
will contact the referring physician within 24 hours to confirm
the patient arrived. The physician also will provide information
on the patient’s medical status and immediate plan of care. If a
patient is admitted on a Friday, the referring physician will be
contacted by Monday.
For acute rehabilitation patients, the standard is to call the
referring physician within 24 hours of the first team meeting,
which is typically held during the patient’s first week at
Shepherd. Team meetings involve the patient’s physician, case
manager, therapists and nurses. The team discusses the patient’s
plan of care, including anticipated therapies and any medical issues
the patient may be having. Referring physicians will be told
the medical status, care plan and anticipated length of stay.
Enhancing Discharge Summaries
Another way Shepherd Center is intent on improving its direct
communication with outside physicians is through enhanced
Above: Shepherd Center physicians, including
Medical Director Donald Peck Leslie, M.D., call referring
physicians to provide insight into their patient’s transition
and rehabilitation plan following admission.
information in its discharge summaries. The hospital’s 13 admissions
liaisons have been meeting with referring physicians from
trauma centers to determine what additional information would be
beneficial for them to have in anticipation of serving patients upon
their return to the community.
New Newsletters
Shepherd Center also will be expanding its physician publications
to include two new newsletters that will complement Consulting
Physician, a newsletter the hospital started earlier this year. The two
new bi-annual newsletters include one written for neurosurgeons
and trauma physicians and the other for physiatrists. The newsletters
provide information on hospital practices, ICU processes,
research trials, continuing education opportunities and more. The
first issue of Consulting Physician is available at www.shepherd.org/
publications. The others are under development.
Photo and Video Updates
A great way to understand Shepherd Center practices is to see
firsthand how a patient is improving. For a visual update, referring
facilities can receive a photo or video of their former patient. Photos
are taken during therapy sessions to demonstrate something the
patient is working to improve, such as lifting their arms or writing
their name. The photos also give the patient an opportunity to say
thank you to the referring team.
Video updates include recorded messages from the patient, his
or her physician and sometimes even family members. It shows
the patient in multiple therapy sessions and tells the story of their
recovery since arriving at Shepherd. The admissions team can take
these to referring hospitals when they visit to show physicians and
case managers how their prior referrals improved.
Photo by Gary Meek
Fall 2009 1 5

ICUFeature
Photos by Gary Meek
Above and Right: Shepherd
Center ICU nurses, such as Kim
Whitlock, have training in both
critical care and rehabilitation.
Acquired Brain Injury Program
Medical Director Darryl Kaelin,
M.D., left, discusses a case wtih
Whitlock and Emory University
resident Dionne Casthely, M.D.
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Un-
Adapting to life after a spinal cord injury is no easy task.
Unlike other less severe injuries, spinal cord injury (SCI) often
comes with a host of other complications – a cascade of health issues
that can result from damaged nerves, sudden immobility, loss
of sensation and paralysis of the breathing muscles, among others.
Some of the most common problems patients may encounter
include skin sores, ventilator-assisted pneumonia, and bowel and
bladder control issues.
It’s important for people with SCI and their loved ones to
remember that many of these health issues are not inevitable
and can be controlled or managed. Knowing how to recognize,
anticipate and treat complications early on is essential for quality
patient care and recovery – and has long been a major priority for
treatment teams at Shepherd Center.
Shepherd’s acute-care capabilities and expert medical staff help
resolve SCI-related complications quickly – often simultaneously
to starting patients in a coordinated rehabilitation program to
maximize recovery and avoid delays.
Keys to Success
“We spend a lot of time making sure our staff understand the
physiology and anatomy of catastrophic injuries,” says Tammy
King, RN, chief nurse executive at Shepherd Center.
That’s because what appears as “normal” body functioning for
any other person is not for someone with a spinal cord injury.
“Their bladder functions differently, the skin is at risk for breakdown,
and patients who appear normal may actually be cognitively
impaired, which means they can’t be relied upon for medical
histories,” she says.
The sheer volume of patients cared for means Shepherd is
accustomed to assessing complications early on and determining
what is the “norm” for neurological problems.
“One marker of success is our ability to wean patients from the
ventilator, a machine that helps them breathe,” King says. “It’s the
difference between a patient going around with a machine every
day and being able to breathe on his or her own, which is a huge
quality-of-life issue – not to mention the additional medical and
financial burdens that come with using a ventilator.”
In 2008, nearly 86 percent of Shepherd SCI patients with injuries
ranging from C-4 to C-7 or T-1 to T-12 were weaned from
Shepherd has success in resolving associated health problems
in people with spinal cord injury. By Amanda Crowe, MA, MPH
complicating
SCI
the ventilator during their inpatient stay
at the hospital in an average of 20 days.
The hospital also prides itself on low,
hospital-acquired infection rates thanks
to its dedicated respiratory therapy and
nursing staff and rigorous quality control
measures, which track the incidence of complications.
Shepherd has been able to sustain
a no-infection rate in ventilator-associated
pneumonia for more than a year. Efforts to
prevent the transmission of other hospitalacquired
infections (for example, MRSA, a
virulent staph infection, and catheter-related
bloodstream infections) are taken very seriously.
These include education of staff on hand
hygiene, proper disinfection of equipment and
adhering to protocols to isolate infected patients,
among other evidence-based precautions.
The intensive care unit (ICU) staff also pays
careful attention to the use of antibiotics, which
can kill the good bacteria in the body and cause
a c. difficile infection in a patient’s intestines.
Staff minimizes use of antibiotics to avoid these
infections.
A Central Resource for Others
Because of Shepherd’s success, ICUs and trauma
centers at other facilities often call on Shepherd for
assistance and best practices to identify complications
and prevent common problems. Managing hospitalacquired
infections or problems among SCI patients
has become increasingly important to other facilities
amid new policies by the Centers for Medicare &
Medicaid Services and managed care organizations.
These policies are aimed at reducing “never events,”
which are considered serious, preventable and costly
Fall 2009 1 7

medical errors. Medicare and other plans
no longer pay for the treatment of these
complications, and several states have
enacted laws requiring the disclosure of
“never events” at hospitals.
Possible Complications from SCI
• Skin breakdown or “pressure sores”
• Urinary tract and bowel management
problems, including loss of bladder or
bowel control that increases the risk of
urinary tract infections
• Respiratory problems, including pneumonia
or ventilator dependence
• Muscle spasms
• Blood clots
• Weight loss and muscle atrophy
• Pain
• Increased likelihood of new injuries, especially
where there is impaired sensation
“Shepherd is both a teacher and an asset
for hospitals worried about never-event costs
because it’s all we do,” says Mitch Fillhaber, vice
president of marketing and managed care at
Shepherd. “Our acute-care capabilities provide
added value for the patient, facilitate earlier referrals
and also can help trauma centers turn over
beds more quickly and help transition patients
into rehab more quickly.”
The rehabilitative environment at Shepherd gives
patients – even the most severely injured – a sense
of control over their situation. Even in the ICU,
aggressive physical therapy is started at some level,
and patients are often helped out of bed and into a
wheelchair.
“Shepherd Center appears to have one of the most
advanced programs for early treatment and strategic
planning for spinal cord injury management, including
having their own ICU,” says Julian E. Bailes,
M.D., chairman of the Department of Neurosurgery
at West Virginia University School of Medicine.
King is most proud of the careful attention
Shepherd clinicians give to every body system, from
the heart and bladder to their sexuality and spirituality.
“Our long-term outcomes are a reflection of everything
we’ve done throughout the continuum of care,”
she says. “And we don’t consider only acute medical or
physical issues. We also take time to focus on patients’
spiritual and emotional well-being.”
Ahead of Its Time
Shepherd’s on-site intensive care unit ensures continuity of care.
Even though Shepherd Center was established 34 years ago, its founders had the foresight to
structure the hospital’s care model so every aspect of spinal cord injury care would be available
under one roof.
In doing so, patients receive seamless, comprehensive care – from acute medical services
and cutting-edge interventions that maximize rehabilitation and recovery to bridge programs that
help them transition back to their communities.
“The founders developed a hospital for the future, where catastrophically injured patients
wouldn’t have to be transferred and there would be no disruption in care,” says Mitch Fillhaber,
vice president of marketing and managed care at Shepherd Center. “Such early intervention and
coordinated rehabilitation are critical for long-term recovery.”
Beginning a rehabilitation regimen within two weeks of injury can lead to increases in
functional improvement and more cost-effective care for people with spinal cord injury (SCI),
experts say. Today, Shepherd Center remains one of only a few facilities that has an on-site
intensive care unit (ICU). Shepherd accepts patients directly from a trauma center’s emergency
department and aggressively starts rehabilitation from day one.
“This capability allows us to admit patients earlier in the acute stage and possibly shorten
their hospital stay by reducing the number of complications,” says Andrew Zadoff, M.D.,
medical director of Shepherd’s 10-bed ICU. “We can start patients in rehabilitation even
while they’re still in the ICU. We get them out of the bed, and that improves their mobility.”
A team of rehabilitation and medical professionals – including orthopedists, internists
and urologists – who have extensive experience in catastrophic care address individual
patient needs and establish short- and long-term rehabilitation goals from the start. The
ICU staff works alongside physical, occupational and speech therapists to begin rehab as
soon as possible and can draw upon the expertise of other specialists as needed.
Dr. Zadoff is proud of Shepherd’s dedicated respiratory therapy and nursing staffs that
work collaboratively to minimize SCI-related complications (for example, skin, bladder
and bowel problems, blood clots, nutritional deficiencies) and have helped contribute to
low, hospital-acquired infection rates.
“Our ICU nurses have both rehabilitation and critical care training, so they look at both
medical issues (the injury itself, as well as related complications) at the same time, and
that benefits patients greatly,” he says. “For example, our ventilator-associated pneumonia
rate is next to zero. That’s because of the way we wean patients and our careful
attention to secretion control. A rate this low is unheard of in an ICU environment.”
This is important because such infections can cost an extra $40,000 per episode
and greatly lengthen a patient’s stay in the ICU, potentially hindering their rehabilitation.
Having an on-site ICU has clear clinical benefits for patients. Much of the care that
starts in the ICU will continue as the patient moves to a regular room and through
rehabilitation to ensure seamless care for patients – and provides reassurance for
patients and families who already have enough to worry about. — Amanda Crowe
Photo by Gary Meek
Left: Shepherd ICU
charge nurse Anneka
Maguigan checks on
patient Tyler Epps
of Lincolnton, Ga.
Patients benefit from
the depth and breadth
of experience of
Shepherd nurses like
Maguigan.
1 8 Spinal Column
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ShepherdTVFeature
Shepherd asked KPKi to incorporate the videos into a
Web site linked to Shepherd’s main site. ShepherdTV.org
went live in late January and has garnered nearly 1 million
hits with 12,700 unique visitors from across the world.
In addition, KPKi produces videos for ShepherdTV.org,
following Shepherd patients during their stays and once
they are back home. In the past two months, the company
has traveled to Lake Martin, Ala.; Nashville, Tenn.; and
Boca Raton and Delray Beach, Fla., to create Stories of
Hope on Shepherd graduates.
Some “Stories of Hope” featured on ShepherdTV.org
include:
On the Net
“Catch Me on ShepherdTV.org” message debuts on
wheelchair sweeper vans during Peachtree Road Race.
Shepherd Center has rolled out the first of several vans
in its transportation fleet that are slated for a cosmetic
update with colorful vehicle wraps promoting Shepherd
Center’s people and programs.
Peachtree Road Race enthusiasts lining the race route were
the first to see Shepherd’s sweeper van during the July 4 race.
The vehicle wrap features messages about the Center and its
video Web site, ShepherdTV.org.
The van is wrapped in large photographs of Shepherd
Wheelchair Division Peachtree Road Race participants, along
with the message “Catch Me on ShepherdTV.org.” The sweeper
van travels alongside wheelchair racers competing in the race in
case any of them need help or don’t clear the course in the time
allotted before foot racers begin.
ShepherdTV.org was launched earlier this year to put
Shepherd Center’s messages and patient success stories –
called “Stories of Hope” – online with compelling, feature-style
videos about Shepherd and its patients.
“Online video has become an important tool to introduce a
facility such as ours to families whose loved one may have just
sustained a catastrophic injury or been diagnosed with a chronic
illness,” says Larry Bowie, public relations director for Shepherd
Center. “Seeing the facility in quality HD video and hearing
from our patients, their families, our founders, staff and physicians
offers a firsthand, realistic look at a place that may become
a ‘home away from home.’”
ShepherdTV.org was created by KPKinteractive (KPKi) after
the company completed a series of nine videos for Shepherd in
2008. Because of enthusiastic reception to the videos,
Shepherd Center File Photo
• Stephanie Beard of Adams, Tenn., who sustained a
spinal cord injury in an automobile crash in April 2007
and now walks unassisted and limp-free, is a college
student in Nashville, Tenn.
• Jennifer Lindquist of Sussex, Wis., who sustained a
spinal cord injury in a skiing accident in January 2007,
can now walk with forearm crutches.
• Parker King of Atlanta, who sustained brain and spinal
cord injuries when he was hit by a truck in August
2003, is now a student at the University of Georgia.
• Alex Vazquez of Boca Raton, Fla., who sustained a
severe brain injury when he was hit by a car in August
2007, is now pursuing a career in video production.
Other content available on ShepherdTV.org includes videos
on Shepherd’s spinal cord and brain injury rehabilitation
programs, research, special events such as patients reunions,
the annual Adventure Skills Workshop and the Wheelchair
Division of the Peachtree Road Race.
Above: Shepherd Center vans are getting a cosmetic update
with colorful vehicle wraps that promote Shepherd's people and
programs, including video content posted at ShepherdTV.org.
Fall 2009 1 9

