Touching your thumb to your forefinger is effortless, unless a spinal cord injury has nearly severed the connection from your brain to your body.
It took James Osborne a couple weeks to relearn how to bring those two fingers together. Touching his thumb to his pinky was another five years. Sitting at the table of his Mercer Island condo, Osborne presses each finger to his thumb like a marionette master. Every movement is like a string that starts in his brain, demanding his feet to lift for each step or his fingers to curl around a fork. For most people, that string is invisible, but for Osborne it takes an incredible amount of conscious thought.
Before June 14, 2007, Osborne was in some of the best shape of his life. The former REI IT director had taken up cycling, and it had become a daily passion. On June 14, he was careening down the steep gradient back into the Kent Valley during a racing ride with his co-workers. Suddenly the main triangle frame — the strongest piece — of his 2006 Novara Team Trionfo fractured in three places. The bike collapsed underneath him, and he fell head-first into the pavement going 25 miles per hour. The crash severed one of the arteries in his neck that supplies blood to the brain, and he suffered an incomplete spinal cord injury, paralyzing him.
It was like hitting a factory reset button. Osborne describes his injury as an eight-lane highway with six lanes permanently blocked with damage. Those “lanes” will never heal. When damaged, the spinal cord is programmed to self-destruct or, at minimum, it walls off and resists attempts at repairing itself. Medical science doesn’t have an explanation for why nerve cells behave this way. He has had to reteach his brain how to connect with the rest of his body. Being able to move anything from his chest down was completely wiped away.
In the early part of his recovery, Osborne convinced himself that he wouldn’t have any impairment. And he’s come a long way — but he’ll never be the same. Everything hurts, he said, which keeps him from doing many of the things he enjoyed before the accident.
“When I sit, my back hurts. The pain level always lives between a three and five out of 10. Between a three and a five, I would describe the pain as distressing,” he said, sitting in a chair with a two-pound bag of frozen peas sandwiched against his back and two smaller bags resting on his thighs as the endorphins from his morning workout began to wear off. “For me, that means I’m always trying to figure out how to manage it. Icing just numbs the pain and gives me some modicum of relief when I’m sitting.”
Mentally, though, Osborne is in a good place. He’s optimistic and energetic. The times he’s frustrated or annoyed at his body quickly passes — the gym has been a great outlet for that.
In February, Osborne published his book, Will Your Way Back: How One Man Overcame Tragedy With A Winning Attitude, chronicling the accident, his recovery, and everything that led up it. In the book, he peels away all the layers that masked his vulnerability, and offers his true self. Before the accident, he was known to many of his colleagues as a sharp but unapproachable person. In his harrowing journey of recovery, Osborne finds new purpose in life — to inspire others — and finally allows others to see him as Jamie, a kind and caring person.
Choose to win
Diane Osborne, his wife, was about to walk into QFC when she got the call. As she was driving to Harborview Medical Center, a social worker called and gave her directions to the emergency room.
“I asked if he’s alive, and she says, ‘Yes, but I need to prep you,’” Diane recalled. “She says, ‘I’ll meet you in the ER.’ That scared me. In all my years, I’ve never had someone call me to prep me for what I’m going to see.”
Knowing what a difficult road this injury was going to be, she and their two children, Kevin and Alana, started seeing a psychiatrist while her husband focused on his recovery.
Osborne was mobilized by two simple words that acted as the carrot in his recovery: “Get independent.”
“Early on I had to have people feed me and dress me, but that wasn’t my aim, and that’s not where I wanted to be,” he said. “I didn’t want someone to have to feed me or take care of my personal hygiene or wheel me around in a wheelchair.”
“When I sit, my back hurts. The pain level always lives between a three and five out of 10.”
Generally, the first six months are considered the most critical for the physical recovery of people with spinal cord injuries, so he approached therapy rigorously. His attitude — choosing to win — was a major contributor to his success. If he hadn’t been so positive and determined, he thinks his progress would have been relatively flat.
“I think I’d still be in a wheelchair,” he said. “And I think I’d be quite depressed, probably feeling victimized, probably feeling bitter. … This is not easy. This injury is cruel and relentless, but absent of effort, I’d basically just be sitting on the treadmill going in circles and not making any forward progress.”
Dr. Jens R. Chapman, a spinal surgeon at the Swedish Neuroscience Institute who is on Osborne’s medical team, said a person’s psychological outlook has a major impact on his patient’s ability to recover.
“We’ve had the good fortune of having a physically and psychologically well-adjusted gentleman, who’s had healthy family support,” Chapman said.
When Osborne arrived at Harborview, Chapman said he was almost completely paralyzed from his neck down with only a bit of hand and arm motion left. Most spinal cord-injured patients spend the rest of their lives in wheelchairs, but Osborne regained the ability to walk and do some sports, albeit with some impairments. And his significant hand and arm strength allows him to be fairly independent.
Initially, Osborne wanted to be back at work within six months of the accident, but the impossibility of that goal slowly became apparent. In the first several months, he’d made incredible progress. Osborne was pushing himself to the maximum, trying to make the most of that timeline. He’d ignored guidance to pace himself, and his body started to push back. His progress began regressing; his pain levels spiked, and the muscle spasms became worse. All of that hard work seemed to be slipping away, and that fear triggered what he calls his “second crash.” In December 2007, an emotional crash wrecked him, and he said he considered taking his own life.
