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ARCHIVED - The remarkable recovery of Captain Trevor Greene

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After an axe blow to his head, Captain Trevor Greene was not expected to survive the trip to hospital. Four years later, Trevor and his wife Debbie are working with an NRC scientist to track the rewiring of his brain with MRI.

Captain Trevor Greene and daughter Grace before his injury.

Captain Trevor Greene before his injury.

It was a story that shocked Canadians: in March 2006, Captain Trevor Greene, a soldier working to build peaceful connections with Afghan communities, took his helmet off to show respect to the elders he was meeting and was attacked from behind by an axe-wielding 16-year-old. His brain injury was so severe that Greene was not expected to survive the medical evacuation to hospital. His fiancée (now wife) Debbie was warned that he would likely be in a permanent comatose state.

Well, not so. Greene has proved the experts wrong, achieving a remarkable and unprecedented recovery from his injury. He is making astounding progress toward regaining his upper and lower limb movement, which is controlled by the area of the brain damaged in the attack. Now Canadians are profoundly inspired by his journey of recovery, which is fuelled by hope, willpower and a lot of hard work.

That journey has taken Greene down new paths in life as a motivational speaker and author, with a book about his experiences in the works. Recently, he and Debbie became research partners with Dr. Ryan D’Arcy, an NRC scientist whose expertise involves using magnetic resonance imaging (MRI), and Dr. Stephen Lindsay, a cognitive psychologist at the University of Victoria. Together, they are looking at the workings of the healing brain.

Their research challenges long-held perceptions about how the brain heals and what treatments are best pursued. The conventional wisdom has been that only a short window for recovery exists, in the period right after an injury. What’s remarkable about Greene is that his really big gains have come four long years after his injury. “He’s proving that the brain is far more capable of recovery than is assumed by conventional medicine — and for much longer following the time of injury,” says Dr. D’Arcy.

Trevor Greene undergoes a brain scan, with Drs. Ryan D'Arcy (left) and Stephen Lindsay by his side.

Trevor Greene undergoes a brain scan, with Drs. Ryan D’Arcy (left) and Stephen Lindsay by his side.

Willpower and hard work bring results

Since 2006, the Greenes have become experts in rehabilitation, which they treat as a full-time job. They turned their garage into a gym and work through exercises for at least two-and-a-half hours most days. They give much credit to physiotherapist Bonnie Lamley, who they call the “physio-whisperer,” and occupational therapist Lila Mandziuk.

“Bonnie can read Trevor’s body like she’s part of him,” says Debbie Greene. This intense focus on repetitious exercises, driven by Greene’s relentless determination, is likely key to the incredible gains he is making.

Visualization as a healing tool

When Drs. D’Arcy and Lindsay first met with the Greenes and Mandziuk in May 2010, together they worked up a list of key functions to track by MRI, with the Greenes suggesting what rehab exercises should be used. Naturally, the list included upper and lower limb movement, but Greene added a highly original one, as well. He wanted to track his brain activity while imagining himself rowing, a sport he had once taken part in at competitive levels.

Their research program runs for two years, with quarterly MRI sessions to track the reorganization of Greene’s brain. So far, the difference between the first MRI done in May 2010 and the second one in August is remarkable. “We can see massive differences in how existing areas in his brain are activating more,” says Dr. D’Arcy. “And, most encouragingly, we can see new areas of the brain taking on functions for his upper and lower limbs.”

Functional magnetic resonance image of Trevor Greene's brain. The yellow areas show new regions in Trevor's brain that are now controlling motor movement in his limbs.

Functional magnetic resonance image of Trevor Greene's brain. The yellow areas show new regions in Trevor's brain that are now controlling motor movement in his limbs.

In that three-month period, while following his rigorous exercise program, Greene has gone from barely being able to stand, to standing for up to 30 minutes. Knowing that his brain is rewiring itself gives him important validation for his exercise program. Interestingly, when Greene visualizes rowing, his brain uses the same motor areas that are active during real movement, matching what is seen in elite athletes who use mental imagery routinely in training. In fact, Greene says that imagining himself rowing leaves him tired, as if he had actually been rowing. This shows that you may be able to rehabilitate the brain simply through mental imagery.

Sharing the results

Debbie Greene says they were motivated to work with Dr. D’Arcy and Dr. Lindsay because it could “help Trevor and other people with brain injuries.” Getting the results widely known in the medical community will be an essential part of this research program, which is generating the objective physiological evidence needed to drive more sophisticated explorations into how the brain heals.

In the longer view, this research could set new rehabilitation standards and timelines for anyone suffering a brain injury or disorder. MRI tracking of changes in the brain could also become a powerful tool for guiding expensive, time-consuming rehabilitation therapy — and make it more effective. It’s fortunate, indeed, that Debbie and Trevor Greene are on the front lines providing hope, inspiration and measurable results for others. End

The documentary that brought them together

Dr. Ryan D’Arcy’s partnership with the Greenes happened by coincidence. Over the Christmas holiday in 2009, Dr.  D’Arcy was watching “Peace Warrior,” a Gemini award-winning documentary about Captain Greene. In one scene, an orthopedic specialist tells Greene that he will never walk again because the muscles in his feet had arched from inactivity.

Dr. D’Arcy knew, however, that was not entirely true because “the root of the problem was Greene’s brain, not his feet.” And so he contacted Trevor and Debbie Greene to offer his expertise. Using MRI tracking, he would tell them whether Greene’s brain was healing as a result of his rehabilitation program, even before there was any external indication of healing.

Coincidentally, another medical specialist saw the documentary and contacted the family. Dr. Norgrove Penny, an orthopedic surgeon, was able to restore mobility to Greene’s feet, making it possible for him to stand and work towards his goal of walking again. If not for Dr. Penny’s intervention, Greene’s rehabilitation efforts would have been much constrained.

View the trailer for “Peace Warrior” (external link)