Monkey Controls Robotic Arm

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Considered science fiction neural technology is opening doors

BY RONALD KOTULAK

Chicago Tribune

CHICAGO - (KRT) - Jesse Sullivan doesn't know exactly how his brain liberated itself from his armless body and began doing things for him on its own. But he has become a pioneer in a new field of medicine called neural engineering, whose practitioners are proving that there is such a thing as mind over matter.

Sullivan, a Tennessee power company worker who lost both arms in a job-related accident, has been outfitted by Rehabilitation Institute of Chicago researchers with a kind of bionic arm, which is controlled directly by his thoughts. This extraordinary achievement - just one of several breakthroughs nationally in linking mental activity with machines-signifies an impending step of immense proportions: The human brain is poised to make its biggest evolutionary leap since the appearance of early man eons ago.

The first direct brain-computer hookups have already been achieved in paralyzed patients, with limited success. Building on that, Cyberkinetics, a Massachusetts biotech company, has government approval to implant chips containing 100 tiny electrodes into the brains of five quadriplegics this year to see if their thoughts can operate computers. At least two other research teams are planning similar brain-machine experiments in people.

"I think what we're going to find is that we can help people who are disabled become super-able in a new sense," says Cyberkinetics chief executive Timothy Surgenor. "These people may be able to do things we can't do, like operate a computer faster or do very precise tasks. That's what we're really trying to accomplish. We're not trying to make an incremental change for these people. We're trying to do something that's a breakthrough."

These experiments have ushered science into a new era, the age of the cyborg, where the melding of brain and machine, long envisioned by the masters of science fiction, is now possible. And the research is not just aimed at the handicapped. Able-bodied people may also be able to greatly expand the capacity of their minds.

"We're getting into sort of a scary field, in a way, that of cyborgs, where relatively healthy people are going to control machines (with their thoughts)," says Dr. Philip Kennedy, of Neural Signals Inc., in Atlanta. In 1998, Kennedy, a former Emory University neurologist, was the first researcher to implant an electrode into the brain of a totally paralyzed patient, who was then empowered to use his mind to slowly spell out words on a computer.

"People are very bad at remembering lots of things and our calculation ability is only fair," he says. "Simple arithmetic is all we can do in our head without having to resort to a calculator. If you've got a tiny chip that you can put in with lots of access points into the brain, then you can enhance the normal memory and the normal ability to communicate."

If it works the way Kennedy and many other scientists now believe, the two-way brain-machine interface could give people expanded memory banks and super calculating power. Implanted computer chips, for example, could enable people to quickly learn a foreign language and master other tough subjects.

"We do dream about that, of enhancing functionality, just like the Six Million Dollar Man," says University of Chicago neuroscientist Nicholas Hatsopoulos, who worked with Brown University's John Donoghue to show that the Cyberkinetics chip enabled monkeys to move a computer cursor with their brains. "It would actually improve your capabilities beyond what a normal person could do. You could see better, hear better, move better and think faster."

Are such things possible? Not now, but very likely soon.

"I have no doubt that that is the future of those technologies," says Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics. "We'll see them for safety purposes, learning purposes and enhancement purposes."

The technology raises disturbing questions: Who would have access to electronic mind-enhancers? Would companies and other institutions coerce employees to have chips implanted in their brains to gain a competitive edge? Would chips be given to children? Would they be used to control the behavior of sex offenders and others? Would it change our notion of what it means to be human?

"How much can I do this and still be me?" Caplan asks. "Not every intervention threatens our sense of who we are, but if you really started to change your memory speed, or clearly started to be able to do things that you weren't able to do before, like learn languages in a day, or had infrared vision, you do start to get to questions about, `Is that still me?'

"My answer to that is, I'm not sure. But that won't stop people."

The National Science Foundation essentially concluded, in a 2002 report called "Converging Technologies for Improving Human Performance," that "super people" are around the corner:

"At this unique moment in the history of technical achievement, improvement of human performance becomes possible. Better understanding of the human body and development of tools for direct human-machine interaction have opened completely new opportunities."

