Written by Charles McNair and Henry Lake
Written by Charles McNair and Henry Lake
Ignacio Montoya woke in his Los Angeles apartment before dawn. The world lay still.
Montoya was a man in motion.
He threw on his clothes. He walked his eager Labrador, Mimi. He grabbed a bowl of oatmeal, then hurried to offices at UCLA. There, with top medical experts, he’s participating in one of the most advanced paralysis recovery therapies ever attempted.
It’s his therapy. Montoya uses the experimental protocols and physical treatments on himself.
It’s been seven years since a motorcycle wreck paralyzed three-fourths of his body. Now, every morning, Montoya opens his eyes determined to walk again.
After that, he’s determined to fly.
Before his 2012 accident, Montoya qualified to be a pilot in the U.S. Air Force, his eyes set on the F-16 fighter jet. Two broken vertebrae (and much else broken) forced him to hit the eject button on his flying career for the moment. It also delayed his graduation from Georgia State.
Just one year after the accident, Montoya finished his degree. He went on to earn a master’s degree from Georgia Tech in biomedical innovation and development, then became executive director of a nonprofit with a mission to transform the standard of care for spinal cord and nerve injuries globally.
Now, he is the subject of one of the most extensive paralysis recovery experiments in medical history.
“This is my personal mission,” Montoya says, “to get the human body to move, feel and function again after paralysis from a spinal cord injury. And I’m using my own body, experience and knowledge so that I and others may walk, run and jump tomorrow.”
Montoya’s academic and personal achievements, and flight credentials, also make him a candidate to become the first human being with a spinal cord injury to fly into space.
To recognize and celebrate his reinvention and determination, the Georgia State Alumni Association awarded Montoya a place on its prestigious 40 Under 40 alumni list for 2020.
“I’m grateful for the recognition,” he says. “And grateful my Georgia State education has opened many doors.”
Also, in an extraordinary dual celebration of achievement, Georgia Tech recognized Montoya as one of its own university 40 Under 40 honorees for 2020.
Imagine the odds against him.
When Montoya was 4, his beloved mother died of cancer.
“She was my everything,” he says.
When Montoya was 6, his family emigrated from Cuba to the United States. The youngster left behind all he’d known — school, friends, customs, extended family. He started life over in a complicated, competitive new country. He was the only family member who spoke English.
Then at age 22, he lost the use of both legs and one arm.
Montoya’s accident hospitalized him for six months. After pulling through, he remembered his Air Force training: Observe. Orient. Decide. Act. He began researching what had happened to him and how he might recover.
“I painfully looked over the opportunities that existed — or actually didn’t exist — for myself and for millions of people with the severity and complexity of this type of injury,” he says. “I decided to create opportunities even if they didn’t exist.”
Montoya’s resolve comes, in part, from a principle his father taught him when the family emigrated.
Create your own American dream, don’t expect to chase it.
On Dec. 4, 2012, one day after his 22nd birthday, Montoya gave a speech at an induction and award ceremony of the Arnold Air Society, a professional organization for Air Force ROTC cadets. (Seeking a career as a pilot, Montoya simultaneously attended Georgia State and the Air Force ROTC program at Georgia Tech.)
“I left the event still in uniform,” he says. “I put on my motorcycle helmet and waved goodbye. Thirty minutes later, I was lying in the middle of a street, no pulse and no breath. I literally died for 15 minutes and came back to life in an emergency room.”
Montoya remembers nothing of the accident. Mercifully.
Witnesses saw Montoya, cruising on his pride-and-joy Yamaha R1 (Raven Edition), entering an intersection near his Duluth, Ga., neighborhood. A minivan cut in front of him. Montoya broadsided it at 45 mph.
Collapsed lungs. Sixteen rib fractures. Broken vertebrae, with paralysis from the chest down and in the right arm. Internal bleeding requiring 17 transfusions. Nerve loss to the right diaphragm, affecting breathing.
