There isn't a doctor in Omaha who makes an entrance quite like Scott Hofmann. One moment, the hallway of the fourth floor at the VA Medical Center is clear. The next, Hofmann comes zooming along on a Segway, the stand-up battery-powered vehicle often associated with strolling security guards, and now associated with this anesthesiologist who zips from here to there.
Hofmann is 50 years old, though he looks a decade younger. He has a boyish face, sandy blond hair and the build of a guy who works out three or four times a week, which he does.
The prevailing theory is that MS is caused by the body's immune system attacking the protective layer around the nerve fibers of the central nervous system. The resulting scar tissue (sclerosis) disrupts communication along the spinal cord and into the brain.
The location and extent of such lesions, said neuroscientist and UNMC nurse practitioner Kathleen Healey, is associated with the type and severity of symptoms a person experiences.
Multiple sclerosis is unpredictable, but it is not a death sentence. Various medications reduce the attacks of MS, including a new oral medication, Tecfidera, which the Food and Drug Administration approved last month.
“We can significantly reduce future disabilities by accurately diagnosing the disease early and providing the appropriate treatment early on,” Healey said.
According to the Mid America Chapter of the National Multiple Sclerosis Society, 400,000 Americans are living with MS, including nearly 3,000 people in Nebraska.
Celebrities diagnosed with MS include actress Teri Garr, TV personality Montel Williams and Ann Romney, wife of former presidential candidate Mitt Romney.
The disease received high-profile attention during the NBC series “The West Wing,” when it was revealed that President Josiah Bartlet (Martin Sheen) had been diagnosed with MS.
For information, visit www.nationalmssociety.org.
He does not look like a man 18 years into a battle against an unbeatable disease. Until he steps down from the Segway. At that point, Hofmann switches to a cane. Over the past decade or so, his legs have weakened to where he can no longer walk on his own strength. He's learned to scan rooms for aids (handrails) and impediments (steps) and to keep a good sense of humor about it all.
“I've learned to be a good faller,” he said.
On the Segway, he glides as though the machine is an extension of himself, but like the cane, it's just a means to an end and it probably calls more attention to him than he'd like. Scott Hofmann is a husband, a father of three, a doctor, and then somewhere further down the line, he's a guy living with multiple sclerosis.
He would prefer to show up to work, serve his patients and slip away without fuss. He bristles when people use the word “inspiration” to describe him.
But the word comes up often.
Until recently, fellow anesthesiologist David Faust worked closely with Hofmann at the VA — whether in nearby offices or together in the operating room. Faust is unequivocal in his admiration, calling Hofmann one of the best people he's ever met.
“I hold him in the highest regard,” he said. “He never complains. He's professionally excellent.”
Faust deployed overseas twice last year with the National Guard. Each time, Hofmann volunteered to take shifts in his absence.
“He chooses to always be there for his patients and do the work,” Faust said. “He does that every day of his life. He's a physician, that's what he is.”
Daryl Kucera, a friend and Hofmann's personal trainer at the gym where he works out, said the same applies outside of work.
“He refuses to be defined by his disease,” Kucera said.
Before she took him on as a patient, Kathleen Healey, a nurse practitioner at UNMC with a PhD in neuroscience, knew of Hofmann by reputation. He's lived up to it.
“He is so highly intelligent, but I would say very humble,” she said. “He just has this fabulous reputation, long-standing, at the university. He has this great sense of humor. And he's very driven.”
Hofmann grew up in the small northeast Nebraska town of Tilden, where “drivers ed” meant chauffeuring a teacher to Norfolk for donuts. He played football and basketball and ran track, in part to observe a certain small-town civic duty.
“You couldn't sit out, because if you did you might not have a team,” he said.
One night, as an undergrad at the University of Nebraska-Lincoln, Hofmann attended a dorm party at Schramm Hall. It was Jan. 22, 1982. He remembers the date because it was his good friend's birthday, and also because it was the night he stood in awe of a girl across the room. When one of his buddies bet him a case of beer he wouldn't talk to Ann Campbell, he finally mustered up the courage.
“I said, 'In that case, I can't lose,'” Hofmann said.
The couple dated for nearly 10 years, well into Hofmann's medical schooling, when the ultimatum arrived.
“She finally told me to fish or cut bait,” he said.
