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John Famechon and Complex Brian-Based Multi-Movement Therapy

12 weeks after trying a new form of therapy, John was walking and talking.

Brian L. Edlow
Diffusion tensor imaging tractography of severe brain injury
Source: Brian L. Edlow

John Famechon was the former featherweight boxing champion of the world. He won the title in London in 1969. John suffered an incapacitating brain injury in August 1991 when a car, estimated to be travelling at 100 kpm (62 mph), hit John as he was crossing a road near Warwick Farm in Sydney, Australia. On his discharge from hospital in October 1992, John and his fiancée Glenys were informed he would remain bedridden and incapacitated. On December 18, 1993, a new form of complex brain-based multi-movement therapy began. Ten to 12 weeks later, John was walking and talking. Four weeks later, John ran into the arms of Glenys.

The Sunday Mail (Qld)
John wins the World Featherweight Title in 1969 in London
Source: The Sunday Mail (Qld)

And so, this new, complex brain-based multi-movement began on December 18, 1993. John was seated in his lounge chair, his chin on his chest. With great effort, he raised his head and smiled. His eyes were alert. John’s left hand was in a tightly clenched fist. I began to speak: “John, I am going to try to open your left hand.” With much, much effort, John whispered: “Aaarrggghh, errrrr, all aarrgghh right.” John’s left fist was cold. I began to massage the fist, wrist, and forearm. John’s fist began to open and began to warm.

When his fingers opened, I placed my left hand and interlocked my fingers with John’s now open and warm hand. I began to flex and bend. During this time, I kept talking to John and explaining what I was doing. Every now and then, John would lift his head, look at me and smile. This new therapy then continued every Saturday thereafter. Each session lasted one to three hours, and John committed himself to each. As time progressed, John’s head began to sit more upright. His speech fluency was returning, as too was the volume of John’s voice. Not once, from the first session, did John ever ask for a session to stop. In terms of stopping to rest and pause, it was always me who made the decision to stop, pause, and rest.

Graham Hartley
Cradling the arm of the Champ as ongoing explanations are taking place
Source: Graham Hartley

This decision was usually based on two things: (1) what I saw in John, in how he was presenting, and (2) how exhausted I actually felt. When it came to me calling a halt to each phase of each session, John’s wonderful ironic response was always the following: “If you must,” to which I would reply: “Yes, John, I must.” To this, John would always smile broadly and say: “You can’t hack it.”

With this in mind, John’s “you can’t hack it” statement shows that he always knew what he was saying and doing. John was not only the former world featherweight champion, but it was also clear that he was the world champ of irony, along with his generous warmth and graciousness.

As time progressed, John could engage in more significant, complex actions. He was now performing a wide variety of complex multiple movements, which required ongoing and more extended periods of intense task-focused concentration. The intensity, frequency, and duration of complex multi-movement actions were now beginning to develop.

Graham Hartley
The Champ is unrelenting with his brilliant insights and irony
Source: Graham Hartley

One example at that time (which then quickly progressed to becoming the standard of this new therapy) included the action where John was seated on his lounge chair, and he was lifting his legs (with his legs straight) vertically. i.e., straight up and down, while John’s arms were moving and crisscrossing horizontally across his torso.

This complex movement pattern changed when I instructed John to crisscross his legs horizontally. This required John to lift from his hip, keep his knees locked and his leg straight, and continue with the movement pattern. As this happened, I instructed John to simultaneously move his arms vertically (with a straight arm) while continually opening and closing both hands (alternatively) to form a fist. “Open the hands, close the hand, open and close, open and close, keep moving,” was the call.

Once this movement pattern was in place and successfully achieved, John was instructed (concurrently with what was also taking place) to begin rotating and turning his head from side to side.

Complex brain-based and complex multiple-body movements were now taking place. As this progressed, I instructed John to begin counting forward and then backwards from 1 to 100, and as this progressed, I instructed John to start increasing the volume of his speech and associated counting.

This progressed to John being directed to include ongoing and repetitive vertical shoulder shrugs up and down, up and down, and continue with the count, as well as continue with the leg and arm sequence movement patterns already in place.

This continued until successful and accurate repetitive, sequential, complex multi-movements were no longer occurring. What was now taking place was confusion. This did not mean the movements had stopped, but that accurate, successful sequence patterns were not taking place. Because of this lack of sequence success, as well as the onset of fatigue, John was not only confused and frustrated, he was also grunting with the physical and mental effort he was now applying.

It was clear to see John wanted accuracy and perfection. But, with all of his immense physical, mental, and emotional effort, it wasn't happening. However, he never stopped trying. At times, John's legs and arms would thrash about. When this took place, John would grunt and, with as much focus and effort as he could muster, would try to return to the correct sequence pattern.

The brain and body event horizon

What was taking place now was that the “brain and body event horizon” had now been reached. Complex multi-movement was taking place; however, sequential accuracy was not being achieved, and, at the same time, physical, mental, and emotional frustration and exhaustion were also occurring, as the look of ongoing frustration and associated intense focus and concentration on John’s face tended to prove.

What was taking place was intense and holistically demanding. None of what I have described here was ad hoc or unintentional. The purpose of this complex brain-based multi-movement therapy was constructively designed (to reach the brain and body event horizon intentionally), all to extend John (physically, mentally, and emotionally), to deliberately bring into existence neurological, neuromuscular, and neurobiological repair that would then hopefully return John to the condition before the accident.

In physics, the event horizon is most commonly associated with black holes, where the gravitational pull is so intense that once an “event horizon boundary” has been reached, not even light can escape the force of the black hole's gravity. At the cusp of the “event horizon boundary,” light disappears and can no longer escape.

As such, regarding the “brain and body event horizon,” the same principle takes place. Before the “brain and body event horizon,” accurate movement sequencing occurs. However, once the “brain and body event horizon” has been reached, sequence accuracy no longer occurs.

Instead of stopping, once the “brain and body event horizon” was reached, it was my contention that was when the highest level of thinking, intensity, and physical action, in terms of discipline, dedication, determination, perseverance, and resilience, had to take place. That is because this lack of sequence accuracy would mean there would now be elevated focus and concentration, which would mean changes to the intensity of thinking, and what the body was doing, also had to take place (i.e., to purposefully drive the thinking and the action from inaccuracy to accuracy). To achieve this goal, higher mental and physical effort had to occur.

Brian L. Edlow
Diffusion tensor imaging tractography reveals the neural connections in a healthy brain
Source: Brian L. Edlow

Now, what had to take place, according to my hypothesis, is that the brain would begin to engage in an intentional, holistic (whole of brain) neurological recruitment process. The purpose of this was to achieve accurate sequence thinking and accurate sequence movement success. I hypothesized that this would now be taking place because there would now be more neurons making connections, which could overcome and extend beyond this current “brain and body event horizon barrier.” When this happens, neurological, neurobiological, and associated neuromuscular repair will take place, all to return John’s brain and body presentation to where it was before the accident.

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