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.

Advancements?

I saw something cool the other day when I was on rotations in a doctor's office and that got me thinking about how advanced our world has become.  We are able to quickly see inside the human body, make a diagnosis, and prescribe appropriate treatment.  Recently, the Curiosity rover landed on Mars and is sending back photos from another planet. Another planet.  When we were young, we would never have thought that we'd have Skype and Facetime, things that allow us to see and talk to people as far away as the other side of the world, on our phones that are small enough to carry in our pockets.  Pause and think for a moment about how amazing all of this is and how far we have come.

But then I remembered that there are whole groups of people in this world dying of starvation.  They constantly feel the stabbing pangs of hunger and are dying.  This happens every single day.  People are killing each other over meaningless "differences" or because their thoughts, values, and what they think is right are not what someone else thinks is right.  We continue to discriminate and even hate others over these differences, whether they be race, religion, sexuality, political beliefs, disabilities, or anything else.  We have the nerve to possess ego and consider ourselves superior to other individuals and groups of people.  We hate our fellow humans.  We are blind and we ignore the pain, suffering, and deaths around the world.  I will say this again--we ignore our brothers and sisters who are dying of hunger or of differences in thought.  Pause and think about this now for a moment.  What justice is this?  What progress is this?

No, we are not advanced.  No matter how quickly and easily we are able to treat/cure those of us blessed to be born in this society, no matter how many planets we explore and discoveries we make, no matter how technological we get, we are not advanced.  We are a failure as a species.

Young folks, old folks

I love med school now.  You may have noticed a change in my tone over these past few years.  The only way to describe my first two years of med school is by a feeling of drowning.  I know others feel the same.  I slowly started to breathe as I progressed.  I’m only partly through my third year now and I am loving it.  The things I see and do every day reinforces why I decided to become a doctor in the first place.  I have also learned a simple truth about life:  really old and really young people are funny, happy, and great to be around.  Everyone else in between is just “blah”.

I have written before about how I love babies and little kids.  This is the first time in my life that I’ve spent several weeks interacting with the elderly, though.

The old and the young are similar in a lot of respects.  They both seem to live in a sort of timeless zone.  There is no past.  There is no future.  They may have completely or partially forgotten about the past.  Thus, it does not bother them.  They also have no worries about the future.  When was the last time you saw a ninety-year-old regretful and in agony for something they had done when they were thirty years old?  When was the last time you saw a four-year-old worrying about what they were going to do in a few weeks?

How often do we regret the things we’ve done in our past?  How many of us are worried about what we will be doing in the future or about our upcoming deadlines?

Both the old and the young have very simple needs:  they need food, they need shelter, they need love.  They are careless and they are content.  What happened to us?

Somewhere along the way while “growing up” and become “mature”, we strayed from this track and became lost.  We started “needing” many different things that really were not vital.  We started needing attention.  We started having pride.  We started getting our self-worth from what other people think.

One thing you may also notice about these two groups is that their mouths usually do not have a filter.  They are honest and say whatever comes to their mind.

There are many things we can learn from the very young and very old.  Firstly, the past does not matter.  It does not matter who you were before or what you have done.  Those things have past.  Forget about them.  Save the good memories that make you smile for when you’re sitting on a balcony and watching the sun rise or talking to your loved ones, but do not worry about the rest.  You cannot change those things.  I cannot change the fact that I have experienced things that I wouldn't wish upon anyone.  Also, the future isn’t that big of a deal.  It will come when it comes.  My future was pretty well laid out before but after my accident, I do not know what to expect and now I am very uncertain about my future.  Who will I become?  What will I do?  Will I have a "normal" life like I always thought I would?  It’s humbling to meet elderly individuals who know they may pass away any day or even any hour, yet have accepted it and take things lightly and are always smiling.  They do not miss an opportunity to help someone else.  And children live so much without care for the future that they can hardly think passed what they want to do when they go to the park that afternoon.

The young and the old are not superficial.  They do not have many preconceived notions about other people or things.  They have been superficial or had biases at certain points in their lives, but now they usually do not care.

