The Life Scientific: Jim Ashworth-Beaumont

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0:56Jim Ashworth-Beaumont:Apple Vacations, where your story starts.

1:03Hello, my guest today is an orthotist and prosthetist who spent years helping people adapt to life with artificial limbs and musculoskeletal supports, before a near-fatal accident left him relying on both. This cruel twist of fate might have derailed many, but Jim Ashworth Beaumont has drawn on reserves of resilience and determination forged long before his accident. Growing up in Scotland, Jim left school with no qualifications and little idea of what to do next. In a decision he describes as transformative, he joined the army and served as a Royal Marine. Returning to civilian life some years later, he was determined to go back to education.

1:42He put himself through night school before earning a place to study prosthetics and orthotics at the University of Strathclyde. Later, alongside clinical work at London's Royal National Orthopaedic Hospital, Jim completed a Master's in Neurorehabilitation and a PhD in Health Studies, driven by a fascination with how the human body adapts under pressure. Then in 2020, while training for a triathlon, Jim was involved in a catastrophic cycling accident that nearly killed him and cost him an arm. But he says the experience gave him an insight few clinicians ever get, profoundly changing the way he now supports patients through recovery.

2:20Jim Ashworth-Beaumont, welcome to The Life Scientific. Hello there. Now, we're going to be talking a lot about the combined field of prosthetics and orthotics today. So maybe you can start by explaining exactly what that covers. Well, prosthetics, I think everybody would know, is the field where you're restituting the limb. So that includes the actual structure itself, but also the function. So in some cases, it's very simple. You're using old-fashioned techniques. and at the other end of the spectrum we're using advanced neurophysiological techniques to try and transfer information between the body and the environment.

2:57And prosthetics I guess is a word that as you say people are familiar with but orthotics less familiar. Oh yeah it's a tough one and you have to go all the way back to the Greeks to try and figure this one out. So orthotics is really means to make straight so it's pre-date surgery I suppose you could say for example in the field you fall over and break a leg you get two bits of wood strap it around the limb and you have a splint a brace of support which delivers stability and enables you to function my wife fractured her knee over the summer so she was wearing a brace okay so that's a orthotic we call it an orthosis but many people call it an orthotic device but very few patients or specialists, I guess, can fully understand this field from all perspectives.

3:42You do. What's the most surprising thing your own experience has taught you about prosthetics and orthotics? I think it's the capacity to enable people to carry on a normal life or to achieve goals that the others wouldn't be able to or hadn't even thought of, for example. And we're going to talk about that journey a bit later. But for now, can you just tell me briefly about the prosthetic you're wearing today? Today, I've chosen to wear an arm that enables me to move the elbow and the wrist and the hand using impulses from the muscles in my residual limb. My residual limb is a stump. It's a stump just below the shoulder so you know most of your arm was lost in the accident.

4:18That's right yeah so I lost my arm just below the level of the humerus really so I have about 10 centimetres of arm left. The prosthetic device connects to that and electrodes on the prosthetic enable me to control the components in the limb using impulses from the muscles. When you came into the studio we shook hands and I shook hands with your prosthetic limb and it felt almost natural in terms of your grip and so on. Yeah sure we're using very advanced componentry here I also use a body-powered limb for my clinical work which is a little bit safer to use with patients and I can get quite similar effects so there are lots of different solutions you know necessity is the mother of invention and that's why it's such a wonderful field to work in.

5:03Well Well, Jim Ashworth Beaumont, you were born in 1966 in Edinburgh. What were you like as a kid? I think I was comfortable in the periphery, you know, not the centre of attention, happy to be on the outside, looking outwards rather than onwards, I think, which is kind of a characteristic that I think defines me. You told my producer that at school you were the pupil most likely to be caught looking out the window. How did you get on academically then? If I engaged with the subject, I'd do well. but if I don't see the underlying, the fundamental reason for something, I switch off very quickly.

