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Desperate patient

At an emergency room in 1995, a doctor couldn't figure out the cause of a sudden attack of vertigo that struck Joseph Delahunt.

He had crawled from the living room of his North Portland house out to his car so that his wife could drive him to the hospital. Delahunt hung his head out the window and vomited most of the way. An Air Force veteran in his mid-50s, he was healthy and active -- selling real estate and practicing yoga -- until the attacks started.

Delahunt consulted his family doctor, then tried a neurologist and an ear, nose and throat doctor. They prescribed motion-sickness drugs and other medicines that didn't help much. One told him he'd have to learn to live with the "benign" condition. None mentioned Epley's treatment. His wife discovered it on the Internet.

Delahunt's condition worsened. To avoid unbearable, spinning nausea, he sat as still as he could in a reclining chair. For nearly three months, he left the recliner only to go the bathroom.

At Epley's office, an assistant helped Delahunt down a long hallway to a gray-walled room with closed blinds. An ungainly apparatus filled much of the room. Inside a giant steel ring hung a padded chair that reminded Delahunt of an ejection seat. Motors, gears and drive-chains were rigged to flip and twirl the chair like a carnival ride.

Delahunt stepped up to a platform and into the chair. An assistant clipped straps across his chest and ankles. She covered his eyes with a bulky mask. It contained a video camera to track his eyes. She clipped a vibrator behind his ear. It buzzed gently, more lightly than a cell phone on vibrate.

"Are you comfortable?" the assistant asked. Delahunt nodded, grateful for the Valium he'd taken.

Epley fingered a joystick controller to tilt the chair back until Delahunt was face up. A flick of the joystick rotated Delahunt like a barbecue skewer. On a black-and-white computer display, Epley monitored his patient's eyes for a characteristic twitching movement triggered by positional vertigo. He repeated the series of calibrated tilts and whirls. Then he swung the chair upright and face-forward.

No waves of vertigo struck when Delahunt moved his head. The nausea had cleared. He stopped taking the medications other doctors prescribed and resumed his life.

Threat to livelihood

In Portland, many doctors still dismissed Epley as a crank.

The conflict flared into a crisis in 1996. The Oregon Board of Medical Examiners notified Epley that he was under investigation for alleged unprofessional conduct.

His medical license and livelihood were on the line.

At issue was Epley's development and use of another cutting-edge technique: the infusion of a drug to deaden nerves suspected of causing inner-ear disturbances. The case dragged on for five years before hearing officer Marilyn Litzenberger ruled.

Epley kept his feelings to himself, even at home. But his wife and daughter knew that the investigation weighed heavily. Epley's stoop worsened, they could see. His health faltered. He had to break into his retirement savings to pay for his legal defense.

Epley's accusers, two Portland physicians, testified that Epley was administering the nerve-deadening drugs recklessly, based on inadequate diagnostic testing.

Epley's main defender, a Harvard-affiliated specialist from Boston, described Epley as "a forward thinker who has been right virtually every time he stuck his neck out."

Litzenberger left no doubt whom she found most credible, portraying the board's medical experts as hostile, one-sided and ill-informed. In the summer of 2001, Litzenberger dismissed all claims.

By then, a review article in the prestigious New England Journal of Medicine had credited John Epley as the inventor of the "treatment currently recommended" for positional vertigo. In clinical trials, about 90 percent of patients were cured by a single treatment. Doctors applying treatment around the world referred to it as the "Epley maneuver."

Daughter's mission

Epley's daughter, Cathy, may have never heard the full story of her father's travails if not for a terrible coincidence.

On Sept. 11, 2001, Cathy was attending a medical convention in Denver, hoping to find job leads. At 43, she had worked as an editor for a business magazine during the Internet boom, then switched to politics, managing anti-tax activist Bill Sizemore's unsuccessful campaign for governor in 1998. She moved on to a job in marketing with a medical device startup. But the firm couldn't afford to keep her on full time. So she tagged along with her father to Denver.

News of multiple jet crashes halted the convention. With airliners grounded, convention goers scrambled to book rental cars from a hopelessly inadequate supply. Cathy Epley accepted an offer to share a ride back to Portland with her father's old friend Ken Aebi and his wife. They headed west trying to make sense of the terrorist strikes, compulsively gleaning news from the radio. As the drive wore on, the conversation turned to John Epley and his struggles.

Cathy Epley felt enraged.

But as she absorbed the details, her anger solidified into something more like resolve: She had to help her father get his due. The rest of the drive, Epley spent talking with Aebi about ways to help her father earn money from his inventions.

Back in Portland, she tried to interest venture capitalists in commercializing her father's work. Several listened to her pitch, but all had the same message: She was unlikely to land venture funding. Endless meetings with fund managers, however, weren't fruitless. One suggested she seek startup money from the National Institutes of Health's small-business innovation program.

Cathy Epley went out on a limb. With scant knowledge of running a company, she worked 10 months without pay, writing grant proposals and a business plan. She named the business Vesticon, and she and her father held monthly "board meetings" at American Dream Pizza, across Glisan Street from the elder Epley's office.

Soon federal grants started rolling in: more than $348,000 in 2003, $1.4 million in 2004 and $1.6 million in 2005. Cathy Epley hired an engineer and technicians to build a sleeker version of the "Omniax" chair. The company leased an office and set up a crowded laboratory in Southeast Portland.

In January, specialists in Louisiana, San Diego and Portland are set to begin clinical trials of the chair. The study should take four to six months. If it stays on track and yields satisfactory results, the U.S. Food and Drug Administration could allow Vesticon to begin sales next summer. Cathy Epley has already begun negotiating with distributors.

Epilogue

On a recent day in the building where Epley has practiced since 1965, the doctor stood by the controls of his rotating chair.

"We're going to roll you back," he said to a patient from Idaho. She'd suffered intermittent vertigo since a rollover car accident and was back for a follow-up on a successful earlier treatment. Epley piloted the chair through rolls and twists. The device showed signs of modifications: a radio transmitter lashed to its frame with nylon straps, a video camera clamped to an adjacent shelf, cables to added components snaking beneath ceiling tiles pushed ajar.

At 76, Epley sees patients three days a week. He spends the two other days of the workweek at Vesticon. His daughter's startup has already launched development of two of Epley's other inventions.

In a pause between patients, Epley reflected on the reasons other doctors refused to accept his findings for so many years.

"If I look back at medical school, much of it was misinformation," he said. "Physicians learn to just do the routine, to do the accepted things -- don't go too far out.

"They've got so much to lose if they stick their neck out."