Sullivan, 57, of Dayton, Tenn., entered this dazzling new world three years ago when his arms were incinerated on the job as a lineman for a Tennessee power company. He doesn't remember how it happened, but somehow he accidently grabbed a high-tension wire carrying 7,400 volts of electricity. His arms took the full fury of the charge.

When it came time to rebuild Sullivan, doctors first fitted him with a standard plastic-and-metal prosthesis. But it moved clumsily and demanded arduous shoulder gyrations.

That's the way things stood until last year, when Sullivan happened to be in the right place at the right time. That was the RIC, where Dr. Todd Kuiken, director of amputee services, was getting ready to test a 20-year-old dream, an experimental myoelectric arm, a device intended to transmit instructions from the brain via unused nerves to points outside the body. In short, Jesse was to think the arm to move.

Sullivan had one important thing in his favor: The memory of his arms and hands remained fresh in his mind, while the neural circuits that controlled those parts were still powered up as they had been before the accident. Would the impulses that commanded movement in his missing left arm leap from his brain, travel down his functional but destination-less nerves to the computerized artificial arm and bring it to life?

Sullivan remembers the moment well. It was a cold January day in Chicago, but Sullivan's thoughts were on matters far from the frigid temperature outside. A single mantra kept running through his mind as he concentrated on getting plastic and metal to react solely to his will: "Think, Jesse, think."

Then it happened. Something moved.

"That was probably one of the best feelings I'd had since I had my accident, when they first put it on and told me to close my hand," Sullivan says. "When I did, this thing closed. This grasper on the end of the arm closed up."

Sullivan's robotic arm has given him a new sense of independence. He can do things he couldn't just a year ago, like shave, put on socks, weed the garden, water the yard, open small jars, use a pair of handicapped scissors and throw a ball to his grandson. "It gave me part of my dignity back," he says.

Sullivan doesn't have to think hard anymore about doing something; he simply does it the way he always did. "I feel my hand when I want to pick something up, then I just close my hand," he says. When he wants to grab a bottle of water, for instance, the computerized arm moves forward, the elbow bends and the mechanical hand grasps the bottle, bringing it to his lips, as his natural arm once did.

It feels so natural, in fact, that Sullivan forgot himself earlier this summer and yanked off the mechanical hand trying to start a lawn mower. The arm had to be sent back to the Rehabilitation Institute for repairs.

For Kuiken it was vindication of an idea he got as a young graduate student two decades ago, prompted by a line he came across in a scientific journal, the Annals of Biomedical Engineering. It was a "what if" kind of article where the authors speculated on things that might be possible someday. The line that caught Kuiken's attention described the theoretical possibility of transferring nerves to different muscles and then using signals from the muscles to control an electronic prosthesis.

The far-out idea grew into an obsession with Kuiken. He would first surgically move the nerves that once led to an arm and transplant them into a chest muscle. Once they took root, sensors could be placed over the nerve endings to amplify the electrical signals still coming from the brain. The signals could then be plugged into a computer and used to control a motorized arm.

It was a wild dream; no one had ever done it. Kuiken spent year after frustrating year overcoming failures in experimental animals until he had a model that could be tried on a human being. Facing Sullivan after the arm was put on for the first time, Kuiken was anxious: "Oh my God," he thought to himself, "what if it doesn't work?"

But as Sullivan's brow knit and his mental effort caused the artificial hand to close, Kuiken at last breathed easier. "I was very relieved and excited," he recalls.

He was even more excited once Sullivan got used to the bionic arm: "Doc, now I don't have to think about it," Sullivan told him. "I just do it."

As wonderful as the robotic arm is for Sullivan and the many others sure to follow-another Rehabilitation Institute patient has since been hooked up to an arm and a third was being fitted as this article went to press - it is only the start of what is to come, as more is being demanded of the brain. Researchers are learning how to harness brainpower to machines so that paralyzed people can use thoughts to operate not only computers, but wheelchairs, robots and other mechanical devices. The Department of Defense funds much of the research in hopes of using thought control to fly airplanes and maneuver combat robots in dangerous war zones.