For as long as he can remember, Hofmann wanted to be a doctor. In 1994, at age 31, he completed his residency at the University of Nebraska Medical Center and accepted a job right there at UNMC. The same year, he celebrated his third anniversary with Ann and welcomed their firstborn, Nathan. In every conceivable way, things seemed to be moving in the right direction.
The following year, he was diagnosed with MS.
In a matter of days, Hofmann went from skiing in Colorado to visiting an eye doctor because of double-vision to receiving an MRI that told him what no member of his family had heard before: that within an outwardly able body, a mysterious form of sabotage was taking place.
“It was devastating,” he said.
Hofmann worried about how it might impact his family, how it might effect a job he loved, how the disease might progress.
At home, Ann Hofmann quickly learned more about MS. She resolved, like Scott, to focus on the here and now.
“We've decided we can't get ahead of ourselves,” she said. “Just because life isn't going to be the way you thought it was, it doesn't mean it's going to be terrible. It's a new normal.”
She knows how hard her husband works. She knows the disease requires more from him, and she knows he'll continue to throw everything he has at it, setting the best example possible for their three kids.
“He finds a way to do it,” she said. “It's not easy, but he'll find a way.”
Early on, Hofmann attended a support group for people with MS, and found the experience so depressing that he refused to go again.
Around the same time, a doctor told him it'd be in his best interest to take things easy and slow down, that an active lifestyle could aggravate his condition (an opinion now disputed).
Hofmann rejected this advice.
“I remember telling my neurologist, 'If I die, I'm not going to die lying on the couch,'” he said.
Three to four times a week, Hofmann throws on his shorts, pulls on a T-shirt, ties up his cross-trainers and drives to a west Omaha gym called FastForward that's the closest thing to a support group in his life these days.
At first glance, FastForward looks like any other gym, with free weights, weight machines, exercise balls and various other fitness instruments spread across the room. A closer look reveals personal testimonials tacked to the walls — photos of people who work out at the gym with handwritten notes about what it means to them. Near the front door, another banner displays the gym's motto: THE ONLY DISABILITY IS A BAD ATTITUDE.
Kucera, a trainer, opened FastForward as a fitness facility for young athletes and sports teams in August 2001. Exactly one month later, Kucera was diagnosed with MS. Following his own rehab, he decided to convert a large portion of the facility into an exercise room for people with MS.
On a recent weekday afternoon, Kucera leads Hofmann through a circuit of exercises, alternating between weight machines and a deceptive-looking weighted rope that stretches halfway across the room.
As Hofmann performs a timed set of chest presses, Kucera sits by with a stopwatch. “This guy's an inspiration,” he says.
Hofmann grimaces at the word. “More like perspiration,” he says.
Truth be told, like any other guy, Hofmann has other things on his mind. He still needs to pack for a family vacation to Las Vegas, and he keeps forgetting what he needs to pick up at the drug store on the way home. At work, his entire department is in a state of flux over an administrative dispute threatening their jobs.
Meanwhile, his daughter, Clare, a freshman at Westside, waits to hear back about her cheerleader and show choir tryouts. The entire Hofmann household is in a state of suspended anxiety until the news arrives.
These were his concerns walking into the gym.
About midway through the workout, Kucera times Hofmann as he rips the weighted rope back and forth across his body. The first set lasts an agonizingly long 30 seconds, followed immediately by another 30 seconds in which Hofmann does the same but as fast as he can.
The rope is tricky because the motion messes with Hofmann's balance, and at one point he falls chest first into the ground.
Kucera sits by with his stopwatch, waiting, as Hofmann walks his hands across the floor until he's on his knees. He reaches up to a machine and lifts himself off the ground, picks up the rope and continues the workout without a pause.
When he's finished, he and Kucera chat for a bit. It's one of the things he likes about the gym — that it is a form of support, nestled within the immediate task of exercise. People arrive early and stay late. They chat. It is and it isn't about having MS.
Shortly after he leaves the gym, small victories begin to collect.
That family trip to Las Vegas is a couple hours closer, and Hofmann suddenly remembers the nagging item he needs to buy on the way home (deodorant).
“You've been dealt a deck of cards, and it's up to you how you play,” he says. “Everyone has something bad happen to them. You've just got to move on. Just like today: I fell down. Get up and go. Keep moving forward.”
A few minutes later, his phone vibrates. He picks it up and scans the message. He smiles proudly. He looks relieved.
“Oh, my God, my daughter made show choir,” he says.
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