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The Boy Who Could Run But Not Walk:
Understanding Neuroplasticity in the Child’s Brain
In the tradition of Oliver Sacks and Norman Doidge, Dr. Karen Pape, a respected neonatologist and clinical neuroscientist, demonstrates that neuroplasticity, the ability of the brain to change and heal itself, can transform children’s lives, just as it has transformed the outlook for adults suffering from brain injuries like stroke or Alzheimer’s.
This extraordinary book reveals the power of unconscious assumptions in medicine and science. For example, a boy with cerebral palsy affecting one side of his body had learned to walk badly with poor balance, but he was also able to run and play in a competitive junior soccer league. Dr. Pape explains that we walk and run with the same parts of the brain. This means that if the run is normal, then the brain has recovered. The explanation is simple. He learned to walk with a damaged, immature brain. He learned to play soccer with a recovered, more mature brain. Doctors are trained to look at the abnormal walk, not more competent, later learned skills. This book offers readers a new understanding of how the baby brain grows and recovers differently than an adult brain.
Throughout this remarkable book Dr. Pape shows that cerebral palsy is not an incurable condition. The movement disorders are a physical habit that can be changed, with a lot of hard work. The stories of children’s recovery and improvements found within these pages are a revelation—surprising, inspiring, and illuminating, offering real hope for some of the world’s most vulnerable children. With profound implications for the nearly 17 million children and adults worldwide living with cerebral palsy, The Boy Who Could Run But Not Walk challenges the outdated thinking that there is no cure for cerebral palsy.
A cure for some. Improvement for all.
in Medical Adolescent Psychology on Amazon.com,
in Neuroscience on Amazon.com and Amazon.ca,
in Special Needs on Amazon.ca
in Medical Adolescent Psychology on Amazon.com,
in Neuroscience on Amazon.com and Amazon.ca, and
in Special Needs on Amazon.ca
This book is chock-full of cases of children with cerebral palsy who vastly exceed their physicians' expectations, as well as practical advice for parents and caregivers on how this can be done. Karen Pape, MD, is a pioneer, rightly demanding that colleagues integrate the new science of brain plasticity as it applies to these children, and this is her cri de coeur, recording not only the new breakthroughs, but effectively explaining why, tragically, so many families are still denied these important interventions.
Norman Doidge, MD
Author of The Brain's Way of Healing and The Brain That Changes Itself
Neonatologist and clinical neuroscientist Pape argues that treatments for children with early damage to the brain, nerves, or spinal cord have not been ambitious enough. Her goal is "a cure for some, improvement for all." She criticizes the inertia she has observed in medicine that causes many primary care providers to postpone referring patients with cerebral palsy (CP) for treatment until symptoms become "bad enough" to warrant attention. Early intervention, she argues, produces far better results.
Publishers Weekly Book Review
No one motivates people like Dr. Karen Pape. Everything she does inspires individuals living with disabilities and their families to aim for higher goals. She is changing the face of rehabilitation.
Executive Director and Founder
Kids with cerebral palsy, teens with half a brain removed, adults with longstanding neurological conditions — Dr. Karen Pape shares example after example of astonishing improvement. Her way of thinking about brain recovery and repair can change the lives of millions of people for the better.
Founder and Executive Director
Reaching for the Stars
This story is much more powerful than just a reassessment of neuroplasticity. What it teaches me is that there are a lot of assumptions in medicine — and in life — that need to be re-evaluated. If you follow it through it’s a powerful lesson for life.
Jay S Greenspan MD MBA
A.I. duPont Hospital for Children
I first saw Daniel (not his real name) as a premature infant when I was a neonatology fellow at the Hospital for Sick Children (HSC, or Sick Kids) in Toronto. Daniel was born at twenty-six weeks. In the first week of his life, he developed a major bleed into the right side of his brain, damaging the areas that would normally control the left side of his body.
A twenty-six-week infant is tiny. Daniel at birth weighed 750 grams, about a pound and a half. When I started in neonatology back in the 1970s, he would have had, at best, about a fifty-fifty chance of surviving. Daniel survived, but the common wisdom at the time was that the damage to his brain was permanent and would lead to disability. The expectation was that he would have difficulty with both gross and fine motor skills. We knew he had a brain lesion so he was started in therapy fairly early. To my surprise, the disabilities that developed in Daniel as he grew from infancy to childhood, as measured on a standardized scale of function, were not too bad. As I expected, he limped on the left side, landing on the front half of his foot, not his heel. His left arm hung at his side and did not swing normally when he walked. His right side was unaffected and his speech and cognition were normal. I diagnosed him with a left-sided hemiplegia, a type of cerebral palsy that affects the motor functions just on one side of the body. Hemiplegia is found in roughly 40 percent of all children with cerebral palsy, and, like Daniel, 99 percent of these children are able to walk.
The Neonatal Follow-Up Clinic, where I worked, tracked patients for only the first three to four years. Daniel had been discharged for several years when his mother phoned me with news. She told me he was now playing soccer, not just in a league that accepted children of diverse ability, but in a league for competitive, able-bodied children.
The hell he is, I thought.
What I said was, “Oh?”
I didn’t believe her. Daniel being able to play competitive soccer was outside my understanding of hemiplegia. I assumed, as many doctors would have, that an overly optimistic mother was seeing a degree of recovery that just wasn’t there. Still, I arranged for her to come in with the boy so I could see for myself. When they came, I had him walk up and down the hallway to confirm that he still had the typical gait of a child with mild spastic hemiplegia. He did.
Then I asked him to run.
And, to my astonishment, he ran like a normal little boy, with an easy, balanced stride and reciprocal arm movements. He performed tight pivot turns, at speed, on both legs. Even the left leg, which had a limp when he walked, performed perfectly when he was running.
For a moment I was speechless. (Anyone who knows me knows this rarely happens.) Then I said, “You can’t do that!” And I meant it. I could not, for the life of me, figure out what was going on. We all know children learn to walk before they run. It’s a phrase embedded in folk wisdom. And yet, here was a child who had turned conventional wisdom upside down.
My first instinct was to think of Daniel as an outlier, an exception who somehow defied the rules. The natural history of cerebral palsy has been studied and described over a period of decades, and Daniel’s ability to run so well didn’t fit the description. It was incomprehensible in terms of the accepted theory of permanent brain damage that my fellow physicians and I understood. Which is why I said, “You can’t do that!” What he was doing was impossible.