11 years: this one goes out to...

It's May 23 again, the day of my accident, a day that will always cause me to slow down and think. It's been eleven years since that pivotal day.

I could not have predicted how my life would change. Nor could I have predicted the amazing people I have had the pleasure of meeting.

On this important day in my life, I want to talk about one person in particular. Someone who fills my color-blind eyes with love and vibrant hues that I did not fathom was possible.

That person is Zainab Alwan, who I am proud to call my wife.

As many of you know, medical school was tough. I perhaps too eagerly started just a year after my accident and was not prepared. I surprisingly met Zainab during this troublesome time.

If I were to describe all the ways my life has changed over the past eleven years, I would write forever. I didn't choose the wheelchair life; I was put into this position without asking for it. I have heard people say that people like me with disabilities are inspirational or are heroes, but we are just ordinary people dealing with the circumstances in life that we have been given. We never asked for this and most of us would not wish this upon anyone.

What is astonishing, though, is how Zainab sacrificed so many things in her life and willingly decided to be by my side despite all the changes in her life that she has made and would have to continue to make.

Now that is commendable.

That is what makes a hero.

Because of my medical training, she has moved with me to three different states, putting her own career as an accomplished lawyer on the backburner.

As a formerly extremely active person who still loves the outdoors, I had to accept the fact that I could never play certain sports, go to certain parks or travel to certain places, or experience many of the things that I before took for granted. Things as simple as feeling the sand between by toes or running into oncoming waves on a beach are things that I can watch others do and if I close my eyes, I can picture myself doing, but that will never again be possible for me. Zainab, who is healthy and able-bodied and also loves those things, knowingly sacrificed doing them because she knows I would not be able to join her.

Over the past eleven years, one main thing that kept me focused was my goal of being the best physician that I could be. When I have any issues, she is the person I go to and she always gives me helpful feedback and advice to help me further excel.

When we go out (or rather when we used to go out before the pandemic), she does not only have to think about and manage herself, but also our son, Laith, and me. It's not uncommon for her to be on busy streets unloading Laith, Laith's stroller and bag, and then my wheelchair while making sure we are all safe. Flying is a whole ordeal in itself.

She is always speaking up for the rights of those with disabilities, even if I am shy and insist that things are not an issue for me. She wants things to be equal and all right for everyone.

Not only is she the most amazing person to me, she is the best and most selfless mother I have seen. From before our son, Laith, was born, she has been planning what to do so he can have the best, healthiest life possible. She survived a traumatic childbirth in which I nearly lost her, and I froze up, unknowingly reliving other traumatic events in my life and not knowing how to handle things. A few hours later, despite dangerously low hemoglobin levels and excruciating pain, she was somehow up and doing things on her own again, thinking only about her son and about me. That's Zainab.

Laith is now almost seventeen months old and I still am physically unable to pick him up out of his crib or lie him down, I cannot put him in his highchair to feed him, I cannot put him in and take him out of the bath tub to bathe him. I've seen her get by with little to no sleep for months while she took care of Laith on her own.  She does all these things and so, so much more.

I of course know what it is like to be unwillingly thrust into a life that is completely different than anything one could imagine or prepare for, but I cannot imagine what it is like to see that life and knowingly choose to become a part of it, accepting all the difficulties with patience and a smile.

For that, I will be always be grateful for Zainab Alwan, the best human I know.

Love conquers all.

Eight years later: back but not the same

I'm not sure what surprises me more: that it has been eight years since my accident or that it has been two years since I have written on here. Perhaps a little bit of both.

Sometimes when I am lost in my mind, I think to myself, "Do I even still know how to write?" I never thought of myself as a writer or someone unique. I just say what I am thinking--these crazy thoughts on wheels--without thinking much about how it will affect others or what they will think. Though I started this less than a year after my accident and before I started medical school to help myself, apparently it helped others, and they encouraged me to keep writing. So I did. Looking back, this has not just become a chronicle of my journey, but, perhaps more importantly, my growth.

If continuing to write touches or entertains just one person, it's worth it.

I'm currently a few years into residency as I specialize in physical medicine and rehabilitation (PM&R), also referred to as physiatry (note: Google Chrome's spellcheck still thinks that "physiatry" is not a real word). I love this specialty. There is nothing like helping a patient improve both physically and mentally and maximize their abilities and quality of life. I would not have known about it had it not been for my accident and my subsequent rehabilitation.

