A devastating accident robbed an Oklahoma farmer of the life he knew. But sometimes hope grows in the most unlikely fields.
A tooth under a drill. Skin torn by a shard of glass. A finger smashed beneath the blow of a hammer.
John Enns would gladly have traded any of these for the pain he felt. A half-ton tractor lay on top of him. He was folded beneath the vehicle like the letter U. With his chest crushed, the air could scarcely enter his lungs.
As luck would have it, a friend had seen what had happened. He rushed across the field where John had been spraying his wheat crop and saw the ditch where John was pinned against the earth.
Tales of superhuman strength in such moments of crisis are the stuff of cinema. But this was no movie. John’s friend couldn’t budge the tractor.
A pick-up raced by. It must have been going 80. Its windows were up, but the thump of heavy metal music leaked from the cab. Help! John’s friend bellowed. The truck didn’t slow.
Yet a minute or so later, it returned. Two men hopped out. They’d driven about a half-mile past on the farm road in Waukomis, a no-stoplight town in western Oklahoma, then one had turned to the other and said, Did you hear someone call for help?
The pair grabbed the tractor, pushed it skyward as best they could. John’s friend wriggled underneath, unfastened John’s seatbelt. Then he dragged John free of the tractor.
John lay on his stomach. He drank in the air in short gulps. His back felt like someone had detonated a bomb in his spine. But he was alive. He couldn’t move his legs. They felt kind of strange. Tingly. His friend would call an ambulance, get him to a hospital. He’d be all right. Until then, all he needed to do was keep focused.
Come on, John, he thought, push the pain out of your mind. Push the pins and needles out of your legs.
Crushed spines, however, do not heal by force of will. The tractor—which would eventually require seven firefighters and a winch to right—had broken John’s back in three different places. The most severe damage occurred in his T-12, a vertebra located about two-thirds of the way down his spine from the base of his skull to his tailbone. The half-ton tractor had caused a so-called shotgun blast fracture, shooting bone fragments into his spinal column.
When paramedics arrived, they asked John to describe his level of discomfort on a scale of one (minimal) to 10 (unbearable). Twelve, he said. The paramedics started a morphine drip. It did little to quiet the pain. As the ambulance sped to Enid, John agonized through every bump, every rut, every pothole. The seconds passed like hours.
At St. Mary’s Hospital, they placed him facedown on a gurney. They wheeled him past a floor-to-ceiling window, and John caught a glimpse of his reflection. Where his back had once been flat, golf-ball-sized bumps now bulged. I’m in real trouble, he thought. He shut his eyes.
You’ve got to help me, he begged the ER doctor. She’d known John for years. She understood how important it was for him to get better.
When John was 32, his father died. John’s brothers and sister had already moved out of state. That left John to run the farm and to take care of his mother. So for the last five years, it had been just the two of them taking care of the farm.
Please, John told his doctor, I need you to give me a chance.
We’re doing all we can, she said. But your injuries are very serious. Then she told him one of the few things he remembers clearly from that day. She said, John, you will never walk again.
Surgeons made an incision in John’s back and vacuumed out the bone fragments that had sprayed into his spinal column. They shaved the bony projections from several of his vertebrae. They set two titanium rods in his spine and performed a surgical fusion and bone graft that would help stabilize his back. After implanting ports—soft, plastic tubes—to allow the surgical site to drain properly, they closed everything back up.
Once John’s condition stabilized, he moved to the Jim Thorpe Rehabilitation Hospital in Oklahoma City. Doctors had encased his midsection in a body cast to immobilize his spine, and the turtle-shell-like contraption kept him in constant discomfort.
With his injuries, John had lost not only the ability to walk, but also to shower, dress himself, go to the bathroom and even to roll over. All his life, John’s physicality had defined him. He’d farmed, fished, hunted, rode horses. Now all that was gone.
So a battery of therapists—physical, occupational and psychological—began the long, hard process of helping him prepare for his new life.
