Those around you

I know I haven’t written anything in a while.  There’s a reason for that.  I feel like a change has come over me, especially since I spoke at the TEDx conference.  I only had a few days to prepare for the talk that I gave and as I have told many people who have asked me about it, I am not really happy with my performance.  But I must say, I opened up my heart to the crowd and left it out on that stage.  When I left the stage, I felt like something had been lifted off of me.

As I mentioned earlier, I am currently on clinical rotations.  This is much more interesting than reading books and taking tests, although I still have to do that when I’m not seeing patients.

This thing we call life is a lot simpler than people make it out to be.

An interesting thing happened when seeing a patient with chronic anxiety and major depressive disorder in the psychiatry clinic. 

“Dr. Aslam, do you have any questions for this patient?” the psychiatrist asked me.

“No, nothing in particular.  All the questions I had were answered,” I replied.

“I have a question for you, actually,” the patient said to me.  “How did you get in a wheelchair? What happened to you?”

I was surprised by this question. “I got into a car accident about three and a half years ago,” I replied.

“Oh, well, I was going to say something.  As soon as I walked in here I noticed you sitting there and thought to ask you.  See, I was in a bad car accident a few years ago.  I got plates put into my leg and had to walk with a cane for a while.  My ribs were broken and everything.  Since then I’ve just been so blah.  But seeing you makes me think, ‘Hey, if he can do it. I can do it.’  That’s very inspirational. If you can do it, then why am I always letting this bring me down?  It’s an inspiration for my depression.  I just wanted to say that.”

I was so surprised that I stuttered a thank you in reply as a bashful smile crept across my face.

That’s the first time a patient has ever said something like that to me so explicitly.

I don’t think my life is anything special.  I do what I do without noticing anything different now. Everything is a habit.  I have grown used to having to make adjustments to the point that they are no longer “adjustments”; they are simply how I do things.

I have been staying at my family’s home in my hometown these past few days since the offices I am going to are closer to here than to my apartment.  It’s always good being with family and reconnecting with friends—both best friends that I always keep in touch with and old friends that I haven’t seen in a long time.  They have been there with me since I have known them, through thick and thin.

Last night, someone very close to me said something that shook the establishment of what I had come to know as reality.

Last year, a classmate and I went to a support group for people who had suffered a stroke and their families.  My classmate and I were shocked and disappointed by the guest speaker there who was making exaggerated and even outright incorrect scientific claims regarding an expensive treatment that he said could cure the nervous system symptoms of those who had a stroke.  The people present at the support group were amazed and seemed ready to give their money for this “snake oil” (http://en.wikipedia.org/wiki/Snake_oil).

“People in dire situations look for something—anything—that gives them hope.  I fell for snake oil myself a few times early in my situation,” I wrote on a piece of paper and showed my classmate.  He nodded in understanding.

I remember how hopeful I was in the beginning, as I discussed in this blog post.  I felt like everything would soon be okay.  Everything would be back to normal like they once were.  I would regain movement, slowly but surely, and start walking again.  All my friends would be happy for me.  Then, I would go on living like I had always thought I would live.

Some people close to me have never lost this hope.  It hurts my heart sometimes knowing that things fell short of the hopeful expectations of those around me.  This does not mean that those close to me are not proud of me.  Of course they are.  I think I just realized that without knowing when or how it happened, I have accepted things.

And that’s okay.

It just hurts me when I am let down and it hurts me even more knowing that other people have been let down.

I know as a physician, that is something that will sadden me.  When people have high expectations for themselves or for their family members or friends (for example, surviving terminal cancer), and are then let down, it can break them.  That is probably what Red from The Shawshank Redemption meant when he said, “Let me tell you something, my friend. Hope is a dangerous thing. Hope can drive a man insane.”

So what are we to do? Give up hope?

No.

That eager, poetic, child-like hope that people have early on when facing extreme struggles is what creates miracles.  Nothing happens from just lying back and taking the beating.  Hope in my situation still hasn’t given me the results for which I had hoped.  So what?  It has led me to do other things that no one thought was possible.  And it has led me to affect those around me in seemingly magical ways.

We have the power to affect any individual we meet.  Be your best.  Leave them with some hope.

