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Still playing to win

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20061001cEyes, not hands, now guide the work of wheelchair-bound vascular surgeon in Greenville

GREENVILLE — Glancing at a U.S. Open doubles tennis match on a big-screen TV in his ranch house, Dr. Bruce Fellows’ eyes sometimes dart back and forth between the bouncing, fuzzy green ball and the players’ quick-footed steps.

Martina Navratilova makes a winning point, but there is no “yeah, baby” clenched fist from Fellows.

That was never the avid tennis player’s style. And even if it was, the vascular surgeon can’t make that gloating gesture now.

The skilled hands that patients credit with saving their limbs and their lives no longer move at his command. Nor do his arms, torso, legs and feet. Fellows, paralyzed from the neck down, can’t even breathe on his own.

The 59-year-old, who once devoted vacations to tennis and windsurfing, broke his neck in a cycling accident last Memorial Day near his Sussex County beach house.

Fellows suffered a traumatic C-2 Cervical spinal cord injury similar to that of the late actor Christopher Reeve. During the past 17 months, the doctor has been adapting to life as a quadriplegic permanently dependent on a Ventilator that helps him breathe.

His once-thriving medical practice has been sold. Fellows has moved into a new home that can accommodate his motorized wheelchair and a team of nursing aides who are by his side 24 hours a day.

“If I get disconnected from the [ventilator], I essentially could be dead very soon,” Fellows said.

There are daily frustrations for this admitted perfectionist, but no wallowing in sorrow.

“I haven’t curled up in a ball. It’s my nature to accept what is there and make the best of it.”

Fellows credits his upbringing as the son of missionaries as well as his medical education and 27-year career as a surgeon with helping his acceptance and resolve.

“I approach life in a practical way. You can go on and have a determined attitude,” said Fellows, who drives through his house in a souped-up wheelchair that is maneuvered with a joystick attached to a headset that he moves with his chin.

Whether it was on the tennis court looking to score a point, caring for stroke patients or repairing blood vessels in surgery to save a limb in danger of amputation, Fellows always played to win.

That same spirit keeps him focused on what he hopes will be his next chapter in medicine — vascular research.

He has developed a proposal to analyze comparative results of alternative treatments for heart problems. He hopes to share that knowledge with others.

“He’s still the same sharp guy he was before, and he can still help out a lot of people,” said Kristine Kuss, a former patient. “He lost a lot, but he still has a lot, too.”

Fellows’ former tennis doubles partner Bruce Shaeffer, who is helping plan the second annual Bruce Fellows tennis benefit Oct. 8 at the Greenville Country Club, isn’t surprised at the determined spirit of his friend.

“Bruce Fellows is a true gentleman on and off the court,” Shaeffer said. “He is also Type A. He loves to do well. He does not take well to not doing well.”

Life was whirlwind of activity

Before his accident, Fellows lived a life of whirlwind activity.

He saw about 40 patients a week at his practice, Vascular Surgery Associates, and performed 300 to 400 surgeries a year. It wasn’t unusual for the doctor to stay up until 2 a.m., working on paperwork.

Dr. Alan J. Fink, a neurologist with a practice in Ogletown, often referred patients to Fellows.

“He is one of the most outstanding people I’ve ever met. He has a stellar reputation,” said Fink. “If I had a problem, he was the one I went to.”

“No moss grew under my feet,” said Fellows, a divorced father of two children, Meghan, 22, and Hunter, 20. “I had limited free time, and I cherished that time.” Fellows played tennis, windsurfed and developed a love for cycling.

On the morning of May 30, 2005, during a visit to his summer house overlooking Quillen’s Point in Ocean View, not far from Bethany Beach, Fellows considered going windsurfing, a sport he had enjoyed for several years. But there were no strong breezes.

Instead, Fellows donned a helmet and took his custom Trek bike out for a ride.

“I was very safety conscious. I had mirrors on my bike, and I wouldn’t go out when there was any rain.”

Fellows was riding south on the shoulder of Cedar Neck Road in Ocean View when a Wilmington man turned his Jeep, towing a trailer, into the parking lot of a storage center — and into Fellows’ path.

Fellows tried to brake, but he was thrown over the handlebars and hit the side of the vehicle.

Fellows stopped breathing at the scene three times. He was flown to Christiana Hospital, where surgery stabilized his broken Vertebrae. Fellows also had a Tracheostomy, an incision made into the windpipe to help him breathe.

Fellows has no memory of the accident. He recalls some conversation the night before — and then waking up in Christiana Hospital’s intensive care unit two days later.

He didn’t need a physician to tell him about his spinal cord injury, one of about 11,000 reported each year in the United States. “I think I knew because I couldn’t feel my hands or legs,” Fellows said.