A year ago, I asked my father to look for and bring my reciprocating gait orthoses (RGO) leg braces the next time my parents visited my wife and me. I made the excuse that I wanted to just show the guys in the orthotics and prosthetics department. RGOs are basically leg braces extending from feet to abdomen that would allow me to stand and take a few really slow steps using upper body momentum with the aid of a walker or other assistive devices. They are supposed to be for someone who has, at minimum, more abdominal control and they work even better if the user has some movement in their hip flexors. I obtained them years ago and my private goal was to use them at my medical school graduation so I could walk and receive my degree like everyone else. When that did not happen, my goal was to use them when I got married. This time, I just wanted to practice using them because I thought it'd be cool to walk again.

And this is where my wife, Zainab, comes into the story. I am paralyzed from below the chest, not from below the waist, so I do not have any abdominal control or trunk stability. But I am stubborn, and that has helped me do a lot of things, so I figured I could do this, too. Alas, I was not. The few times I tried many years ago, it was incredibly hard for me to stand without the help of others and once I was standing, I was unable to bring my leg forward to take a step.. When Zainab saw them, she asked why I wanted to try them again.

She knows that I am not troubled or embarrassed with anything in regards to my disabilities. I admitted to her that I thought it would be awesome if I could secretly practice and then surprise everyone by being able to stand and move without the use of my wheelchair.

I continue to have dreams at night in which I am walking around and doing things like everyone else.

With the leg braces, I could easily fall. I could break many bones. I would have to miss work and I would not be able to go anywhere or do anything for a while. "Is it worth it?" my wife asked me. "Hammad, we do more things than a lot of able-bodied couples. We play tennis, we swim, we go on walks, we travel, we've been kayaking."

I put the braces back in storage.

It is not like me to want something more than what I already have. I have been given so much. There are many times I feel like I do not deserve everything with which I have been blessed.

There are so many things I will never experience. I live close to a few amazing parks but I cannot go hiking in them. When traveling, I cannot explore some areas or do some touristy things. I will never be able to ride a roller coaster again or know what it's like to hold my wife's hand while we stand barefoot in the sand on a beach. I cannot play soccer with my friends or go zip lining with my co-workers.

But there are other things.

Each day is a beautiful day. Things are not taken for granted. Anger and other negative feelings are not an issue.

Quality. Not quantity.

This accident eight years ago is the best thing that could have happened to me.

Where love is.

There is something profoundly simple yet so touching I have noticed since embarking on my path to become a physician. I am regularly reminded and think about this subject. I have not posted anything in a long, long time. This is a topic about which I have wanted to write many times these past few years but never knew how to encompass something so big, so instead I'll just keep this short.

In the movie Love Actually, the narrator in the beginning states that love is everywhere. To illustrate that point, he shows scenes from an airport. Family members, lovers, significant others and best friends are shown embracing each other after being away from each other or before leaving each other for some time. It is implied that the easiest and most visual representation of the love people have for each other is seen in airports.

I disagree.

We physicians have to maintain a certain emotional distance at times. If we do not, this profession may break us.

In the superficial world of social media, advertisements and our ego, love is smiling. Love is happiness. It’s flawless jewelry, perfect outfits, beautiful Instagram photos, inside jokes, amazing meals, wonderful scents. It’s about showing your best. Love is hiding your flaws and being the best version of you that you can be.

As a former patient, then a medical student, and now as a physician, I continue to see how misleading and fleeting this is.

Love is the woman in her 60’s who sits with her husband in the ICU every day. She reads the magazines and the Bible a thousand times. Though she gets frustrated sometimes when someone new does things differently, she greets every member of the hospital staff with a smile and thanks them when they leave. Her husband has not vocalized anything in a few weeks, but that doesn’t bother her. She has been with him for decades. She cannot imagine being anywhere else or living life without his presence. The beeping heart monitor and the gargling sounds he makes before she suctions him are the few remaining connections she still has with him.

Love is being able to leave whenever you want, but never doing so.

Love is the mother whose son has just been in a devastating accident and doesn’t know how to live anymore. She wakes up at 5 AM, works a full day, and then drives to see her son every day despite living 45 minutes away and being scared to drive on the interstate. His life will never be the same and he needs to know that things will be okay.

