Not every journey begins with a single step. Davarn Wright’s journey to Dr. Michael Kaiser sure didn’t—because Davarn couldn’t even stand up.
In fact, when Davarn first called Dr. Kaiser’s office at The Spine Hospital at the Neurological Institute of New York, he wasn’t sure how he would make it there at all. His spinal stenosis (a narrowing of the spinal canal that pinches the spinal cord) was so severe that his brain and his legs could barely communicate. He was on the second floor of a house, without the use of his legs. He did not own a wheelchair, and he weighed 350 pounds. Even with friends and family to assist, he wasn’t sure how he could get out the front door.
Davarn and his family never expected things would get so bad. His spinal stenosis had been diagnosed more than a decade before, although back then it wasn’t severe. Davarn explains: “The compression of spinal stenosis is almost like if you’re drinking through a straw and you squeeze the straw—you don’t get as much fluid coming through.” When it was first diagnosed, Davarn’s stenosis barely “squeezed the straw” of his spinal cord at all. As time went on, though, he noticed that his feet usually felt tingly, like they were thawing out after a walk in the snow, but it didn’t really bother him. He went on with his busy life, applying an impeccable work ethic to his job as a compliance analyst and taking care of his close-knit extended family and wider community in New Jersey.
One morning in the fall of 2014, more than a year before his appointment with Dr. Kaiser, Davarn woke up with a new, severe pain in his lower back. An MRI revealed a herniated disc in his lower spine.
At the time, Davarn was in his mid-40s and weighed more than 450 pounds. “I’ve always been a big guy,” he says. “I was a heavy kid, but it never hindered me from being active.” However, he knew he needed to ask whether his weight was causing the pain in his lower back. The doctor he saw at the time explained that weight alone wouldn’t cause a bulging disc—small people have them too. “I will say this to you, though,” he went on. “Your weight is not helping the situation.”
Davarn knew he would need to lose weight in order to reduce stress on his back. He started by eliminating sodas, and some weight came off. He took part in physical therapy, got steroid injections in his back, made appointments with a neurologist and a pain management specialist, and saw a chiropractor. In short, Davarn was making all the right moves.
But not all things were moving in the right direction.
By the summer of 2015, Davarn noticed that his legs were getting clumsier. Then, one night while bringing in groceries with his wife, Davarn fell—and he couldn’t get back on his feet. Sure, it was painful, and embarrassing to be stuck on the sidewalk as people passed by. But the thing Davarn remembers most is his wife’s reaction. “My wife is a tough woman, and she doesn’t get weirded out with stuff like that,” he says. He could see that in this case, though, she was seriously worried. “I was working hard to get up off the ground, trying to hurry up to get that look off her face,” he remembers.
He just couldn’t do it on his own. Eventually, with Davarn pulling up on some railings with his arms and his wife pulling up on his belt, he got to his feet.
That night, Davarn and his wife had a talk about safety. He insisted he was okay to drive but agreed to get a cane for walking.
Over the next few weeks, even with the cane, he fell more and more often. He fell at physical therapy, he fell at work and he fell at home. If he was home alone when he fell, he’d make some phone calls. Then he’d have to wait, sometimes for hours, for someone strong enough to help him. Meanwhile, his legs would have painful spasms that rubbed his skin raw against the carpet.
In response, Davarn worked harder than ever in physical therapy. For safety, he switched from a cane to a walker. To help himself lose weight more quickly, he started the process of getting approved for bariatric surgery. Still, while a few things got better, others were getting worse bit by bit.
Davarn switched to a new neurologist. At one appointment, he explained that he was falling more and more often—and to make things worse, over the last several days it was getting harder to get to the bathroom in time. The neurologist wrote out a prescription for an MRI of Davarn’s neck. “My neck?” said Davarn. “My neck doesn’t hurt, it’s my back.”
“Trust me,” said the neurologist. He suspected that Davarn’s lower back pain was about to become the least of his problems. His feeling was that Davarn’s cervical stenosis needed another look. He said, “When you get the results, don’t come back to see me. I need you to see a neurosurgeon.”
“How in the world am I going to find a neurosurgeon?” wondered Davarn. He went through his insurance company’s website, picked a neurosurgeon with an address close to him in New Jersey and made an appointment for the end of October. Meanwhile, his symptoms continued getting worse. Then, the day before that appointment with the neurosurgeon, Davarn experienced the stuff of nightmares.
At work, he set out for the bathroom with his walker—but he just wasn’t able to make it in time. Before he got there, he lost control of his bladder and bowel, symptoms of severe spinal stenosis. Horrified, he called a coworker and explained the situation. He asked her to notify maintenance and said he wanted to go home. “Absolutely. I’ll get your stuff from your desk,” she said. “And Davarn, don’t worry about it. You’re sick. You can’t help it.” A few minutes later his coworker texted him: “Take your time. I pulled your car around. I’ll meet you in the foyer.”