As it happened, the vehicle behind Montoya carried, he says, an “angel from God” — Kathryn Thorpe, a registered nurse from Children’s Healthcare of Atlanta. When she came to Montoya’s rescue, she found no heartbeat. In medical terms, Montoya was dead. But Thorpe didn’t lose faith. Somehow, she kept Montoya’s lungs filled with air until an ambulance arrived to connect him to an oxygen supply.
“I experienced cardiac arrest another six times in the intensive care unit,” Montoya says. “For 31 days, I remained in a roto-hospital bed, turned from one side to the other, chest tubes on each side draining blood from my lungs. Every day for a month, doctors told my family they didn’t know if I’d make it.”
He made it.
His body stabilized after 30 days. His mind stayed asleep, in a coma, for 60 more.
Late in February, he woke.
Six months in a hospital give a man time to remember.
Montoya recalled Camaguey, Cuba, where he was born Dec. 3, 1990. The Cuban government called the time the “special period”— a severe economic crisis. The Soviet Union had withdrawn support. Everyday Cubans fought to survive.
“Because I was only a baby, to me, things seemed normal,” Montoya recalls. “I didn’t know any better. I had a plate of food on the table. I had my family and the unconditional love of my mother, Carmen Maria.”
Montoya’s dad made ends meet. He drove bicycle taxis, tended bar, made electrical repairs, cooked. When electrical power failed, sometimes for days, Montoya’s dad kept the lights on with lines connected to huge train batteries hidden in the backyard.
Montoya learned to be resourceful, too.
“If things broke, you’d always have to find a way to put them back together. There was no Walmart or Home Depot,” he says. “I learned how to value and care for things at a young age.”
Authoritarian life under the Castro regime grew unbearable. The Montoya family, he says, began to “re-evaluate our priorities, values, principles and self-dignity.”
Montoya’s father had considered fleeing the island, as many Cubans did, on a boat or raft — “anything that floated,” Montoya says. The elder Montoya submitted applications to a visa lottery provided by the U.S. Interest Section in Havana. Only 1 percent of entrants would win.
The next year, “miraculously,” Montoya says, the family received a precious visa to the U.S. But the miracle would be bittersweet — Montoya’s mom was no longer with him.
“In late 1993, she was suddenly diagnosed with leukemia,” Montoya says.
She died less than nine months after her diagnosis.
During his mother's illness, Montoya grew closer to his sister and grandmother. He was three months shy of his seventh birthday, and he did not want to leave the only home he’d ever known. Cuba held his mom’s memories, his uncles and aunts, everyone and everything in his experience.
His uncle, Rafael Montoya, saw qualities in the youngster that would help him survive.
“Ignacio was strong and smart,” he says. “Even then, he showed a willpower that few people will ever have. He was never the type to surrender.”
On Oct. 6, 1997, at 6:30 p.m., Ignacio Montoya boarded a jet at Frank País International Airport in Holguín, Cuba. He stood by his father and waved goodbye to the first part of his life.
“I remember people telling me when my mom died that she’d gone up to the sky, to heaven,” Montoya says. “And I was going inside a huge aircraft, a thing that I’d never even seen, much less flown in, and I was going up to the sky as well.
“And I was experiencing how everyone in that airplane burst into tears and started yelling ‘Freedom at last!' as we landed in Miami. I saw my father cry for the first time in my life as he looked out the plane window.”
It was a life-changing realization, one that has shaped him into who he is today.
“That day, I began to love and have a tremendous need for aviation — because in my mind that would be how I could help others, including my own family,” he says. “Flying is how I would see them again, and one day possibly even rescue them.”
Well into 2013, Montoya found himself in rehab at Atlanta’s renowned Shepherd Center.
He then endured another collision — with the system.
“I was in one of the top 10 rehabilitation hospitals in the country, which had the latest and best rehabilitation technologies and staff, but it meant nothing because insurance would not pay for it,” he says. “I sought assistance from Veterans Affairs (VA), too, but they wouldn’t recognize me as a veteran.”
Montoya wasn’t just any Air Force ROTC cadet — he had a top-secret clearance and was in the top 5 percent of his class. Still, the VA wouldn’t acknowledge his service, and the insurance companies considered his injuries too serious to treat.