Research
It’s an exciting time for neuroscience, including the hope for
new therapies to treat spinal cord injury (SCI). While basic
scientists and clinicians are making important advances, they
face daunting challenges when it comes to moving promising
research from the bench to the bedside.
To identify and address these barriers, leading experts in neuroscience
and stem cells recently came together for the one-day
workshop at the University of Georgia.
“The concept of this workshop grew out of a need for better
communication between stem cells scientists, who dared to use
the term ‘cure’ for spinal cord injury, and care providers, who are
worried about raising ‘false hopes’ and setting unrealistic goals
for people with spinal cord injury,” says Ann Kiessling, Ph.D.,
associate professor of surgery at Harvard Medical School and
director of the Bedford Stem Cell Research Foundation, which
organized the second annual gathering in cooperation with
Shepherd Center. “Both groups clearly have the patient’s best
interest at heart, but were not hearing each other’s concerns.”
A key challenge for people with SCI is the concern among
clinicians that any direct intervention at the site of the injury
could impose further damage and additional loss of function,
Dr. Kiessling says. “They are understandably reluctant to expose
their patients to the risk of further spinal cord damage for
research purposes,” she adds.
There is also a lack of infrastructure within the SCI research
community to support multi-center studies, and to define how
studies in SCI can be made safe and relevant to human patients.
Keith Tansey, M.D., Ph.D., director of spinal cord injury research
at Shepherd, spoke to the group about the need to ensure
animal studies are more relevant to humans.
“Humans aren’t necessarily just big rats, and we need to better
understand how and why animals are recovering from SCI
because the mechanisms may not be the same in humans,”
Dr. Tansey says. “Studies of animals and humans with incomplete
injuries reveal a bias toward spinal plasticity in animals
and brain plasticity in humans as the reason for functional
recovery, so treatments may need to be different. In complete
injuries, spinal circuits in rodents can regain stepping, but
humans can’t, so we need to learn how to make human spinal
cords function like rats’.”
Dr. Kiessling agrees, adding that animal model research needs
to be more carefully aligned with human injuries and the outto
Bedside
From Bench
Leading experts in basic science and clinical care discuss barriers to a “cure”
for spinal cord injury. By Amanda Crowe, MA, MPH
come goals for human therapies. “If walking is the outcome
measure, animal models need to reflect that. But if bladder
control is what’s important, a different animal model may be
needed,” she says.
Researchers and clinicians must gain a better understanding
of how much recovery is due to re-establishment of brainspinal
cord connections versus improvements in interpreting
and using sensory information in the spinal cord below the
level of injury. Dr. Tansey challenged the traditional view of
translational research in which discoveries at the cellular level
move from the lab to clinical practice, arguing that it should
be more of a two-way street. That is, questions that arise in the
clinical setting can go back to the lab to find answers. Other
attendees said this model could help inspire greater communication
and partnership, as well.
A memorable highlight of the workshop was a tour of
Shepherd Center, the only specialty rehabilitation center in
the country that combines intensive medical care, rehabilitation
and a clinical research program under one roof. This visit
gave basic scientists a chance to see what their work can do at
the human level, well beyond studying cell biology in the lab.
“We could have held this workshop anywhere in the
country, but we were impressed by the clear enthusiasm and
determination of Shepherd’s leadership, particularly Alana
Shepherd, in creating a unique center of excellence in patient
care,” Dr. Kiessling says.
Still, experts say the complexity of SCI cannot be overstated,
and there is no silver bullet – no single cell, no single
surgery, no single nerve-growth factor that will solve the
whole riddle. “The more realistic expectation is that a combination
of incremental steps is needed to improve recovery and
maximize function,” Dr. Tansey says. “There is huge potential
with stem cell biology and cell-replacement therapies, but
there’s also a long distance between where we are today and
where we need to be to find a ‘cure.’”
Collaborations among these leading experts will help
forge the path forward. In the meantime, patients and their
families should be encouraged by the progress made thus far,
experts say. Prevention and early intervention, regeneration
therapies at the cellular and extra-cellular levels and aggressive
rehabilitation are all contributing to significant neurological
recovery after SCI.
2 0 Spinal Column
w w w. s h e p h e r d . o r g

ManagedCareCorner
Why Shepherd
By Colleen McCrory, Shepherd Center Director of Marketing and Managed Care
Photo by Gary Meek
I am continually challenged by
managed care payers, referring hospital
systems, patients and families
with the question “Why Shepherd?”
when they are considering rehabilitation
options.
While I try to verbalize our
strengths, outcomes, and earlyintervention
ICU and other levels
along our continuum of care, the
message sometimes isn’t conveyed or
received – as compelling as I think the verbal “evidence” might be.
Showcasing Shepherd Center’s specialization in the treatment of
spinal cord and brain injuries and multiple traumas in a conversation
just isn’t enough.
Working in conjunction with our Quality, Resources and
Outcomes Department, we’ve assembled a compelling outcomes
scorecard. It illustrates why we are not a general rehabilitation
hospital like the majority of facilities you encounter or consider for
the care of your member, patient, client or loved one. Here’s why:
Shepherd Center is ranked by U.S. News and World Report
as one of the top 10 best rehabilitation hospitals in the nation.
This is the type of news
you expect to hear about
Shepherd Center. After all,
we’re the only rehabilitation
facility in the nation with an
intensive care unit and acute
medical component on site,
allowing us to begin the rehabilitation process sooner than other
rehabilitation hospitals.
Our specialization has enabled our staff to develop higher levels
of expertise and achieve better results and outcomes for our
patients. When it comes to independence, functional improvement
and prevention of secondary complications, our patients are
more independent and have better outcomes than the national
average. In fact our patient outcomes are among the best in the
United States.
As part of Shepherd Center’s efforts and a growing trend
among hospitals to be transparent in terms of patient outcomes,
Transparency of data can help families,
referral sources and the medical community
make more informed decisions on the care
of their loved ones and patients.
we have included our data in this issue of Spinal Column in a
removable fact sheet attached to this page. So when you ask,
“Why Shepherd?,” you have documentation of the evidence.
The fact sheet is composed of four sections – data on early
intervention, independence, prevention and evidence.
Early intervention focuses on Shepherd Center’s ventilatorweaning
rates with respect to clinical acuity, secondary
diagnoses and co-morbidities. The prevention data reflects
the “never-event” occurrences and an approximate cost of
such occurrences, which highlights potential cost-savings
associated with admissions to Shepherd Center.
All rehabilitation hospitals measure patient results in terms
of “functional improvement” as measured by the FIM rating
scale. The independence section of outcomes showcases
Shepherd Center’s average FIM change for both spinal
cord and brain injuries, as well as the percentage of patients
returned to their home community rather than a long-term
care facility.
Finally, the evidence quadrant focuses on Shepherd’s
dedication to a unique patient population, the specialization
associated with more than 33 years of care for these patients,
the volume of patients seen and their average age. And, as the
only free-standing rehabilitation
facility in the country
with an ICU level-of-care,
Shepherd Center’s average
length-of-stay in ICU and the
number of admissions to our
ICU quarterly further reflect
Shepherd Center’s highly specialized continuum of care.
As I am continually challenged by our potential referring
hospitals, payers and patients, I challenge each of you to ask
for the same outcomes data from our rehabilitation facility
peers. Transparency of data can help families, referral sources
and the medical community make more informed decisions
on the care of their loved ones and patients.
If you have any questions or would like to discuss these
outcomes in more detail, please contact me or Susan Bowen,
director of our Quality, Resources and Outcomes
Department, at 404-352-2020.
Fall 2009 2 1

Early Intervention
Level of Injury
C1 - C2 7
C3
C4
C5 - C7
T1 - T12
L1 - L5
Rancho 1 - 3
Total Volume
6
25
25
6
1
13
2007 2008
Ventilator-weaning data is analyzed
annually by Andrew Zadoff,
M.D., medical director, ICU and
PulmonaryServices.
Data includes patients admitted within
the calendar year.
# D/C Home on Vent
4
2
3
3
0
0
3
# Weaned
3
4
22
22
6
1
10
Avg Days to Wean
-
8
23
16
18
8
7
Wean Rate
42.9%
66.7%
88%
88%
100%
100%
76.9%
Level of Injury
C1 - C2
C3
C4
C5 - C7
T1 - T12
Rancho 1 - 3
Total Volume
12
6
27
26
18
6
# D/C Home on Vent
9
4
4
2
2
1
# Weaned
3
2
22
24
15
5
Avg Days to Wean
27
21
24
13
20
12
Wean Rate
25%
33.3%
81.5%
92.3%
83.3%
83.3%
Patients excluded from population:
• Patients with a primary diagnosis
other than SCI or ABI.
• Patients who have not
discharged by reporting cut-off
date.
• Patients whose injury level is
not complex and are, therefore,
“expected” to wean.
SCI/ABI dual diagnosis patients are
reported according to their spinal
cord injury level.
Independence
90
75
60
45
Discharge Total FIM ®
Total Spinal Cord Injury
85.0
80.1
Q3
2008
83.3
81.6
Q4
2008
88.4
83.2
Q1
2009
85.8
80.9
Q2
2009
40
30
20
10
28.7
28.9
Q3
2008
Shepherd
Nation
Total FIM ® Change
Total Brain Injury
33.2
29.7
Q4
2008
30.1
26.9
Q1
2009
30.3
29.0
Q2
2009
Story Behind the Data
Wean Rates
• Data represents medically complex patients only.
• Influenced by clinical acuity and primary/
secondary diagnoses, the following are
considered significant influences in determining
the potential capability to wean a patient from
ventilator assistance:
• Level of injury
• Patient age
• Complete vs. incomplete spinal cord injury
• Co-morbidity
Discharge to Community
• Rate is high because of Shepherd Center family
education programs and continued support of
families in their homes.
Discharge to Community
100%
75%
50%
25%
Total Spinal Cord Injury
90.1%
74.2%
Q3
2008
92.8%
74.7%
Q4
2008
93.1%
73.1%
Q1
2009
87.8%
74.8%
Q2
2009
100%
75%
50%
25%
Total Brain Injury
Source: UDS Quarterly Trends Report M240_9021 (July 1, 2008 – June 30, 2009) unless otherwise cited.
91.9%
70.0%
Q3
2008
93.5%
68.8%
Q4
2008
92.2%
70.0%
Q1
2009
91.0%
70.7%
Q2
2009
• Discharge Total FIM ® (Total SCI) Published quarterly by UDS.
The functional assessment instrument is composed of 18
items rated on a seven-level scale that represents gradations
in function from independence to complete dependence.
Measured at discharge to the rehabilitation program.
• Total FIM ® Change (Total Brain Injury) Published quarterly
by UDS. The difference in FIM ® Score as measured at
discharge to the rehabilitation program and admission to the
rehabilitation program.
• Discharge to Community (Total Spinal Cord Injury and Total Brain
Injury) Published quarterly by UDS. The percentage of patients
who return to a community-based setting, including a home
(of the patient, relative or another person), transitional living
setting, board and care setting, or assisted living residence.

