Daring to reach for the skies

Almost 40 years ago David Skidmore lost both his arms in a road accident. Now he is becoming a pilot. With hooks for hands, on artificial arms, he has passed the basic test, permitting him to fly under supervision, and is about to take a final examination that will let him go solo.

His is an incredible story of personal determination; but it also reflects a series of quiet revolutions within the little-known world of prosthetics.

Skidmore's tale echoes that of Douglas Bader, who returned to his Spitfire cockpit after losing his legs in an air crash during the Second World War. Where the modern story differs, however, is that the loss of arms places far more complex demands: both on the individual, and on the designers whose job it is to help amputees recover their mobility and their lives after disastrous loss.

The story begins on 8 October 1958, when the young Skidmore was seeing out his National Service in Cyprus. In those days he was an unqualified solicitor's clerk, who had left school at 15 with no clear ambition. Then a car smashed into his lorry on a trip to Famagusta. Thrown on to the road, Skidmore was run over and awoke in a Nicosia hospital to find a doctor peering down at him. "The doctor said, `Do you know what's wrong?'," Skidmore recalls. "I said, `I think I have lost my arm.' He said, `You've lost both arms.' I went back to sleep."

In the following years, Skidmore discovered something common to many amputees: disability makes them want to do more, not less. He returned to college, qualified as a solicitor, married, had three children, learnt to drive a car equipped with an ordinary gear-stick, took up snooker and became a senior partner in a law firm specialising in personal injury claims.

Much of this "normal" life was made possible by false arms which, although they look basic, provide a surprising amount of dexterity. Skidmore at work is an impressive sight: subtle movements of his shoulders allow him to pick up a pencil with a split hook and write fluently; he can operate the smallest buttons on a VCR handset; he can hold an egg without breaking it; and he can pick up two 50lb weights and spin round effortlessly.

Twenty years ago it was inconceivable that Skidmore would have risked flying. But in June 1990 he took his first lesson, virtually on a dare; it was another challenge to overcome. He was able to take the controls within minutes of take-off, and last year he passed the major part of his test after 94 hours of tuition. Since then, the Civil Aviation Authority has subjected his false arms to a series of engineering tests, before a final exam - due any day - which should permit solo flying.

Skidmore is looking forward to it and is clear about the debt he owes to his false arms. He says, "They are far more reliable now. Take the straps: in the early days they were made of leather which stretches, so you had to tighten the harness every so often. Now they use silk fibres which never stretch, and you can lift up massive weights. The hooks are stronger, too, because they are made of plastic and carbon fibre instead of tin - and the mechanisms are far more durable."

Behind this unusual story - Skidmore is thought to be the only pilot in Britain to fly with such major amputations - lies another about the advances in prosthetics.

Skidmore's arms were provided by RSL, a small company set up in the mid- Eighties and based in Rochester, Kent. Until then, the industry was dominated by manufacturers, which also provided the medical service to patients - giving a natural bias, and limitation, to the products offered. A government inquiry chaired by Professor (now Lord) Ian McColl and a Monopolies and Mergers Commission report combined to introduce more competition in the field; the report forced health authorities to seek wider tenders from purely service-based companies, which could buy from many manufacturers, and customise the result.

The edge which that added to the market has pushed forward new developments and has been crucial for people like Skidmore. Simon Webster, chief executive of RSL, says: "Before the mid-Eighties, amputees were having to wait many months for their limbs and the service they were offered was pretty limited. A lot of the technology used had not progressed for many years. The difference nowadays is in terms of comfort and versatility - the things you can actually do."

Design, materials, and service have improved. In Skidmore's case his arms were provided with new locking devices and strengthened joints to allow for greater stresses. Chris Moon, another RSL client, made international headlines recently by completing the six-marathon Great Sahara Race, despite having lost an arm and a leg in a landmine accident. Moon's prosthetic leg contained glass fibre struts to avoid energy waste and a damping device to absorb running shocks.

RSL has also designed a special multi-positional wrist to allow another patient to play golf, while alteration of a false leg has allowed a woman to return to riding.

Electrical wizardry makes its contribution, though Skidmore rejects the "bionic man" tendency, preferring mechanical refinements. "That way, it's still me doing the movements," he insists. Even so, microchips are being used to control the return speeds of false knees and there are advanced experiments with electronic switches to govern limb movement. RSL is able to use a recently installed hi-tech "gait-lab" at the Roehampton Centre in London (where Douglas Bader was fitted with legs) using a system of cameras, computers and sensitised floor designed by Surrey University to measure the slightest nuance in a client's walking position. Artificial limbs are then minutely crafted to cope with idiosyncratic pressures. "It means that patients get the most appropriate type of prosthetic," says Stuart Reeves, the centre's manager. "They can walk further, jump higher, run faster."

The result, Webster says, is that more people who lose limbs have a better chance of being active. Though he warns: "It is a matter of understanding the patient's limitations, both physically and psychologically. Some people have ambitions that can't be realised. You have to work with them to help them achieve their full potential."

Skidmore represents the best outcome: for him, mobility is more than physical enjoyment. It is an opportunity to compensate for something that can never be undone. "Flying was just something I did," he says. "It wasn't that it turned me on particularly, but it was a challenge. That's the way disabled people think. They have to prove themselves the whole time. It runs through everything I do. It gives me a reason to reach for the sky".