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Supine science

Lots of people donate their bodies to science. But most of them wait until after they're dead.

Not Charlie Procter. For five months earlier this year, the 45-year-old petroleum engineer allowed nurses to probe and prick him dozens of times while drilling for blood; underwent several bone-density sonagram tests forcing him to contort his body in uncomfortable positions for up to several hours at a time; and permitted a doctor to take, in his words, "a Black and Decker" to his hip bone while conducting two bone biopsies--all in the name of science.

And that was the easy part.
For three solid months, Procter was, in his words, "incarcerated" in the General Clinical Research Center on the campus of the University of Texas Southwestern Medical Center. He was confined to bed for 24 hours a day, where he ate all his meals and did all his business--all while forbidden to raise his upper body above a thirty-degree angle.

For his five-month effort, Procter received $6,500 and the satisfaction of being an active (or, more accurately, an inactive) participant in furthering the frontiers of science.

As preposterous as it may sound, Procter was a human guinea pig--more of a hibernating bear, actually--in a study with direct applications to aiding long-term space travel. When astronauts go into space, especially for extended periods of time, they suffer severe bone loss, which puts them at an increased risk for fractures and kidney stones, according to Dr. Lisa Ruml, an instructor of internal medicine who is assisting in the bed-rest study.

The study's purpose is to test the effectiveness of olpadronate, an osteoporosis medication, in preventing bone loss and kidney stone formation in zero gravity situations. The study, which began last spring and is expected to last several years and include 16 to 20 volunteers, is funded by the National Aeronautics and Space Administration (NASA), which awarded UT Southwestern a $5 million grant in 1991 to set up the country's only Specialized Center of Research and Training in Physiology.

According to Ruml, the Russian cosmonaut who spent 356 days in space--the longest stint thus far--suffered 50 percent loss of bone in his heels. He also had significant bone loss in his hips and spine, while his skull gained bone. Scientists do not know why this happens--something the UT Southwestern study will also investigate.

NASA has conducted several 17-week bed rest studies on bone loss prevention, but had little luck getting results. Scientists first thought exercise was the key, but that helped preserve muscle, not bone. They also tried calcium supplements and banging the bottom of feet to simulate feet hitting pavement--all to no avail.

Extended bed rest is not a perfect simulation of zero gravity, but it offers a good model, says Ruml. Bedridden patients lose even more bone mass than astronauts.

While NASA has a whole department devoted to recruiting volunteers for other studies, UT Southwestern has to rely on newspaper advertising to find its guinea pigs. The advertisements for bed rest studies have resulted in calls from as far away as New York. But Ruml cautions that part of their job involves carefully excluding people who make a livelihood of being experiment subjects.

It is equally paramount that they find candidates who can stick it out. Lying in bed for 12 consecutive weeks may sound inviting, but it's tougher than it looks. There's the boredom factor, which is not helped by the fact that during half the week subjects are on a restricted metabolic diet.

"The study can be difficult," she concedes. "You get cabin fever. I couldn't do it."

Still, Ruml's only lost one candidate to date, a man who couldn't stick it out past week two.

"That seems to be the threshold week," Ruml says. "That's when they get very irritable. They revert to childhood and ring for the nurses for every little thing."

"Don't bother me unless you're Janet Jackson," reads the sign on the hospital room door.

Inside, Chris Talton lies shirtless in bed, surrounded by the objects and activities that have made his 12-week voluntary stay here more bearable--posters of beautiful female singers--Jackson, Sade, Toni Braxton--his saxophone, tape player and television. He's only got four more days to go.

A 23-year-old security guard, Talton found out about the study from his mother, who is a secretary on this research floor. He had recently quit his security job, because his assignment--apartment complexes in south Oak Cliff--had gotten too dangerous.

He has a beeper so he can call friends after the hospital turns off incoming calls at night. He has had a steady stream of friends visit--some of whom think he's crazy, some of whom have signed up as future candidates. But, all in all, Talton has enjoyed the solitude.

