Eric Weil's Stroke Patient Story
Physician Learns Humbling Lessons From Stroke, Regains Function, Confidence, Career Aspirations
Eric Weil with Dr. Richard Harvey and occupational
therapist Meghan Buell from his care team.
Known as "Smiling Eric" when he was a child, Eric Weil, M.D., describes himself as an "eternal optimist" and "over-achiever" who is dedicated to helping others. He drew on that spirit and resolve during his remarkable recovery from a severe stroke, determined to use the experience to be a better pediatrician when he returns to his patients.
Weil, a pediatrician on staff at University of Chicago's Friend Family Health Center, suffered a massive stroke in October 2008 while on duty at the community health clinic on Chicago's Southwest Side. Only 30 years old, he had no idea he had a dangerous arteriovenous malformation (AVM), an abnormal tangle of blood vessels in his brain, until it ruptured.
He was rushed to the emergency room and stabilized. Within days, he underwent two surgeries -- one to stop the bleeding in his brain, and one to remove the AVM. In early November, he was transferred to the Rehabilitation Institute of Chicago's stroke rehabilitation unit. "And thus began my journey to get my voice and my body back," he says.
Recapturing His "Prime of Life"
"When I first met Eric, he couldn't walk, couldn't move his right side and struggled to say anything," reports physical medicine and rehabilitation specialist Richard L. Harvey, M.D., medical director of RIC's Stroke Rehabilitation Program. Weil and his physician and team of RIC stroke rehabilitation specialists together mapped out a plan of care that included intensive speech, physical and occupational therapy through RIC's Prime of Life program, a program that is designed for people with stroke whose vigorous lives demand aggressive intervention. This program is specifically for otherwise-healthy younger patients whose career goals, family lives and other aspirations have been short-circuited by stroke.
"First and foremost, I tell these patients, 'You can do anything you want to do -- go back to work, drive, travel, raise your kids, work
Eric works with outpatient occupational
therapist Anne Armstrong at RIC.
out, anything." We're not going to let them even conceive of the idea that they can't. I stress this upfront so they get it in their minds. The mindset is crucial," says Dr. Harvey. "Then we follow through with the appropriate therapies, focusing on specific areas of function necessary to get them where they want to be."
Where Weil wants to be is back to work as a practicing pediatrician and his team of therapists set out to get him there. As an inpatient, he received a minimum of three hours daily of physical, occupational and speech therapy to regain strength, movement, balance, speech and language. "Every day was a day of major improvement," he says with characteristic optimism.
Within a few days of starting speech therapy, his expressive aphasia -- difficulty finding the right words -- had markedly improved. One of the first things he said, although in a whisper, was to wish his mother a happy birthday. Slowly, his voice got stronger and louder as well.
With the help of his physical therapist and a supportive brace on his weakened right ankle, Weil quickly moved from just being able to stand to taking a few tentative steps with support, to walking a short way with the aid of a walker, to walking the halls with a large four-footed cane, to eventually walking with only a cane. One of the Prime of Life program's innovative treatments that allowed Weil to improve his mobility was the body-weight-supported treadmill that allowed him to practice walking and build endurance with minimal risk of fall or injury.
After two weeks, Weil was able to get dressed by himself and was approved to go from his bed to the chair or bathroom without assistance -- big steps on the road to independence.
Research-Driven Clinical Tools
A key component of Weil's therapy was working with the Armeo®, an innovative tool developed and clinically-tested at RIC that uses 3-D gaming technology to help patients regain arm strength and movement. Weil calls it "the medical Wii." The Armeo uses an adjustable arm support system that mimics a weightless environment allowing patients to move their arms more freely and allowing them to relearn normal arm movements. A highly sensitive handgrip and video-game-like exercises simulate arm movements used in specific real-life tasks, and exercises are displayed on a computer screen, giving patients immediate visual feedback on how well they are doing. "You can actually see the effect of your movements, even if you don't think you're moving your arm at all,&" says Meghan Buell, Weil's occupational therapist. "It increases confidence and hastens coordination -- plus it's fun."