“I could not do the therapy I needed to excite and retrain my spinal circuitry to relearn how to walk. Why? Because insurance companies did not believe I had any possibility of recovery,” he says.
Doctors categorized Montoya’s as a “complete” spinal cord injury — no independent sensation, function or movement below the break. He says more than half of all spinal cord injuries worldwide bear that grim label: “complete.”
“For nearly everyone injured like this, that label closes off any chance of fighting or trying to recover,” he says.
Not for Montoya.
“It blew my mind,” he says. “And it pissed me off.”
After graduating from Georgia State in 2014, Montoya traveled widely, visiting rehab hospitals, clinics, conferences and symposiums. He met top scientists, researchers, clinicians, therapists, engineers and innovators.
“We have incredible explorers in this field of uncertainty,” Montoya says. “They’re not afraid to ask, ‘what if?’ and step outside every box to try to make nerves regenerate, reconnect, rewire. But there’s little collaboration between fields. As a biomedical engineer, a soon-to-be neuroscientist and an explorer of new treatments for spinal injuries, that’s where I come in.”
Montoya began participating in 2016 in a trial to test a robotic right arm. This technology has provided new hope for treatment of peripheral nerve injuries and changed the standard of care for patients living with damage to the brachial plexus, the network of nerves sending signals to and from the shoulder, arm and hand.
Montoya graduated in December 2018 at the top of his Georgia Tech class. The Georgia House of Representatives passed House Resolution 301 honoring his achievements. In the battle to be fully recognized for his military service, it took seven years for Montoya to be listed as a veteran by the National Personnel Records Center at the National Archives — another hard-won achievement. Still, Montoya’s fight to be fully recognized by the VA goes on.
Montoya took a role as executive director of a nonprofit called HINRI Labs — The Healthcare Institute for NeuroRecovery and Innovations. At HINRI, he would offer himself for emerging technology, techniques and protocols to help the recovery of patients with spinal cord injuries.
Ross Mason founded HINRI. He believes Montoya’s unique work will transform the spinal injury field sooner rather than later.
“Ignacio is a genius, with an insane work ethic,” Mason says. “He’s brought the determination of an aspiring Olympic athlete to this field of health care. He’s a miracle in the making.”
In 2019, Montoya attended a Chicago symposium featuring Dr. Reggie Edgerton, UCLA’s vice chair of integrative biology and physiology. Edgerton has been a leading scientist in neurobiology and spinal cord injury for five decades. After his presentation, Montoya approached.
The two men spent the next six hours talking.
Montoya told Edgerton he’d just been given a deadline by the Air Force to re-enter his officer commission. He had until December 2020 to stand on his own if he wanted to return to the Air Force and pursue his fighter-pilot dreams.
Montoya explained that he’d just walked a record-setting 650 miles — nearly 25 marathons — in the first-ever home lokomat, an exoskeleton orthosis suspended over a weight-support system attached to a treadmill. He added that HINRI had just raised $9.3 million to fast-track a cure for paralysis, and that it was his job as executive director to find, test, optimize and accelerate potential therapies — on himself.
The meeting eventually led to Montoya’s groundbreaking 12-month test program in Los Angeles. He drove from Atlanta to California in his adapted SUV and started in January 2020.
“We have never studied an individual with the combinations of injuries received by Ignacio,” says Edgerton. “We’re anxious to utilize the physiological and technical capabilities we and others have developed to determine if it’s possible to achieve a new level of multiple sensory-motor and autonomic functions for him, with our primary target being independent standing.”
“This is the longest clinical trial ever of this type,” Montoya says. “It’s the first time in history that electrical stimulation is being used to attempt to reverse paralysis in all systems of the body after a spinal cord injury, and it’s the first time that the body as a whole is being analyzed and targeted as one single organism.
“We’re using electrical stimulation to amplify remaining connections and help create new ones to get me moving voluntarily and standing by December 2020,” he says. “We then want to fast-track and scale these findings in our lab in Atlanta to 400 participants.”