5:38Right, right, right. So I was thinking about what words might be on my gravestone, you know, not to be too morbid, but I think the single word why would be on my gravestone. I need to have a reason for engaging. Right, right. I mean, would it be fair to say then that in your teen years you started to rebel against the traditional education route? Oh, completely. Yeah, yeah. I think learning by rote is just not something I can do. It's just not within me to do that. In fact, I gather the school eventually asked you to leave. They did, yes. I attended a really great school, but yeah, I was not a great student, I'm afraid.

6:16Well, in the early 1980s, there you were, expelled from school, unemployed, in the midst of a serious recession at the time. Your options might have seemed pretty limited. but one day you were walking through Edinburgh and inspiration struck. Yeah, Hanover Street, the centre of Edinburgh. It was a cold day, you need to find somewhere to sit down and stay warm and the army recruitment office was there. So I just walked into the recruitment office and talked to the recruitment sergeant and see what was available. But I think I had very low expectations of myself academically. I didn't consider myself to be clever in any way.

6:51But you joined the army and actually this experience drew out talents you hadn't realised you had. Absolutely. So when you first go into the recruitment office, they get you to do a whole bunch of tests to see how suited you are to different jobs. And I got 100 % in all of them, I think. So pretty much they said you're going to join like an advanced trade. So I was recruited at the Royal Signals and went through my trade training into a job. So a very different educational experience from school and clearly it struck a chord with you. But after six years, you decided to leave the forces. Why was that?

7:29So through the course of my army and Royal Marine career, I gained experience in a wide range of technical subjects, was able to go out in the field into reconnaissance and surveillance. But I was really worried about getting institutionalised. You know, it's very difficult to get out of that environment and rejoin normal life. And I really became concerned that it would limit me in later life. Well, you left the army, settled on England's south coast and went back to school, studying for your ordinary national diploma in engineering at a further education college in Dorset. But it didn't quite work out, did it?

8:06No, the bottom line is money, really. Unfortunately, I didn't have enough money to finish the course. So that plan fell flat, to be honest with you. Although I had accrued sufficient skills to take that on to a technical job within Halfords. So I ended up going into retail, which was actually a blessing. And then you ended up moving back to Scotland, I believe, and being promoted to manager. Was there ever a point when you thought, actually, I'm doing OK, maybe I don't need to go back to school? Well, what's always driven me a little bit is that thirst for knowledge, you know, that constant curiosity about things.

8:45You had at this point an interest in both engineering and health. And one day you came across a course that ticked both those boxes, a degree in prosthetics and orthotics at the University of Strathclyde. Did you know much about the field at that point? I'm often asked why. Why did you get involved in this career? And really it was the interest in technicality. I'd gained some experience in engineering, but particularly through the retail environment, actually, I found that I was really good at engaging with people, getting results there. So combining the two was perfect. Of course, you didn't have the grades at that point to get into Strathclyde University to do this degree.

9:25So you started night classes at the local technical college to get your Scottish hires. This is, you know, roughly the equivalent of A-levels in England. Initially in human biology and English, then at a higher level in mechatronic engineering. Well, all that hard work paid off because in 1996, Jim, you were accepted onto that prosthetics and orthotics course. You graduated with honours and started working as an orthotist. What did that involve on a daily basis? We've talked about prosthetics and orthotics and the differences between them. With prosthetics, the goal seems quite straightforward in that you are reinstating a limb.

10:05In orthotics, it can be a little bit more nuanced. We're dealing with a lot of different pathologies, like a problem arises from trauma or from disease or neurodegeneration, for example. And your goal as an orthotist is really to take that information that you glean from the patient and their medical history and then convert that into a solution which solves a practical problem. Well, in 2005, you joined the Royal National Orthopaedic Hospital and that prompted another return to education for you. In 2007, you started a part-time master's in neurorehabilitation at London's Brunel University. What was your focus?

10:46Well, when we're taking a patient with a neurological problem, we're looking to maximise the potential to undergo therapy and improving their quality of life. so I always had a thought on how we might develop technologies to help people improve their neurological status and from that I gained an interest in non-invasive brain stimulation there are a few different methods of actually stimulating the brain non-invasively using magnetic fields or electrical stimulation so essentially you're combining brain stimulation with rehabilitation. Yeah. So exercise is really important to me and I see that as very important to patients.

