Clearing my mind

I started to apologize for the scant amount of blog posts for the past month or two, but I deleted it. I don’t feel like I need to apologize.

It’s been great. I’ve been clearing my mind.

If you kept up with my blog posts from the past school year and when I finished up first year, you may have noticed that I had a lot on my mind. I carried a big load on my shoulders: a load consisting of stress, insecurities, and feelings of potential failure—in all senses of the word. After our final exam on the last day of school, those feelings did not stop.

I remember when our class had a specialty roundtable one evening. Physicians participating in different specialties in the community sat with us and answered questions. Somehow the topic of relaxation came up, and one physician advised that if given a certain amount of vacation time per year, one should take vacations of at least two weeks off, not one week. The first week will be spent unwinding, and then the second week can be enjoyed.

When I was finally free of responsibility for a few months, it took me about a week to de-tense.

I decided in May that my plan for the summer was just self-development and recovery. I was going to read a lot, exercise a lot, re-learn guitar, and get a lot of sleep.

My ADHD got the best of me as I started a few books but put each of them down after about forty pages. The guitar stayed in its case in my closet. I got a decent amount of sleep when I wasn’t staying up late watching movies or chatting with friends. I exercised a lot but burned out and took a couple of weeks off before school started up again.

But it was all great. I feel like a new person.

Sometimes it surprises me at how little people think—not about certain things, but anything, even about nothing.

This world is a noisy place. Our minds are noisy places. Don’t you wish there was a mute button for both the world and for our minds?

As I quoted in my blog post “Mad Cow”: “In the midst of movement and chaos, keep stillness inside of you.” – Deepak Chopra

For most of us, our first impulse when we get in a car, especially if we are going on a long drive, is to turn on the music. I admit, I’m the same way. But I continue to grow more and more fond of turning off the music, silencing my cell phone, and rolling the windows down. Then it’s just me, myself, and I in the car. Quiet.

Sometimes I think about things deeply. Everyone thinks about things, but this isn’t forced thinking or the thinking one does under pressure or in crisis.

And then sometimes, I enjoy just not thinking, maintaining a state of “no mind”. This is a meditative state that is practiced in people of almost all cultures and faiths. It's essentially about not worrying about the past, about what has happened, about the future, about what will happen—it’s about concerning oneself only with the present moment.

Because of this, I sometimes find myself forgetting about my current state of affairs. It’s not until I see people rushing somewhere or talking about playing sports that I remember that I am in a wheelchair. Maybe it’s because I have gotten used to who I am, physically and mentally.

As anyone can imagine, coming to terms with a physical disability is not an easy task. Certain people never grow accustomed, and they may end up committing suicide. Because my currents tasks require me to use my intellect, coming to terms with how differently I am now mentally has been harder for me over the past year. But I think I am getting there.

I still do think about the past and about the future, so don’t hold me accountable for any future thoughts, but I must say that I am much more at peace.

It’ll be alright.

Character flaw

“He’s stubborn,” the faculty member told my mother and aunt, “real stubborn. But his stubbornness is what got him through this.”

My khala (that’s an Urdu term for mom’s sister) was visiting so I took her, my mom, and sisters to Athens with me one day to show them around. We stopped by my medical college and met with a few of my professors and deans from this past year.

My khala was telling them how the rest of my extended family in Pakistan is always concerned about my well-being and how I am getting by and doing things, such as attending medical school. She said it was good that she came and saw things for herself so could reassure everyone back in the motherland that I was doing well.

One faculty member at my school told my mother and khala how I’m really stubborn, how they’ve had to fight against my stubbornness, and how she thinks I’m coming around now. “But his stubbornness is what got him through this,” she also noted.

Before I started medical school, my mom said she was going to quit working for a little while and live with me. But I was stubborn. I refused. I wouldn’t let my parents ever bring it up. Then the next phase was that they wanted a nurse to live with me. Again, I refused. Next, they wanted me to live with a roommate who would be willing to help me if I ever needed it. I turned it down again. This whole process went on for a few months. Finally, I settled upon allowing my parents to visit for a few hours on Sundays to help me clean up my place. I wanted to live on my own without anyone’s help, and I made sure I got what I wanted. I’ve had my share of obstacles—I’ve fallen onto the floor a few times and had to muscle my way back onto my chair or sofa, I recently got a second degree burn on my leg from a mistake in the kitchen, etc—but it’s been an invaluable experience and I’m glad I was stubborn.

I tend to also resist help from friends, fellow students, and faculty members. This just made me get stronger—physically, mentally, and emotionally. There were times when I felt like I shouldn’t be doing this, when I felt like I should have taken another year off to recover—physically, mentally, and emotionally. But I had started it, so I was going to finish it.

I have just a little over a week left before we start classes again and there will be no break until who-knows-when. This year brings its own set of challenges: mandatory patient exams which I still cannot perform properly due to physical/structural limitations, harder material, visits to the hospitals a few times a week for our clinical skills class, and the most important standardized exam we will take in our medical careers (after the MCAT, of course). But I’m stubborn. It’ll help.