And bolstered by new knowledge of how neural circuits reorganize themselves from minute to minute to adapt to the outside world, scientists are developing high-tech tools to prod the brains of stroke patients into healing faster and more completely than ever before.

As scientists explore the brain-machine interface, they are wonder-struck at the brain's ability to make room for new conditions-for instance, considering a robotic arm as much a part of the body as a flesh and blood one, and accepting an implanted computer chip as a natural extension of its powers.

To be sure, the ubiquitous computer has already, in a sense, become an appendage of the brain. Preschool children who have daily access to a computer, according to a recent study by Xiaoming Li of Wayne State University, perform significantly better on measures of school readiness and cognitive development (perception, awareness, reasoning and judgment) than those who don't.

"We are driven by several themes: The idea that the brain, even in the adult, is modifiable-it's plastic, and has adaptive capacity," says Dr. W. Zev Rymer, director of research at RIC, who is spearheading the nation's leading effort to use the newest technology to help heal the brain. "We didn't believe that for a long time. We had believed that after the first few years of life, the capacity of your brain to change was severely limited."

That old way of thinking also put limits on rehabilitation. When something goes terribly wrong with a person's brain or spine - as it does for more than a million Americans who suffer strokes, spinal cord injury or head trauma - that person is usually given immediate supportive medical care, but the brain, for the most part, is left on its own to get better.

Trying to turn that dismal picture around, Rymer is focusing 80 percent of the RIC's research on ways to help the damaged brain or the injured spinal cord. It has become the 150-bed institution's top priority, since the majority of its patients have some type of neurologic injury.

"Our future lies in exploring the limits of ways to optimize recovery of brain function, reorganization and plasticity," Rymer says. "The point of all this is the plasticity idea: that we now have ways to modify the reorganization of the brain in a constructive way."

One way the Rehabilitation Institute's scientists are trying to rearrange the damaged brain is with electrical stimulation. Our brains work on electricity. Neurons communicate with one another through electrical impulses, and animal studies reveal that a small electrical charge can stimulate the production of new connections between brain cells that helped the injured animals recover.

Of the 750,000 Americans who suffer strokes each year, 300,000 are left with serious deficits, such as weakness, paralysis or inability to speak. Most recovery occurs within the first three months after a stroke, and the deficits that remain after that are usually considered permanent.

Dr. Mark Huang, a RIC rehabilitation expert, is trying to break that frustrating three-month barrier. In a recently completed phase one clinical trial, five patients with paralyzed arms underwent surgery to have specially designed electrodes made by a Seattle-based company, Northstar Neurosciences, implanted near their motor cortex, the part of the brain that controls nerves and muscles. The patients were well beyond the point of optimal recovery, having had their strokes anywhere from four months to six years earlier, yet they experienced significant recovery.

An ongoing phase two study is showing similar promise and a phase three study involving many more patients at multiple centers across the country is scheduled to start later this year. These three-phase studies are required by the U.S. Food and Drug Administration to show that a product is both safe and efficacious.

Using functional magnetic resonance imaging, researchers pinpoint an area of the motor cortex that is likely to take control of commands to the arm from neurons destroyed by the stroke. A surgeon makes a small opening in the skull, placing an electrode over the site. The idea is to stimulate this area electrically while a patient undergoes intensive physical rehabilitation of his or her paralyzed arm.

The results, though preliminary, are stunning: Patients recovered an average of 30 percent of lost function in their paralyzed arms. Five similar stroke patients, who did not receive the implants but underwent the same intensive rehabilitation, recovered only 10 percent of lost function.

"The main purpose of the device is to provide the stimulation that will allow the brain to heal," Huang explains. "It basically means you're getting the brain to retrain itself to do activities that it did before."