11:27But if we could combine that with some sort of technical input, like improving the abilities for the brain to take on new skills, that would be a fantastic boon to patients because it would improve the efficiency of the therapy that they can undertake to get better, make their improvement quicker, more effective perhaps. And it's inspired you to go on after your master's to do a PhD in health studies. Yeah. So I spent some time learning about non-invasive brain stimulation as a way of trying to leverage skill learning. So the question that came to me was, would brain stimulation improve motor skill learning?

12:05And specifically the group of patients that I was working with at the RNOH, which is patients with spinal cord injury. That's fascinating. So this could be a useful therapeutic tool for particular patients then? certainly in fact non-invasive brain stimulation is actually used in patients with depression to alter mood it's used in patients following stroke to upregulate the excitability of the brain in order to gain more benefit from therapy the question is whether you can actually improve motor skill with that brain stimulation and that was the question i was trying to answer during my phd okay so step one is to get the brain more stimulated and more active yes indeed and then Step two is to link that to...

12:45Whether you can actually improve the skill itself. Improve the skill itself, yeah. Well, Jim, in 2020, the COVID pandemic hit, which had a big impact on your work life for a while. Yeah, the NHS, we just had to pivot 180 degrees in order to accommodate the needs of the population. Around the same time as this, I gather you were also training for the British Sprint Triathlon Championships. What's different about a sprint triathlon compared with what we normally regard as a full triathlon. But yeah, the classic sort of Ironman is a massive undertaking. It takes up a lot of time, whereas the sprint triathlon is much more manageable.

13:23You're looking at sort of a 400 to 800 metre swim and maybe a 20 or 40 kilometre cycle ride and then a 10k at the end of that. So it's much faster, the tempo is much higher. It's quite satisfying. Then on the 21st of July 2020, you had that catastrophic accident while you were out training. Tell me what happened that day. Well, it was the end of the first lockdown in COVID and I took the chance to take a couple of weeks leave. I got stuck into my training for the triathlon and on this particular day I'd done a run, I'd done a swim and then third training session of the day, a quick cycle up to Crystal Palace from where I live in Greenwich and ended up at the side of a lorry.

14:05Didn't think much of it. I'd been in that position a thousand times before. but on this particular occasion the vehicle moved sideways and I got trapped between the pavement and the trailer of the vehicle and at that point I had nowhere to go really I went under the trailer Unsurprisingly given the severity of the accident your injuries were extensive what was the situation when you were admitted to hospital? I don't think the expectation from the teams that I've talked to at the hospital was that I'd live right um so i'd had very severe crush injuries and burns lost the arm went through surgery stabilization put into a juice coma went into multi-organ failure it didn't look very good for a while i gather the coma weeks were a very strange experience for you yeah i ran conscious during the accident and for about 20 minutes afterwards and i resigned myself to the fact that I was going to die.

15:08So when I became aware again, I was convinced that I was dead and went through these sort of strange scenarios, perhaps drug-induced, influenced by things going on around me in the ward. But for me, they're very real kind of experiences. Such as? One scenario was where I crashed in a plane and was buried for a couple of thousand years and then was brought back again and sat before a jury who would decide whether I was going to live or die or not. And there was a period of reasoning, should I live or should I die? And I'm really not quite sure what the process meant. Was it me deciding whether it was worth living or dying, for example?

15:52I mean, was it in some sense your brain trying to make sense of the situation that you were determined to try and get through this? You weren't ready to die? I think so. I think so, yeah. I think there was a process behind it. And in hindsight, I can see the process. But, you know, nonetheless, very interesting and unique experience. Do you remember waking up from the coma state? Yeah, everybody's seen Robocop, I think. Yeah. Where you have this technician switching on the camera and going, hi, how are you doing? And then switching off again. Right, right, yeah, yeah. And there were definitely experiences like that, where I come to perhaps see a nurse's face, interact with that nurse and then drop out again.

