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Dr. McDonough in the Newspaper

Spine surgeon saw a need in Abilene
July 14, 2002

At a young age, Dr. Paul McDonough was exposed to two different sides of the medical world.

One of his grandfathers was a family practitioner. Another died after having spine surgery, made necessary by years of professional football injuries.

Paul Roy McDonough, for whom Dr. McDonough is named, was a pro ballplayer for the Cleveland Rams and the Pittsburgh Pirates, but a series of back injuries left him in the clutches of debilitating pain. He died not long after having back surgery at the age of 42.

McDonough’s father told him stories of having to help his once hale-and-hearty grandfather out of bed each morning because of his condition.

“I never got a chance to meet him, but I remember hearing that story,” he said. “I would sometimes sit and think about his back surgery and wonder why it led to his untimely death.”

Years later, McDonough’s step-grandfather was a primary surgeon serving in southern Utah. McDonough recalls during his summer visits hearing him creep out of the house in the night, the door softly closing behind him as he prepared to fly his small plane to wherever he was needed.

“He told me a great number of surgery stories when I stayed with them,” he said. “All of these things essentially added up to my taking an interest in medicine.”

Spine surgery has made incredible progress since McDonough’s grandfather died, and the grandson who bears his name is at the forefront of innovation in that field.

With an impressive resume and years of training under his belt, McDonough, who came to Abilene less than a year ago, employs microsurgical techniques using a powerful microscope to make spine surgery as minimally invasive as possible.

“The idea is simple: The less invasive the procedure, the easier it will be on the patient,” he said. “What we’re able to do now is make extremely small incisions and conduct very precise surgical work that lessens recovery time and is overall far more agreeable to the patient.”

The physician came to Abilene after hearing of its family-friendly atmosphere, thinking it would be an excellent place to start a practice.

“No one needs to or should have to travel three hours to Dallas for similar spine care,” he said. “I saw a genuine need in this area for the sorts of services I knew I could provide.”

He said he has not been disappointed in the locals, finding Abilenians equal to their kindly reputation.

“I have found the people of Abilene are generally very down-to-earth and appreciative of someone’s efforts to help them,” he said. “... I enjoy helping them find solutions for their problems.”

Need to succeed

McDonough was driven to excel at an early age. The oldest of six children, he said setting an example for his brothers and sisters was essential.

“I took this responsibility seriously in many facets of my life, particularly in academic achievement,” he said.

As an undergraduate at the University of Utah, he excelled in the sciences, majoring in chemistry while intrigued by his physics and anatomy courses. Those two interests eventually led him to the art and science of orthopedic surgery.

Since completing his medical training, McDonough has distinguished himself by publishing multiple research papers in spine journals from 1998 to 2001, including a survey of neck surgeries in the prestigious research journal Spine.

He has also performed extensive research in spinal surgery and presented his results at medical conferences in New Orleans, San Francisco, Atlanta, and Edinburgh, Scotland.

McDonough participated in research for the FDA approval of bone morphogenic protein, the first genetically engineered product available for the spine, he said.

“It’s a protein that stimulates the body to make more bone, which speeds healing immensely,” he said.

McDonough presented the results of the research at the annual meeting of the International Society for Study of the Lumbar Spine in Edinburgh, last summer.

Of all the instruction he has received, McDonough said he values his fellowship training under the direction of Dr. Thomas Zdeblick most.

“He is the developer of much of the modern spinal instrumentation and is known worldwide,” McDonough said. “Training with a world-class spine surgeon really helped me develop my surgical decision-making skills.”

Spine fellowship training is the highest level of training available in spine surgery in the United States, and its inclusion allows McDonough to perform complex surgeries while preparing him to find the best alternatives for each patient, he said.

“The most gratifying portion of my work for me is working with people who have had severe pain for months, or even years, and then seeing them get relief with surgery and returning to the activities they enjoy,” he said.

Making a difference

That said, spine problems can be complex.

“It takes much physical and mental energy and devotion to carefully evaluate each patient and perform the delicate and complex surgeries,” he said. “The results, both for them and for me, are worth it, though.”

Sharon Anders, owner of the Mezamiz coffee house on South 7th Street, knows firsthand the benefits of such surgery. McDonough operated on her neck a few months ago, and her recovery has been “remarkable,” she said.

“I was in terrible, terrible pain,” she said. “We’d tried everything first before opting for surgery, including shots in the neck, physical therapy, you name it. Nothing seemed to relieve it at all.”

McDonough performed a variety of sophisticated surgical work on Anders’ neck.

“Now, I have people who ask me who worked on my neck because they can see such a difference,” she said. “It really made a positive impact on my life, and he was a wonderful, caring physician throughout it all.”

Although his career is important to him, and he has devoted much time to building his practice in the mere months he has been in town, McDonough also allocates time for his family and other pursuits, such as golf and playing guitar.

“He’s incredibly down to earth,” said Dr. Dale Funk, a local orthopedic specialist who works with McDonough. “He’s not from Texas originally, but he may as well be. He’s an extremely laid-back, personable guy, and he’s a remarkable surgeon.”

© 2011 Abilene Reporter-News. All rights reserved.
By Brian Bethel at 676-6739 or bethelb@reporternews.com

Ballinger woman recovering from assault, broken neck
March 12, 2011

Medical personnel see her level of recovery from broken neck remarkable.

When her body was broken in mid-July, Mary Jones didn't know that days of nightmare yet awaited her.

For four days after her husband, Joseph Jones, allegedly grabbed her neck and wrenched it in a fit of rage, she lay frozen, unable to move, unable to get help, she said.