"We're taking people who basically plateaued neurologically, and providing them with improvement. When you get a stroke you usually reach a certain point and then you plateau. That's pretty much all you get back. These people are not returning to normal, but they're getting some gains back."

Like Jesse Sullivan, Laurie Sears doesn't fully comprehend how her brain changed to make her better, except that it had something to do with the electrode under her skull. Her right arm had hung uselessly by her side ever since her stroke six years ago.

Sears cheerfully describes how the wire from the electrode burrowed under her skull and then threaded down under her skin to a small battery-powered receiving disc in her left chest. A radio signal from the outside turns the electrode on only during the intense rehabilitation sessions, which last for six weeks. Sears says she never felt the electricity in her head. At the end of the experiment, the wire and electrode were removed.

Sears had three goals in mind when she volunteered to participate in the electrical brain stimulation experiment: to be able to hug loved ones with both arms; to take up knitting again; and to use a spoon to eat soup.

She can now do all three-nowhere near as well as before her stroke, but with a proficiency that represents a quantum leap over having no use at all.

"I'm not zooming through the bowl of soup," she laughs. "It's a very slow process. But just to be able to do something like that made me very hopeful. It's so very, very important that we have this kind of research. If we don't have it, where's the hope? The hope also goes into reality. Would I do it over? Yeah. I'd jump at the opportunity."

Judy Walsh, 59, of Elmwood Park, Ill., said thinking about having the brain stimulator was "scary," and her children tried to talk her out of it. Now she and her children are glad she went through with the procedure. She's enjoyed a 40 percent recovery of function in her left arm, which had been paralyzed by a stroke five years earlier.

"I definitely feel I have improved," Walsh says. "I can do more things with it. Instead of just letting it hang there, I'm picking it up more and using it more. I use my fork and knife at the dinner table. I didn't think I would recover so much."

Walsh says she also noticed a big change in her mood: "My attitude is better because I feel more confident. That's a big difference; you're more self-confident."

Dr. Robert Levy, the Northwestern Memorial Hospital neurosurgeon who implanted the stimulator in Sears, Walsh and other patients in the study, says he's amazed at the early findings. "We have for the first time a relatively innocuous procedure that appears to have the ability, at least in part, to reverse a fixed neurological deficit. That is something that has not been available to me as a clinician ever in the course of my 20-year career."

While the preliminary results appear enticing, scientists still lack an adequate explanation of how electrical stimulation works. "Obviously the body has electricity, that's how we're powered," said Dr. Mark Huang, rehabilitation expert. "For some reason the electrical stimulation is helpful. We're not sure why it's helpful, but it seems to assist with this neuroplasticity, more so than if we did just straight rehabilitation therapy. This seems to be above and beyond that."

Electrical stimulation seems to affect other body structures beyond the targeted limb. A few patients who lost some ability to talk after their stroke experienced improved speech, even though the stimulation was intended to help their paralyzed arm. Northstar Neurosciences officials intend to expand testing to speech-impaired stroke patients and people incapacitated by traumatic brain injury, especially those involved in motor vehicle accidents.

Would electrical brain stimulation help normal people learn faster?

"There are many possibilities that have to be answered ethically," said Dr. Mark Huang, a rehabilitation expert. "You can use this in any application where you want to potentially enhance brain function. If you want to learn a new language, potentially the stimulator might help. Would I recommend you do it for that purpose? No. But down the road, who knows? Obviously the sky's the limit and we're still in the infancy stage."

Elsewhere on the sprawling upper floors of the RIC, neuroscientists, engineers, doctors and technicians bustle around strange new equipment-much of it built for the first time-that is intended to get patients to do things they never did before, and perhaps get them to heal better than ever before.

"Where we're heading with all this now is this knowledge that we can change many aspects of brain function," Dr. W. Zev Rymer explains. "It gives us a tool to look carefully at what it is we do when a therapist begins to work together with a patient on promoting recovery. In rehabilitation, the idea is that the robot could be a substitute for some lost or impaired function."