16:33Right, right, right. So quite strange. Of course, the most challenging part was still to come, your long road to recovery. What did that involve? The outcome of being in a coma for six weeks, having a very badly damaged liver, a lot of the body systems had been affected. I'd gone through the sepsis, etc. I was very debilitated. So as well as the nerve injuries I had and the disuse injuries you get from lying about for six weeks, I'd lost about a third of my body weight and most of my muscle mass. So there was a huge hill to climb in order to get any return to normal function. I wasn't able to walk.

17:12I wasn't able to get out of bed. I certainly wasn't able to move around in bed because without the arm, it is actually quite difficult to mobilise. So in order to see a pathway forward, it was really important for me to just firstly accept where I was, understand the situation I was in and then start planning, you know, a return from there. I also imagine for you, the mental and physical resilience you developed in the army and through competitive sport must have helped hugely. Yeah, definitely. It's being able to sort of break down what seems like an incementable goal into a succession of cycles and then make it manageable psychologically as well as physically in order to try and gradually build up your physical tone.

17:54and i gather your family set up a crowdfunder towards getting you a bionic arm yeah so my prognosis my outlook was not great but looking on the positive side my sisters my wife set up crowdfunder to fund a bionic arm visions of the six million dollar man if we're old enough yes and you know the promise of science is that you can basically rebuild the guy and here we are today i mean well yeah i don't know if anybody can hear my arm operating right now but yes i'm wearing a bionic arm. It's great, I was just thinking that. On radio, listeners might be hearing sort of buzzing and squeaks during our conversation.

18:29That is your arm moving, flexing as you're moving in your chair. Yeah, I'm naturally a bit of a fidget. So that includes operating the prosthetic device as well. It's a great sound actually. Well, Jim, you were discharged in November 2020, four months after the accident, but continuing with dialysis as an outpatient, which by the way, you were told you'd need for the rest of your life but in fact you made a remarkable recovery extraordinary i'd been crushed across my midriff so lots of rib and spinal fractures yes but a lot of soft tissue injuries as well my kidneys were non-functional for six months and then i think it was christmas they they started functioning again and by the end of january 2021 i was given the all clear to stop dialysis.

19:19That's incredible. And how about your condition more generally? I mean, I gather it wasn't long before you were back competing in triathlons, for heaven's sakes. Yeah, I think one of my innate characteristics is stubbornness, probably. Once I have a goal in mind, it's happening. So although I couldn't compete as an able-bodied person, I still wanted to attain the goal that I'd set out to do in July 2020. So I just pushed and pushed and pushed to rebuild my fitness and took part in the British Paratriathlon Championships in June 2021. How did you get on? I got a bronze medal. That puts the rest of us to shame with our now waning New Year's resolutions.

20:06Let's talk about the practicalities of getting you literally back on your feet. Orthotics played a big part in that, didn't it? Yeah. So aside from the prosthetic side of the thing, which is obvious, I'd sustained a rather severe nerve injury to my left leg, which meant that below the knee, I couldn't move or sense or feel my foot or my ankle. Fortunately, being in the business, I was able to access not complicated or expensive orthotics, but effective orthotics. And I knew what I needed as well. I was very lucky in order to be able to treat myself to some extent. Then on the arm front there were different prosthetic options available but this was a particularly difficult case because of how much of the limb you'd lost.

20:51I'd lost essentially the whole of my arm below the shoulder. So there you're losing all the muscles, all the joints obviously, as well as the limb length and that's an awful lot of structure to try and reinstate. So talk me through your prosthesis journey as it were from those early days of the very basic version through to the surgery that you had last year so you know there are various things you're looking for in a prosthetic limb and one of the fundamental things is the connection between you and the limb itself although you know i had access to prosthetics they were not effective they were not comfortable and i couldn't wear them for a long period of time so i started out with a body-powered prosthesis which which is something that's controlled by cables and body force rather than powered electronics, for example.