With his car waiting for him, Davarn thought he would be able to leave work with few people the wiser. However, the nightmare wasn’t over. On his way to the car, using his walker, Davarn fell. The coworker who had pulled up his car couldn’t get him back to his feet. More and more people came to help—his supervisor, the maintenance director, a security guard. A personal embarrassment was becoming public. A man who prided himself on helping other people, Davarn was now fully dependent on others. And he was physically trapped—he couldn’t even get up and leave. Eventually he was able to direct them how to help him to his car, but inside, he says, “I was just destroyed.”
“I never wanted to go back to work,” he says. “The only glimmer of hope I had was that I was going to see the neurosurgeon the next day, with my family, to interpret the MRI. It was my birthday, too.”
As things turned out, it was no happy birthday. Davarn learned that he had multiple severe areas of stenosis—many “squeezes in the straw.” Each constriction in his spinal cord made it harder for his legs and brain to communicate and had the potential to permanently damage his spinal cord.
A fairly common surgery could relieve the compression of his spinal cord caused by the stenosis. However, the neurosurgeon had some bad news: “I won’t be able to operate on you. My table only accommodates up to 350 pounds.” Davarn had lost some weight and was now at 400 pounds. “He said to call him back when I was under 350.”
If Davarn had felt low the day before, he felt even lower then. Right there in the doctor’s office, Davarn’s mother told him, “God doesn’t give you more than you can bear. You’re going to have to do what you have to do to lose the weight.” Davarn agreed. The next day, he arranged for a leave of absence from work so he could focus on losing weight.
Meanwhile, his condition continued to deteriorate. Falling was now the norm. Even with the walker, he says, “I could barely make it the eight feet from my living room to my bedroom.” He and his wife had worked out a system for getting him into bed at night, but it didn’t always work. He set up a wider group of friends who didn’t turn in for the night until they got a text from Davarn saying he was okay and in bed. “If they didn’t get that text,” he says, “it was an SOS.”
By December 12, the weight was off. Davarn’s family was overjoyed. “You can go see the doctor now!” said his mom. “No,” he said. “We’re going to have to find another doctor.” Davarn wanted nothing more to do with the first neurosurgeon. “He has not called once to check on me. That man doesn’t know if I’m dead or alive, so we’re not going back there.”
However, Davarn was no closer than before to knowing how to choose a neurosurgeon. His cousin’s wife suggested he look at Columbia, where her boss had had an outstanding experience with a kidney transplant. “How am I going to get all the way there?” he asked. “And how will I get there for follow-ups?”
Davarn’s community was determined to care for him, as he had always done for them. His cousin told him, “Davarn, if you find a doctor, let your village worry about how we’re going to get you there.”
So Davarn looked carefully at the Spine Hospital, part of Columbia University Medical Center/NewYork-Presbyterian Hospital, and he called the office of Dr. Michael Kaiser. Dr. Kaiser is the Spine Hospital’s Associate Director, and spinal stenosis is one of his areas of expertise.
Davarn explained to Dr. Kaiser’s administrative assistant, Vivian, what had happened so far. She listened carefully and was happy to tell him there was an opening the next day, “Can you get here tomorrow?” Davarn couldn’t. He hadn’t worked out a way to get out of the house. “The next appointment is in three weeks,” said Vivian. Davarn told her to book that appointment. He’d figure out how to get there.
Then things started happening quickly. A close friend of Davarn’s brought him good news. His barber—who also happened to be a childhood friend of Davarn’s—owned a medical transportation company. He was sure he could help Davarn, but Davarn had mixed feelings: The stairs were so tricky! He was so heavy! Besides, he really didn’t want more people to see him in such a low place. Even so, Davarn knew the opportunity was just what he needed, and he gave the man a call.
The transport owner came to familiarize himself with the layout of the house and described to Davarn exactly what his company would do. Davarn thought, “This just might work.” Dr. Kaiser got in touch and asked Davarn to have X-rays taken prior to his appointment. Davarn used the transport company to get to the X-rays, and sure enough, everything went off without a hitch.
Finally, on January 5, 2016, Davarn got to Dr. Kaiser. Davarn’s wife, his mother, his sister and a good friend were there with him as well. Dr. Kaiser was welcoming, but the condition was serious and they needed to know. “I’m going to be honest with you, Mr. Wright,” said Dr. Kaiser. “This doesn’t look good. You definitely need surgery.” The images showed that Davarn had compression from his cervical spine (neck) down into at least the top part of his thoracic spine (upper back).
Unfortunately, there were a couple problems with the images. Their clarity was slightly compromised by Davarn’s body shape. And they stopped too high up, not showing how far down the thoracic spine the compression went. “I’m going to need you to get an MRI of the thoracic region so we can see what we’re dealing with,” said Dr. Kaiser.
Davarn and Dr. Kaiser agreed that when it came to surgery, the sooner the better. They set a date of January 22, less than three weeks away.