When Rymer uses the term "robot," he is not referring to the beeping, self-propelled androids that the word usually conjures up, but to machines that engage humans in motion. These machines have ramped up the work of physical therapists, who have been manually moving the limbs of patients with brain and spinal cord injury for a long time, hoping that some of it would take, but not knowing how it helped and what was most effective.

"The framework within which they work has been very obscure," Rymer says. "It was obscure then, and it remains obscure to this day. A lot of it is just seat-of-the-pants clinical practice. They think that these things are helpful, and there are some straightforward things that they do that probably are helpful without invoking any elaborate theories of mechanism."

Rymer feels that robots may now provide the answer to what works and what doesn't. RIC researchers use the robots to move paralyzed hands, arms and legs, trying to teach the brain how to regain lost functions by rewiring itself. And the robots do so tirelessly, putting patients through brain-stimulating workouts that would exhaust a team of physical therapists.

One of the most cutting-edge robots is a virtual reality machine that takes up most of a small room on the RIC's 14th floor. It's the only one of its kind, and its job, if it works, is to coax the brain and body of stroke patients back into cooperating. It does so, for example, by enabling a patient to feel and manipulate an object that appears in space before him but really isn't there. The purpose is to get the brain to retool itself to move muscles that are still good but which have lost their linkup to command central.

"The global idea-that the brain is modifiable with experience, and that by retraining muscle activity you can produce physical changes in the brain-is pivotal," said Dr. W. Zev Rymer, director of research at RIC.

That's what paraplegics using another machine called the Lokomat are counting on. The $250,000 contrivance looks like the steel frame of a small building. A harness holds patients so that their feet rest on a moving floor. Computers operate motorized braces that force a patient's paralyzed legs to go through walking motions while sensors pick up muscular activity.

Neurologists believe that there may be two roads to recovery in patients with serious but partial spinal cord injuries that cause paralysis. Physically moving paralyzed limbs may help retrain the brain to take command, and it may also reawaken "mini-brains" in the spinal cord itself. These mini-brains are clumps of neurons, called pattern generators, which control routine leg movements, so that a person can walk without thinking about it.

The potential benefits of the Lokomat rely on both avenues, since experiments on paralyzed animals showed that putting them on a treadmill could reactivate their pattern generators.

Patients so far tested on the Lokomat already had gone through standard physical therapy with no improvement. They remained paralyzed from the waist down but still experienced some feeling in their legs. "We and others showed that their walking gait was improved with the Lokomat," Rymer says. "We are now looking to intervene earlier after spinal cord injury to see if that improves their ultimate performance." The research has also been expanded to include stroke patients who have leg paralysis.

Martine Maenhout, 58, of Naperville, Ill., says her brain forgot how to walk after a blood clot in her spinal cord paralyzed her from the waist down in November 2002. Doctors said that at most, she had a 5 percent chance of ever walking again.

"Then we heard about this robot program, the Lokomat," she says. "I started to come here 10 months after I was paralyzed and still unable to walk. Within six weeks, I walked."

Maenhout ambulates easily now with a walker and can walk short distances with two canes. She expects to keep improving and to be able to go shopping on her own by Christmas.

She isn't sure what happened in her brain to get her back on her feet, or whether her spinal cord also helped. She suspects that the walking motion that the Lokomat forced her legs to go through somehow put the memory of how to walk back into her brain, like reprogramming a computer.

"At first it was very strange, almost like somebody else's legs were being moved," she says. "I could feel my legs being moved, but I had absolutely no control over them. They had to tell me everything, as if I had never walked. Keep your feet up, lift your knees, everything. Within a couple of weeks I could start moving my legs."

Other scientists are exploring new brain-machine boundaries.

Kennedy of Neural Signals in Atlanta was the first to show that the brain's commands could be tapped to operate machinery outside the body. In 1998, he implanted an electrode into the brain of 63-year-old Johnny Ray, who had suffered a massive brain-stem stroke that left him totally paralyzed and unable to speak. Yet his brain remained intact.

