What Makes Frank Run
In his quest to bring a revolutionary treatment to market, Boston entrepreneur Frank Reynolds aims to get the better of traumatic spinal cord injury. Again.
Mike McGregor
Showing Some Spine Frank Reynolds was partially paralyzed in a car accident. "I need my technology to come to market to keep my spine healthy," he says. "That helps drive me at 11 p.m."
Mike McGregor
The Brain MIT scientist and InVivo adviser Robert Langer has some 750 patents to his name. "Frank is totally committed," he saysof Reynolds. "If he had to run through a wall, he'd do it."
Frank Reynolds was about to give up hope. He had been living in almost constant pain, his body bound in a knee-to-neck body cast, flat on his back in a small Philadelphia condominium. Before the car accident, nearly anything had seemed possible. He was planning his wedding and studying for a career as a hospital administrator. Then, on the morning of December 14, 1992, while he was driving to his job as a psychotherapist at the Philadelphia Psychiatric Center, another motorist slammed into the rear of his Oldsmobile Cutlass coupe. When he came to that night in the University of Pennsylvania hospital, Reynolds couldn't move. Trauma-room surgeons had operated to stabilize a dislocated vertebra in the middle of his back, he learned. But the wayward bone had also pinched his spinal cord -- an untreatable wound that left him unable to walk.
His world withered. Days consisted of long hours staring at the ceiling, punctuated by excruciating sessions of physical therapy. After three years, Reynolds could walk just 80 feet, and afterward he would be in agony. He was 30 years old, and some of the nation's top spine doctors warned him that further improvement was unlikely, if not impossible.
Then, one day in 1995, Reynolds's wife brought home a VHS cassette of the movie Lorenzo's Oil. The film is about a couple that defy the medical establishment to discover a cure for their son's rare illness, and for Reynolds, it sparked an epiphany. "I thought, Jesus, I could do that," he says. And so began what Reynolds calls a "crusade" to regain the ability to walk. He set about learning everything he could about spinal cord injury, or SCI. Using a glacial early Internet connection, from his bed he tapped into the databases of university libraries; through supporters at St. Joseph's University in Philadelphia, where he had been studying for a master's degree before his accident, he secured interlibrary loans of hard-to-find medical publications.
Somewhere in those pages, Reynolds came across a theory -- a notion that has since gained credibility among many experts -- that by intensifying his physical rehab routine, he could reactivate dormant neural connections and make his spine come alive again. Instead of 45-minute sessions with a therapist three times a week, he began daily workouts that combined hours of aquatic therapy in a YMCA pool with as much time as he could handle on a treadmill. Supporting himself with his upper body, he grimaced through the pain and simply forced his legs to move. After three months, he could walk a quarter of a mile a day; after a year, he could manage five. He was now able to drive himself, using both feet. He removed his body cast and got ready to go back to work.
"It's kind of surreal: I spent years in bed dreaming about walking in the woods and walking on the beach and putting a golf ball, never believing it would happen," Reynolds, now 45, says. "I spent five years staring at the ceiling saying, 'God, give me another chance.' "
Somehow, that opportunity materialized. But once it did, he found that a second chance just for himself was not enough. That's when Frank Reynolds's second crusade got under way. Some 12,000 Americans a year suffer traumatic spinal cord injuries. Two-thirds of those who are injured endure chronic, and often severe, pain, and only about a third are able to eventually hold a job. Reynolds wants them to have their second chance, too. And as co-founder and CEO of the Cambridge, Massachusetts–based biomedical start-up InVivo Therapeutics, he won't stop moving until they get it.
The scar on Reynolds's back starts between his buttocks and runs in a ragged line 14 inches to the middle of his back. It's a constant reminder of what he is trying to accomplish. So is the pain. The stainless-steel screws that hold his spine together sit just beneath his skin; when they get cold, he says, "it feels like a little bomb in there." In the area in which surgeons cut away bone to relieve pressure on his swelling spinal cord, he says, "The only thing between me and my spinal cord is muscle, fat, and skin. If you had a stick, you could actually paralyze me." It could be a distraction -- the hole in your back, the pain, the awareness that your own damaged spinal tissue is gradually degenerating. It's what keeps Reynolds focused.
His goal is wildly ambitious -- in large part because of how little is really understood about the central nervous system, which consists of the brain and spinal cord, and its healing mechanisms. "We're just scratching the surface of what's going on," says Steve Williams, a specialist in spinal cord injury and rehabilitation at Boston Medical Center. "It's like studying deep space -- like a big black hole. How does it really work?"
The spinal cord may be best understood as a thick data cable that processes and transmits the constant stream of electrical impulses that flow between your brain and the rest of your body, enabling motion and sensation. Motor signals move downstream, from the brain, and sensory signals move from the rest of the body up. The center of the cord is gray matter -- essentially an extension of the brain, like a tail -- that is sheathed in fibrous white matter, with long, thin nerve fibers called axons shooting out at intervals to wire every part of the body.
Normally, the sensitive cord tissue is protected by the flexible stack of 33 bones that make up the spinal column. But when these bones are knocked out of line -- auto accidents are the most common cause -- the cord inside may be bruised, stretched, cut, or even severed. The result: The flow of signals up and down is impeded or blocked completely at the level of the injury, leaving most victims of SCI with some degree of paralysis. Upon discharge from the hospital, more than 25 percent of SCI patients have complete paraplegia, meaning they are unable to feel or move their legs; more than 20 percent suffer from complete tetraplegia, or paralysis in all four limbs and the torso.
Physical therapy aimed at rebuilding neural pathways can often improve a patient's level of functioning in the months and years after a spinal cord injury. But Reynolds believes that his company's technology can give SCI victims a better shot at recovery by taking advantage of the window of opportunity that exists in the immediate aftermath of the injury. At that point, there is often still enough surviving spinal cord tissue to allow for a sort of neural workaround, a rerouting of signals to maintain the flow of sensory and motor signals below the wound. But in the following hours and days, the body's self-defense mechanisms backfire: White blood cells come in to clean up dead tissue, which causes massive inflammation, which in turn triggers healthy cells in the surrounding tissue to self-destruct in a process called apoptosis. This secondary injury amplifies the original wound and the corresponding loss of function, creating a true dead area in the spinal cord that defies rehabilitation.