Why Shepherd
Evidence
ICU Statistics
General Statistics
6.0
5.0
4.0
3.0
2.0
1.0
0.0
ICU Average LOS
(in days)
5.64
Q3
2008
5.70
Q4
2008
5.60
Q1
2009
5.09
Q2
2009
Source for Both ICU Statistics: Shepherd Center Internal Databases
Prevention
Raw # Cases/Month
Raw # Cases/Month
Raw # Cases/Month
5
4
3
2
1
0
5
4
3
2
1
0
5
4
3
2
1
0
Jul
08
Jul
08
Jul
08
Aug
08
Ventilator-Associated Pneumonia
Oct
08
Wounds Requiring Surgical Intervention
Aug
08
Oct
08
Catheter-Related Blood Stream Infections
Aug
08
Sept
08
Sept
08
Sept
08
Oct
08
60
40
20
0
Nov
08
Nov
08
Nov
08
57
ICU Admissions
Source for Chart Data Below (Not Cost
Data): Shepherd Center Internal Databases
Dec
08
Dec
08
Dec
08
Jan
09
Cost = $40,000/infection
Cost = $1,600/day; Patients
three times more likely to D/C to LTCH
Jan
09
Jan
09
Feb
09
Feb
09
Feb
09
Mar
09
Mar
09
Cost = $45,000/infection
Mar
09
Apr
09
Apr
09
Apr
09
May
09
Source: UDS Office of Quality and Performance (10Q). FY 2008, Q1 technical manual for the
VHA performance measurement system. Washington (DC); 2007 Oct 31. 315 p.
May
09
Source: Russo, C.A. (Thomson Reuters), Steiner, C. (AHRQ) and Spector, W. (AHRQ).
Hospitalizations Related to Pressure Ulcers, 2006. HCUP Statistical Brief #64. December 2008.
Agency for Healthcare Research and Quality, Rockville, MD.
May
09
Source: "An intervention to decrease catheter-related bloodstream infections in the ICU,"
by Dr. Pronovost, Dale Needham, M.D., Ph.D., Sean Berenholtz, M.D., and others, in the
December 28, 2006, New England Journal of Medicine 355(26), pp. 2725-2732.
43
Q3
2008
51
29
Q4
2008
38
25
Q1
2009
57
39
Q2
2009
All Patients Admitted Directly to ICU
ICU Patients Admitted Within 30
Days of Injury
160
140
120
100
80
60
40
20
0
Jun
09
Jun
09
Jun
09
ABI SCI All Patients
300
77
Discharge Volume
216 207 249 249
107
Q3
2008
77
95
Q4
2008
93
96
Q1
2009
91
87
Q2
2009
250
200
150
100
50
Source: Shepherd Center Internal Databases
0
Average Patient Age/# Shepherd Cases
Shepherd
Total SCI
Nation
Total SCI
Shepherd
Total Brain
Nation
Total Brain
Shepherd
Total Stroke
Nation
Total Stroke
Q3
2008
Q4
2008
Q1
2009
Q2
2009
Avg. Age 37.3 38.5 41.2 37.9
# Cases
Avg. Age
Avg. Age
# Cases
Avg. Age
Avg. Age
# Cases
Avg. Age
71 69 72 82
47.1 50.5 52.3 50.4
33.3 32.5 33.4 32.9
37 46 51 67
58.1 56.8 61.1 59.8
45.3 44.8 48.6 42.8
9 15 11 18
67.2 67.7 68.2 67.5
Source: UDS Quarterly Trends Report M240_9021 (July 1,
2008 – June 30, 2009)
Evidence
General Statistics
Discharge Volume
• ABI population includes: Medical and rehabilitation patients with an
impairment code of “ABI” (no dual diagnosis patients).
• SCI population includes: Medical and rehabilitation patients with an
impairment code of “SCI” (no dual diagnosis patients).
• Average Patient Age / # Shepherd Cases: Published quarterly by Uniform
Data System (UDS). All Shepherd patients are not reported to UDS. UDS
requires patients to receive at least three hours of therapy per day to be
included in the dataset.
ICU Statistics
• ICU Average Length of Stay (LOS): Data collected from Shepherd
financial system. Average number of days Shepherd patients stayed in
ICU per episode of care during the reporting period.
•ICU Admissions: Data collected from Shepherd financial system. All
patients admitted directly to ICU (compares first date of stay in ICU to a
patient’s admission date to see if they were admitted directly to ICU). ICU
patients admitted within 30 days of injury (from the above pool of patients
who were admitted directly to ICU; compares date of injury to admission
date to see if they were admitted to Shepherd within 30 days of injury).
Prevention
• Ventilator-Associated Pneumonia: Cases reported by Shepherd Center
Infection Control. Figure reflects number of healthcare-associated
infections of patients on ventilators.
• Wounds Requiring Surgical Intervention Cases reported by Shepherd
Center wound nurse. Figure reflects number of
patients with hospital-acquired wounds.
• Catheter-Related Blood Stream Infection: Cases reported by
Shepherd Center Infection Control. Figure reflects blood stream infections
where central venous line (CVL) or peripherally inserted central catheter
(PICC) is the primary source of infection.

PatientProfile
Flying
HighBy Bill Sanders
Former patient
overcomes trauma and
tense situation, then
earns a pilot’s license.
Above and Following Page: Mal Zackery, a former
spinal cord injury patient from Atlanta, underwent
flight training through the Able Flight scholarship
program in an adapted Sky Arrow 600 LSA with Matt
Hansen of Hansen Air Group based at McCollum
Field in Kennesaw, Ga. Some 38 hours of flying time
later, Mal earned his pilot’s license – but not until
after an emergency landing incident.
Photos by Leita Cowart
Somehow, Mal Zackery doesn’t seem shell-shocked at all. In
the course of less than two years, the 29-year-old Atlantan was
shot during a robbery and left paralyzed below the waist and
was then involved in a harrowing emergency landing of a small
airplane on a busy Georgia highway. The latter captured live
national media coverage.
That Mal lived through those two incidents is miracle enough. That
he came out determined, happy and focused is more than a miracle. It’s
a testament to his inner strength and the positive spirit that Shepherd
Center staff reinforced in him every day he spent in rehabilitation at
the hospital.
“The care at Shepherd was the best,” Mal says. “They taught me
how to do the things I’d need to do in my everyday life, and they kept
it real upbeat. It’s a hard enough time as it is, and the last thing you’d
need is for people to be all heavy and depressing. It wasn’t like that at
all. They informed me of everything I needed to know, but they always
kept it positive.”
Mal came to Shepherd after being shot by a gunman in Montgomery,
Ala., who robbed him and a fellow employee as they were making a bank
deposit after hours. The gunman demanded the money and Mal’s car.
“The next thing I know, I hear a gunshot and I collapse,” Mal
recalls. “There was no blood really, but I went down and couldn’t move
my legs, had no feeling, and I knew what had happened.”
Mal spent about 10 days at Jackson Hospital in Montgomery.
Almost from the beginning, the staff there encouraged him to transfer
to Shepherd for rehabilitation. “They were very nice, showing me
brochures about Shepherd,” he recalls. “When I got to Shepherd, it was
the best.”
Mal sustained a T-12 to L-1 incomplete spinal cord injury. But it
was the worst kind of incomplete injury, Mal says, and he has regained
very little movement in his legs.
During his time as both an inpatient and outpatient, Shepherd’s
therapeutic recreation therapists urged Mal to find an activity that
2 2 Spinal Column
w w w. s h e p h e r d . o r g

interested him. They suggested basketball or swimming, but Mal
just wasn’t interested.
“I tried every angle possible to get him involved, and there
wasn’t much that got through,” recalls Ashleigh Koontz, a therapeutic
recreation specialist. “He was resistant to participating in
much more than physical and occupational therapy because he
was not someone who was open to the idea of participating in
those things he once loved to do – now from a wheelchair.”
Then someone told him about Able Flight, which provides
flight training scholarships for people with disabilities.
“It was the first time I saw a sparkle in his eye, and from what
I can remember, the first time in a long time I saw that smile,”
Ashleigh says. “It wasn’t long after hearing about Able Flight that
Mal took the necessary steps and applied for the scholarship.”
Mal wrote an essay for the scholarship application and was
accepted into the
program. Within a
few weeks, he began
flight training in an
adapted Sky Arrow
600 LSA with Matt
Hansen of Hansen
Air Group based at
McCollum Field
in Kennesaw, Ga.
Some 38 hours of flying time later, Mal earned his pilot’s license
– but not until after the emergency landing incident.
Here’s Mal’s recollection, in his words:
“We had some hints that things weren’t perfect. The oil
temperature was high as it had been on the previous flight, but
no one thought that was a big deal. So I was flying it, and we’d
climbed to about 2,500 feet when my instructor and I started
smelling smoke.
We looked around to see if there was something burning on
the ground, but we saw smoke coming from the cockpit.
“The instructor took over and shut off most of the electrical
stuff. Then he had me try to turn the radio back on, and it
wouldn’t work. He told me to try the master switch, and when I
switched it, everything went off. We were flying with no engine,
and there was nowhere to land except Cobb Parkway (a busy
four-lane highway in suburban Atlanta).
“We flew right over two trucks, whose drivers saw what was
happening, and they stopped and blocked traffic behind them.
And we landed there on the road. It was a perfect landing. It
really wasn’t that scary because we train for that, and we knew
the landing itself would be
easy. It was just a matter of
having a place to land.”
Within a couple weeks
later, Mal was back in
the cockpit of the same
airplane. “The first time was
a bit tense,” he recalls. “But
after that, all was good.”
Mal’s instructor, Matt
Hansen, praises both Able Flight and Mal, who was the
organization’s 12th scholarship student.
“We’ve worked with Able Flight from the beginning because
it’s something we feel strongly about,” Matt says. “Mal’s done
great. He’s right where he ought to be in his flying schedule.”
“It was the first time I saw a sparkle in his eye, and from
what I can remember, the first time in a long time I saw
that smile. It wasn’t long after hearing about Able Flight
that Mal took the necessary steps and applied for the
scholarship.” — Ashleigh Koontz, Shepherd Center recreation therapist
Fall 2009 2 3