While Montoya wants to walk in the world again, he’s also shooting for the stars.
“I have applied to be an astronaut candidate through NASA,” he says. “My experience as a fighter pilot select through the Air Force and my master’s in biomedical engineering qualify me.
“I went from riding an R1 motorcycle and dreaming of flying an F-16,” Montoya says, “to riding an F5 Permobil Vertical Standing Power Wheelchair, and now, hopefully soon, a rocket.”
Edgerton has worked with space agencies to send 12 primates into space for experiments, testing different conditions for effects on the spinal cord.
“I’d like to be primate number 13,” Montoya smiles. “It’s always been a dream to go into space.”
Edgerton feels Montoya is capable.
“Zero gravity is probably more easily manageable for a paraplegic well adapted to the absence of weight-bearing,” Edgerton says. “Ignacio certainly is not bound by the lack of motivation and determination. With his bioengineering training, he could be a wise choice.”
Edgerton is not the only believer in Montoya’s dream. NASA has notified Montoya he is on its highly qualified applicant list. Montoya hopes as soon as 2021 or 2022 to go to space.
“Ironically,” he says, “it may work out that this spinal cord injury has put me in a special position to accomplish that goal.”
But Montoya’s more immediate goal and deadline are approaching this December.
As Montoya’s trial began early this year, therapists each morning applied electrical stimulation to his lower, mid and upper back in a daily, multi-hour session. Small electrodes sent continuous currents, and Montoya’s body contracted and quivered during intense exercises that engaged different muscle groups.
“I sweated my life out,” he says.
After hours of this therapy, he would then drive himself to a paralysis recovery gym for training all afternoon.
When the coronavirus pandemic swept in, things changed. On March 6, UCLA suspended the clinical trial until further notice. On March 12, the paralysis recovery gym locked down, too.
“I moved all of my physical therapy equipment and locomotor training devices to my apartment and basically turned it into a decent-sized gym,” Montoya says. “I coordinated schedules with my physical trainers and, thank God, we’ve kept our routine.
“Every single day for three hours straight I use my left arm, my only fully functional extremity, to move and activate the other three limbs. This way, I’ve been able to maintain what I’ve recovered in the clinical trial.”
There’s the million-dollar question: What has Montoya recovered?
Keep in mind that the word recovery is rarely mentioned with “complete” spinal cord injury. Montoya’s physical therapist, Cindy Lopez, updates his progress:
“Ignacio is and has been constantly improving,” she says. “His muscles are engaging more with each exercise. His quads are engaging and contracting on command. His independent trunk posture and stability have also significantly improved. From what he recovered in just the first two months, I can say that his paralysis is no longer considered ‘complete.’ It’s now ‘incomplete’ and hopefully soon completely reversible.”
On Aug. 11, he began moving his toes for the first time in seven years. He can now kick his legs while exercising, using both sets of obliques, hamstrings and quads.
“If someone just runs a finger down my thigh or the bottom of my foot, my whole body and nervous system respond,” he says. “I get chills, goosebumps, my toes wiggle, my ankle moves and my legs react. I’ve actually kicked a few people really hard, including my poor girlfriend Hilda.”
Hours each day, he walks on a treadmill with two therapists moving his legs and another supporting his waist.
“I do this while I stare at a mirror, tricking my mind, imagining I am generating the movements, not the therapists,” Montoya says. “I’m using visualization and all my senses to help me create new neural connections and respective coordinated and controlled muscle activation.”
The same month he began to regain movement in his toes, Montoya drove six hours to San Francisco to take 1,204 steps in a filmed test of a revolutionary locomotion exoskeleton. The trial was such a success Montoya is now using the video footage to crowdfund for the $500,000 he’ll need to buy an exoskeleton of his own.
He has a personal deadline to walk again by Dec. 4, 2020 — the eighth anniversary of his accident. The day he woke from his coma, he set this goal.
Now, he’s on track to meet it.
Top photo by Steven Thackston. Other photos courtesy of Ignacio Montoya