Learning to Drive Again, Without The Use of His Feet

Sep 22, 2014

Behind the wheel of his BMW, James Thomas carefully manages the turns around Springfield’s Phelps Grove Park. There are more pedestrians out walking and biking today, he tells his passenger. And he beams as I ask him from the back seat about his former job; vice president of architecture and construction under the legendary John Q. Hammons. His last big job, he says, was overseeing the design and construction of Hammons Field.  

But this is more than just a typical leisurely car ride around the neighborhood.

Thomas, who was diagnosed with multiple sclerosis in 2001, is operating a vehicle specially designed to account for his physical impairments, mainly an inability to feel from the neck down.

“When you lay on your arm or something and it goes to sleep because it stops the blood flow, well that’s what my body from my neck down feels like all the time,” Thomas says.

As I speak with the 65-year-old from inside his home office, jazz music radiates from the living room speakers. Assisted by a walker on wheels, his residence near downtown Springfield has been at times the only place Thomas could safety navigate.

Just over a year ago, Thomas’ condition had worsened to the point where he no longer felt comfortable behind the wheel. Then about two months ago, he sought a change.

“I got a little tired of doing all the stuff that I do on a regular basis just at home and being a homebody; even though I have friends that will take me wherever I wanna go whenever I wanna go there.”

Thomas, now more confident in his mental capacity, reached out to Mercy’s Outpatient Therapy driving rehabilitation program. The service helps people with physical ailments or mild cognitive impairments get back behind the wheel.

The modified controls inside James Thomas' BMW.
Credit Scott Harvey / KSMU

Thomas’ feet rest atop a steel plate that covers the gas and brake pedals. Instead, his right arm controls when to stop and go, via a lever next to the center console. The steering wheel, which is equipped with a knob at the 8 o’clock positions for better handling, is operated by his left arm. He’s essentially learning how to drive again, this time without the use of his feet.

“That was a nice, smooth start,” notes Smithwick, as Thomas slowly accelerates out of a turn. 23:23

That’s Mindy Smithwick, an occupational therapist and certified driving rehabilitation specialist with Mercy Hospital. She’s riding alongside Thomas as she does roughly twice a week to monitor his driving and assist with the hand controls, if needed.  Each year, she helps dozens of people through the driving program, which starts with a comprehensive evaluation testing vision, cognition, and motor skills. Then comes a field test, where patients are judged by their ability to operate a vehicle, whether with modified hand and foot controls or without.

“In the case of James, he came in for a hand-control evaluation. So if someone in his position obviously can’t jump in the car and drive with his hand controls all over town. So we’re gonna start those in a parking lot, look at their potential to steer that vehicle – do they have the strength to turn the wheel, or are they gonna need modifications to the wheel? What is it gonna take? And we apply the adaptive equipment and test it to see that they have the potential to operate it and learn it.”

Smithwick says the driving program’s low-tech adaptive tools are designed to overcome most physical disabilities, but vision and cognition issues are the hardest. Besides MS, as in Thomas’ case, Smithwick says the hospital has worked to help patients with spinal cord injuries, stroke victims, and amputees, among others, drive again.

For Thomas, early struggles involved an inability to lock the break tool during a prolonged stop. It’s a process that requires selecting a button on the side of the stop and go lever, what Thomas called a T-bar. That issue was remedied about a week ago.

“We determined that it didn’t take the buttons on both sides of the T-bar. I could do it with just the one on the left side with just my thumb. And after a while I could do it with practically without looking at it,” Thomas said.

Thomas says it never felt as though the program would be too much of a challenge for him. He credits the fact that he was already used to driving with mainly hand controls from the days where Thomas rode a motorcycle. And given he has no feeling in his feet, he’s not distracted by the impulse to pump the accelerator or brake.

Thomas says getting back behind the wheel is a psychological boost.

“Even though I have a great support system out there of friends and family, you can’t call on ‘em for just every whim that you might have. So having this little bit of freedom back is pretty fortunate.”

Smithwick says while working with Thomas, she’s noticed an improvement in his confidence behind the wheel, which in turn has lowered his stress levels. And the process is not as fatiguing anymore for Thomas, she notes, which he’s prone to with MS.

Once Smithwick and Thomas feel he’s ready to be released from the program, Thomas will get tested through the Missouri Department of Motor Vehicles. If approved, his license would show a restriction to operate a modified vehicle.

While there’s still training to be done, Thomas is on pace to soon drive on his own again. This, more than a year after losing the ability to safety do so. Awaiting Thomas are those errands to the grocery story, jaunts through the drive thru, or perhaps a trip down memory lane and a leisurely stroll by Hammons Field.