Q+A
ask the Doc
Shepherd Center physicians answer medical questions from patients and family members.
Q: What infertility problems are found in people with
spinal cord injury?
A: Most spinal cord injury (SCI) patients with infertility issues
are men. Women may be concerned about obstetrical
issues and complications – depending on whether they
have lung, kidney, neurologic and clotting problems. If
women are over 35, the normal issues with achieving
a pregnancy relate to age, rather than their SCI status.
But if there are medical concerns regarding carrying a
pregnancy successfully, a gestational carrier (surrogate)
can be used through in vitro fertilization (IVF).
Men with SCI may have varying types of erectile
dysfunction (ED) that may lead to infertility. It is important
to have a semen analysis (SA) to determine what options
are available for treatment. But many men with more
extensive injuries may need to have electroejaculation
(EEJ) to determine what treatment is indicated for
achieving a pregnancy.
If the SA is normal and the spouse is under age 35,
ovulation induction with Clomid can be used with
intrauterine inseminations (IUI) with a success rate
of 8 to 12 percent per cycle. If the woman is over 35,
medications may need to be more extensive with
injectable drugs that can increase results up to 20
percent. EEJ can cause concern because it may have
to be done under anesthesia, and repeated procedures
may irritate the rectal mucosa.
Most couples in these situations should do IVF so an EEJ
may be done only once, if possible. The success rate can
be 45 to 50 percent, depending on the woman’s age. If
sperm aspiration or testicular sperm extraction (TESE) is
needed due to a failed EEJ or extremely low sperm count,
IVF is the only option for achieving a pregnancy.
When a couple is considering a pregnancy with known
issues, they should consult with a urologist specializing
in male infertility. This may be done in combination with
a reproductive endocrinologist and infertility specialist.
Each case is individualized. Overall, pregnancy rates are
excellent, and if IVF is considered, most couples will have
a sufficient number of embryos stored to complete their
family with one cycle if all factors are optimal.
— Dorothy Mitchell-Leef, M.D.
Q: Do I really need to start one of the injectable medications if I've
just been diagnosed with relapsing-remitting MS? Can’t I just
wait and see how things go over the next couple of years?
A: There are several reasons to strongly consider starting an injectable
medication soon after a diagnosis of relapsing-remitting MS.
1) Nerve fiber damage may occur early in MS. For years, MS was
thought to involve mainly damage to the insulation (myelin) of the
nerve fibers (axons) in the brain and/or spinal cord. This is referred to
as demyelination. In 1998, researchers confirmed that MS also can
damage axons themselves. This damage is permanent and leads to
disability. It has been shown to occur early in MS. Starting
an injectable MS therapy early may help prevent this.
2) MS changes over time. Without treatment, most people with
relapsing-remitting MS will move toward secondary progressive
MS. This form of MS does not respond well to currently approved
therapies and is characterized by a steady accumulation of disability.
Starting treatment early may slow or prevent this move from
relapsing-remitting to secondary progressive MS.
3) While benign forms of MS exist, we are not good at predicting who
might follow a milder course. We have some clues in early MS that
may point toward someone doing well versus someone who’s
going to have a more aggressive course, but most MS healthcare
providers would not feel confident enough in them to recommend
absolutely against starting therapy. — Ben Thrower, M.D.
contributors
Submit your questions for “Ask the Doc”
to jane_sanders@shepherd.org or via
fax at 404-350-3145
Dorothy Mitchell-Leef, M.D.,
Shepherd consulting physician,
reproductive endocrinologist
and infertility
specialist with Reproductive
Biology Associates
Ben Thrower, M.D., medical
director of the Andrew C.
Carlos Multiple Sclerosis
Institute at Shepherd Center
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Q&A
Q+A
with John Lin, M.D., Associate Medical
Director of Post-Acute Services
Interviewed by Kayla Eubanks
Q: How did you come to Shepherd Center – both as a
patient and a doctor?
A: In 1991, I had an aneurysm-like condition known as epidural
arteriovenous malformation, which left me paralyzed. At the
time, I was on summer break from college, visiting my parents
in Charleston. A Shepherd Center admissions liaison came to
my hospital to discuss rehabilitation options. I had never heard
of Shepherd Center before – like most people who had no
reason to. However, it was apparent to me that the Center had
the expertise I needed since it treated more spinal cord injuries
than the average rehabilitation facility.
After my discharge, I wanted to practice medicine. I spoke
with (Medical Director) Dr. Donald Leslie who mentored me
before, during and after medical school. When I completed my
residency, we discussed my joining Shepherd, but the timing
wasn’t right. I practiced general rehab medicine for a while and
worked at a VA hospital for a few years. Then in 2005, I joined
the Shepherd medical staff.
Q: What is it like going from patient to doctor? Does that
make your approach unique from other physicians?
A: It was a transformative process. At first, it was difficult to
readjust my mindset. I found myself getting lost in patients’
tragic stories. It became difficult to hear again and again. To
be emotionally immersed was draining and did not allow me
to be as objective as necessary. As a doctor, you have to
be objective. Today, I am better able to find a balance: Be
empathic when I can, but be objective when possible.
Q: Explain how your experience in internal medicine and
physical medicine and rehabilitation (PM&R) work
together to benefit your patients.
A: Internal medicine is the prevention, diagnosis and care of
general illness, disease and injury. Having knowledge in both
fields makes it easier to take patients from acute injury to
preventative treatment.
I find myself able to see things happening and prevent it, rather
than having to deal with the consequences. For the patient,
it’s better because there are many interactions with the various
medications that require deeper knowledge of the drugs and
their effects.
Q: How important is research to patients with SCI? What
expectations should people have about discoveries in
the future?
A: Research is critical to advance the field and impacts people
worldwide. Without it, we would be stuck in the past. With
as many clinical trials as our staff conduct and the tremendous
number of patients we see with SCI, we are becoming leaders in
SCI research. Our experience and knowledge in this field goes
beyond what people can get at many other facilities because they
simply don’t have the same volume of cases.
When setting expectations, it’s important for patients and families
to realize there are two types of research – bench research, which
is conducted prior to human trials, and clinical research, which
is the phase when studies start being tested on humans. For
research like stem cells, which is moving to the clinical phase,
it will take many years to see any impact. However, there will
be a more immediate impact from testing new medications or
therapies. Some of this research will have an effect within months
or a year. But a cure will take many years.
Q: What advice do you give patients and their family members
when they arrive at Shepherd?
A: When patients first arrive, I tell them to keep an open mind. A lot
of things are possible here. Don’t be confined by presumptions of
what your injury will or will not allow you to do. You have the chance
to become a person with an SCI, not an SCI person.
When patients return home, it’s important to jump back into life.
The most successful patients are the ones who integrate back into
society and do well enough that we only see them every year or so.
INTERESTING FACTS
John Lin, M.D.
Shepherd File Photo
Residency:
Internal Medicine and
Rehabilitation Medicine at
Temple University
Medical School:
Medical University of
South Carolina
Undergraduate Degree:
Emory University
Board Certification:
Physical medicine and
rehabilitation, spinal cord injury
medicine and internal medicine
Experience:
Joined Shepherd medical staff in
January 2005
Random Facts:
• English was Dr. Lin’s fourth
language. He learned
Taiwanese, Mandarin-Chinese
and Spanish first.
• Dr. Lin is an avid wheelchair
tennis player and competes in
local league tournaments.
• He travels to a new country
every year.
Fall 2009 2 5

ShepherdAlums
By sara baxter
John Trimbath,
of Cleveland, Ohio
Susan Gaudet,
of Falmouth, Maine
Traci Pauls, of
Blackville, S.C.
Mike McHale,
of Ruston, La.
Vicki Karnes,
of Atlanta, Ga.
FROM NEAR
AND FAR
Former Shepherd Center patients
from across the nation report on their
productive lives post-injury.
As a spinal cord injury patient, Susan
Gaudet, of Falmouth, Maine, did
something unusual when she came to
Shepherd: She walked in.
“It wasn’t pretty,” she recalls. “I was on
a walker, and I looked like a drunkard.”
Susan was on her way to a doctor’s
appointment in March 2009 when she
slipped on some ice. To prevent herself
from falling, she contorted her body
in a way that herniated two disks. At
the doctor’s visit, she was simply given
medication to help the pain.
Three days later, Susan woke up and
couldn’t feel her legs and lost bowel and
bladder function.
The swelling in her back had strangulated
a network of peripheral nerves
at the lower end of the spinal cord.
The condition, known as cauda equina
syndrome, can lead to permanent loss
of bowel and bladder control, as well
as sensation and weakness of the legs.
Despite this, Susan is able to walk and is
referred to as a “walking paraplegic.”
After stays at Maine Medical Center and
a rehabilitation hospital in Portland, Susan
transferred to Shepherd Center. Here, she
learned the daily living skills of bowel and
bladder management, caring for herself,
and worked on regaining strength in her
legs. She stayed just 12 days.
“My goal was to make it home in time
to spend Easter with my family,” says
Susan, who has a husband and three
daughters.
Susan’s recovery has been slow, but
steady. She can now walk unassisted and
is back at work as a rehabilitation counselor,
helping those with various degrees
of injury.
Though the road to recovery has been
rough, Susan remains grateful for her
progress.
“Every step I take, however painful, is
precious,” she says. “I also have a huge
amount of respect and gratitude for all
the people who have helped me.” She
also is optimistic on a full recovery: “I’m
not hopeful – I’m expecting it.”
Vicki Karnes, of Atlanta, credits the staff
at Shepherd Center’s Andrew C. Carlos
Multiple Sclerosis Institute for helping prepare
her for new changes – and challenges
– in her life after being diagnosed with MS
in 1998.
“I felt 100 percent supported by my care
team at Shepherd Center when I decided
to retire from a career as an airline pilot
in 2003,” she says. “It was time to put my
health first.”
Vicki, who had flown for Delta Air Lines
for nearly 20 years, initially found enjoyment
playing the mandolin and taking
Spanish classes after retirement. But she
wanted more interaction with people.
“I began volunteering in Shepherd’s
Noble Learning Resource Center in 2004,”
Vicki says. “Being surrounded by the
medical books, journals and videos in the
library reminded me how much I enjoyed
learning and helping other people to learn.”
After two years of weekly volunteering,
Vicki decided to embark on a new career
as a registered nurse and enrolled in the
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nursing program at Georgia Perimeter
College.
“I had my concerns about managing
the fatigue that comes with living with
MS,” Vicki says. But with the support of
her family and her new friends in nursing
school, she completed seven semesters
of nursing school and graduated in May
2009. She even became a mentor to other
students, developing study guides and
helping them get organized.
After graduating in May 2009, Vicki took
a job in community health, working at a
Snellville, Ga., clinic providing diabetes
education and disease management.
“In helping those with diabetes, I can
draw upon my experience of living with a
chronic illness,” she says. “I feel like I can
make a difference.”
Mike McHale, from Ruston, La., learned
so much from Shepherd Center about
daily living that he’s often asked for advice
by people in wheelchairs who didn’t go to
Shepherd, he says.
“They ask me, ‘What do you do about
this?’ or ‘How did you learn to do that?’”
Mike explains. “Shepherd did a wonderful
job of teaching me the little things.”
Mike was injured on Sept. 14, 2006 when
he fell 30 feet from a deer stand he had
been building. He severed his spinal cord
at the T-12 level and is paralyzed from the
waist down.
Before his accident, he owned a convenience
store and an adjacent storage facility.
While at Shepherd, he realized he was not
going to be able to handle running the store
and sold both businesses as a package.
A year after the accident, Mike went to
work for a good friend who owns an air
conditioning service company and was looking
for someone to take care of the business
side. Mike now calls on new customers
in the morning and works on finance and
accounting in the afternoon. Thanks to
Mike’s business expertise and his friend’s
knowledge of the industry, the company is
thriving.
Today, Mike drives an adapted truck and
is accompanied by a service dog who helps
him with daily tasks. He enjoys woodworking
and loves to work in the yard. Mike has
a vegetable garden, which he named in
honor of Shepherd horticultural therapist
Debi Cziok, who helped show him
how to create a garden.
Mike was active before his accident
and was determined to stay that way.
“Before my accident, I got up at 6 a.m.
and didn’t quit until 9 p.m.,” he says.
“The chair has slowed me down, but my
quality of life has improved thanks to
the training I received at Shepherd.”
Traci Pauls, of Blackville, S.C., was
so inspired by the work of speech
pathologists at Shepherd Center, she
has decided that one day she will
become one.
Traci was a sophomore at Winthrop
College in Rock Hill, S.C., when she
sustained a T-4 spinal cord injury in a
car accident in 2007. Originally a biology
major, Traci returned to Winthrop
in January 2009 and changed her major.
“Through my own work with the
speech pathologist and what I saw
them do with others, I was inspired,”
Traci says.
Though she was excited about a career
change, she was a little nervous about
returning to school after taking a year
off. “I didn’t know what to expect,” Traci
says, “or how I would get around.” She
credits her mother with giving her the
confidence and motivation she needed.
“She told me I could do it and said she’d
be there to help whenever I needed it.”
Also there to help is her twin brother,
who also is a student at Winthrop and
shares an apartment with her. “He
pushes me to class if I’m running late
and helps in many other ways,” Traci
says. She also receives a lot of support
from her friends.
Now Traci is turning her attention to
helping others in her situation. She has
created Project Live, a campus club for
students with disabilities. “This will be
a place for us to come together to share
our experiences and suggest ways to
improve things at Winthrop,” Traci says.
She also hopes the organization will
be a place for the community to learn
about those with physical disabilities.
As a physician’s assistant, John
Trimbath, of Cleveland, Ohio, knew
something was seriously wrong the moment
he was thrown from a mechanical
bull in October 2008.
“I couldn’t feel my arms and legs, and I
had difficulty breathing,” John recalls.
“Being a PA, I knew what was happening.”
When he arrived at the hospital, he
asked physicians to put him in traction.
That request was prescient: John had
sustained a C-4 spinal cord injury, which
left him a quadriplegic.
John came to Shepherd Center on Feb.
10, 2009, and the seven weeks he spent as
an inpatient brought a profound change
of perspective. “The surgeons and pulmonologists
saved my life,” he says, “but
Shepherd gave me back my will to live.”
One important aspect of his recovery,
John says, was the support he received
from both his family and the other patients
– both of which Shepherd helped
facilitate.
“Shepherd helped with the social and
emotional aspects of my recovery,” John
says. “It was so helpful meeting other
people who had gone through what I had.
The upbeat staff helped me stay motivated
– and learn that the hurdles you have to
face aren’t insurmountable.”
John, who worked full time in a hospital
emergency department, hopes to return
to work in some capacity, even if it’s not
direct patient care. He’s also continuing his
volunteer work with American Academy
of Physician’s Assistants, where he just
finished a two-year term on the organization’s
board of directors.
John is continuing his rehabilitation
through the Cleveland VA hospital and
is regaining movement in his arms and
hands. His short-term goal is to continue
his recovery so he can meet his long-term
goal: celebrating his 20th wedding anniversary
in Egypt with wife Diane in 2012.
What’s New?
We want to stay current on any personal or
professional news in your life. Send us an
update and a photo (we’ll return it to you):
Jane Sanders, Spinal Column Magazine, 2020
Peachtree Rd., N.W., Atlanta, GA, 30309. You can
also e-mail us at spinalcolumn@shepherd.org.
Fall 2009 2 7

