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That night, Mary took John, 19, Bess, 17, and Charles, 15, to see their father in the ICU. Alford murmured reassurances, then passed out again. The family set up a vigil by his bedside. The next evening, an orthopedic spine specialist fused the vertebrae in Alford's middle back and reinforced them with titanium rods. The operation was successful, but the patient was still in danger. Because Alford's lungs were bruised, doctors wanted to perform a tracheotomy and hook him up to a ventilator. With Alford still unconscious, it was up to Mary to give consent. She also okayed placing a filter in a vein near his heart in order to trap blood clots, another potentially lethal risk. Alford had always been the one to handle big medical decisions for the family. "I thought, He's supposed to be giving me instructions about this," Mary says. "I felt horribly alone."
After almost two weeks in the ICU, Alford awoke, and his condition improved enough for him to be taken off the ventilator. He was soon moved across the street to a rehabilitation unit, where he began physical therapy and learned to use a wheelchair.
He confronted his new reality one afternoon as he watched an NFL game on TV from his hospital bed. He had no movement or feeling below his navel. His doctors couldn't say if he would ever recover them entirely. "I wondered, Will I ever be able to go back to work?" he recalls. "Will I be able to be a surgeon again? Will I be able to be a husband and father?"
In February 2008, six weeks after the accident, Alford returned to his 100-year-old home in Houston. At first, he was so weak that he could sit up only when strapped into a wheelchair; Mary lifted him in and out of it using a sling attached to an electric winch. In constant pain and with frequent muscle spasms, he spent his time in a bed set up in the family room. "Every day was exactly the same," Mary says. "Every bit of our energy was focused on just surviving."
Before the accident, Alford had been a solidly built six-footer and was used to being in charge. Now, entirely dependent on others, he fell into despair. "If it weren't for my wife and kids, I would have killed myself," he says.
But then the love started pouring in. Alford's brother David, 40, a businessman in Henderson, maintained a blog to provide updates about Alford's recovery. Over the next three months, he received a staggering 40,000 messages from colleagues, former patients and their families, acquaintances, even strangers. Carolyn Thomas wrote, "When you're back in the OR, I want to be the first one on the table."
Friends took hot meals to the Alfords every evening and drove Charles to school and to lacrosse and other activities. One woman at church gave the family a wheelchair-ready van that had been used by her late husband. "Anything I've done for other people has been repaid to me a million times over," Alford now marvels.
The outpouring raised his spirits. It also gave Mary a new perspective on him. For years, Alford's schedule of 15-hour days hadn't left him much time for her and the kids. "I'd just about decided you liked work more than us," Mary told him one day over lunch. "But now I realize you didn't want to leave the hospital because there were so many folks that needed you. You couldn't just abandon them."
Alford was moved by his wife's understanding—and grateful for one thing about the accident: It gave him an opportunity to focus on the people he loved most. When Mary wheeled him to the garage for a shower that she gave him by hose, or when one of his children helped him dress in the morning, Alford says, it was as if God had used the accident to send him a message: "You need to slow down and appreciate what you've got at home."
The couple refurbished their house with ramps, a wheelchair-accessible bathroom, and an elevator. They bought an extended-cab pickup truck and fitted it with a wheelchair hoist, a swiveling driver's seat, and hand controls so Alford could drive himself.
But Alford's goal was to make such adjustments temporary. After a month of physical therapy, he graduated from an electric to a manual wheelchair. One day last winter, he wiggled his toes. "It was huge," he remembers. "Mary and I just cried and cried, we were so happy." More sensation and movement returned in his legs and feet.
The daily workouts built strength in his back and abdominal muscles, improving his ability to hold himself upright. Soon he was able to stand with the aid of a tubular steel frame; seated in his chair, he could now draw his legs toward his chest.
In May, Alford began the next phase of treatment—an experimental regimen developed by the Christopher & Dana Reeve Foundation. Each morning, he went to the Institute for Rehabilitation and Research at Memorial Hermann. By putting a paralyzed patient through his paces, therapists hoped to grow new neuromuscular connections.
When Alford arrived at the clinic, a physical therapist and a team of assistants would strap him into a harness suspended above a treadmill. They swung his legs at a steady pace as Alford, eyes fixed on a full-length mirror, struggled to help by lifting a thigh with each stride.
After three months of this routine, Alford's coordination had improved markedly. He felt ready to pick up a scalpel again, with the hospital's approval. He started small, with an office procedure on a friend's son who had injured his nose. The operation went smoothly. A few days later, using a wheelchair specially designed to lift him into position, he joined a colleague in performing an hour-long optic nerve decompression at Methodist. "It felt wonderful," Alford says with a smile. "It was just so good to be back in that environment."
Still, his limitations were never far from his mind. On the night that Hurricane Ike struck Houston with 110 mph winds, Alford's bedroom window exploded, showering him and Mary with glass. "I watched my wife and my 15-year-old son use a card table, a Boy Scout tent, and duct tape to cover the window," he says. "I realized that I was different forever. I also realized that Mary was different forever—and she could handle it."
Alford still goes for four hours of rehab every morning and spends his evenings stretching and riding a motorized stationary bike to keep muscle spasms at bay. But in the hours between, he sees patients or performs surgeries—as many as five a week. "My stamina has come back," he says. "I don't hurt like I used to."
On a recent afternoon in a Methodist Hospital operating room, he repaired the deviated septum of Darren DeFabo, a 40-year-old Houston engineer. Leaning in from his elevated chair, Alford cut through the bone and cartilage, working quickly and methodically, occasionally exchanging a comment with a nurse or a surgical tech.
With Creedence Clearwater Revival's "Fortunate Son" playing in the background, Alford sutured in temporary splints to support his patient's nose after the operation. In all, the procedure took 22 minutes. "It was very normal, embarrassingly simple," Alford remarked as he wheeled himself out of the OR.
He's eager to do more complex surgeries and plans to increase his workload. Walking remains uncertain. "I always tell him if I had a crystal ball, I'd be a millionaire," says Marcie Kern, one of his physical therapists. Still, the doctor considers himself a lucky man.
"I wondered if I could practice medicine as well as I used to, and I think I've answered that question," Alford says. "My brain works, my hands work. I'm closer than ever to Mary and my children. I've got so much. Why should I feel sorry for myself?"
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