Love is supporting someone, even if neither of you know what’s next.
(PS: thank you, Ummy)

Love is the husband in his 40’s whose wife has recently had a stroke. He is with her every day, sleeping on an uncomfortable couch in her hospital room. He accompanies her daily in therapy. He learns how to catheterize her to drain her bladder. Though he was never good at changing their own kids’ diapers or potty training them when they were young, he now learns how to help his wife to the bathroom and clean up her messes.

Love is smelling like vomit, urine and feces, but being perfectly okay with that.

A favorite band of mine, Death Cab for Cutie, has a song called “What Sarah Said” with the following lyrics:

And it came to me then that every plan is a tiny prayer to father time As I stared at my shoes in the ICU that reeked of piss and 409 And I rationed my breaths as I said to myself that I'd already taken too much today As each descending peak on the LCD took you a little farther away from me Away from me Amongst the vending machines and year-old magazines in a place where we only say goodbye It stung like a violent wind that our memories depend on a faulty camera in our minds But I knew that you were a truth I would rather lose than to have never lain beside at all And I looked around at all the eyes on the ground as the TV entertained itself 'Cause there's no comfort in the waiting room Just nervous pacers bracing for bad news And then the nurse comes round and everyone will lift their heads But I'm thinking of what Sarah said that "Love is watching someone die" So who's going to watch you die?

I contend that love is best seen in hospitals. Though the medical profession is known to be one of science, facts and physiological processes, it is also one of pure love. I see it and feel it every day. It keeps me grounded and keeps my heart soft.

Still Journeying

Sometimes, we wake up and it’s “just another day”. Our life is stagnant, it seems. We get ready, we go to work or to school, do what we need to do, try not to screw up, and come home. In order to break the monotony, we whip out our phones and get on Facebook. Or Instagram. Or Twitter. Certainly, other people are living their lives in a more interesting way. We are here, they are there. We are doing this, they are doing that. We have this, they have that. We are stuck.

Many times, once we get to a certain “set point” and are comfortable with our lives, we believe we are who we are and don’t see ourselves changing. Sure, we are in a different place from when we started, but now it seems like every day is exactly the same.

Admittedly, these may have been my sentiments.

Many people over the past several months have asked why I have not written anything in so long. Many people—including myself—thought that I may have stopped writing permanently.

I can give the usual excuses of being too busy or that I just discuss things I think about with those close to me, and I would not be lying. But it’s more than that.

We do not notice our changes until later. Nor do we notice our growth until later.  But each day is an opportunity for growth. I have grown a lot over the years since I started writing. This is clearly evident.

I thought that because I was comfortable with whom I am, with this relatively new life, that I had stopped growing. I have been grossly mistaken.

Each day, I am given the opportunity to affect people. I can choose to stay stuck in my own world, be encompassed in my own life’s worries and the next thing I have to do, or I can take a look at the broader picture. I can choose to stay the same, or I can choose to change. I can live each day as if it was the exact same as yesterday, or I can make a difference.  I can wake up each morning and groan that I have to go to work early every morning, or I can be thankful that I have woken up so I can have the privilege to try to help and heal my patients, speak to my loved ones, reconnect with old friends, and bring my passion each day to do my best while doing what I love.

I have made my decisions.

A patient's goal

Sometimes we get so caught up in our lives that we forget about the little things. I remember writing on here once about how a research subject of mine who also uses a wheelchair said to me once, “It’s the little things that you miss the most.” I whole-heartedly agree.

When I couldn’t swallow and had to eat pureed food and drink thickened liquids, I yearned to eat a nice slice of pizza. After about a month and a half, I was finally able to do that on my birthday.

Whenever I see patients who cannot swallow, my heart goes out to them. The taste of both simple and complex foods is something that is not really appreciated by us until we cannot do so. A lot of people I know cannot go a day, let alone a few hours, without eating. Self-control in terms of more sensible/healthy choices versus unhealthy options is also becoming rare. Food is the drug we take advantage of and abuse.