Neuro thoughts

Today was my first day of my neurology rotation.  I knew this was going to be interesting since I have first-hand experience in some of the things I was going to see.  After seeing some patients and talking to the attending physician, I became very thankful.

I was thankful not only to my family and friends, but also to myself.  I know that sounds odd, but I was thankful that I didn't take the easy way out.

Doc:  "You had a similar injury to your shoulder?"
Me:  [I explain my injuries]
Doc:  "What happened to you?"
Me:  [I talk about the car accident and how I was the only one in my family seriously injured]
Doc:  "Did it take long to adapt and learn to get around?"
Me:  [I explain how I took one year off after my accident before moving out, living on my own, and attending medical school]
Doc:  "I'm sorry if I'm asking so many questions."
Me:  "No, no.  No one has asked me these questions in a long time.  I sometimes forget about these things.  It's good to talk about them with someone who knows about the nervous system."

Talking about these things made me reminiscent and really thankful for how things turned out.

I remember when I wasn't able to use my right arm at all due to a nerve injury affecting my right shoulder.  I was unable to lift my arm and using this arm gave me a lot of pain.  The therapists didn't listen to me at first and made me continue to try and work with it until I confronted the doctor about getting it tested for any possible nerve damage.

I remember the intense neuropathic pain it caused me.  I refused any serious pain medications besides a simple dose of Tylenol at night so I could fall asleep through the pain.

I remember how the therapists and hospital staff tried to convince me to get a motorized wheelchair because of the weakness in my right arm.  They also tried to convince me to get a van that I could simply roll my wheelchair into and not have to transfer onto the driver's seat.  I refused both.  I knew using a manual wheelchair that I would have to push would make my arm stronger.  I didn't want to drive a van because it embarrassingly screamed, "Look at me. I have a handicap!"  I wanted to drive a car like a "normal" person.  I knew it would be tough at first trying to take apart my chair and putting it in my car multiple times a day.  But it was something that I wanted to do.  I just wanted to be normal.

I remember how I had many arguments with my family as I tried to convince them to let me live on my own.  They wanted me to have a nurse or at least have a roommate living with me just in case I needed something. I didn't want that, though.  I wanted to live on my own.  I knew I could live on my own.

Those decisions may have seemed stupid by other people at the time, but I am thankful for them.  They are what made me stronger, both literally and figuratively speaking.  I didn't like taking the easy way out.

Don't take the easy way out.  Work through the pain and discomfort if it's going to get you to a better place. You'll thank yourself in the future.

Stages, part 2: Anger

Although I have a shelf exam next week, I thought it was time I finally finished the post “Stages”.  My talk at TEDxGeorgiaTech went alright but I know I could have done a lot better.  I really opened my heart and grew on that stage, so even if no one else was affected by my talk, I was affected.  I will post the video on here once it is posted online.

As I mentioned in the previous post on stages of grief, after denial comes anger.

My doctor and therapists sat down with my family and me one day, as they do with all patients at that hospital, to tell me about my injuries and my prognosis.  We were shocked.  I had no idea what some of the medical terms meant, but it didn’t matter.  I would show my doctors and everyone else that no one really knows what’s going to happen.  They can’t hold me back.  I’ll throw their silly statistics and prognosis back in their face and show them who’s boss.

Some people who suffer from a debilitating and life-changing injury become bitter, as I have previously mentioned on here.  I remember watching as a fellow patient became really mad at his wife because he thought she had misplaced his iPhone.  “My whole life was on there. That’s the last time I trust you with anything,” he said to her.

When misfortunes like this happen to us, it is perfectly reasonable to see why anger and frustration may arise.  We all like to have things the way we want them and the way we are used to having them.  Other people can’t do things the way we usually do them.  Mistrust and skepticism arise. “Why must things change,” we ask ourselves. “Everything was going so perfect, and then this had to happen. Ugh.”

Adapting to new things is hard.  Most of us do not like escaping from our comfort level.  What makes everything worse is when situations like this are thrown upon us without any warning.  Then, we have no choice but to adapt.  We have no choice but to once again relearn everything we once knew and learn how to do things in a new way.  It is in times of hardship that our true character is revealed.