FoundationFeatures
Photo by Gary Meek
Fall 2009
“It was an awful year, and I lived through the family
trauma of what a devastating diagnosis can do to the life of
not just the patient, but the family as a whole,” Vida says. “I
learned a lot from that experience and felt that I might be a
good fit and useful volunteer at Shepherd Center.”
Vida volunteers three days a week, dividing her time
between staffing the welcome desk, feeding lunches to
patients and assisting with Family Support Services. She
has logged more than 500 volunteer hours in the year and
“I’d say some key life lessons are: Don’t take
things for granted, count your blessings –
both big and small – daily, stay focused on
what’s really important and practice humility.
It is a virtue. Adversity can be a lesson, as
well as an opportunity.” — Vida Harmon
Volunteer Profile
Vida Harmon
Former New Yorker finds fulfilling volunteer work
at Shepherd Center. By Lauren Angelo
When Vida Harmon moved to Atlanta from New York
City two years ago, she had no idea her new home would
be within walking distance of Shepherd Center, or that her
frequent walks throughout her neighborhood would lead to
such a fulfilling volunteer opportunity.
But after passing Shepherd Center several times and
learning more about the highly specialized care the hospital
offers, Vida was impressed and wanted to give her time to
contribute to the patients and families at Shepherd.
After losing her brother to a brain tumor in 2001, Vida
says she feels an especially strong connection to families
facing the same fear and uncertainty her family experienced.
Her brother’s struggle with cancer lasted eight months, and
instead of pulling her family closer together, the tragedy
pushed them further apart, she says. He was the patriarch of
her family, and they found themselves lost without him.
a half she has been volunteering at Shepherd, and Vida
says she has loved every minute of it. Her time with Family
Support Services allows her to meet the families of the
patients and further her goal of helping families survive
difficult circumstances and emerge from them even stronger.
She also makes a great effort to answer families’ questions
and help in any way she can during the time she spends at
the welcome desk.
“It’s a wonderful feeling to know that you can make a
difference in another person’s life, even if only for a short
time,” Vida says. “As in any area of life, I believe that a kind
word and a smile can go a long way.”
Jackie Gehner, Shepherd Center’s former volunteer
manager, says Vida is known for doing favors for people
throughout the hospital and is someone they really count on.
Vida says she has learned a lot from volunteering and
believes it is a learning experience on both ends. Through
her own life experiences and her volunteer experience at
Shepherd, Vida has a wealth of knowledge to share.
“I’d say some key life lessons are: Don’t take things
for granted, count your blessings – both big and small –
daily, stay focused on what’s really important and practice
humility,” Vida says. “It is a virtue. Adversity can be a lesson,
as well as an opportunity.”
Above: Vida Harmon, left, of Atlanta is a frequent volunteer
at Shepherd Center. She splits her volunteer time between
staffing the welcome desk, feeding lunches to patients and
assisting with Family Support Services. Here, she chats with
patient Keith Champion of Forest City, N.C.
2 8 Spinal Column
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Partners for
Passengers
Shepherd’s relationships with two Atlanta-based airlines
help ease travel woes for patients. By Sara Baxter
Many people find air travel somewhat stressful. But for people
in a wheelchair who travel by plane, that level of stress can take
on a whole new dimension.
That’s why Shepherd Center has partnered with Delta Air
Lines and AirTran Airways to make it easier for Shepherd patients
to readjust to air travel.
“Some patients have to fly home after their discharge from
Shepherd, so they are flying for the first time with a wheelchair,”
says Dean Melcher, Shepherd’s director of annual giving. “That can
be very stressful.”
The trauma can be mitigated with a lot of knowledge and a
little practice, however. Delta donated airline seats and transfer
chairs to Shepherd for occupational and recreational therapists to
help patients learn how to make the transition from the wheelchair
to the aircraft seat. Therapists also take patients on outings
to Atlanta’s Hartsfield-Jackson International Airport, where they
practice checking luggage, going through security and getting to
the gate. Then they board an empty Delta jet to become familiar
with the transfer and boarding procedures and learn more about
the onboard accessibility features on Delta aircraft.
“Delta has been instrumental in this training,” Melcher says.
“Travelers with disabilities have to be comfortable, and they have to
do it correctly so they don’t hurt themselves. These trial runs help
them know what to expect and can take away a lot of the anxiety.”
“Delta’s relationship with Shepherd Center, now entering its
20th year, reflects our commitment to serving people with disabilities
and compliance to federal regulations that protect the
rights of customers with disabilities in air travel,” says David S.
Martin, Delta’s disabilities program manager. “This relationship
reminds me that what we are providing is not just an educational
experience. We are giving people back their independence and
hope for their future.”
To facilitate transferring from a wheelchair to a seat where the
armrest does not come up (common in older planes), Delta has
developed a hydraulic transfer chair that elevates patients above
the armrest. This decreases the chance of the passenger scraping
the armrest, which could cause problems on already sensitive skin.
“This is another example of how Delta listens to the needs of
the disabled community,” says Pete Collman, Shepherd’s community
relations coordinator, who also uses a wheelchair and travels
extensively with the Shepherd fencing team. “They saw this as a
customer service issue and fixed it.”
Like Delta, AirTran is also stepping up its customer service for
travelers with disabilities. The airline is working with Shepherd
on a training video for its employees on disability awareness. The
video, which will feature Shepherd staff members, will give an
overview of how to accommodate disabled travelers, including
how to safely transfer them into a seat.
“A video is so much more helpful and educational than someone
telling them or having them read about it,” Melcher says.
“Staff training is imperative – it’s the other half of the equation.”
Aside from training, Melcher says both airlines have generously
provided free tickets and frequent flyer miles to fly
patients and family members to and from Atlanta, as well as
donating tickets for Shepherd fundraisers.
Photos by Kayla Eubanks
Above: Shepherd Center therapists take patients on outings to
Atlanta’s Hartsfield-Jackson International Airport, where they
practice checking luggage, going through security and getting to the
gate. Then they board an empty Delta jet to become familiar with the
transfer and boarding procedures and learn more about the onboard
accessibility features on Delta aircraft.
Fall 2009 2 9

FoundationFeatures
A Desire to
SHARE
The generosity of individuals and
organizations enables Shepherd Center
to extend its specialty care to military
service personnel. By Sara Baxter
Photo by Anthony Orig
Matthew Sanchez and three friends biked 4,500 miles across the country this past summer –
not just for thrills, but to raise awareness and funds for a Shepherd Center program that serves
active and separated service members.
The program is SHARE – Shaping Hope and Recovery
Excellence – and it extends Shepherd’s continuum of care
to U.S. service men and women who have served in Iraq and
Afghanistan. Through their cross-country odyssey, Matthew
and his team raised $9,625, and donations are still coming in.
“We talked to as many people as we could along the way to
let them know about the program, what it does and why we
were raising the money for it,” Matthew says. “In many cases,
people approached us and asked us about it because we had
car magnets on our support vehicle.”
Matthew’s commitment to bicycle thousands of miles was
born out of a simple desire to give back to those who make
the ultimate sacrifice for country.
“I feel that the men and women serving our nation should
have access to the best treatment available,” he says, “and I
believe this to be at Shepherd Center.”
Matthew experienced Shepherd care first hand: He spent
time at the hospital after sustaining an incomplete C-5 spinal
cord injury in a high school football game in 2005.
The Tyrone, Ga., native walked out of Shepherd and has
been running, biking and swimming ever since.
Matthew is far from alone in his quest to support
the SHARE Initiative. Funded by an initial gift from
philanthropist Bernie Marcus, who also believes the
men and women fighting for our country should have
the best care possible, the program has received support
from other foundations, organizations and individuals.
While the bulk of medical payments for service
members is provided through the military’s healthcare
benefits provider, SHARE helps service members
cover a wide range of other expenses associated with
their injuries.“I see this as the vehicle through which
we can help eliminate barriers associated with coming
to Shepherd for care,” says Terran Cooper, SHARE
project manager. “The things we pay for are a little off
the beaten path.”
3 0 Spinal Column
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As examples, Cooper cites money for groceries and monthly bills, all
the way up to big expenses, such as providing in-home care or airline
tickets. SHARE donations also cover operational costs, such as staff
travel expenses for visits to U.S. Department of Veterans Affairs hospitals,
as well as equipment and items not covered by insurance.
Cooper tells a story of a service member in Florida who wanted to
receive treatment at Shepherd, but was hesitant because he had no one
to care for his dog, which he couldn’t afford to board. “We found a kennel
for his dog in Atlanta,” Cooper says. “They gave us a discounted rate,
and the dog received veterinary care for no charge.”
Photo by Gary Meek
“We work with each service member on a case-bycase
basis. We help each one establish individual
goals and then give them the tools and skills
needed to meet those goals. We want to help them
become as independent as possible, whether that
means returning to active duty or living back at
home in the civilian community.” — Terran Cooper
Another service member wanted to receive outpatient care at
Shepherd, but couldn’t live on his own in an apartment. SHARE paid
for an attendant so the man could come to therapy at Shepherd.
“The funding is not so much covering care, but quality-of-life issues,”
says Dean Melcher, director of annual giving for Shepherd. “This is a
different group. They need more specialized help.”
In addition to brain and/or spinal cord injuries, injured troops may
be dealing with skeletal issues from carrying their equipment packs or
suffer from severe headaches, Melcher says. Some have substance abuse
problems, and most suffer from some level of post-traumatic stress
disorder. Service men and women who are not returning to active duty
may need help with re-entering the job market, planning their finances
or related activities.
No matter the need, SHARE has an answer. “We work with each service
member on a case-by-case basis,” Cooper says. “We help each one
establish individual goals and then give them the tools and skills needed
to meet those goals. We want to help them become as independent as
possible, whether that means returning to active duty or living back at
home in the civilian community.”
Because of their specialized needs, patients in the SHARE
Initiative are treated separately from the general patient population.
“They are unique in psychology and temperament,” Melcher says. “They
don’t respond to the same therapy and stimulus that others do, based on
their training and demeanor. We found they respond better in their own
environment.”
Thus, Shepherd renovated six apartments at Biscayne Place, which is
near the hospital. The apartments had been used in the past for family
housing, but now that Shepherd has the Irene and George Woodruff
Family Residence Center, the Biscayne apartments are available to
service members and their families.
Support for SHARE also goes beyond monetary contributions.
Volunteers shop for groceries and run other errands, and businesses have
donated their products and services at no charge or for a discounted rate.
“It’s amazing how much the whole community wants to help,”
Cooper says. “The support we’ve received has been absolutely wonderful.”
Photo Courtesy of Anthony Orig
Above: Dillon Cannon of Sugar Land, Texas, sustained
a spinal cord injury while serving in Iraq. He received
treatment in Shepherd's SCI Day Program through the
SHARE Initiative.
Matthew Sanchez, right, and his friends decided to raise
money for SHARE because they believe all soldiers should
have access to the best possible care. Left to right are:
Anthony Orig, Jonny Cromwell, Marina Fleming, Peter
Zhang and Matthew.
Previous Page: Former spinal cord injury patient Matthew
Sanchez and some friends, including Marina Fleming,
biked 4,500 miles across the United States this past
summer to raise money for military patients being treated
in Shepherd's SHARE Initiative.
Fall 2009 3 1

