I just received a private message from a member who pointed out that her "friends" had told her that it would take a long time for any treatment to be shown to improve spinal cord injury, that it would take twenty years or longer even after the CRPA is passed. I thought that I would comment publicly about the negativity that has long dominated spinal cord injury.

Why people were so negative about the prospects of recovery after spinal cord injury or the possibilities of therapies that can restore function? Why do doctors tell patients the day after their injury that they would never walk again, despite data that indicate that this assertion is incorrect? I know of no other condition where such pessimism is imposed on people. You don't find doctors telling patients with cancer that they have no chance to recover and that there will be no therapy in the future that would help them.

When I first started in the field in the late 1970's, my neurosurgery colleagues (I was on the faculty of the one of the best neurosurgical departments in the world) told me that there is no possibility that any drug would be helpful for spinal cord injury. One of my closest friends told me that restoring the spinal cord is like reconstructing a crushed strawberry and that was crazy for me to think that it could be done.

When our first experiments showed that methylprednisolone improved blood flow in injured animal spinal cords and improved recovery, most of my colleagues in the field were skeptical that this would work in humans. It took five years to convince my colleagues to test the drug and to persuade NIH to fund a clinical trial to test the treatment. Fourteen leading spinal cord injury centers in the United States participated in the study.

Even after we showed that methylprednisolone significantly improved neurological recovery by about 20% in people with both complete and incomplete spinal cord injury, the naysayers continued. This was the first double-blind placebo-controlled multicenter clinical trial that passed the most rigorous peer review and was published in the New England Journal of Medicine. Several other clinical trials confirmed our results. Despite this, the naysayers continued.

The naysayers first claimed that the improvement was not “functionally significant”. However, as most people with spinal cord injury know, the return of even one or two levels of function is very worthwhile. Some tried to claim that a 24-hour course of methylprednisolone is harmful. But, our trial showed clearly that it was not. Nevertheless, without presenting any credible data of their own, doctors managed to declare that methylprednisolone should be an “option” and not a “standard” of therapy.

I am not telling this sad story to say that I am right and they were wrong but simply to point out that there is an unusual level of pessimism and naysaying that has long impeded progress in the spinal cord injury. That pessimism still exists today. It shows up in the form of people declaring that no therapies are possible and that, even if therapies were possible, their crystal balls tell them that would take 20 or more years before any therapy will be available.

Pessimism is a self-fulfilling prophecy. We don’t need a crystal ball to tell us that if we don’t try, there will be no therapy. If we don’t start it now, it will take even longer. The problem with saying that it will take 20 years is that it will take 20 years. Let’s not fall into that trap of pessimism. Nobody ever said that it would be easy but let’s not make it impossible before we even start. Christopher Reeve died trying. Let's not compound that tragedy by giving up before we try.

Wise.