21:37Back muscles, for example. Yeah, that sort of thing. Yeah. Or like a very simple device, which would be like something that's attached to your body and then essentially is a stick, enables you to support yourself or touch objects, for example. And that's where I started out. But now you have a more permanent connection between the limb and your body. Certainly. Yeah. Yeah, so for four years I was living with a set of devices that attach to me through a socket. So that's something that just sits on your residual limb, your stump, and then you apply force through that interface. Now, what you're really trying to do is actually apply force from the skeleton to the prosthetic, but you've got all this overlying tissue, so it makes it very unstable, all that soft tissue, like fat or muscle or so forth.

22:24And it just makes it quite difficult to operate a limb. So there's this technology called dossier integration, which basically means that you can take a metal pin, insert it into the end of the bone. It sticks out through the skin and then you attach your prosthetic device to that metal post. So you have a sort of like a universal connector that you can then attach different prosthetic. Indeed. Yeah. So although you're buying into a connector system, almost, it makes it much more secure. it's transformed my life i would have to say before having the osso integration i was able to operate a prosthetic limb i wasn't able to use advanced limb technology because that's heavy after this surgery which i had in october 2024 i'm able to basically put my entire body weight through that limb so it's very satisfying from a sporting point of view because it means i can do pull-ups i can do press-ups but also from an activities of daily living professional point of view I have got a very high level of dexterity and ability to use the arm.

23:29Incredible well Jim you've been back at work since 2021 and I guess even during your recovery it must have crossed your mind that you are now in a unique position to understand your patients better how has it changed things? I think I would also have tried to be empathic and understanding of my patients needs in order to treat them effectively. But I think now, having been through the mill, as it were, I have lived experience of this. So for me, it doesn't take a leap of the imagination not to put myself in the place of my patients. Although I don't consider myself to have a disability, I've certainly got a visible difference.

24:11And patients can see that as soon as I walk through the door. So the gulf between the practitioner and the patient has been broken. So it makes the process of building a relationship with the patient understanding their needs and hopefully working towards a good solution for them much easier so you'd say it has made you a better clinician then i think so yeah definitely so coming back to prosthetics where's the technology heading next well there's a kind of a meeting of different technologies now neurology robotics or bionics or cybernetics they're all coming together to try and solve these problems and And in terms of like the actual structure of the limbs themselves, the bottleneck is probably taking the information, the brain intent, as it were, that kind of the mental intent and actually getting that into the limb to move the limb.

25:00In doing what a body would does naturally, sending a signal via the nerves. Absolutely. So here's the problem when you have an amputation, that nerve signal is broken. Yeah. And you lose a lot of complexity of information. So actually trying to either get that richness of information into the limb or compensate it for it in some way has resulted in a few different approaches one is essentially trying to tap directly into the nervous system in order to get that information to limb so you might be looking at a brain computer interface these chips that you put into the brain or trying to identify the nerves that would drive the prosthesis tap into those and get a continuation of the signal that's got that far so really to be honest with the simpler the better i'd rather not have a brain interface if i could help it but certainly there are technologies which try to understand the pattern of electrical information on the surface of the stump and translate that into information that will drive the prosthesis in a kind of dexterous way and this isn't science fiction this is stuff that's happening stuff that's happening at some academic level right or commercial level so the pattern recognition technology which is where you're trying to understand that information that's actually available from the surface of the skin is commercially available now for a price.

26:18And what's next for you then? Any more academic ambitions? Well, one of my longstanding interests has been in sort of rehabilitation psychology. So trying to give that individual the right mindset to accept and understand their situation, plan and recover from their injury for the best quality of life, which is the bottom line, really. so what advice would you offer to others maybe you do this already but others trying to come back from say a major trauma like the one that you went through i try to keep it realistic i suppose in that it's okay to dream in the same way as an athlete might dream about winning olympic gold for example it can be fantastic from a motivational point of view but actually it can be very negative when you fail to hit those outcomes.

27:12So in terms of managing yourself, turning up is number one. You've got to turn up. And secondly, is being prepared to do the work, work hard, have the guts to actually perform, and then the fruits will come. Well, it certainly seems to have worked very well for you. Jim Ashworth-Beaumont, thank you very much for sharing your life scientific. Thanks, Jim.