Benjamin Reeve Testimony: June 27, 1995

Mr. Chairman, Members of the Committee, Senator Hatfield, thank you for your invitation to be here today.

Before you, and before the Congress as a whole, lies the matter of funding basic research concerning the structure and function of the central nervous system, by which we mean the brain and spinal cord. I am given the chance to speak here today because my brother has recently suffered a bad accident, but I say to you what I would have said in any event. I have learned a lot in the last three weeks about neurons, myelin, and glial cells, and for that I am thankful to all the many people who have educated and counseled me recently. Yet I was not a doctor before my brother's accident, and certainly have not become one since. The technical information I have gathered has only reinforced basic beliefs our family has long shared with many other people. My testimony today, summed up in a thought, is that although as a nation, we will need to do the housekeeping involved in protecting our borders or administering our currency, our most important business is to learn about ourselves and use what we learn to improve our lives.

In no area of medical research can effort be better spent than on the neurology of the central nervous system. Other areas of work certainly merit the attention we give to them, and more; while we are here in this room, millions of Americans are suffering the ravages of cancer. Nevertheless, work on the central nervous system rightfully should be our highest priority for basic medical research.

First, most of the potentially treatable disease in this country now is related to the condition of the central nervous system. Our successes against many infectious diseases and other illnesses have left us with those diseases and disorders against which we have not made the same kind of progress. Our population is aging. Older people experience more neurological ailments. Greater understandings in neuroscience will only continue to increase in value to the patient population.

To the need is coupled opportunity. Even those injuries to the nervous system we conceive to be sudden are, in fact, progressive. The secondary and tertiary effects of spinal cord trauma continue for weeks after the damaging event. We have in every instance, therefore, the chance to accomplish medical intervention.

Second, in no other area can incremental medical advances provide such a major alleviation of human suffering. I do not say that a "ten-percent cure" would not be valued by a person suffering from AIDS or antibiotic-resistant tuberculosis, but a ten-percent cure in the instance of many of the neural disorders can make much more than a ten percent improvement in a patient's condition. We have substantial laboratory evidence, for example, to indicate that even a five percent improvement in neural functionality in the spinal cord can make nearly a one hundred percent improvement in muscular function below the site of the lesion.

As will be described by economists who will testify in the next panel, leveraged cost savings accompany the human benefits. In no other medical field can the price of cure be so well repaid by a reduction in the costs of care.

Third, in no other area can a single advance in science potentially answer so many different questions and solve so many problems. Scientists in panels later to come in the course of this hearing will tell you that neural damage and neural aging appear to be very similar processes. The same research realistically can hope to benefit people suffering conditions as diverse as spinal cord trauma, Parkinson's disease, and multiple sclerosis.

Fourth, the central nervous system remains probably the least well understood of any of the major components of human physiology. Were we to gain an understanding of neural mechanisms as relatively good as our understanding of cardiology, what could be accomplished clinically would astound us all. Additionally, an improved understanding of the human brain and spinal cord is uniquely likely to provide us with non-medical knowledge - with insight, for example, about the behavior of complex systems, structures that learn, adapt, and have language and memory - among all of the fields of medical research.

Fifth, our nation is now in the lead in this area of research. It has taken us a great deal of effort and time, but we have built a research infrastructure which no other country can claim to match. We can make use of that advantage by continuing our research. We have before made the mistake of abandoning the value of our work and forsaken the opportunities provided by other technologies we have developed, but need not repeat the error.

Sixth, no other area of work is a likely to provide marketable results. Basic research in this area is not only likely to produce useful results, but economically valuable useful results.

Seventh, finally, and most importantly, the central nervous system is the organ of the mind, of personality, individuality, consciousness, and knowledge. The qualities by which we are distinguished as human beings arise more from this physical part of us than from any other. People without a kidney miss having it, no doubt, but there is something fundamental, intimate, and absolute about our dependency upon neural function not duplicated by any other physical requirement we have as living humans. The liver, the pancreas, or the heart may all be transplanted, but, correctly, we have no thought to transplant, as an organ, the central nervous system. To work on central neural function is to work on our ability to be ourselves in a very primary way.

I recognize that this is the Special Committee on Aging, that for reasons of legislative convience and necessity we have created a structure to focus on particular areas of concern, and that the issues particular to older Americans properly are one such area. I also recognize that many of the problems of the old are the problems of us who are not yet old, merely raised in a different context. Mr. Arthur Ullian of this panel will soon tell you that, when his spinal cord was injured, he became older quicker than he had before thought possible.

Let us be simple about it, we have a large population of aging people for the same reason we have a large population of people who have survived injury: advances in medical care have enabled us to keep alive those who otherwise would have died. We are now challenged to provide medically sound treatment truly to improve the lives of those with and for whom we have shunned death.

My brother Christopher has had the bad luck to sustain a severe injury for which there is not, and really can't be, complete protective equipment. Riding horses in a suit of armor has been tried; perhaps it satisfied the purposes of that time, but armor did not then and cannot now relieve all risk. At issue, necessarily, is our common courage in a sometimes dangerous and unforgiving world.

During his stay in the hospital in Charlottesville, Christopher and the family have received quite a bit of mail, tens of thousands of cards and letters, and, therefore, a certain amount of our time as a family has been spent reading messages from people in this country, almost all of them people we did not know, people from all walks of life. Many of them have suffered a neurological injury or disease, or have a relative or friend who has. We have received letters suggesting unusual courses of therapy or treatment, but we have not received a single piece of mail anything less than thoughtful, compassionate, and supportive. I can tell you with some assurance that the will of the people of this country is to transcend the limitations of our present knowledge and circumstances and to achieve real improvement both in the lives of individuals and in our common life together.

Certainly it is no secret that these are the days of budget cuts in Washington. The national debt is too large and growing too rapidly, and we truly need to think hard about what we are to spend money on. We are all aware that asking to spend money on one purpose is to say we should deny funding to another purpose, also good. Making the choice takes courage.

Again and again in the notes and letters we have received in Charlottesville we are reminded that at the moment we experience great fear, our courage is most required, and it will be most rewarded. Every person has a central nervous system, a brain and spinal cord. I have come here to say to you, to the extent I can persuade you to listen, that your decision to further the common commitment to understanding ourselves and improving our lives that we make by doing neuroscience will, no doubt, be the right one.

Thank you. I will, of course, be pleased to answer any questions you may have.