My best friends who were and are always with me in my journey recall how scared I was when I first started physical therapy after I regained consciousness.  I was terrified.  I was on the edge of the mat and I was holding on tightly to the mat and the physical therapist.  My eyes were screaming, “Help me,” to my friends and family members.  I was convinced that I would fall off the mat and crack my head open.  Why was this so hard? What happened to me? Is this a dream? When will I wake up?

Several months later, a physical therapist gave me a toy Velcro ball/catcher’s mitt set one day during therapy.  She wanted me to sit on the mat and play catch with her.  The goal of this was to practice sitting up, moving my arms, and maintaining balance.  When a friend later asked me what I did in therapy that day, I was embarrassed to describe how I spent the day like a six month old child, learning how to sit and balance myself.

Why did I have to do all of this? What did I do to deserve this? No one I know has ever had to do anything like this.

A friend’s older brother one day gave me some of the best advice I was ever told.  He said, “Never ever ask, ‘Why me?’”  Asking myself, “Why me?” and becoming angry would not have gotten me anywhere.  In reality, it would have prevented my progression.

No, I wasn’t angry.  I was thankful.  I was thankful that although everyone in my family except my brother was in the vehicle, I was the only one injured. I was thankful that none of my friends had to experience what I had to experience.  I was thankful that through my injuries, I was rekindling old friendships, developing new friendships, and influencing my family and friends.

Admittedly, although I was never actually angry, I did become frustrated a few times.  It frustrated me that I had to put off future plans for an extra year.  It saddened me when I couldn’t play sports or go to certain places with friends.  It embarrassed me a year after my accident when the wheelchair elevator got stuck in front of all my classmates during the first day of medical school orientations.  But I never let it show.  In reality, I know that these things never completely bothered me.

If I let my hardship blind me and if I only perceived the difficulties, I would not be able to see all my blessings.  And if my situation affected my family and friends in such a deep and sometimes wounding manner, then I had to be the one to show them that even in times of complete darkness, the oft-forgotten and discarded candle brings light until the sun rises.

[It looks like I still haven't finished up with writing about all of the stages of grief. I may finish it up or I may move on to a different topic. My TEDx talk seems to cover the rest of it!]

TED

Please excuse me for not finishing my last blog post yet. Things have been really busy in the hospital. I was also asked on Monday to do a TED talk this Saturday! Unlike other TED speakers who have months of preparation, I only have a few days to come up with an idea and prepare. Let's hope I do okay. Only the best talks are posted online, so if I'm good enough, I will post the link on here.

Stages

Since my last blog post, I have been fairly busy with my medical rotations. Currently, I have twenty-four hour shifts on Mondays, Wednesdays, and Saturdays.  When I am not in the hospital, I am trying to catch up on sleep or trying to study.

I use my standing wheelchair when I am in the operating room or sometimes when I am seeing patients.  When I am not doing that, I am usually sitting and observing/talking to patients or sitting at a desk and trying to study.  My leg muscles get really tight from sitting in one position for so long.  Scrubbing in (thoroughly scrubbing/washing the hands up to the elbows and wearing sterile gloves/apron) and keeping things sterile while in the operating room has proven to be an interesting challenge.  When I am fully scrubbed in, I cannot touch my wheelchair to move myself.  One of the nurses on the surgical team has to move my chair for me and raise/lower the standing mechanism on the chair so I do not touch anything that is not sterile.

This is a new experience for everyone.  The physicians, nurses, anesthesiologists, midwives, and other members of the medical staff have never had to figure out how to do things while in a wheelchair.  Things may take a few seconds to figure out, but I’ve noticed that most people don’t look at me any differently (or maybe they do look at me differently and I have just stopped noticing).

That’s why a practice question I came across earlier caused me to think about my progress.  The question stem described a couple whose newly born child had just passed away and were questioning what had happened and could not believe it.  The question then asked what stage they would go through next.

The Kübler-Ross model’s five stages of grief are denial, anger, bargaining, depression, and acceptance.

I’ve been through pretty intense situations, so when did I experience this?  Did I go through all of these stages?

Let’s start with the first stage:  denial.  I am not sure if what I went through would be what others would consider as denial.  When I first heard about what had happened to me, I thought that I would be out of the hospital and 100% recovered in a few weeks.  My friends and family thought that as well.  It was not that we refused to believe the reality of the situation; we simply did not know exactly what to believe.  I had countless people asking me if I tried any specific surgeries or telling me about an old medicine man from their homeland that knows how to treat everything.  No one really knew what a spinal cord injury meant.  In regards to my brain injury, I would always tell my neuropsychologist, therapists, and physicians that there was no difference in the way my mind worked.