Davarn also had an important question: “Doc, when you do the surgery, am I going to be able to walk again?” He remembers that Dr. Kaiser “didn’t try to sugarcoat it, but he wasn’t rude either.” He told Davarn, “In all likelihood, all I can do is stop this from getting any worse. I don’t anticipate that you’ll walk again, not how you’re accustomed to walking. But if we do nothing, I assure you this will get worse.”
The possibility of permanent damage bothered Dr. Kaiser. There was the chance that such damage had already occurred, or—more worrisome—that it would occur during the weeks leading up to surgery. Dr. Kaiser’s schedule was full, but he looked for some way to get Davarn in. The next day, scheduling book in hand, he called Davarn to see about moving the surgery up to January 13. “That’s just one week away,” said Davarn. Dr. Kaiser knew it was short notice, but also knew the surgery needed to be done and said, “I told you, your situation is very serious.”
Davarn scrambled to find an MRI facility that could both accommodate his size and provide an appointment almost immediately. Once he did, he recruited a family member to deliver the results to Dr. Kaiser’s office on a Friday night.
That Monday, January 11, Dr. Kaiser called Davarn to say that he had looked at the images over the weekend—and that what he had seen wasn’t good. The compression continued far down into the thoracic spine. The surgery to decompress Davarn’s spinal cord was going to involve a large portion of his spine, and bone graft and metal rods would be necessary to restabilize the long section of spine.
Less than 48 hours later, surgery began. It started at 8:00 in the morning on Wednesday the 13th. It’s usually about a six-hour surgery, but Davarn’s procedure was complicated by his weight and by the sheer extent of his condition. The entire operative experience lasted until 10:30 that night—14 1/2 hours.
Davarn spent the rest of January recovering at Columbia, and by February he moved to a rehabilitation facility. “Every day, Dr. Kaiser would come and check the strength and sensation in my legs. He said he was impressed every day at the strength I still had. He was like, ‘Oh, okay, well… maybe. Maybe.’ ”
In physical therapy, Davarn was working hard. Eventually he was even able to go up and down the hallway with a walker. By March, he moved home to continue rehab, but in April his recovery hit a bump. At a follow-up appointment, Dr. Kaiser took out Davarn’s most recent X-ray. He leaned closer to it, then looked at Davarn. Back at the X-ray, back at Davarn. He asked Davarn if he was having trouble with certain movements. Davarn was flabbergasted. “Yes! It’s right here on my list of things to ask you about.” “Well,” said Dr. Kaiser, “that’s because there’s a problem with one of the supporting rods. Look at the difference between your last X-ray and this one.”
The first available surgery date was Davarn’s wife’s birthday. Without hesitation, she urged him to take it. She said, “Baby, we got plenty of years to celebrate birthdays. You get what you need to get done.”
That surgery was a success; the rod was replaced and made even more secure. Davarn was released to continue his recovery and rehabilitation for the rest of the spring and summer at home. Dr. Kaiser spoke with Davarn’s physical therapist to make sure he was experienced with spine surgery and spinal cord injury patients, and that he understood all Davarn’s requirements.
By that fall, Davarn had regained a lot of strength in his feet, and Dr. Kaiser told him he could start driving again. “I want you to try to get back to your life as you knew it, as much as possible, and this is the first step.” Davarn knew another step he wanted to take: With Dr. Kaiser’s permission, he resumed the process of getting approved for bariatric surgery. And finally, in December, he had it.
At his next appointment with Dr. Kaiser, the following June, everything looked great. The office staff exclaimed over Davarn’s weight loss. Dr. Kaiser was impressed and glad. He was puzzled, though. “Where are the medical transportation people who bring you?” he asked. “Oh, they’re not here,” said Davarn. “You got a ride with someone?” “No,” said Davarn. “I took public transportation. From my house in New Jersey I took the bus, then I walked to the subway, caught the A train and walked from the stop to your office.” No walker. No cane.
“Well, Mr. Wright, I stand corrected. I remember telling you that you would probably never walk again, and here you are!” Congratulations Davarn!
Today Davarn walks a mile and a half, four times a week. His goal for next year is to walk a 5K for spinal cord injury awareness.
He says the ordeal has “been a very humbling experience.” At the same time, it’s been one that inspired him to take care of his health, and today he is doing better than ever.
And he is full of gratitude for Dr. Kaiser: “I appreciate how he was always straightforward and to the point. And I’ve never, ever experienced a doctor who is so caring about his patients. He genuinely cared. He took the time to call me himself to make sure I was okay, to see how was I doing.”
Dr. Kaiser saw Davarn as a person, not just a case of spinal stenosis. He was an active member of Davarn’s medical team, speaking to his other doctors and physical therapists. Davarn credits Dr. Kaiser with giving him the chance to make the strides he’s making today. But in the end, says Davarn, Dr. Kaiser’s actions speak for themselves—louder than any words Davarn can say.