 

"If you have nothing to do and a lot on your mind, this is perfect for putting your thoughts together," he says. "It's like a long vacation."

During his 12 weeks lying down, Talton says he's figured out what to do with his life. He has enrolled in community college for January, where he plans to study psychology and go into youth counseling. He figures he'll transfer to the University of North Texas and minor in music.

"On my job I talked to troubled young people a lot," he says, propping himself up on an elbow. "A couple didn't listen. But this one little girl, she's doing pretty good now. If one out of 10 listens to me, I feel like I'm doing my job."

Just days before the protocol is to end, Talton is focused on the immediate future. What he misses the most is his mother's home cooking and playing basketball. He plans to partake of both as soon as he gets out.

"But first I'll have to learn how to walk again."
Charlie Procter was between engineering consulting jobs when he learned about the bed rest study. A friend of his wife works at the UT Southwestern General Clinical Research Center, which is funded by National Institutes of Health.

Procter had a choice of studies. Doctors at UT Southwestern are also investigating how the heart and circulatory system behaves in space. In that study, participants only have to be supine for three weeks. But volunteers are required to have a catheter inserted in their heart twice.

"At 45, I didn't want people unnecessarily poking about my heart," Procter says. "Of course, in this study they put a Black and Decker to your hip bones and I wasn't terribly impressed by the prospect of that either."

Procter found the admittedly grueling five-month-long project fascinating, even the three-month bed rest. Scientifically inclined by nature and profession, Procter was the first volunteer and helped the doctors work out the bugs in the protocol for future subjects.

With his suggestion, for example, doctors shortened and improved the comfort level of the ultrasound tests to measure bone quality.

"Doctors are extremely interesting people," Procter says. "But for the most part they don't usually treat you like a human being. But when you're the focus of their scientific study, the focus shifts a little in the patient's favor."

Procter survived the boredom and tedium with visits from his wife and friends. He attempted to study biomedical engineering--for fun--but the biomedical engineering school on the UT Southwestern campus was incapable of handling his request without insisting he enroll in graduate school first.

So he read Advanced Engineering Thermodynamics instead, plus the entire published works of John Le Carre and P.D. James. Ensconced on a gurney, he visited the nurses in the middle of the night--he had become nocturnal, sleeping three hours at a time during the day and no more than six hours total. And he played a lot of checkers with another "inmate," a volunteer enrolled in a different study.

Those checkers games, played propped on one elbow, led to a nasty shoulder injury--undoubtedly the first recorded checkers-related injury in the annals of sports.

What occupied Procter during most of his stay was his computer, on which he kept a daily journal about the study and his musings. Not surprisingly, flatulence looms large in his writings, but the journal does offer a glimpse into horizontal research:

The bone biopsy surgery is OK. Surgeons should not discuss needle sizes and other cases in front of a conscious patient, it does not foster the idea that you have his full attention...

Fifth week of bed rest is depressing...I don't even have the energy to stay awake for "Jeopardy."...

The sixth week ends...The dinner meal of the metabolic diet is still beige. The downhill slide to my release begins...

I must do something about the eating system. I eat all my meals at the upper left side of the bed. The food spills of the last six weeks are petrifying by the bed. There needs to be a towel on the bed or the floor to catch the inevitable food spills associated with eating supine...

Some well-meaning soul added two slices of toast, margarine and grape juice to my breakfast order. I have consumed over 350 slices of bread in bed and 252 graham crackers. When I next want a bed full of crumbs I will follow Marie Antoinette's advice and eat cake. Cake crumbs are gentler on the buttocks. Grape juice is best when it has passed through the gates of the Chateau Margaux.

Procter is proud of his journal. In fact he was thinking of giving it a title. He was going to call it The Resident Patient.

 

But the avowed budget-cutting majority seated in Congress might find Your Tax Dollars at Rest a better title.


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