Rene Douglas remembers one of his greatest challenges as a jockey. At the 1996 Belmont Stakes, he willed Editor's Note over the finish line because the horse couldn't do so himself. Yet since Douglas' devastating spill in 2009, trying to coax that kind of heroic effort from his own body has proved much tougher. Now when he falls out of his wheelchair, his wife, Natalia, has to scoop him up.
Just getting around on a daily basis is as big a victory for Douglas these days as winning a Breeders' Cup race, which he did in 2006.
In the hopes of finding the finish line in this difficult race, the Douglases have grown exponentially desperate.
"To find the cure, I'll pay whatever I have to pay, even if I have to milk a goat in the highest hills I can find in stiletto heels. To see him walk again, it's priceless," Natalia has said.
On May 23, 2009, Douglas rode a 4-year-old filly named Born to Be in a stakes race at Arlington Park in Chicago -- where he had won six riding titles in the decade. Douglas guided his charge in the second path around the far turn when she was bumped from the inside by a horse named Sky Mom, ridden by Jamie Theriot. Born to Be then veered out slightly and clipped heels with a filly, Boudoir, just in front of her. In a frightening flash, Born to Be flipped head over heels, throwing Douglas down to the dirt. The horse somersaulted over her neck and shoulders like a gymnast on a mat, flipping up in the air momentarily with her head facing up and bottom side down. Then, as Douglas landed, the horse crashed rump-first directly on top of him as she continued flipping.
Born to Be was euthanized. Douglas underwent seven hours of spinal surgery at nearby Northwestern Memorial Hospital. He had broken several ribs and his sternum, but the bigger problem was the pair of compressed thoracic discs (T5 and T6) pressing into his spinal cord. During the surgery, Douglas was opened up from his neck to his tailbone, as doctors relieved compression on the discs and inserted screws into his upper vertebrae.
Since his spinal cord had not been punctured, there was initial hope for a recovery. But the reality soon set in that he would not regain feeling in his legs. The family -- including Natalia and their two sons Giancarlo (then age 13) and Christian (then age 8) -- started searching for a miracle. "Because one of our friends is a doctor, he told us right away about stem cell therapy," Douglas said. "[The doctor] said, 'That's your hope.'"
What Rene and Natalia found was a new frontier, untamed and potentially dangerous. Stem cells are naturally occurring cells harvested from various places in the body. When strategically reinjected into the body, stem cells can regenerate into the various specialized cells that become bodily organs. The hope is that injecting stem cells into the spinal cord of someone like Douglas will regenerate the pathways needed to connect his legs to his brain.
Unfortunately for the ex-jockey, breakthroughs in medical practices happen slowly in the United States. Any new biological drug has to go through a rigorous, expensive and time-consuming three-tiered clinical trial before the Food and Drug Administration will approve it. These studies could take decades, which is far too much time for patients like Douglas.
"We did a lot of research," Douglas said. "We thought about Germany, Portugal and China. We didn't know [anything] about Panama. I mean, it's my country, but it's a small country. I didn't expect we'd have that treatment in Panama, and the doctor [Jorge Paz Rodriguez, medical director of the Stem Cell Institute] knew who I was, so it made it easier for me to connect with that doctor."
So Douglas went back to his native Panama to a clinic called the Stem Cell Institute. Begun in 2005 by Phoenix researcher Neil Riordan, the Stem Cell Institute claims it can treat a variety of chronic conditions such as osteoarthritis, autoimmune diseases, heart disease, multiple sclerosis and, of course, spinal cord injuries. Some, however, see that kind of as more of a red flag than a panacea.
"Unlike specializing in one type of discipline -- like orthopedics -- they try to be all things to all people," said Dr. Chris Centeno, founder of the International Cellular Medicine Society. "That strains credibility when you see that, when a clinic is willing to treat every common malady of mankind."
In these early years of stem cell research, the lack of uniform standards opens doors to risky and potentially fraudulent practices. Patients, many from the United States, pay these clinics up to $5,000 per week for miracle treatments. No organization has the authority to unify standards of stem cell clinics around the world, just as general practitioners operate somewhat differently from country to country.
"There should be ethical protections involved, and you shouldn't be charging people tremendous amounts of money to try this," said Larry Goldstein, director of the UC San Diego Stem Cell Program and a member of the International Society of Stem Cell Research.
The Wild West element is one part of the stem cell controversy. The other part lies in the source of the cells. Using stem cells from unborn embryos, of course, flings open deeply held right-to-life issues. There are also smaller but significant issues in using stem cells taken from the umbilical cords of recently born babies.
Douglas' treatment involves neither embryos nor umbilical cords. His stem cells come from his bone marrow, and after harvesting, the stem cells are injected into his spinal column. "We're using our own cells. We're not killing babies," he said.
The FDA mandates that cells taken from one spot in the body and reinjected elsewhere in the same person's body require the same rigorous, clinical trials as newly developed drugs. "You can take the heart or kidney out of someone and put it in another person [which is not FDA-controlled]," SCI's Riordan said. "You can take someone's bone marrow out, freeze it and put it back in as bone marrow -- that's exempt. But you can't inject the stem cells [from the marrow] into the spinal cord. It has to be bone marrow for bone marrow."
With that kind of stem cell treatment unavailable in the U.S., Douglas has made three pilgrimages to Panama City -- in August 2010, November 2010 and February 2011. It took more than a year for the wiry jockey to recover sufficiently from the initial trauma and be strong enough to undergo the stem cell treatments.
Each two- to three-week stay at SCI begins with the stem cell injection right into his spine. "I'm excited when the needle comes," Douglas said of each of his stays at the clinic. "It's exciting. I don't get nervous, I get anxious. I used to get more nervous before I jumped on a horse because you see all the owners and they're telling you how to ride the horse. I just wanted to get on the horse, and then it's just you and the horse."
Still looking muscular and athletic, Douglas has not experienced the headaches or other immediate aftereffects of the treatment. Jockeys are used to keeping their weight down, so Douglas is well programmed to deal with the grueling rehab regimen that accompanies the stem cell injections. He uses a kind of elliptical machine where his arms force his legs to move. He also will soon start biofeedback, where electrodes on his skin send impulses to the brain in the hope of stimulating it once again to send messages to the legs.
Before leaving for his third treatment, Douglas said that he could move a toe on command ever so slightly. Sometimes, he felt he could move a lower body part, even though it did not actually move. Douglas said, "It's a big step when you feel like you can move something."
Dr. Warren Sherman, of New York Presbyterian, said early research shows reasons for hope.
"There's very exciting work that's gone on in small animals, [when] embryonic stem cells [from an animal's heart] are placed into a different environment and culture, are being used to help repair spinal cord," he said.
Despite a lack of tangible results, Douglas remains steadfastly optimistic. "I know we made the right choice, even if it doesn't work for me," he said.
That, of course, is the main question. Will this story end with the triumphant image of Douglas climbing up on a horse again?
Barry Abrams is an ESPN television feature producer.