Weil also enjoyed what he calls his "extracurricular activities" art therapy, which gave him a break from the rigors of daily therapy and a chance to reflect while working with his hands, and canine therapy. "This is not just about having dogs come in and play with the patients," he says. Rather, specific goals are translated into working with a specially trained therapy dog. Weil worked on giving hand commands using his weak right arm and strong voice commands. "This is one of the unique things about RIC," he says. "The staff works with the whole person, understanding that there are different ways to recover."
As a physician, Weil especially appreciated the opportunity to participate in some of the many state-of-the-art research studies taking place at RIC: a study exploring bone density in stroke patients, a qualitative quality- of- life study, and a study called AMES -- Assisted Movement with Enhanced Sensation -- that is researching the effectiveness of vibration therapy on tendons. "I was happy to participate in studies with or without the possibility of a direct benefit to myself, because I want to make as much good as possible come out of my experiences," he says. "My whole life has been based on helping others. Suddenly to not able to do much was very frustrating. Being able to help others through research played a fundamental role in my psychological recovery."
As the nation's only federally designated Stroke Rehabilitation Research & Training Center, patients benefit from ongoing research that translates into new standards of clinical care allowing RIC's patients the most advanced care. RIC's robust research enterprise is the largest rehabilitation research program in the world, known for bionic medicine discoveries and advances in rehabilitation robotics.
Eric works on going up steps with outpatient
physical therapy assistant Walter Guminiak
Within a week of coming to RIC, Weil went bowling with other stroke patients, part of the Prime of Life program's emphasis on preparing patients for their return home and into "the real world." In addition to bowling better than he ever had before the stroke, he practiced stair-climbing skills between sets. "Not since I was about 18 months old had I put so much effort and concentration into going up and down stairs," he wrote in the blog he and his family kept during his recovery. Stairs were an especially important skill for Weil to master, as he and his wife, fellow pediatrician Angela Byrd, had recently moved into a four-story townhouse. "It seemed like a good idea at the time," he quips.
He and his fellow patients also took a supervised outing to the Shedd Aquarium and participated in "family training day," during which his wife learned how to safely help him in and out of his wheelchair, in and out of the car, up and down the stairs, and other things they would need to do without a therapist by their side once he got home but was still recovering.
He went home shortly before Thanksgiving, with a lot of work still to be done. He attended speech, physical and occupational therapy at RIC's main campus three times per week. By the end of the year he was happy to report that he had "graduated" from speech therapy, he could pick up his 13-pound dog, he was walking more and more without a cane, and he had returned his rental wheelchair.
Weil had a significant setback in January when he fell at home and fractured his femur bone just below the hip and another while recovering when he experienced a seizure, a common side-effect for people recovering from stroke. Despite all of this, his upbeat attitude and determination to recover remained undeterred. "Someday people will look up the word 'inspiring' in the dictionary and see a picture of Eric," his father wrote.
"I always wanted to be an academic pediatrician, but I never thought I'd be using my own experiences to teach people," Eric says. "I have a much better understanding of what patients go through now. I'm certain that my experiences have made me a more empathetic physician than I was before any of this happened."
Weil continues to attend outpatient physical and occupational therapy at RIC to fine tune a few remaining functional issues including limitations in moving his shoulder that he would like to overcome before returning to taking care of his pediatric patients.
"The last 10 percent is the hardest to get back -- but I will get it back," he says. Dr. Harvey agrees with his positive prognosis: "He will be able to do everything he wants to do."
Weil has become active in a Chicago-area organization called CURE (Citizens United for Research in Epilepsy) and has helped educate people on the high incidence of non-epilepsy-related seizures. "This has helped me use my medical knowledge and personal experience to educate people when I couldn't function in the clinic, Weil said.
Additionally, he has already started back at the ethics fellowship at the MacLean Center for Clinical Medical Ethics at the University of Chicago where he is studying the ethical implications and discussion surrounding medical care. He is thrilled to return his focus to providing medical care to others rather than to himself. "I really look forward to returning to the ethics program full-time this fall," said Weil.
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