FoundationFeatures
Shepherd Injury Prevention Program
Launches Online Effort to Reach
More Teens and Young Adults
By Pete Collman, Shepherd Center Community Relations Coordinator
and Think First Director of Georgia
It is said that an ounce of prevention
is worth a pound of cure. This
proverb describes the foundation on
which Shepherd Center’s Think First
and injury prevention programs are
built. For nearly 20 years, Shepherd
Center’s injury prevention message
has been delivered by speakers living
with disabilities, explaining their
unique stories of injury and teaching
youth on how to avoid brain and
Pete Collman
spinal cord trauma.
Having managed the Think First Program at Shepherd for
Photo by Leita Cowart
the past 10 years, I have found that teens and young adults
don’t easily seek out information on injury prevention. The
challenge lies in getting the message to them. That is why we
are creating a new, socially
dynamic outreach program
called YiPES!! (Youth and
Injury Prevention Education
at Shepherd).
Shepherd’s adolescent team
orthopedic physician, Herndon
Murray, M.D., proposed a
new approach to reach young
people on the perils of diving
and other risky behaviors related to water recreation. “I wanted
to see a specific focus on preventing diving and skim-boarding
injuries in the Southeast,” he says. “What Pete (Collman) and
his team have done has given this injury prevention message a
vehicle to reach even more young people than the 13,000 reached
through Shepherd Center’s current Think First Program.”
YiPES!! is designed to use social networking sites, such as
Facebook, Twitter and YouTube, to get an “edgier” message out to
teens and young adults. This addition to the Think First Program
will help in the broadening of our audience through the World
Wide Web. Activities such as diving, skim boarding, skateboarding,
ATV riding and other extreme sports will be highlighted. Also, a
special emphasis will be placed upon distracted driving with a preventative
approach to educating drivers on the perils of texting and
phone usage while behind the wheel.
Video public service announcements (PSAs) will be created to
capture the attention of the adolescent Web surfer. Those will be
followed by a message from a current Shepherd Center patient explaining
their injury and how to avoid spinal cord and brain trauma.
“I feel this is a great effort to get behind and show support for
our injury prevention programs
here at Shepherd,” Dr.
Murray says. “I will be
presenting our efforts on
Think First and YiPES!! at
the International Spinal Cord
Society Convention this October
in Florence, Italy. I feel
this may just jump-start other
organizations to follow suit
in decreasing these catastrophic injuries among our young people.”
The YiPES!! Facebook page is active and is linked from the
Shepherd Center Facebook homepage at www.facebook.com/shepherd.
The YouTube and Twitter endeavors are under construction.
“I wanted to see a specific focus on preventing diving and
skim-boarding injuries in the Southeast. What Pete (Collman)
and his team have done has given this injury prevention
message a vehicle to reach even more young people than
the 13,000 reached through Shepherd Center’s current
Think First Program.” — Herndon Murray, M.D.
3 2 Spinal Column
w w w. s h e p h e r d . o r g

A Holiday Gift with Meaning
The true spirit of the holidays is conveyed through
giving. Many of our friends and supporters plan to give
a personal and special gift to their friends and family –
the gift of hope for Shepherd Center’s patients –
by making a “Holiday Tribute” gift to Shepherd Center
Foundation in honor of their family and associates.
The Foundation sends personalized cards with our
donors’ own greetings to their holiday card mailing lists.
In addition, their friends and families are included in
Spinal Column’s annual Holiday Tribute listing.
Long-time Shepherd Center supporters Forrest
Leef and Dorothy Mitchell-Leef and Becca and
Rudy Harrell have a tradition of sharing their spirit
of philanthropy by making Holiday Tributes for
their friends and associates. Stan Topol & Associates
was among the businesses that chose to honor their
customers by making gifts to the Foundation to help
Shepherd in its mission to restore our patients’ lives with
hope, dignity and independence.
For information about Shepherd’s Holiday Tribute
program, contact Dean Melcher at 404-350-7306 or
dean_melcher@shepherd.org.
Gritz at the Ritz Honors Dell Sikes
The Phoenix Society hosted its annual
Gritz at the Ritz fashion show luncheon
at the Ritz-Carlton, Buckhead on July 26.
The guests enjoyed a delicious meal featuring
a fashion show from Belk at Phipps
Plaza and an entertaining and enlightening
presentation by Shepherd Center
Chief Nurse Executive Tammy King.
Ty Tippett, Senior Director of Planned
Giving for Shepherd Center Foundation,
served as master of ceremonies and had
the pleasure of recognizing his friend and
mentor, Dell Sikes, who was honorary
chairman of the event. Dell served
as vice-president of development for
Shepherd Center form 1986-2002 and
has been serving as special advisor to the
Foundation since 2002.
The 2009 Phoenix Debutantes were introduced
and recognized for their outstanding
efforts in volunteering with Shepherd
Center’s patients and families, and particularly
for their wonderful work at the
Wheelchair Division of the Peachtree Road
Race. Alli Gombolay was awarded the prize
of Debutante of the Year for her tireless
volunteerism and outstanding commitment
to the Phoenix Society.
This year’s highly successful luncheon
was thanks to the hard work and careful
planning of Co-Chairmen Robin
Phillips and Melinda Dabbiere. Leslie
Grace, Connie Kushner, Karen Martin
and Lois Puckett served as planning
committee members. — Dean Melcher
Above: Shepherd Center Foundation
advisor Dell Sikes, second from right,
was honored by the Phoenix Society and
Shepherd Center for his many years of
service. Also pictured, left to right, are event
Co-Chairman Robin Phillips, Hugh McLeod,
M.D., and Alana Shepherd.
Shepherd Center co-founder Alana
Shepherd, left, congratulates Phoenix
Society Debutante of the Year Alli Gombolay.
Shepherd Center
Auxiliary Announces
Pecans Fundraiser
The Shepherd Center Auxiliary’s
annual holiday fundraiser, Pecans
on Peachtree, runs from Nov. 9 to
Dec. 24. This is the 26th year for
the fundraiser, which has raised
more than $1.3 million for patientrelated
programs and Auxiliary
operations since 1982.
Georgia pecan farmers report
that this year’s pecan crop appears
to be even better than last year’s.
Plus, all of the fundraiser’s mouthwatering
pecan varieties will be
available again this year along with
two new products – Sweet & Salty
Pleasures and a Holiday Trio.
The Auxiliary is busy signing up
volunteers to work the sales tables
inside Shepherd Center from 9 a.m.
to 4 p.m. weekdays and to host
“Pecan Parties” in their homes or
businesses. If you would like to volunteer,
receive a brochure or place
an order, call 404-367-1322 or go to
www.pecansonpeachtree.org.
— Midge Tracy
Fall 2009 3 3

FoundationFeatures
Junior Ball
Promises Great Times
and Great Music
Get ready for a fun-filled night of great times,
good friends and terrific music. On Saturday, Nov.
7, Junior Ball Chairmen Heather and Eli Flint and
Junior Committee Co-Chairmen Miller Jackson
and Kirk Martin will host “Back to the Future,”
the annual Junior Ball held in conjunction with
The Legendary Party, Shepherd Center’s black-tie
gala. While The Legendary Party will celebrate the
historical dream of Jules Verne, the Junior Ball will
party to his visions of time and space travel in a
modern set-up.
Not only is this a great party on its own, but
the Junior Ball gives our younger crowd a chance
to sample The Legendary Party and let these two
groups of Shepherd supporters mingle and have a
great time for a great cause.
This year’s bash will be at The Ritz-Carlton,
Buckhead and will feature a terrific Atlanta party
band, League of Decency, in the Plaza Ballroom.
Guests will also party into the late night hours to
DJ-led karaoke in the Reform Club.
The party starts at 10 p.m. and ends at 2 a.m.
with late-night buffets featuring The Ritz-
Carlton’s famous waffle bar and a hosted bar.
Tickets are $75 per person and include all festivities.
For more information, please contact Anne
Pearce at (404) 350-7302 or
anne_pearce@shepherd.org. — Dean Melcher
Below: Junior Ball Chairmen Heather and Eli Flint, center,
along with Junior Committee Chairmen Miller Jackson
and Kirk Martin (not pictured), will host this year's event,
which coincides with The Legendary Party. Pictured with
the Flints are party Chairman-elect Dorothy Mitchell-Leef,
M.D., left, and Chairman Cyndae Arrendale.
Photos by Jim Fitts
Legendary Party to
Dazzle and Amaze
Much as Jules Verne’s classic character Phileas Fogg embarked on
an 80-day journey filled with intrigue and excitement, the guests
of The Legendary Party 2009 will experience a wondrous adventure
filled with fun and glamour – and perhaps the unexpected.
“Around the World in 80 Days, The Legend of Jules Verne”
promises to be the most imaginative and thrilling gala yet.
Chairman Cyndae Arrendale and her dear friend and
Chairman-elect, Dororthy Mitchell-Leef, M.D., have been
working hard with The Legendary Committee to plan a truly
amazing event to celebrate the vision and accomplishments of
Jules Verne and Shepherd Center.
“Since Shepherd has seen patients from all 50 states and 44
countries, what better theme for The Legendary Party than
‘Around the World in 80 Days’?” Cyndae says. She is also delighted
the ball will celebrate the devotion and accomplishment
of long-time Shepherd Center supporter Jane Woodruff, who
serves as honorary chairman.
On Nov. 7, Tony Conway’s A Legendary Event will transform
the Ritz-Carlton, Buckhead into a real-life adventure. Guests
will explore the cultures of the Victorian world while they dine
on scrumptious food and dance the night away to Doc Scantlin’s
Imperial Palms Orchestra. The late-night entertainment will
feature DJ-led karaoke. Festivities begin with cocktails at 7 p.m.
and dancing and carousing will continue until 2 a.m.
For sponsorship or ticket information, please contact
Cara Puckett at cara_puckett@shepherd.org or
404-350-7778. — Dean Melcher
Photo by Jim Fitts
Above: Committee leaders for The Legendary Party 2009 are,
left to right, Terri Vawter, Steve Lore, John Woodruff, Cyndae
Arrendale and Dorothy Mitchell-Leef, M.D.
Inset: Cyndae is chairman of the 2009 committee, and Dorothy
is chairman-elect for next year's event.
3 4 Spinal Column
w w w. s h e p h e r d . o r g