The extremely thin electrode is open at the end to allow brain cells to grow axonal branches inside. Wired to a computer, the electrode picks up the firing pattern of individual neurons-each of which can control complex functions.

Watching a cursor on the computer screen, and listening to the crackle of neurons firing, Ray quickly learned how to concentrate his thoughts. He could control the firing of the neurons inside the electrode, increasing or decreasing their speed of firing. Programmed to respond to the commands of individual neurons, the computer obeyed his thoughts. Increasing the firing action of one neuron moved the cursor from left to right, while decreasing its firing rate made the cursor stop. Another neuron was taught to move the cursor up and down, enabling Ray to spell out words at a rate of three letters a minute.

His body was locked in, but his brain was now free to communicate with the outside world. "See you later," Ray liked to say. "Nice talking with you." Or, "I'm hungry."

"We would ask him questions about himself and his family and he'd spell (the answers) out," Kennedy says. "He was very pleased. He was very sick all of the time and in pain a lot of the time. But he always expressed to us that he was very glad he could do it.

"To see him control the cursor with his brain was unbelievable. But then there was the awe at what it meant, what it meant for others. I realized that when we had Johnny controlling the cursor, we had crossed a threshold. People who are locked in should be able to communicate easily, control their environment, control their wheelchair, control just about everything."

Ray and five other paralyzed patients were terminally ill when they received the experimental brain implants, and all have since died. With major equipment upgrades, Kennedy is planning more implants in patients.

He will be collaborating with Duke University neurobiologist Andrew Schwartz, who has succeeded in training monkeys to eat with a robotic arm using only their brainpower to guide the arm's movements.

In Schwartz's experiment, an electrode with multiple contact points is implanted in the animal's motor cortex-which controls its arms-and the electrode is then connected to a computer, which controls the robot arm. With the computer reading output from the motor cortex, both of the animal's arms are strapped to its side. The animal is then presented with an orange slice at the end of the robot arm, only inches from its mouth. The monkey's urge to grab the orange with its real, immobilized arm causes a lot of motor neurons to fire. At first the computer is programmed to move the orange close enough for the monkey to eat it in response to the firing of any neurons in the motor cortex. Then the task grows harder. The arm is moved farther and farther away, forcing the monkey to fine-tune the firing of neurons to control the motorized arm. While the computer records the patterns of brain activity, the animal gradually learns that it doesn't have to try to move one of its own arms to get the orange. It only has to think about getting the orange. When the computer reads that thought pattern, it moves the robot arm to the monkey's mouth.

"We call it closed-loop learning," Schwartz explains. "The animal changes its neural output. We decode that and feed it to the robot. The robot moves and the animal decides if the robot is moving in the right direction or not."

Subconsciously, the monkey makes a connection between what it is thinking and how that gets the robot arm to move in the desired direction. Schwartz believes that a paralyzed patient with such electrode-mediated brain control over a robot arm could feed himself, work an electric wheelchair and do many other things.

A Duke University team, led by neurobiologist Miquel Nicolelis and neurosurgeon Dr. Dennis Turner, was the first to get monkeys to move a robot arm with their thoughts. With a 32-electrode array implanted in their brains, the animals were initially taught to use a joystick with their hands to move a cursor on a screen that controlled the mechanical arm. A computer recorded the pattern of neuronal firing the animals used to maneuver the arm in three dimensions.

Then an amazing thing happened. Power was cut off to the joystick, leaving only the animal's thoughts funneled through the computer to control the arm. At first the monkeys kept using the joystick. Gradually they noticed something was different: The arm was not responding to the joystick as before, yet the screen cursor, obeying the computer's readings of their brain patterns, was moving. It didn't take long before they figured it out. They stopped using the joystick, but kept moving the cursor with their brains.

