“It’s the little things that you miss the most.”

During this last summer break for the rest of our MD lives, I am conducting research in Athens. I am researching the cardiovascular response to functional electrical stimulation in patients with spinal cord injuries. One of the patients that comes in is a “regular”. He’s quite animated and all of us researchers enjoy it when he comes in. The other day, he said something to us that I think only I fully understood.

“It’s the little things that you miss the most,” he told us. He described the ability to cough. He recalled how he initially was not able to cough strongly or cough up things. I zoned out a bit as I thought back to my experiences, but I caught the end of his discussion of the topic when he said, “I miss being able to do those kinds of things. People think it’s about the big stuff like walking, but it’s the little things that you miss: being able to cough, man.”

My mother and a good friend would describe how they had to give me water with a dropper. Another good friend told me how I once woke up in the middle of the night choking and gasping for air. When the nurses rushed there, they stuck a tube down my throat and removed a tiny bit of mucus present, due to pneumonia, which had been obstructing my airway. This was all when I was delirious and coming out of a coma. I don’t remember any of it. My ribs had broken off and had punctured my lungs and my throat and airways were constricted, which I assume were a side effect of the spinal cord injury or possibly due to other injuries.

I became fully conscious and able to form memories after I reached the Shepherd Center in early June. I could not speak above a whisper and after saying a few words, I would become out of breath and fatigued. Two best friends of mine who were always there with me told me that despite this, I made sure to talk to everyone who came in. I guess I felt rude not talking to people if they came to see me—some from far away. Months later, I would receive the encouraging compliment from my therapists, “Nice sneeze!!!” if I let out anything that was even barely audible.

For a long time, I was not able to eat solid food or drink normal fluids. My food was pureed like baby food and my fluids had to be thickened with corn starch. If you read my last birthday post, you may recall that that was when I was finally allowed to eat solid food and drink normal fluids. The reason my drinks had to be thickened is because normal fluids could go down the wrong tube, causing the fluid to enter my lungs (aspiration) and making me prone to pneumonia. As stated in the birthday post, pneumonia is the number one cause of death among people with spinal cord injuries and I already had it twice.

I stated in this blog post and in this interview that even a year later, I could not talk loud and I feared running out of breath whenever I spoke. Tonight while driving, I was thinking back to what our patient had said and about my own experiences and I decided to test out how strong my lungs had become. I remembered how I had a pretty good sneeze earlier that day and I was feeling pretty cocky. So I let out a loud shout and a yell with this song playing through my speakers. If you listen to the song you can see why that's ironic. I smiled.

It’s the little things.

Really?

I recently interacted with a surgeon and a therapist, both South Asian, on different occasions during appointments.

They were, as most people are, surprised to hear I'm going to be in my second year in medical school and that I already completed one year like this.

Then, they are even more surprised to hear that I am living by myself in my own apartment. And that I drive myself to where I need to go.

Is it really that hard to believe?

Things are different, but you adapt.

Mad cow

It’s interesting to sit back and watch how people react to certain situations.

“A lot of people get angry after they become paralyzed. They get pissed off at the world, at God, at other people,” I was telling someone the other day.

“You never really got angry,” he replied.

With a life-changing injury, extended hospital stay, paralysis, and a wheelchair come a lot of frustrations for which one cannot predict or prepare. On top of these things, nobody else can understand unless they are in the same situation. Thus, people in wheelchairs tend to be angry.

I remember one day, a group of us patients at the Shepherd Center with accompanying guests and a few therapists went to the airport to participate in a simulation by Delta airlines. We were shown how to go through security and metal detectors, get onto the plane, and get into our seats. After we went through security a second time, one patient asked his wife for his iPhone. She didn’t have it. He blew up. He was swearing at his wife and telling her how his whole life was on that phone and how he would never trust her with anything ever again. She apologized, but he just kept getting angrier. Everyone in our group was quiet. His wife went back to the security line to see if she had accidentally left his phone in one of the boxes. A few minutes later, he found the phone in his bag. I looked over at my brother and we both were trying hard not to burst out laughing.

I've heard about people becoming bitter and full of resent. After my friend's dad temporarily injured his leg in an accident and couldn't do certain things, he would get mad at his son if things weren't done perfectly. I explained to my friend how it can be frustrating and make people really mad when they are unable to do things the way they prefer. People don't like change. So one can easily see what effects a life-changing incident may bring.

When I was younger and going through my stage of teenage angst, my brother and my parents would often tease me about being easily irritated. That phase came and passed, as I’m sure it does with most people. Years later, my close friends would note how impatient I was: I would finish other people’s sentences; I would skip songs after listening to the first 15 seconds; I would get impatient waiting for someone’s response; I would get antsy waiting for exam results… I couldn’t wait for anything!

Things changed. Now, I honestly do not see the point of being angry or upset.

Why do we get angry? Are we that into ourselves? Are our egos that big and fragile that anything that goes against our opinions or what we believe or know makes us angry? Sometimes we get angry when we see or hear something happen to someone else. How productive is it, really?

I was talking to a friend of mine who was getting angry over something. I wanted to stop and ask, “What are you getting out of being angry? Is it helping the cause? Or are you just reinforcing the negativities?”

After going through everything, I’ve realized that life is too short to be angry. It seems like such an irrational and pointless use of one’s energy. When I see someone getting angry, I just smile. Things can be frustrating at times (as can be seen by my frustrations with school), and I can still be impatient at times (though magnitudes less than the way I was before), but anger is something I just don’t understand. It almost always causes more harm than benefit.

Raising voices makes people seem powerful and in control of the situation to themselves. The person who yells back usually tries to raise the volume by a few more decibels to try and become the one on top of the argument. In reality, it is not the one who gets angry over a situation nor the one who yells back that is strong, but the one who knows how to show proper constraint and compassion. All others are fools.

While anger is a general expression of insecurity to something, it can also be the result of being passionate about something. “I’m angry because I care.” Well, if you care that much about something, then use your energy to figure out a way to truly understand and change the situation.

Although things happen and we may not see the reason for them, one should learn to find solutions, to make things better. When things are seen or words are said that rub us the wrong way, this is just an opportunity for change. And if things, situations, or the words people say/believe cannot be altered, then that is fine. We should be secure with ourselves.

“In the midst of movement and chaos, keep stillness inside of you.” – Deepak Chopra

Since I was in the hospital a few years ago, people have asked why I laugh at things, even during inappropriate moments. My answer at the time? "If I wasn't laughing, I'd be crying." I continue to smile/laugh at things because almost everything in life seems so trivial, and there is nothing else to do but smile in this world.