Once I learned about the extent of my injuries and what a spinal cord injury actually was, the harsh reality still didn’t settle within me or my family and friends.  As a therapist once said, everyone wants to be that guy who defies all the odds and leaves his wheelchair behind and walks out of the hospital.  I wanted to be that guy.  My family and friends were confident that I would be that guy.  We all hoped and prayed, all day, every day.

Every night, I went to bed praying and wishing that this was all a dream and that I would wake up like the old Hammad.  And then, every morning, I would wake up and nothing had changed.  It was hard for me at first to get motivated to get up and get out of bed, but I did it.  Sometimes I think I didn’t do it for myself; I did it for my family and friends.

This is not me.  This is not who I was.  This is not who I am.  This is not who I am supposed to be.  My loved ones and I tried hard to convince ourselves of those things.

I had a friend who told me it hurt her too much to look at me.  We had become good friends through my college years and our group of friends had plenty of good times together.  We did the funniest and craziest things during those years.  But to see me bearing the pain and disabilities that I had was too much for my friend to handle.  So I smiled and told her everything was okay and that I was fine.

My family and friends told me not to think of any other option for me but success and complete healing.  That is exactly what I did.

But what happens when the infinite amount of prayers, positive thoughts, well wishes, dreams, and goals fall short of making something—anything—change?  Where do you go from there?

I want to continue my story but this post is already getting a bit long.  I am talking about the past because I have met many new people who have asked me questions about my life and as I have said on here before, I do not want to forget my past.

To answer the question I asked above and to serve as a preview for my future posts, I end this post with a quote by the nineteenth century author Oscar Wilde:  The aim of life is self-development. To realize one's nature perfectly – that is what each of us is here for.

Connecting

[Disclaimer:  I was told this post was pretty personal. All my posts are personal to some degree but they all just skim the surface of what has happened and what I am thinking. No, nothing specific happened that led me to write this. I know readers of this blog come from different backgrounds and I do not mean to isolate anyone. I just thought it was time to say the ugly truth that no one likes to acknowledge.]

I know I haven’t written anything in a while.  These days I wake up early, go to the hospital, come back exhausted late in the afternoon and then rest and eat at my apartment or out with friends. I have barely enough time and mental energy to study. Starting next week, I will be on call for three nights each week.

A friend of mine recently asked to interview me for an assignment.  She asked me many questions and we ended up having a good discussion on many topics related to my disability and life in general. Her questions eventually led to a discussion on how people view disabilities and on relationships.

I have skipped around this topic on my blog a few times but I have not addressed it explicitly. This is usually a discussion I have with my friends. So let me say things plainly and straightforward now.

Soon after my accident, some things happened and I was hit with a hard reality that I already knew but weighed heavily on me nonetheless:  people would never look at me the same ever again. My life was forever changed. Everything I used to know and everything I used to be was gone. I know I have said those things a few times on here, but I don’t think people truly understand what I mean.

My friend who was interviewing me said she was going to ask some personal questions and asked me how I envisioned my future.  She asked if I still planned on getting married and having kids.  “Of course,” I replied. I told her how my situation now doesn't change my ability to find someone like I once thought it would. As an immigrant who naturally seems to cast his net for other first- and second-generation immigrants, the problem does not lie in me “clicking” and “connecting” with a girl; it lies in the approval of their parents.

You see, according to many immigrant parents, no matter what the country of origin, and even to some close-minded young folks here, having a handicap does not mean that everything is normal except for the one handicap. For them, it means that the person himself/herself is handicapped. The person is disabled. There is nothing he/she can do. There is no way that he/she can take care of themselves. Back in the motherland, a person with a disability did not do anything. The person is a burden upon society and a burden upon their family. That is why people like me are looked down upon by these people.

My friend who was interviewing me told me how frustrated she was by this view that people have. It’s not my fault that I have to use a wheelchair now. I didn't ask for this. I didn't do anything to deserve this. If someone’s son or daughter had a tragic accident and was in the same situation, how would they feel and how would they want their son or daughter to be treated? If your husband or wife was in an accident and acquired a disability, either physical or mental, would you leave them?