After trying to strong-arm the mental side to his recovery, Osborne finally relented and sought the help of a clinical psychologist in June 2008.
Together they scraped inside the caverns of his childhood and the feeling that he was never “good enough” when he was growing up. They also explored why he was tying so much of his personal identity to his career.
“That was hard work, and it took me a while to get adjusted to the process of therapy,” he said. “I’m results-oriented. What do we need to do to get to the finish line? What’s the finish line going to look like? And that’s not how it works. There’s no script to any session. It was kind of top of mind. Sometimes I’d dig into places when I was just a toddler, or when I was just a teenager.”
Two years later, he started seeing a behavioral psychologist who helped him navigate his purpose in life and what he wanted to do going forward, whether it was continuing with IT or trying something completely different.
He started working for REI again in July 2008 — 13 months after the accident — as an individual contributor, working eight hours a week from home. Over the course of four years, he gradually worked up to 24 to 28 hours a week in the office, and spent the remaining hours in rehabilitation.
Those initial months after Osborne left the hospital were hard on his family too, Diane said. She was taking him to six to 12 appointments a week. For several months, he wore a special collar that Diane had to carefully clean.
“Every time I moved his neck, I was worried I was damaging him more,” she said.
Her therapist warned her about how life-altering Osborne’s injury would be. Even though he’s made significant strides, their life has never been the same.
“I can’t just hold hands with him because it throws off his balance,” she said. “He’ll lean on my shoulder, but we haven’t held hands for like 10 years. We have to put pillows between us in bed because if I roll over or get into bed wrong, I could send him into spasms. I haven’t had a good night’s sleep in 10 years. Every time I hear him in pain, it’s hard. It’s hard to watch someone you love suffer.”
“Jim” had evolved over time and became the persona most knew him by. With the exception of family and close friends, everyone called him Jim, and it was the mask he wore to hide his emotional side.
“I had a lot of self-consciousness growing up,” Osborne said, and he wrote about it at length in his book. “I had attitude issues growing up. Jim became a way to sweep it under the rug if you will. … Most of my work friends wouldn’t describe me as the ‘shoot the breeze’ kind of guy. It was always business, but not a lot of time engaging and connecting with people.”
Before the accident, Osborne was working with an executive coach assigned to him by REI management to draw out his personable side. He figures Jim and Jamie would have eventually merged, but not at the cadence they have after the accident.
Therapy and the catharsis of writing the book made Osborne realize that Jim isn’t who he wanted to be known as anymore. Before the accident, he would have introduced himself as his alternate self, Jim. Today, he’s Jamie.
“Jamie does have a heart and he does have emotions that he wants to share, and be more open,” he said. “When your life gets kind of stripped down and taken apart, you feel pretty exposed. Here I was totally exposed and trying to think to myself, who am I? What do I want to do?”
As he became stronger, Osborne started publicly speaking about his injury. Among the first was a medical conference with some of his doctors. His doctor spoke before him, sharing a slideshow that revealed 10 percent of spinal cord-injury patients go back to work within five years of their injury. Forty percent go back to work within 25 years, and 60 percent don’t go back to work at all.
“Here’s old Jamie Osborne thinking he’s going to go back to work in six months,” Osborne said. “I never forgot that slide because it had such an impact on me.”
He’s shared his story during radio and podcast interviews, book signings, and presentations and, in April, he spoke at a TEDx event at Bellevue College, where he’s worked as an IT manager since March 2016. He hopes to offer inspiration for anyone dealing with an injury or difficult time in his or her life. So many have approached him, saying their pain is incomparable to what he’s had to overcome, but that’s not the point, he said. Everyone has pain, and everyone has to find a way to manage it.
Through this journey, he’s met countless spinal cord-injury patients, and has seen them make remarkable strides beyond medical expectations.
“Define your terms. Take a stand. Choose to win.”
Chapman said in the last couple years, medical research is rewriting what doctors thought those with spinal cord injuries could accomplish. The Swedish Neuroscience Institute is about a year into a study of Neurorobotics, which helps patients regain and optimize some of their function, and is on the cusp of publishing some of its findings. But centers in Germany, Sweden, and Japan have been researching it for about two years, and have published peer-reviewed results.
“We found internationally that even chronic incomplete spinal cord injury patients can have tremendous progress after two years,” Chapman said.
Since Osborne’s injury, he’s been researching the spinal cord insatiably, and is hopeful that medicine is catching up to the reality of what patients can do.
Osborne doesn’t bike, ski, or hike as often as he used to, but his upper body is as strong as ever. When we met at the Seattle Athletic Center at 7 a.m., he out-paced me in every exercise. As I stopped to catch my breath and shake out my tired muscles, he persevered with pull-ups, overheard presses, planks, and Russian twists. His goal is to do 10 full-on pull-ups by 2020 or sooner. There’s no doubt he’ll achieve it.
As he likes to say: “Define your terms. Take a stand. Choose to win.”