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. Last Updated: 07/27/2016

Dispute Could Cripple Unique Clinic

Ilya Poluektov is standing tall again.


An American businessman from California, Poluektov has used a wheelchair since injuring his neck in January in a fall from a staircase landing. But he has been working out for several hours a day since late May at a clinic for spinal injury patients at Moscow's Children's Hospital of St. Vladimir.


Since his arrival in May, Poluektov, 31, has made visible progress: He can now stand with the aid of a therapist and leg braces. But he and other patients at the clinic will have to leave by Oct. 31. The clinic is closing in a murky dispute over its reorganization and it is not clear when or if it will reopen.


The hospital uses a method developed by Valentin Dikul, a former circus performer who broke his back in 1961 and rehabilitated himself after doctors said he would never walk again. Today he shows no sign of paralysis.


"It's the only system in the world I know of that offers this kind of hope, so it's a shame that it's closing, if only for a short period of time," said Poluektov, who hopes the clinic will reopen.


"I know there are many people like me who would want to come here and learn the system to help themselves get on their feet."


Doctors and therapists who use Dikul's method employ months of exercise, weightlifting and physical therapy to "reprogram" the central nervous system to use compensatory groups of muscles that might help patients regain as much movement as possible or walk with braces or crutches. They don't claim to cure paralysis resulting from spinal cord injuries.


For St. Vladimir patients who have made progress, the interruption in their workouts is distressing, particularly for the ones who traveled from the United States or Germany seeking Dikul's method, available only in clinics in Russia, Japan and Italy.


Dikul, a charismatic man with the face of an Old Testament prophet and the body of a well-fed bull, said his centers cannot keep up with demand. "I have 128,000 applications from patients in 32 countries," Dikul, who is not a physician, said in his office Tuesday. Demand is high, he said, because his goal is unique.


"The goal in Europe is to adapt the patient to his environment, so he can sit in his wheelchair, so he can turn on the television or light with remote control, or work at a computer with his teeth, if need be.


"I have another goal: to return to the patient the highest percentage of movement possible, to get him on his feet, to return him to his former way of life."Oleg Tereshchenkov, the director of the hospital, said the Moscow government required the clinic's founders to submit more paperwork by Sept. 1 "because of organizational and legal questions" involved in the reorganization. The founders -- who Tereshchenkov said included the chief physician of the hospital, Pavel Kosyan -- did not submit the papers "for a number of reasons" and the license was revoked. Kosyan could not be reached.


Dikul, who runs an outpatient center in Moscow and acts as a consultant at St. Vladimir's, said he understood that the reorganization involved the removal of a foreign partner. "Something hasn't worked out between them on the financial front, because the management of the hospital thinks the partner is asking for too much financially," he said.


Personnel at the St. Vladimir clinic identified the foreign partner as a Colombian living in Spain. None could say how he might be reached.


The clinic, a for-profit organization that can treat up to 14 people on an inpatient basis, was formed in August 1992, Tereshchenkov said. It charges foreigners $7,100 per month and Russians $3,300. At the main Dikul treatment center, which handles up to 300 people a day on an outpatient basis, residents of Moscow and the Moscow region pay nothing for treatment.


Dikul said that other countries -- particularly those that rely on insurance to pay for spinal injury rehabilitation -- consider his method too expensive. "There's no guarantee that after a year or two of treatment a patient will walk," he said.


But many of the patients at St. Vladimir's think they have made progress and may want to come back. Given the unique service that the clinic provides, Tereshchenkov said, it will probably reopen. "When the center reorganizes, in a month, or two weeks ... then it will get a license and start operating again."


In the meantime, St. Vladimir's, once full of patients who worked out in two fully equipped weight rooms and zoomed through its corridors in their wheelchairs, is now quiet. Even the goldfish in the aquarium have been evacuated. Atyana Verigova, a 17-year-old from Chechnya who was injured during the war, said her goodbyes to the other patients and staff on Tuesday. A veteran of the clinic -- she had received six months of treatment before her present stay -- Verigova had come back for a three-month treatment, but had to leave after completing only a month.


Her departure left three patients: Poluektov; Andrei Lyuven, 22, from Hamm, Germany, stabbed in February at a discotheque; and Alexander Agafonov, 19, a veteran of war in Chechnya who stepped on a land mine in June 1996.


Medical personnel said they regretted the closing, and not just because they face an uncertain future professionally. "I like it here," said Lyubov Zorina, 45, a nurse. "After working with these patients, I look at life in a different way."


As staff packed boxes Tuesday afternoon, the only sound in the hallway was an insistent tap, tap. Agafonov, who came to the clinic in April, was slowly walking down the hall with the aid of two crutches.