All of this not only got me thinking about how I look at the world, but also how the world looks at me.  Older people never make a big deal out of my wheelchair.  Neither do little kids.  Well, they sometimes run up to it and start playing with it, but they do not see how it could be a hindrance to anything.  You may say that they are simply ignorant.  But I contend that they are just not worried about what other people will think.  They do not get their self-worth from others; they get it from themselves.  They only judge something based on the criteria that it makes them happy and makes them smile.

When you are worried about that upcoming exam or deadline, about what you plan on doing for the rest of your life, or about what the girl you met last night thought of you, talk to a small child or an elderly individual.  Ask them what’s on their mind and what they are worried about.

Love before you lose.

I feel like I should first explain what I have been doing these past few months, because many of my friends haven’t seen me in a while and I have not written any new blog posts recently.  This summer, I was busy studying and taking the first and most important of our three medical licensing exams, the USMLE Step 1.  A mere few days after taking the exam, I started my third year clinical rotations.  I have thought and seen many things over these past couple of months that I have wanted to write about, but I have not had the time.  I usually just ended up discussing those things with friends.

I am currently on a palliative care rotation, which focuses on relieving and preventing the suffering of patients.  I mostly see patients who are at the end of their lives.

Let me share a little story with you (with a few details modified for privacy purposes, of course):

     You are asked to consult on a 72-year-old woman in the ICU who was recently brought to the ER after suffering her second stroke.  She has end-stage dementia and is now unable to speak due to her stroke.  Her two sons are both present with her in the hospital.  As you flip through her chart, you notice that she does not have an advance directive, meaning that she has not specified what she wishes her care to be and who she wants to make health care decisions for her in case she is incapacitated—either physically or mentally.  Her lab values and tests show that it is unlikely that she will live much longer.
     Since she does not have an advance directive and is currently unable to make her own medical decisions, the health care power of attorney (the power to make health care decisions) is now legally with the widowed patient’s adult children.  You decide to bring up the difficult topic of their mother dying and what should be done.
     You explain the situation to her two sons.  One son listens calmly, is quiet for a few minutes, and then states that since their mother is in pain and will not live more than a few days, he wishes that she is kept pain-free, comfortable, and that she passes peacefully.  The other son is angered by this.  He states that there is no way his mother is dying and that everything must be done to keep her alive.  You explain to him that doing some things will only further her suffering without prolonging her life, but he does not listen.
      The two sons argue with each other all night while you are away.  When you return and see this, you decide to take the angrier son aside to your office to have a talk with him.  After about thirty minutes and plenty of tears, the son leaves your office and states that he too now wants his mother to be kept comfortable and free of pain, and that he will sit and pray for her as she passes.

Why was one son unable to accept his mother’s death?  Why did he argue and insist that she was not dying?

When he entered your office, you asked him these questions.  He burst out crying and explained to you that he did not feel like he had done enough for his mother.  While the other son lived with his mother and cared for her, this son lived in another state and hardly saw or spoke to his mother.  He initially felt that if he let her pass away now without doing everything medically possible, even if it meant more pain and suffering for her, he would be ridden with guilt.

Friends, do not let this situation happen to you.

Often times, it is not the patient who has trouble accepting their situation; it is their family members and friends.  I have both experienced this myself and seen this in other patients.  I was fine whenever something happened to  me.  When hit by life, I'm briefly frustrated, and then I do my best to be done with it.  There are some things we just have to accept and realize that we can't change, so we do our best to change everything else that we have the ability to do so.  I have noticed, though, that others cannot let it go.  Sometimes it is family members.  Sometimes it is friends who regret doing or not doing things to/for me.  I feel sorry for them.

We have a tendency to delay things.  We get so caught up in our own lives and our own desires that we push other things and other people aside.  We consider ourselves too important.  We are ungrateful.

Think about all the people who have done so much for us, including our parents, our siblings, our children if we have any, our other family members, our teachers, and our friends.  We cannot let opportunities to reach out to them and be kind pass by us.  We do not want to be left thinking after it is too late that we wish we could have done more for someone when we had the opportunity, but we were too blind to see it.

Love before it’s too late.  Love before you lose.