During my first month as a “real doctor”, I worked in the spinal cord injury unit at the VA hospital. I developed a good relationship with my patients there. There was one patient in particular with whom I would just sit by and talk with for a long time. He was on a ventilator and could not speak, so he would mouth his words out to me. It would take a long time for him to tell me things, but we made it work. A feeding tube had been placed so he did not eat. I did not ask him the last time it was that he ate or drank something but he told me how he really misses eating and misses the taste of the food we all indulge in, like burgers and pizza. He had a lower cervical level spinal cord injury, which meant he was paralyzed from neck down and had the ability to use his arms but not his fingers. He was in the hospital being treated for a large pressure ulcer on his backside. Every day I saw him, he was in the same position lying in bed and watching TV. He always had a smile on his face and he always greeted everyone warmly.

He told me something that again made me thankful for everything. This patient’s goal and what he wanted most? To go outside and feel the sun on his face. He told me that he had only been outside four times very briefly since November 2013.

I love the feeling of the warm sun after being inside an air conditioned room all day. I cannot imagine going months without seeing the sun or feeling and breathing in the air outside.

As busy as I am, I made time to see this patient and talk with him. My heart was touched and I was reminded again of how far I have come, how blessed I am and how grateful I should be for everything, especially the little things that may not seem important to some people.

I promised my patient that once he is strong enough and his wound heals up enough, I will take him outside. He promised me that once he gets out of the hospital, he will buy me a cheeseburger.

Perfect.

Five years

I know it’s been a while. My life has been very busy yet also filled with a whole lot of beautiful, blissful nothingness. I guess you could say I have taken a leave of absence from writing and I will on another day touch upon why that is so. 

So far, 2014 has been pretty good to me.

I thankfully matched into great residency programs. I am doing one year of internal medicine at the Medical College of Georgia in Augusta and then I will be specializing in physical medicine and rehabilitation (PM&R) at the University of Alabama at Birmingham. I also graduated and earned my medical degree this past May. I am now a real doctor.

People turn to me for help. For the most part, I am no longer seen as an invalid. For the most part, I am respected now. I have the privilege of seeing people when they are most vulnerable. I have the ability to help and to heal.

The things for which I worked so hard my whole life, especially these past five years, have finally come to fruition. I struggled so much these past five years.

My friend’s father suffered a hemorrhagic stroke the other night and is still unconscious. It reminds me of my traumatic brain injury that also resulted in a significant brain bleed. I was in a comatose state for about two weeks. My doctors at first did not think I would survive. After I survived the most critical time period, my family and friends were told that I may suffer significant mental deficits. I am forever grateful that I made it through better than what was expected.

When I wasn’t able to lift my right arm, I worked hard to get it stronger and stronger. I could not transfer onto things by myself but I worked at it just so I could move out of my family’s home and live by myself and attend medical school. That was my dream and I had to hold on to it. It was one of the very few things I still had left.

I didn’t want a van. I wanted a car. I didn’t want a big power wheelchair. I wanted a small, manual wheelchair. I wanted to be as “normal” as I could be.

When I had to see a neuropsychologist and speech therapist every week and they told me that I was not mentally the same and that I had to adapt, I ignored them. This was my chance. I had been given a second lease on life. Who knows how much longer I would have. So many things had been taken from me. I had to use whatever I still had left. If not for myself, then for everyone else I have come across who are in much worse conditions than I am or ever have been.

I would have to be the best I could be.

It has been five years.

That’s half a decade.

That’s half of the age of my youngest sister.

Things could have been totally different. Some say that things should have been totally different. I may be an outlier.

But I refuse to live life with the societal restraints of simple terms such as “handicapped” or “disabled” that people use when they themselves have not come to term with their disadvantages.

I do not remember what it was like to walk. I do not remember what it was like to stand. I do not remember the feeling of sand between my toes while on the beach. I do not remember running, jumping, playing or lifting.

But these things do not bother me. I have learned that life is not something onto which we can hold. It is not supposed to be perfect. The future cannot be feared. These past five years have shown me that.

And now, looking back, I would not want my life to be any other way.

My speech at the BHS Baccalaureate Ceremony, 05/18/2014

I know it has been an incredibly long time (five months!) since my last blog post. Once this blog became more popular and started to hit a few thousand views each month from people all over the world, I started writing less and less. I will write something and post something up this week or early next week and update everyone with where I have been and what has been going on in my life. In the meantime, here is the talk I gave at the Brookwood High School Baccalaureate Ceremony this past May. I graduated from Brookwood High School in 2005 and was asked to speak at this ceremony.