“Within 24 hours, I knew enough, being in medicine, that this was going to be a situation I had to accept and deal with. I had to deal with my limitations.”

After two weeks in Christiana Hospital, Fellows transferred to Kessler Institute for Rehabilitation in West Orange, N.J., where he spent four months gaining strength and learning to adjust to his injury.

Patients whom he had regularly visited in hospitals now came to see him.

Not long after the accident, James DeNardo drove more than two hours to visit Fellows in New Jersey.

“He wasn’t in too good of a shape. He could barely spit out a few words,” the 20-year-old said.

But it was important to DeNardo to support the man whom he credits with saving his life.

In the summer of 2004, DeNardo had received a cut on his left leg from a baseball cleat. The wound became infected, and the then-teenager saw Fellows in the emergency room at Christiana Hospital.

DeNardo didn’t know it at the time, but he had developed necrotizing fasciitis, more commonly known as flesh-eating bacteria. Fellows had to act fast. The doctor performed three surgeries on DeNardo. The Pike Creek resident suffered some tissue loss, but has since fully recovered.

Now, a student at West Chester (Pa.) University studying physical education and health, DeNardo still stays in touch with Fellows regularly through e-mails and visits. ”

“I just stopped by the other day to say hello and catch up,” he said. “He saved my life. I wouldn’t be here right now.”

Missionary upbringing

Fellows’ deep well of faith has fueled his resilience.

Born and raised in Ethiopia, his parents worked with the Sudan Interior Mission. Now called SIM, it’s an international evangelical mission organization with more than 1,600 active missionaries serving in more than 40 countries on five continents.

Fellows lived in various Ethiopian villages and later attended boarding school in the capital of Addis Ababa. In high school, he transferred to a Michigan boarding school. During his last year of college at Ohio State University, Fellows was trying to decide whether to do missionary work or study chemistry. Eventually, he decided on a career in medicine and moved to Wilmington in the 1970s for his internship and residency at Wilmington Hospital.

Fellows comes from a family of caregivers. His parents, now in their 80s and living in Florida, are planning to return for another half-year stint in Ethiopia. Two brothers are missionaries, another is active in charitable organizations in Canada and a sister works for famine relief in Africa.

All have a strong faith in God. The doctor said his own wasn’t challenged after his injury.

“It helped to have a faith in God and have a sense of his guidance and support,” Fellows said. “I can’t say I have a blind faith in God, but it is almost a respect.”

Fellows knows he could have suffered brain damage in the accident or lost brain function after he stopped breathing three times, but he did not.

“I feel God has had his hand on me. My faith believes I will be used in one mission. It’s closing one chapter and opening another.”

Maria Garbayo, 66, said it is the same kind of faith and practicality that Fellows passed along to her and her mother, Patria Juarbe, both former patients.

Garbayo recalled a visit to Fellows’ office several years earlier that gave her hope. The doctor told her some potentially bad news but also made her see the positives.

“My mother’s circulation was really bad and we talked about, maybe, amputation. I said, ‘No, no, no.’ Dr. Fellows then got up from his chair and said, ‘Would you rather be dead or walk this way?’ Then, he began to hop around. He really felt it was better to live.”

Those memories give Garbayo encouragement for the doctor’s future. “Somebody else would have thought, ‘No, I can’t do this. I’ll pull the plug.’ But not him.

“I think he finds that there is a reason for everything. He always said that to us.'”

Dedicated to patient care

Kristine Kuss thinks of Fellows every time she goes for a run or cycling. She credits the doctor with giving her back her athletic career.

Kuss, 38, went to see Fellows after four years of visits to other doctors. No one could figure out why the competitive cyclist’s leg would give out during intensive workouts, she said.

“Unlike most doctors, who treat you like you have half a brain and are supercilious and patronizing, he listened to you and wasn’t in a hurry to get to next patient. He treated you with respect,” said Kuss, of Pike Creek.

Fellows discovered Kuss had a circulation problem and was losing blood flow to her leg. She needed an iliac bypass, basically a surgery in which a portion of an artery is removed and replaced with a strand of Gore-Tex.

The initial surgery went fine, but Kuss soon needed another emergency surgery because of problems with blood clotting. In 2000, Fellows drove from his then-Pennsylvania home to Christiana Hospital — in a raging snow storm — to operate.

“That was above and beyond the call to duty,” Kuss said.

In February, she achieved an All-American status in U.S. Triathlon rankings, an honor for athletes in swim-bike-run competitions who rank among the top 5 percent in their age group.

Kuss, who considers Fellows a friend, visited him at the Kessler Center in New Jersey and later when he transferred to Riverside Hospital in Wilmington.