"He just grabbed my neck and just twisted it," she said of the incident in which her husband has been charged. "It just happened so fast."

Looking back now, Mary Jones has through luck, hard work and determination "beat the odds," said Dr. Paul McDonough, her spine surgeon.

The fact that she can move at all, much less walk a block or so under her own power, is a victory, he said. But before she could find herself in McDonough's care, she said she had to bargain for her life with her husband.

Her account of days spent wondering if she would even survive, trapped in a house in the 200 block of Clinton Street in Abilene, is gut-wrenching. Her husband's anger, she said, stemmed from her decision that their relationship must end.

At first, thinking she was pretending to be paralyzed, he held a knife against her nose, threatening to hurt her further if she failed to move, Jones said. The mother of two, who recently had acquired her own apartment in Ballinger, said she could only bargain with him to try to get medical help.

She said she was given only a few ounces of water to sip on throughout the long days and nights, offered only a couple of ice pops for food.

Realizing that she wasn't faking an injury, her husband got scared, she said, attempting at one point to kill himself through an overdose of pills. Later, he threatened to kill them both, brandishing a cigarette lighter and saying the two could "die together," she alleged.

After she finally convinced Joseph Jones to summon an ambulance, McDonough, on call that day, found her in dire straits.
"There was a 32-year-old woman lying there in the emergency room, scared, with no idea what was going on," he remembered. "What do you tell her when the odds are horrible? Do you just tell her, 'You're done,' or do you try to give her some hope?"
Mary Jones said that, out of fear, she originally told medical personnel that the injury was an accident, something that had happened the night before.

Medical tests and other evidence soon would reveal that the story didn't add up. Joseph Jones, still in the Taylor County Jail on a $200,000 bond, was arrested that day. Court records indicate his trial date is set for May 31.

McDonough remembered Mary Jones as being dehydrated and suffering from rhabdomyolysis, a breakdown of muscle fibers that potentially can cause kidney damage. She was given fluids, then McDonough ordered X-rays and an MRI, tests that revealed a C fracture dislocation in her upper neck.

In the 24-hour period following a spinal injury, it's difficult to know what a patient's ultimate prognosis will be, McDonough said. But four days after her initial injury, the surgeon knew that Jones would no longer be in the "spinal shock" that typically characterizes such an injury, he said.

With that grim realization, McDonough said he didn't expect any significant recovery.

"Less than 1 percent of patients in that situation will see any meaningful improvement," he said, though he performed surgery to stabilize and remove pressure from Jones' spine.
Jones said McDonough was honest with her, telling her he couldn't promise that she would recover.

She appreciated both his expertise, she said, as well as his honesty.
But the thought of not being able to hold close her two children, Jared Jones, 8, and Chelsie Combs, 11, was just too much to bear, she said."I just wanted to be strong," she said. "Everyone told me how bad it was, but I just said, 'I want to do this.'"

And she did.

The road back

Physical therapist Rachael Barr, 29, said that like with all patients at Hendrick Center for Rehabilitation, Jones' therapy began with assessing what she couldn't do. Unfortunately, that was just about everything.

"When she first got here, she wasn't able to sit up at all," said Barr, who has been a therapist for five years at Hendrick. "She wasn't moving her arms or her legs, she couldn't control her body at all."
By the time she left Hendrick, after three hours of therapy every day, Jones was able to take a few tentative steps, Barr said.

"We had worked a lot on getting her trunk strong and her legs came along," she said. "She just worked like crazy to get there."
Within a few weeks, Jones remembered, she was moving her right foot. Within a month, she could send text messages with her right hand. "They really encouraged me," Jones said of her time at Hendrick. "They cried with me. If it wasn't for them, I wouldn't even be able to sit up."

She left Hendrick's inpatient rehab program after about two months, she said, undergoing more rehabilitation in Ballinger until early December.

"I went home with a wheelchair and a cane," she said. "I used the wheelchair for a day and then thought, 'I'm not doing this.' I used that cane for a few days, and after that, I just stopped."
Getting even some movement back would be a significant milestone for a patient like Jones, McDonough and others said.
Recently, she has been to walk more than a block on her own.
"I'm still not real stable," Jones said, though she expects further improvement with time.

McDonough, who performed his 3,000th surgery in Abilene in November, said he fully believes it may have been Jones' unshakable belief that she would recover that may have helped her do so.

"It's an amazing thing," he said, especially for someone whose future was so exceptionally unclear. "She's a happy person, she's grateful, she smiles, and she seems to understand that providence has smiled on her. You don't see her dwelling on negatives."
Jones, who still has some impairment in her left hand, admits to dealing with some anger when it comes to the assault itself.
At times, she said, she has questioned why the injury happened, especially because the attack came from someone who at one point professed to love her.

But faith, she said, has sustained her, as well as love for her family.

I'm one out of a hundred," she said. "I shouldn't be here. I should be gone. But God gave me another chance."
Though her journey is not over, Jones said she wants to help change the lives of other women who may, without positive change, find themselves in a similar situation.

"I actually want to help people in situations like mine, if I can," she said. I'd like to go talk to women in shelters. I know a lot of times, they go back. I think it might open their eyes, at least some of them."
Jones said that she would leave her husband for sometimes months, but then return.
"I would never go back now, never," she said. "I almost lost my kids. I almost lost my life. But my eyes have been opened, and I've been given a second chance."

© 2011 Abilene Reporter-News. All rights reserved.
By Brian Bethel at 676-6739 or bethelb@reporternews.com