They hooked circulatory pumps to his legs to increase blood flow. Every morning and every afternoon, they stretched his muscles to prevent them from contracting and losing function. They played games with John—Ping Pong, grab the Frisbee—to improve his upper-body strength and dexterity. They brought him to a greenhouse, where he tended plants to refine his small-muscle skills and soak in the peaceful garden environment.
For hours each day, he worked to build strength in his upper body and to restore function to his legs. Expect a miracle, said a big sign that John and his family hung at Jim Thorpe. And John did, even though he couldn’t wiggle his toes.
When he was finally ready to leave Jim Thorpe, his uncle built a ramp on the exterior of his home. A friend in the construction business remodeled his bathroom to make it handicap-accessible. John moved from the second-floor master bedroom into a guestroom on the ground floor. He hired a nurse.
The first day John arrived at home, his physical therapist said, yes, you will walk again. Then she stood him up. The strapping farmer, who towered over the five-foot-one therapist, was scared. She supported all the weight his legs once had. She can’t possibly hold me, he thought, as she struggled to keep his six-foot-one frame vertical. She’s going to drop me. But she didn’t. In the months that followed, she kept pushing him, daring his legs to remember what it felt like to put one foot in front of the other.
John sold some cattle to pay for the new expenses and to hire two part-time farm workers. He started getting around in a manual wheelchair and, eventually, a powered scooter. He fitted his tractor and pick-up trucks with lifts. Now he could drive, plow the fields, plant and harvest crops. He was starting to feel, well, normal.
For years, he’d dated Charla, an Enid schoolteacher. They’d been preparing to get married when John had his accident. For a long while after that, the time just hadn’t seemed right. Then one evening, right as they were supposed to go out on a date, John wiggled his toes. Forget dinner and a movie; instead, they spent that whole night gazing at John’s right foot.
Not long after that, John and Charla decided it was time to move forward. But you have to be patient, he told her, because I don’t want to push myself down the aisle. I want to walk. In July 2006, following two grueling years of rehabilitation—four hours a day, seven days a week—he did.
Yet this story is not a fairy tale.
Today, more than six years after his accident, John is still largely confined to a wheelchair. With the help of a walker and a pair of leg braces that stretch from his feet to his knees, he has been able to walk up to 700 feet. But his rehabilitative progress stopped four years ago, and he now must work constantly to fight the loss of muscle and function in his legs.
He lives with constant pain. And accident-related health problems dog him. This summer, blood clots developed in one of his legs, then broke loose and traveled to his lungs, causing a pulmonary embolism. Doctors told him the thrown clot likely would have killed him but for the strong condition of his cardiovascular system, a product of the vigorous physical therapy regimen he continues to follow. John spent the better part of a week in intensive care, where physicians put him on blood thinners and surgically inserted a filter in his veins to guard against future embolisms.
Still, just days after leaving the hospital, John was back out in the field, planting his winter wheat crop. He’s now farming 640 acres of his family’s land, and he hopes one day to return to a full 1,000-acre operation.
Since his accident, he’s also taken on a second job. In 2006, he was elected to the Oklahoma Legislature. As Representative John Enns, he’s had a chance to advocate for issues close to his heart: agriculture, rural development, social services. But perhaps the most profound mark he’s made as a legislator will be in the realm of adult stem-cell research.
Adult stem cells are like raw materials that the body keeps around in case it needs to repair itself. At any point, it may call these cells into action to replenish dying cells and regenerate damaged tissues. The stem cells then “mature” into specialized cells the body needs at that moment.
As a biology major and, later, a microbiology instructor at Northern Oklahoma College, John learned a great deal about these cells. He was intrigued by research suggesting they might have therapeutic uses in treating a wide range of health conditions. And while so-called embryonic stem cells have generated considerable controversy in the research world, adult stem cells have not. That’s because work with adult stem cells does not involve the destruction of any embryos.
After his accident, John’s interest in this field of research revived. In particular, he learned about how researchers were exploring the use of stem cells to treat spinal-cord injuries. When he became a legislator, he saw an opportunity to help Oklahoma researchers move ahead in this emerging field.