“I remember, it was just tough,” she said of his condition. But Kuss knew Fellows, a perfectionist who demands the best of himself and others around him, would pull through.

“I remember saying, ‘Oh man. I pity the people who are trying to work with you,” she said, laughing.

“I’m going to have to learn to be a little patient,” he told Kuss.

Adapting to physical changes

Patience is now an exercise Fellows practices every day, along with two hours of Physical Therapy, at his Greenville ranch house.

He moved there after his accident. It was too difficult maneuvering around his former three-level home in Chadds Ford, Pa.

“This was a house that was seemingly meant for me,” Fellows says of the extra-wide doorways and a wooded back yard.

Because he could no longer examine patients, he sold his practice not long after the accident. His Sussex County beach house was sold several weeks ago. Fellows relies on Disability insurance.

The first year after a spinal cord injury — when medical intervention is most intense — is expensive. Costs range from $209,000 to $710,000, according to the United Spinal Association, a nonprofit organization based in Jackson Heights, N.Y.

Every year thereafter, spinal cord-injured people will incur annual costs of between $14,000 and $127,000. For an individual suffering a severe spinal injury at 25 years of age, total lifetime costs can be between $624,000 and $2.8 million.

Fellows, whose two children are away at college, now shares his home with two cats and a rotating staff of four nursing aides.

All privacy is gone. They help put him to bed at night, which involves lowering him into a special bed designed to help avoid deadly pressure or bed sores. They bathe and dress him and situate him in a hefty, 125-pound wheelchair. Positioning is critical. If Fellows is slouching even an inch, he can’t control the headsets that he uses for his wheelchair and the telephone.

Fellows uses a laptop computer by way of two motion sensors — one tiny, barely noticeable bar placed in the center nosepiece of his eyeglasses and another, round “eye” on top of his computer monitor. The “eye” on the monitor reads his head movements and controls the mouse on the screen. Fellows can send e-mail messages through a voice-activated program.

One recent afternoon, Fellows isn’t positioned properly and he is having trouble adjusting his wheelchair with his chin. He asks nursing aide Gloria Zhang for help moving the headset.

“No, no, that’s not right Gloria. To the left, please,” said Fellows as Zhang tries to maneuver the headpiece one way and then another. “No, no, your other left.”

Doctors don’t often make good patients, and Fellows admits he has his share of daily frustrations.

“It’s certainly given me an added perspective one goes through with this injury,” he said. “It’s not just the disability, but it’s humiliating as well.”

“From the role as patient, you get a completely different perspective how the nurses carry out the orders. As a physician, you realize there needs to be more sensitivity to the privacy of individuals, a little bit more time in communicating things.”

His medical knowledge can be a help and a hindrance. “Some people taking care of you know less about your problems then you do. In my case, being a physician, I have better insight and knowledge about my problems.”

It has helped Fellows avoid life-threatening situations. His health has been very good, but he has had a blockage of his bowels. Fellows suspected and diagnosed a condition known as Autonomic Dysreflexia because his blood pressure was elevated. “You can get into major trouble when your blood pressure goes sky-high.”

He also is mindful of developing bed sores that can form from not changing positions.

“A bedsore, even it’s minor, can get infected. It can kill you. That killed Christopher Reeve,” he said. The actor died in October 2004 at the age of 52 of heart failure, reported to be the result of complications from an infected bed sore.

Fellows believes the biggest impact on his life has been trying to become accustomed to not being active.

“TV is OK for a little bit, but you get bored. My mind is still active.”

He is currently looking into the possibility of teaching medical students or possibly the directorship of a vascular research lab.

“I am very interested in having him involved very heavily in our research,” said Dr. Michael Rhodes, chairman of Christiana Hospital’s department of surgery.

And after more than a year of inactivity, Fellows is itching to get busy again.

“I’m ready, willing, able and chomping at the bit,” he says, a broad smile spreading across his face.

The ball is in play.

Fellows wants back in the match and, as always, he wants to win.
Contact Patricia Talorico at 324-2861 or

Bruce Fellows Tennis Benefit

WHAT: A fundraiser in support of surgeon Bruce Fellows, who was paralyzed after a 2005 bicycle accident. The round robin doubles team competition is open to men and women tennis players at all skill levels. Preliminary rounds are held at local country clubs. Last year, the event raised more than $10,000 and involved 56 participants. Proceeds will be divided equally between the Bruce Fellows Trust Fund and the Delaware Chapter of ThinkFirst, a national not-for-profit organization dedicated to injury prevention.

WHERE: Greenville Country Club, Owls Nest Road, Greenville
COST: Entry fee is $50
WHEN: 12:30-5 p.m. Oct. 8, followed by cocktails and dinner. Rain date is Oct. 15.


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