I am a big proponent of breaking any and all stereotypes.

As I stated in this previous post, that is one of the reasons why I work so hard. That is one of the reasons why I have lived alone since just one short year after my accident. That is one of the reasons why I continue to pursue my dream of becoming a doctor. As I said in this post, keep playing. I know I am different, but not in the way most people think I am.

I want to change people’s perceptions. I want to show the more close-minded people that they should not judge people simply by their looks.

Unfortunately, changing people’s perceptions may just be the first, simple step. Immigrant friends and their parents also care too much about what other people think. Gossip is the most favorite pastime among almost all of our cultures. What will these people tell their friends or their family members, especially those still in the motherland, if they or their child is attracted to someone with a disability? The egotistical concern for the approval of others is prevalent and at times sickening. We are all at fault at times, but we must learn to keep this in check when it comes at the expense of being intolerant or caring for one’s own self-perception instead of others.

A new friend recently said to me how surprised he was when he found out a few weeks ago that I have not been in a wheelchair my whole life. He had to ask a few other friends to get my full story. He then proceeded to view my Facebook pictures and go through my Facebook timeline to see my past. Yes, I told him, I spent twenty-two full years of my life able-bodied like almost everyone else. “From what I got from Facebook stalking your past, it seems like you have taken things very well. The energy and outlook on life you had before is still there. That’s awesome,” he said.

The smile I wear every day is the result of previous pain and experiences I would never wish upon anyone. They have resulted in my contentment and love for everyone and everything. I wish to break stereotypes that people hold and spread tolerance and acceptance.

Go confidently

This post is to serve as a reminder for myself.

Before I started third year clinical rotations, I was eager to start seeing patients but I was also a little anxious.  I was anxious because it is well known that physicians will ask medical students questions regarding a patient’s disorder and its etiology, symptoms, and management.  I wasn’t sure if I would be able to answer all of these questions correctly on the spot.

Being in the hospital has been amazing.  I can honestly say that this is my true calling.  Even though I have to wake up every morning earlier than usual, I am eager to see patients, learn from the attending physicians and nurses, and try to help the patient in whatever way I can.  I meet the most interesting people, both young and old.

All the patients have been very cooperative in regards to the awkwardness of having to use a large wheelchair.  The elderly folks smile and tell me to keep pursuing my goals while the children love to play with my wheelchair. 

It happens pretty often that a physician or nurse will tell me, “Watch out for that one,” or, “This patient is crazy,” before I go into a patient’s room to interview and examine them.  I can confidently say that I have never seen what they’re talking about.  Sure, I’ve had some unusual patients, but they have all been very kind and cooperative with me.

One attending physician told the nurses that I’m “the patient whisperer” because no matter how “crazy” or “out there” the medical staff says a patient is, they are completely normal around me and tell me things.  Being called “the patient whisperer” may not seem like an accomplishment to some, but for me, it is.  I love connecting with people.

Another attending physician was telling other medical students about an unusual patient we saw and added, “She said she was going to leave but Hammad talked her out of it.  Hammad disarmed her... with his charm.”  I loved hearing that.

As I said above, my main concern was being able to answer the random questions asked by the attending physicians.  Whenever I am questioned, I freeze up.  I usually answer slowly as if I’m unsure of myself.  Surprisingly, however, I am correct most of the times.

I guess these past few years have made me unsure of myself.  I thought I had gotten over being unsure, and I have for the most part, but I think being expected to instantly give an answer for something I haven’t studied in months or years makes me a little nervous.

During an evaluation, my attending physician seemed to pick up on these things.  The physician told me, “I’ve noticed that you don’t try to prove yourself. But in doing so, you prove yourself,” thus acknowledging the fact that I’m not a gunner and always trying to show off.  I’m not self-conscious about the wheelchair anymore, of course, but I seem to still be self-conscious about my current knowledge base even though it seems to be adequate.

There is a time to be confident and a time to be modest.

I just want what is best for my future patients.  I know I need to start answering more confidently, but I will still question myself and make sure I look at other possibilities before being overzealous and jumping to conclusions. 

I don’t need to impress anyone; I just want to be the best that I can be.  As I stated here, that is all we can ask of ourselves.