Walking barefoot on green moss..one of life's simple pleasures.

Dear William,

You called several months ago from across the country to talk with me, as many others do. The story you told moved me as many others do. But the way your story ends is different from many others and, because of this, is now etched in my memory.

You broke your back at age 16 and you were paralyzed from the neck down. I can’t remember exactly how it happened, a diving accident, skateboarding fall, car accident or a gunshot wound. And for 6 years you had been trying to conceive. I remember telling you that although you cannot move any of your limbs with purpose, remarkably enough, the part of the spinal cord responsible for the ejaculation reflex is still intact and that your fertility potential is very high. Penile vibratory stimulation or electroejaculation are techy ways in which I can routinely stimulate this reflex, much like a sneeze, and offer you the opportunity of fatherhood. Several interesting issues made your case unique but did not pose insurmountable obstacles.

I may have even mentioned that the most rewarding moments of my career have occurred while watching giggling children running around their father’s wheelchairs. The satisfaction of helping spinal cord injured men become fathers is immense and continually motivates me to help.

We had a plan to optimize you medically and then bring you out to California where the sun always shines to make your dream of fatherhood come true.

But then, just like that, it got ugly.

I will never forget the day your wife called to tell me that you were in the intensive care unit at Johns Hopkins Hospital, the worlds best, with a very serious pneumonia. So serious that it had eaten up most of your precious lungs and forced you to be on maximal life support, with little chance of making it out of the hospital.

Yet through all of this, through weeks and weeks of deteriorating health and increasing suffering, you made it crystal clear that your ultimate wish was to be a father and, through the newness of life, be remembered by those who you loved and those who loved you.

My life is now somehow different after knowing you. With your grace, will power and singularity of purpose, you have taught me something about life, and living, that I did not know before. You have clarified once again, what really matters in a well-lived life. You have reminded me of the sound that small flowers make as they open in the morning.

So, William, I salute you. And, in the words of Nobelist Thomas Mann, may you always walk on the greenest of mosses.

Your friend,

Paul

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The spine: OK for shivers and tingling, but that's it.

I have a lot of patients in my practice who have broken their backs. Not figuratively by working so hard, but literally, by having spinal cord injuries. Some have been crushed by rolling logs, fallen from tall heights, been victims of shooting, dived into shallow pools or took an untoward jump while skiing or skateboarding. As a group, these men are impressive: imbibed with fortitude, perseverance, decisiveness and joie de vivre, they take nothing in life for granted. Live it hard, wring it dry, no regrets.

Their numbers are not insignificant either. Roughly 5,000-10,000 individuals experience spinal cord injury annually in the U.S. alone. And although you may think that cars have plenty of safety measures, they don’t, as the biggest cause of cord injury is motor vehicle accidents. Violence, recreational activities and workplace-related injuries round out the top four causes. And, of course, single, reproductive age men (ages 20-34 years old) are by far the most commonly affected.

I am reminded of these patients after a good friend, Dr. Stephen Seager, came over for dinner last week. A true Irish gentleman (“blended scotch before dinner and single malt after, no ice”) and world famous veterinarian, Dr. Seager invented the rectal probe electroejaculator in the early 1980s. I will leave it up to your imagination to wonder how this device works. But realize that this one doctor, through his invention and its popularization worldwide among male fertility specialists, has touched every spinal cord injured father from around the world over the past 30 years.

Seriously, the Seager Electroejaculator has revolutionized our ability to help men with spinal cord injury to conceive and become fathers. It takes advantage of the fact that ejaculation is governed by a spinal reflex (like sneezing) and it stimulates that reflex to happen. In fact, probably the only biological function that is not seriously affected in men who have broken their necks and cannot move any of their limbs (quadriplegic) is reproduction as this reflex generally remains intact.

By his innovative thinking, Dr. Seager brings hope to every spinal cord injured patient who dreams of being a father. Personally, seeing my patients with their little children running around their wheelchairs, and the wide, grateful smiles on their faces is easily one of the most satisfying experiences I have had in my medical career.

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