Time

[Originally written on July 13, 2011 but finished today. Well, it still seems unfinished but I'm posting it anyways]

Last week, I had a birthday, and it got me thinking.

Yesterday, I found out my neighbor who is my age died at a party the night before, and it got me thinking.

Today, I went to the Shepherd Center, and it got me thinking.

I started thinking about time.

Like time, there's always time
On my mind
So pass me by, I'll be fine
Just give me time

How quickly time does pass. When I was my younger sister’s age, one year meant seemed like forever. Being 20-something felt so far off. It seemed so old. I remember in third grade thinking that by mid-20’s, I’d be working, married, and established.

I am none of those three. And that’s okay. I am just making a point about the absurdities of time.

When we were going through the Shepherd Center, I was reliving memories—good and bad—that I had during my stay there. My former doctor and therapists recognized me and when I told them that I was there two years ago, their mouth dropped when they realized how long it had been.

My neighbor who passed away was also so young. “We saw him mowing the lawn and running just the other day,” my family kept staying. “He would always take care of our cats when we would go out of town.” Death is a thief that robs people’s loved ones without any warning or preparations. Life and time are such fragile things that must be protected and valued above all other things.

The other day when my youngest sister was sitting in bed next to me reading, I thought about how she probably doesn’t remember me being able-bodied. She probably only knows “wheelchair Hammad”.

There is no time: there is no time for grudges; for arguments; for unhappiness; for hate; for all things negative. We need to let go. We need to stop keeping people around us that make us unhappy and stop doing things that we know are self-destructive.

Being in a wheelchair sometimes makes me feel like a silent observer in the world around me, like I am sitting still while the world around me is running around at great speeds. I wish I could just slow things down. Put a hold on time.

There’s always time. On my mind. So pass me by, I’ll be fine. Just give me time.

It’s time to let go.

“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.

Two Years. The scars remind me that the past is real.

I started writing a blog post last week about finishing my first year of medical school, but stopped writing after about half a page. I looked at the date and my mind got distracted.

It has now been two full years since my accident. Two years. Wow, it’s hard to believe. It’s hard to believe I’ve come this far. I never thought I’d make it.

Things have become routine now. I sometimes forget about the way I used to do things before my accident.

When I look in the mirror, I still see a scar.

The scars remind me that the past is real.

I have several scars that have faded with time—some not fully, though. I had two prominent scars on my face that were not a direct result of my accident, but were due to the hospital staff in Augusta strapping my face mask on extra tight because I deliriously kept trying to rip it off. It left two deep, dark scars on each side of my nose. The one on my right side faded within the first year after much scar cream, but the one on my left side is still slightly visible.

The gnarly scar on my neck is still there. I believe the back scar is also still there, although it has probably faded significantly, as indicated by this photo from one year ago:

Why am I talking about scars? Sometimes I forget about my situation until I see them, and then I remember. The scars hide a lot.

I finished off a year of medical school! It’s been a long year, but it has also gone by so incredibly quick.

When I think back to one year ago, all I remember is apprehensiveness surrounding the whole thing. My parents were still trying to convince me to not live by myself. They were worried about how I’d live on my own and how I’d do in school with everything I have to balance. Other people were concerned about the same thing. I felt like people looked at me with doubt. I was concerned about how my classmates would treat me and look at me.

Throughout the year, I doubted myself many times. I came in very confident and almost immediately got shot down.

There was about a one month period when a certain medication I started put me into severe depression. Once I discovered what was making me feel like that, I immediately stopped it. That was not a bright time. I wrote about it, but did not post it. I will post it here now ("Bulletproof"). I’m glad that only lasted a short while.

I had a few meetings with some faculty members at school. I told them that I was frustrated with things, and they told me how they were all impressed at how I was dealing with things, progressing, and how far I was going. That was certainly encouraging.

Living alone and going to medical school a year after everything I have known for +22 years was turned upside-down really made me “grow up”, so to speak.

During year one post-injury, I was coping more with my physical situation. Over year two, I dealt with my mental situation. I’ve never worked so hard in my life and I can confidently say I worked harder than any of my classmates and anyone that I know.

There were times when I told myself I was in over my head. There were times when I wanted to quit. I became so frustrated with things because everything was different. I wasn’t the same person. I spent a long, long time studying things. On our weekly quizzes and on our exams, my grades were definitely not reflecting my effort at all.

Or perhaps they were reflecting my effort, considering certain circumstances. I was pulling my hair out because I really wasn’t the same person at all. I did not have the same mind. The scar on my neck reminds me of my traumatic brain injury; it reminds me of the time I spent on the brain injury floor; it reminds me of all the times I was told to reconsider professions; it reminds me of why I had to work so hard to keep my dream alive of becoming a physician.

Thankfully, I made it through alive.

I’ve decided to live in the present as much as I can. These past two years have gone by faster than I have ever thought, and two more years will go by just as quick. No doubt, though, I am surrounded by constant reminders of how different I am, and I am also grateful because I feel like they have given me a new outlook on things. I’ve always liked challenges.