Junior Committee Preparing for a Memorable Year
Photo by Anne Pearce
The Junior Committee is back from its summer break and ready to start another
year of fundraising and fun.
Earlier this year, the Junior Committee’s annual fundraiser, Derby Day, raised
$200,000 – an especially impressive figure considering the state of the economy.
Derby Day 2010 Co-Chairs Miller Jackson and Kirk Martin got started with
planning early this summer with what is sure to be the best event yet.
This season’s first Junior Committee meeting was held on Sept.16. The first order
of business was showing appreciation to last year’s co-chairs, Erin Jernigan and
Ryan Hoyt, for all the time and hard work they put into making Derby Day 2009
so successful. After hearing from several members of the Shepherd Center staff, the
committee jumped right in with their plans for sponsorship, an auction and how to
make Derby Day 2010 the best one to date.
For more information on joining the Junior Committee or becoming a sponsor of
Derby Day, please contact Anne Pearce at 404-350-7302 or anne_pearce@shepherd.org.
2009-2010
Executive Board:
Derby Day Co-Chairs:
Miller Jackson and Kirk Miller
Sponsorship Co-Chairs:
Dan Lenahan and Scott Tucker
Auction Co-Chairs:
Reagan Michaelis, Lauren Tucker
and Philip Mize
Membership Co-Chairs:
Stuart Griswold and Shannon Shipley
Beverage Co-Chairs:
Brenden Harper and Hunter Ross
Operations Committee:
Hamilton Bridges, Orin Romain,
Wesley Snapp and Trey Weatherly
Treasurer:
Nadine Helal
Shepherd Center Staff:
Anne Pearce
Above: The 2009-2010 Junior Committee
Executive Board: front row, left to right –
Nadine Helal, Wesley Snapp, Shannon
Shipley, Lauren Tucker, Reagan Michaelis, Kirk
Martin and Miller Jackson; back row: Brenden
Harper, Orin Romain, Hamilton Bridges, Trey
Weatherly, Stuart Griswold, Scott Tucker,
Hunter Ross and Philip Mize. Not pictured are
Dan Lenahan and Anne Pearce.
Shepherd Center Society Gets Its Second Year Under Way
Photo by Anne Pearce
Above: Daryn Schwartz, left,
and Albie Whitaker are the
2009-2010 Shepherd Center
Society co-chairmen.
Last summer, 16 individuals, many recent Junior
Committee alumni, formed a new volunteer group
to bridge the gap between the Junior
Committee and Shepherd Center’s other two
volunteer groups, Peach Corps and the Shepherd
Center Auxiliary.
Shepherd Center Society (SCS) was born and
couldn’t have had a more successful first year. Under
SCS Co-Chairs Lauren Hooks and Alex Panos,
the group grew to 167 members and raised a net of
more than $10,000 for Shepherd Center.
This fall, SCS has launched its second year under
the guidance of new SCS Co-Chairs Daryn Schwartz and Albie Whitaker. With events
in the fall, winter, spring and summer, there’s sure to be something for everyone.
For more information on joining SCS, please contact Anne Pearce at 404-350-7302
or anne_pearce@shepherd.org — Anne Pearce
SCS Leadership
for 2009-2010
SCS Co-Chairs:
Daryn Schwartz and Albie Whitaker
Kick-off Party Co-Chairs:
Lucy King and Meredith Repp
“Big Game” Bash Co-Chairs:
Brandie Miner and Will Lovell
Casino Night Co-Chairs:
Lauren and Mike Imber
Sarah and Jamie Shepherd
Summer In the City Co-Chairs:
Leah Humphries, Caeser Pruett
and Stacey Lucas
Fall 2009 3 5

FoundationFeatures
Photo by Leita Cowart
Notes from Scott Sikes
Shepherd Center Foundation Executive Director
Giving Thanks!
Dear Shepherd Center Volunteers and Donor Friends:
I’m writing you this letter in the heat and humidity of an
Atlanta summer. By the time you see this in print, fall has
returned, and you are busy with all sorts of activities.
Kids are back in school. Young adults are in college. The first
cooler, drier days have arrived in Atlanta. The leaves are changing.
College football is in full swing with many of you intently
following scores nationwide. Those of you who are super-organized
may be gathering your income tax-related information. Your
meetings with your accountant or other tax preparer may involve
pre-planning before the end of the
”These aren’t simply monetary
values. Often, they are a guidebook
for living a generous life.”
calendar/tax year. Normally, you consider
accelerating any payments or gifts that
might be deductible into this year and
delaying any income into next year.
Regardless of what you are doing
this fall with family and/or friends or how sophisticated your
tax planning is, consider what one Atlanta family has done for
decades. They hold a family meeting after their Thanksgiving
dinner and discuss the charitable organizations to which they give
and how large to make their contributions.
Each family member brings with them some of the charitable
solicitations they received during the year. Even the youngest
family members are involved. The family members discuss each of
these charitable organizations: each organization’s return-on-gift
“investment,” the impact of the organization on society, how
the organization has benefited the family members’ loved ones
and/or friends, etc. Afterward, family members vote on the
charitable organizations that will receive gifts and determine
what size the contributions will be.
This meeting serves as one way for grandparents and parents
to transfer their own values and identities to their children and
other loved ones at a significant time of year. The Thanksgiving
holiday is a time when one can thank those organizations
doing crucial work for important constituencies. Also, it is an
excellent time to prepare prudently for the
end of the tax year.
Sophisticated financial and estate
planners don’t spend time with clients
simply helping the clients transfer their
money to heirs. Instead, planners spend
time with clients helping them to transfer their most deeply
held convictions and values to the generation that follows.
These aren’t simply monetary values. Often, they are a
guidebook for living a generous life.
If you would like to leave a legacy to the next generation
of your family on Thanksgiving Day, please call me, and I can
help you organize a game plan. Thank you for your generous
investments in our work, which helps better the lives of
patients and families.
Seasons
of Shepherd Center
Supporters
From season to season, Shepherd
Center supporters combine generous
giving with fun events and
activities to benefit patients and their
families. From The Legendary Party
to Casino Night to Derby Day, supporters
consistently donate their time
and money to help patients rebuild
their lives with hope, dignity and
independence.
3 6 Spinal Column
w w w. s h e p h e r d . o r g

Alyson Roth:
Advocate and Surfing Competitor
Former Shepherd Center spinal cord
injury patient Alyson Roth of Irvine,
Calif., was crowned Ms. Wheelchair
California in April and placed second
in the Ms. Wheelchair America
competition in August. The California
and national pageants are competitions
designed to select the most accomplished
and articulate spokeswoman for the
millions of Americans with disabilities.
Alyson has been involved in advocacy
work for nearly a decade. She is now
the development manager for Free
Wheelchair Mission, a non-profit organization that distributes wheelchairs
to poor people with disabilities in 71 countries around the world. For more
information on Alyson and the pageant, see www.mswheelchairca.org and
www.mswheelchaircalifornia2009.blogspot.com.
Also, in July, Alyson became the first woman with a disability to ever
surf in the Hurley U.S. Open of Surfing in Huntington Beach, Calif.
More than half a million people attended the event to witness this
history-making moment.
“I was truly honored to have been chosen and to represent not only
women, but all people with disabilities and let them know that life
doesn't stop after injury!” Alyson says.
You can read more about the event on Alyson’s blog at
http://alysonroth.blogspot.com/2009/07/us-open-of-surfing.html.
Photo Courtesy of Alyson Roth
Above: Former patient Alyson Roth of Irvine, Calif., was crowned
Ms. Wheelchair California and placed second in the Ms. Wheelchair
America pageant.
Shepherd Center’s
2009 Annual Report
Available Online
Shepherd Center’s 2009 Annual Report is
available both online and in printed format.
The report includes statistical information
about Shepherd patients, financial information
about the hospital and information about
philanthropic gifts to
the Shepherd Center
Foundation.
It also includes features
on Shepherd’s programs
in therapeutic recreation
and assistive technology,
the Marcus Community
Bridge Program, animalassisted
therapy and the
Patient Care and Patient
Equipment funds.
Also available both
online and in print is a
separate donor directory
that lists individual and organizational donors,
as well as Bridge Builders and endowed funds.
To request copies, contact Dean Melcher at
404-350-7306 or dean_melcher@shepherd.
org. Also, you can download electronic copies
in PDF format from our Web site at
www.shepherd.org/publications.
Fall 2009 3 7

LovingTributes
Honorariums
Honorees are listed first in bold print followed by the names of
those making gifts in their honor. This list reflects gifts made to
Shepherd Center between June 1, 2009 and July 31, 2009.
Cyndae Arrendale’s Birthday
Mr. and Mrs. Steve A. Williams
Winkie Arrendale’s Birthday
Mr. and Mrs. Steve A. Williams
Marla Jones Bennett’s Birthday
Mr. and Mrs. Thomas J. Bennett
Irene Berson’s Recovery
Mrs. William Schwartz
Rachel D. Betzler – “Thanks for
C.V. help.”
Dr. David F. Apple, Jr.
Susan Bowen – “Congratulations on
the JCAHO results.”
Dr. David F. Apple, Jr.
Richard Brazones’ Birthday
Mr. and Mrs. Patrick T. Hickey, Jr.
Wanda Buckley’s Marriage to
Dr. Steven Morganstern
Mr. and Mrs. Joel K. Isenberg
William F. Bundy
Ms. Susan Gregory
Dr. and Mrs. Christopher Clare – For
their Unending Love and Support
Ms. Carol A. Clare
Jonathan R. Cromwell – We Ride
for Shepherd
Mr. R. James Cromwell
Hill Daniel
Mr. Phillip Lee
Mr. and Mrs. Douglas S. Simpson
Jason DiSanto
Mr. and Mrs. Giuseppe Vitulli
Carol Chambers and Col. Jack
Gibson’s Wedding
Mr. and Mrs. Joel K. Isenberg
Kim Harrison
Mr. Dan Chase
Cathy Ellis and Greg Hendrix’s
Wedding
Mr. and Mrs. Jere V. Garde
Steve Holleman – Great CFO of
the Year
Dr. David F. Apple, Jr.
Captain Brian Jantzen
Mr. and Mrs. Robert Jantzen
Linda Jones, PT – “Thanks for all
your hard work.”
Dr. David F. Apple, Jr.
Kings County Bicyclists
Mr. Gary Chuba
Joan Latiolais
Mr. Stan Topol
Mae Laverty
Mr. and Mrs. William Laverty
Above: Donor Sydell
Harris, right, founder of Spa
Sydell based in Atlanta,
volunteers her time to provide
makeovers to female patients
at Shepherd Center.
Donald Peck Leslie, M.D.
Mrs. Morris I. McDonald
Donald Peck Leslie, M.D. – “For
saving lives and changing lives
for the better forever”
Ms. Carol A. Clare
Leslie and Hugh McLeod
Dr. and Mrs. William A. Blincoe
Brian Mock’s Recovery
Mr. and Mrs. Ronald L. Mock
Michael Moderow
Mr. and Mrs. Joseph Moderow
Laurence Moore – “Thanks for your
great job.”
Dr. David F. Apple, Jr.
Anthony Orig’s Ride for Shepherd
Carroll County Nephrology, PC
Mr. Jim LaRocca
Dr. Harry Uy
Carrie Ann Patterson’s Graduation
– Receipt of Doctor of Physical
Therapy Degree
Ms. Teresa L. Little
Libby Pearce
Mrs. Virginia Roe
Matt Sanchez’s Efforts for our Troops
Mr. William E. Barry
Mr. Steve Branigan
Mr. John Brucato
Mtn. View RV, Inc.
Dr. Harry Uy
Janis Sheftel’s Retirement
The UPS Foundation
Beverly and Jack Shields
Mr. John R. Simmerman
Dell Sikes – Gritz at the Ritz
Mr. and Mrs. Louie A. Pittman, Jr.
Elizabeth Fowler Smith
Mr. K. Boynton Smith
Nicole Smith and Bryan Wynn’s
Engagement
Mrs. Mary E. Forgione
LTG Stephen Speakes
Captain Brennan Speakes
Smith Wallace’s Birthday
Mr. Harold R. Smith
Phillip Watters
Ms. Christine Lynn
Photo by Gary Meek
Molly Welch
Mrs. Kyle Watzman
Mr. Gerald Welch
The Birth of Audrey Turner Wilson
Mr. and Mrs. James H. Shepherd III
Mr. and Mrs. Mark M. Whitney
Above: The fifth floor of the Marcus-Woodruff Building is almost complete. Staff and patients from the
Spinal Cord Injury Unit expect to move in soon.
Hortense B. Wolf
Mr. and Mrs. David D. Wolf
3 8 Spinal Column
w w w. s h e p h e r d . o r g