The first time it happened, Nicolelis and the other scientists fell silent, staring at each other in disbelief. A momentous goal had been reached-the brain was operating out of the box. The Duke team now believes its array is ready to be tried in humans and is seeking FDA approval to implant the electrodes into the brains of paralyzed patients.

How far can the brain go? Is the body in which it resides actually holding back its full potential?

The University of Chicago's Hatsopoulos is trying to find out and thinks there may be a way to get the brain to run a computer at warp speed. What if a computer could be operated, not by using the brain to move a cursor around, but by using complete thoughts to do many functions at once?

Hatsopoulos is implanting Cyberkinetics' Braingate, the 100-electrode chip, into the premotor cortex of monkeys as well as into the motor cortex. He found that the chip in the premotor cortex, which sits in front of the motor cortex and is involved in the planning of movement, was able to predict what the motor cortex was going to do before it did it.

Tapping directly into the premotor cortex would bypass the arm and hand, which currently limit the speed at which a computer can be used.

Instead of having the motor cortex direct the muscles to go through all the individual steps necessary to move a cursor from one position to another, the premotor cortex would simply command that the whole function be done at once. The computer, in a sense, would be reading a person's thoughts and putting them into action.

"The idea would be for a general purpose brain-machine interface," Hatsopoulos says. "You have this different mode of operation where you say, `I have a neural remote control. I want to change the channel but I don't want to change the channel by moving the cursor to hit a button. I just want to intentionally select this button.' That presumably is going to be a lot faster than actually moving a cursor to the button. You just say to yourself, `Activate that button.'"

Before brain-computer interfaces can become a reality for therapy or to enhance mental abilities, a lot more research must be done. But the field is moving fast and is energized as never before.

"Just by thinking, patients could control and choose objects," says Northwestern Memorial Hospital's Robert Levy. "That's the first step in enabling the brain to bypass the spinal cord and send signals directly to some output function. That's breathtaking work. It's no longer a question of if this stuff is going to replace much of what we do now. It's really how soon it's going to be."

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SIDEBAR

This year marks the 50th anniversary of the Rehabilitation Institute of Chicago, which began in 1954 as a small outpatient clinic and has become the nation's top rehabilitation hospital, according to U. S. News & World Report. RIC was the brainchild of a former chief of the Veteran's Administration, Dr. Paul Magnuson, who envisioned opening up to private citizens the kind of rehabilitative care received by returning World War II and Korean War veterans. In 1963, Dr. Henry Betts, a young physician specializing in rehabilitative medicine, was recruited from New York City and became RIC's medical director, serving for two decades before becoming chief executive officer and president.

In 1974, RIC built the nation's first freestanding rehabilitation center that furthers a holistic treatment approach, teaming doctors, nurses, therapists and spiritual counselors in pursuit of the institution's stated goal, "to maximize the potential of each patient." Meanwhile the hospital has raised huge sums of money to conduct cutting-edge research programs to find ways to compensate for such problems as brain or spinal injury, stroke and other disabling events and physical conditions that limit individual independence.

"RIC has evolved into a clinical, educational and research institute of great size and strength," says Betts, who is now chairman of the Rehabilitation Institute Foundation. "We must work toward reaching more people and the ultimate outcome of achieving prevention and cure."

Wayne M. Lerner, RIC's current president and CEO, says the institute, through its emphasis on patient care, research and advocacy for the disabled, has generated a "synergy that creates exceptional results for patients and their families, attending physicians and support staff, and the scientists, clinicians and engineers behind our research program-the largest in the world."

RIC's anniversary year will culminate in a benefit dinner on Oct. 5 at the Chicago Hilton and Towers. With the theme "Transforming Medicine, Transforming Lives," the dinner will honor Mayor Richard M. Daley for establishing the nation's first Task Force on Employment of People with Disabilities. Appearing at the dinner will be noted Irish tenor Ronan Tynan, himself a physician and double-amputee, who recently sang at Ronald Reagan's funeral.

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© 2004, Chicago Tribune.

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