In early 2010, working with the Oklahoma Tobacco Settlement Endowment Trust, John helped establish the Oklahoma Center for Adult Stem Cell Research. With $5.5 million over an initial five-year period, OCASCR will fund researchers throughout the state as they work on projects using adult stem cells. Dr. Paul Kincade, who heads the Immunobiology and Cancer Research Program at OMRF and has spent more than three decades studying adult stem cells found in bone marrow, was named OCASCR’s scientific director. With the help of OMRF administrators and support staff, Kincade established OCASCR’s headquarters at OMRF, then set to work on his main goal: giving grants to support adult stem-cell research in the state.
Within months, OCASCR awarded $700,000 in grants to seven scientists at OMRF, the University of Oklahoma Health Sciences Center and Oklahoma State University. The researchers’ projects focused on different targets, from lung disease to osteoporosis. But all of them were built upon using adult stem cells as potential treatments. This past summer, one of those researchers made a major breakthrough.
Each day, OMRF’s Dr. Carol Webb had watched as a group of cells she’d cultured refused to die. By all accounts, they should have been dead months ago. But every morning when she’d peer through her microscope, there they’d be. Alive and kicking.
She puzzled and puzzled over what was happening. Then, one day, it struck her. She dashed down the hall to Kincade’s office. Come and look at this, she said. Tell me what you see.
Kincade looked. Yes, he agreed, something very strange was going on. The cells had changed. What once had been adult bone marrow cells now resembled nerve cells and cells lining blood vessels.
Webb had—inadvertently—reprogrammed adult cells taken from throughout the body into different types of cells. She had done it by adding a substance to inhibit the action of a protein in the cells. That process had essentially turned back the clock on the cells, causing them to revert to a stem-cell like condition. The cells then “re-matured” into adult cells that looked quite different from the original cells.
The discovery, published in the prestigious scientific journal Stem Cells, could give rise to a method for transforming a person’s own cells into whatever special cell is needed. Indeed, doctors recently injected the first patient in the U.S. with human embryonic stem cells as a part of a clinical trial exploring the use of these cells to treat spinal-cord injuries. Webb’s method, though, does not use embryonic stem cells. And because it would utilize cells taken from a person’s own body, it would not carry with it the risk of the body rejecting the cells.
The work is still at an early stage. Webb has not determined whether the reprogrammed cells are fully capable of changing into all types of cells. She has not figured how to tell the cells to become whatever kind of cell she wants to make. Even if she figures out these riddles, the reprogrammed cells still could become tumorous.
Despite these uncertainties, Webb’s findings represent a significant step ahead. She and her OMRF colleagues are now concentrating on how to make the reprogrammed adult cells become whatever cells the body needs to heal itself. She hopes that years from now, this basic research will lead to new therapies for diabetes or heart disease. For neurodegenerative conditions such as Parkinson’s disease and Lou Gehrig’s disease. Or for spinal-cord injuries like the one John Enns suffered.
Not long ago, John was looking out over the plot of land his family had farmed for generations. John had worked this red dirt his entire life. At the age of six, he’d calved his first cow there. As he grew, this was where he’d learned to drive a tractor, to sow crops. After graduating from college, he’d come back to farm alongside his father. Now it was just him.
John sat in the cab of his tractor, an immense machine that dwarfed the scooter he’d used to travel from his pick-up to the tractor. Then a power lift had hoisted him, legs dangling, into the driver’s seat.
The adult stem-cell research that’s taking place in Oklahoma, he said, it’s a source of great promise. One day, that work is going to pay off. And when it does, it’s going to mean the world for lots of sick and injured folks.
He’s visited OMRF’s labs, seen the work that OCASCR is making possible. He’s a realist, and he understands that whatever is happening now likely won’t come to fruition in time to help him. Still, he holds out hope.
But, he said, supporting medical research has never been about him. It’s about helping people who might someday find themselves in his situation.
The engine roared to life. John had 80 acres of winter wheat to sow that day, and it was already noon. He threw the tractor in gear and began to roll out of sight. To move forward. It was the only way John had ever known.