LovingTributes
Memorials
Deceased friends of Shepherd Center are listed first in bold
print followed by the names of those making gifts in their
memory. This list reflects gifts made to Shepherd Center
between June 1, 2009 and July 31, 2009.
Craig Alford
Mr. and Mrs. Edwin Cowart
Danforth P. Bearse
Mrs. Frank C. Bowen, Jr.
Mr. and Mrs. Edwin Cowart
Griffin B. Bell
Mr. and Mrs. Geoffrey S. Fishman
Jonathan M. Bethel – In Loving
Memory
Mr. and Mrs. Robert M. Slider
Lauren Clark
Mr. and Mrs. William T. Hopkins
David and Billy Foster
Ms. Jane S. Taylor
W. A. Gardner
Mr. and Mrs. Gary Roques
Malissa L. Grady
Mr. and Mrs. Richard W. Sorenson
Silas G. Gurley, Jr.
Mr. and Mrs. Donald Atcheson
Mr. John R. Atcheson
Delree, Annette and Bob Friant
Dr. Aprille Holland
Mr. and Mrs. Jack Julian and Family
McKenney's, Inc.
John Drayton Conley, M.D.
Mr. and Mrs. Larry Anderson
Mrs. Sandra S. Biggs
Mr. and Mrs. Lanny W. Marsh
Suzanne Schilling Doughtie
Mrs. Frank C. Bowen, Jr.
Larry Doyal
Mr. and Mrs. James M. Caswell, Jr.
Mrs. Patricia C. Williams
Paul A. Duke
Mr. and Mrs. Edwin Cowart
Mr. and Mrs. Theodore M. Forbes, Jr.
Mr. and Mrs. Connor F. Nelson, Jr.
Mr. and Mrs. William R. Newton
Mr. and Mrs. Louie A. Pittman, Jr.
Lil Hankey
Elizabeth and Mark Pope
Zuma W. Harris
Mr. and Mrs. Nick Brink
Mr. and Mrs. Grifton Carden
Mrs. Peg Confer
Mr. and Mrs. Paul Corley
Captain and Mrs. James C. Hatch
Mrs. Betty Ann Inman
Mr. and Mrs. Daniel Kuerner
Mr. and Mrs. Benjamin L. Mason
Mr. and Mrs. William D. Morrison
Mr. and Mrs. William H. Schneidewind, Jr.
Ms. Rebecca Shuler
Ms. Nancy B. Thomas
Mr. and Mrs. Almand J. Westbrook, Sr.
Mr. and Mrs. Randolph Wolfe
Above: Players and cheerleaders for the Atlanta Falcons visited
Shepherd Center rehabilitation inpatients at the hospital this
past summer.
Paul Bowen
1924-2009
Shepherd Center celebrates the life of beloved
volunteer Paul Bowen, who passed away on Aug.
26. Paul had been a donor and volunteer since
1985. In 2003, Paul was honored as one of the
11Alive Community Service Award recipients
for founding “The Breakfast Club,” a group of
volunteers who assist with feeding breakfast to our
patients. The Breakfast Club and Shepherd Center
salute his faithful service to volunteering for this
program for many years.
Paul personally recorded more than 3,500
volunteer hours since 1992 and earned himself the
nickname “The Colonel” by the other Breakfast
Club members for his take-charge, former Marine
approach. In 2002, Shepherd Center presented Paul
with a Bronze Star for his excellent customer service
to our patients and staff. In 2007, Paul was named
Shepherd Center Angel of the Year to honor his
service to our patients and their families.
Fall 2009 3 9

LovingTributes
John W. McIntyre, Sr.
Mr. and Mrs. James M. Caswell, Jr.
Mrs. Joan Woodall
Rebecca Cox McKinley
Mr. and Mrs. James M. Caswell, Jr.
Alice Davis McKnight
Mrs. Frank C. Bowen, Jr.
Mr. and Mrs. Edwin Cowart
John O. Mitchell
Mrs. John Jungman
Caleb C. Moffat
Jacksonville Hockey Boosters
Club, Inc.
B. Waldo “Buck” Moore, M.D.
Ms. Marcia J. Hubbard
Ms. Mabel A. Nicholson
Mr. and Mrs. J. Harold Shepherd
Joseph K. Orr III
Mr. and Mrs. William C. Rawson, Sr.
Ronald Parker
Mrs. John R. Robinson
David C. Patrick II
Dr. and Mrs. C. W. Bolinger
Ms. Jeanne K. Costigan
Mr. and Mrs. William Eller
Mr. and Mrs. Walter P. Ledet
Mrs. Frances F. Outland
Above: Former spinal cord injury patients Matthew Sanchez, left, and Dillon Cannon, center,
were interviewed in August by CNN's Dr. Sanjay Gupta. Matthew and some friends completed
a cross-country bicycle ride this past summer to raise money for the SHARE Initiative, which
funds care for soldiers and veterans, such as Dillon.
Alexander Radev
Mr. and Mrs. Skip Foley
Claire Rappaport
Ms. Sally Atwell
Nathan Robertson
Mr. and Mrs. Milton Jacobson
Robert Lee Harvey
Mrs. R. B. Lippincott, Jr.
Charles E. Houswirth, Sr.
Mrs. Lindsey Hopkins III
Ken Hawkins
Mr. Alex Painter
Jennings Hertz, Jr.
Mr. and Mrs. J. Harold Shepherd
McArba Hunter
Mr. and Mrs. Joel K. Isenberg
Jack Izard
Mr. and Mrs. James M. Caswell, Jr.
Robert Joel
Mrs. Patricia C. Williams
Ralph “RNK” Kelley
Mr. and Mrs. Thomas J. Bennett, Jr.
Dr. John Dudley King, Sr.
Mr. and Mrs. Marshall J. Bachman
Mr. and Mrs. Rhea Bowden
Mr. and Mrs. Lawrence W. Gillespie
Mrs. Frank S. Goodman
Ms. Peggy Hatcher
Mr. and Mrs. William C. Hatcher
Ms. Mary Klein
Pat and Tricia McConathy
Elizabeth and Mark Pope
Mr. Richard F. Romeo
Mr. and Mrs. J. Harold Shepherd
Mrs. Patricia C. Williams
Tom King
Harp & Callier, LP
O. David Kulman
Dr. and Mrs. David F. Apple, Jr.
Mavis P. Leslie
Dr. and Mrs. David DuBose
Roberta Letton
Mrs. J. Lucian Smith
Tim Lovelace
Ms. Jane S. Taylor
Donald M. Lynch
Mr. and Mrs. Christopher W. Cay
Nathan “Nat” Manning
U.S. Customs Law Enforcement
Explorers Post 4601, Newark, NJ
Elizabeth Deckle Marks
Mr. John Barton Marks, Jr.
Ellen Marrs’ Mother
Mr. and Mrs. Mark W. Slonaker
Lawrence F. McArdle
Mrs. Barbara McArdle
Madlyn McCollum
Dr. and Mrs. David F. Apple, Jr.
Don McDaniel
Dr. and Mrs. Brock Bowman
Ms. Nora Mangrum
Shepherd Center Financial
Services and Materials
Management Staff
Shepherd Center Foundation Staff
Dr. and Mrs. David L. Smith
Dr. Allen McDonough
Mr. and Mrs. Theodore M.
Forbes, Jr.
Harold C. McKenzie
Mr. and Mrs. J. Harold Shepherd
Mrs. Joan Woodall
Sherri Rudd
Mr. and Mrs. Bruce Barkley
Mr. Gerald Barnes
Benchmark Rehabilitation
Mr. and Mrs. Wayne Cranford
Mr. and Mrs. Lewis J. DiPrima
Ms. Patricia Harwell
Mr. and Mrs. Byrne E. Heninger
Dr. and Mrs. Mark Lobstein
Ms. Betsy McDaniel
Ms. Mary L. Rudd
Ms. Pat Walter
White County Middle School
Mr. and Mrs. Mark Winchester
Dr. Leigh Scott
Mr. and Mrs. James M. Caswell, Jr.
Sallie Sellers
Mr. John M. Tinley
Charles R. Shepherd
Mr. and Mrs. Louie A. Pittman, Jr.
Captain Sean P. Sims
Mr. Thomas Sims
Wyman P. Sloan, M.D.
Mr. and Mrs. J. Harold Shepherd
Mrs. Patricia C. Williams
4 0 Spinal Column
w w w. s h e p h e r d . o r g

Anita M. Smith
Mrs. Frank C. Bowen, Jr.
Laura Maddox Smith
Dr. and Mrs. David F. Apple, Jr.
Mr. and Mrs. James M. Caswell, Jr.
Mr. and Mrs. Theodore M. Forbes, Jr.
Mr. and Mrs. J. Harold Shepherd
Wilfred Sollenberger
Mrs. R. B. Lippincott, Jr.
Mrs. Stark – Ruth Baxter’s Mother
Mr. and Mrs. T. Ray Logan
Doris Rose Thomas
Mr. and Mrs. James R. Balkcom, Jr.
Mr. and Mrs. Jack J. Berlin
Mr. and Mrs. Ronald B. Bobo
Mr. Broughton Ferguson
Mr. and Mrs. William M. Graves
Governor and Mrs. Joe F. Harris
Mr. and Mrs. Wilder G. Little
Mr. and Mrs. Bryan E. Marshall
Mr. and Mrs. Kenneth W. Miller, Jr.
Mr. and Mrs. James M. Morris
Ms. Ann P. Morriss
Mr. David C. Mulkey
Mr. and Mrs. Arthur J. Schwartz
Mr. and Mrs. Richard W. Taylor
Mr. and Mrs. Ken Thrasher
Mr. Andrew Turner
Mr. Jerry Withers
Frank “Bubba” Thurmond
Mr. David G. Hall
Above: Atlanta Falcons players found some fans when they visited Shepherd Center
inpatients this past summer.
Lee Timberlake
Ms. Linda Crowley
Mark P. Tomlinson
Mr. and Mrs. James M. Caswell, Jr.
Hardon McDonald Wade III
Mrs. Virginia Iszard
John Watt
Mr. Spencer W. Smith, Sr.
Walter C. Wattles
Mr. and Mrs. William R. Newton
Elizabeth and Mark Pope
Brenda White
Mr. and Mrs. William T. Hopkins
Tate Wright, Jr.
Mr. and Mrs. C. Alexander Peterson
Margaret Shepherd Yates
Cobb Community Foundation
Mr. and Mrs. P. Daniel Yates III
Lawson Yow
Mr. and Mrs. James M. Caswell, Jr.
Mr. and Mrs. J. Harold Shepherd
Josephine Zachary
Dr. and Mrs. Brock Bowman
Mr. and Mrs. Stephen B. Goot
Mr. and Mrs. J. Harold Shepherd
The Shepherd Center Auxiliary
Mr. and Mrs. Dell B. Sikes
Mr. and Mrs. Terrence M. Tracy
Above: Former brain injury patient Brooke Albright of Troy, Tenn., participates in art therapy with
lead Acquired Brain Injury Unit recreation therapist Ashley Haynes.
Fall 2009 4 1

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Photo Courtesy of Brian Waldersen
A Dream No Longer Deferred
Brian Waldersen’s dream to go to medical school was sidelined after a February
2007 car accident injured his C-5 to C-7 vertebrae, leaving him a quadriplegic.
But Brian’s dream is back on track.
This past summer, he moved from Phoenix to Baltimore and began studying
medicine at Johns Hopkins University on Aug. 17. He will be the first person in
a wheelchair ever to attend medical school at the university.
“It feels good to be focused on something and have a true purpose,” says
Brian, who spent four months at Shepherd. “Before the accident, I had been
thinking about med school for four or five years. Now it’s here, and I’m ready to
get going.”
While Johns Hopkins held Brian to the same standards as all other applicants,
the university is making some adjustments in environment and equipment to accommodate
him. The medical school purchased a specialized power wheelchair
that allows Brian to stand and move around, as well as adapted standard equipment
and instruments such as his stethoscope. Brian plans to review Webcasts
and online class notes and complete assignments using voice-activated software.
“It will definitely be a challenge because I’m not at the same physical level as
everyone else,” Brian says. “But I’m up for it.”
Brian is interested in shaping health policy, possibly by working in an academic
setting, although he hasn’t ruled out treating patients. “I’m especially interested
in working to address health disparities within the disabled community,” he says.