What a difference a year makes! 2nd-year medical student Hammad Aslam shares how he’s changed since entering medical school in 2010, just one year after a car accident left him paralyzed from the waist down.
From patient to doctor: Life rolls on
by Chelsea Toledo
In his blog, Thoughts on Wheels, Hammad Aslam wrote: “I was being interviewed for something today, and when the camera was briefly turned off and the interviewer was about to pack up, I decided to let down my guard. I was all smiles before that moment, as I almost always am. Even as I discussed the true state of the last two years, I continued to smile and spoke of it as if I was summarizing a book I had just read.”
Aslam’s story sounds like the plot of a novel: A University of Georgia graduate with his whole future ahead of him. A drive home from house hunting in Augusta, where he planned to attend medical school. An accident and a fallen tree. A traumatic brain injury and a severed spine. A week in a coma, a year in rehabilitation.
Yet somehow Aslam has clambered out of the ditch and is back on the road toward becoming a doctor, which has been his goal for years. His way of getting there, however, is forever changed.
New beginnings all around
This month Aslam completes his second year at the Georgia Health Sciences University-University of Georgia Medical Partnership in Athens. When he enrolled in fall of 2010, everything about the enterprise was new and untested – from the building to the student body. Having a partially paralyzed student was one more set of complications to consider.
“It became clear that there were going to be challenges,” said Barbara Schuster, campus dean of the GHSU-UGA Medical Partnership. “How do you do a full physical exam with the disabilities that he has?”
Faculty members knew that teaching physical examination skills to a student in a wheelchair would require some creativity, but they also suspected this might apply to book learning as well. Most medical students arrive accustomed to being at the top of their class, and many discover that the challenging curriculum and constant competition amount to a new and unexpected level of difficulty.
“Hammad’s no different in that regard. But in addition to that, he might have had even a little bit more perhaps because of what challenge he had from the accident. The paradigm changed in more than one way,” said Cheryl Dickson, the Medical Partnership’s dean of student and multicultural affairs.
Relearning how to learn
Aslam survived a near-fatal car crash, after all. When the tree fell on him, he suffered from a subarachnoid hematoma (or bruise on the temporal lobe), along with intraparenchymal hemorrhages (bleeding in the fleshy part of the brain) and a fracture of the occipital bone at the lower back of his head.
“I didn’t think it was that big of a deal, but apparently, it was a big deal. At the hospital, they kept telling me it was huge, and I was like ‘I’m the same,’” said Aslam. “I didn’t know how big of a change it was until first year when it seemed like no matter how hard I studied, I wasn’t good enough.”
Aslam’s first year of medical school was a struggle. He studied nights and weekends when other students were going out. His long-term friendships fell by the wayside, and he didn’t make many new friends in his classes. He felt frustrated and depressed, but ultimately, he passed his courses.
“Somewhere between the first and second year I decided to just chill out, and when I came back I was just totally relaxed,” said Aslam. “I’m trying to enjoy life while still studying a lot.”
That proved harder than expected. Coming off a relaxing summer, Aslam failed the first module of his second year. His professors urged him to consult a neuropsychologist and find out whether lingering effects from the accident were making it harder for him to learn.
He was reluctant. “I kept saying, ‘No, I’m fine,’ because I don’t like to consider myself any different,” said Aslam.
When he finally went for assessment, Aslam was relieved to learn that his scores for mental competence were normal—in fact, he scored “really well” in most areas and didn’t require accommodations for mental disabilities. Instead, Aslam worked with the therapist to “relearn how to learn.”
“I’m not dumb, I’m smart. Everything’s in there, I just need to find out how to get it out,” he said.
Standing up for their student
After two years, Aslam and his classmates are thinking hard about their future careers. Aslam is certain that he wants to work directly with patients, as opposed to being a researcher, and he has considered working with children or with patients with spinal cord injuries like his own. The fact that he is paralyzed from the waist down, however, means that some physical aspects of patient care may be more difficult for him.
Some barriers are easy to get around. For example, Aslam uses a “grabber” to pluck supplies from overhead shelves. And his Medical Partnership professors suggest other tweaks as the need arises. For instance, one clinical mentor suggested that Aslam cover his lap with a thin pad to keep the patients’ arms away from his “private equipment” while he tests their reflexes.
Other obstacles have required more elaborate and costly solutions. Certain parts of a physical exam —such as inspecting the eyes and ears—must be performed at eye level with the patient. To comply with the Americans with Disabilities Act of 1990, the Medical Partnership provided Aslam with a wheelchair that raised and lowered him in a seated position. It cost more than $10,000.
Unfortunately, the bulky chair wouldn’t fit into his car and barely fit through doorways with him in it.
“The one that elevated him didn’t work as well as we had hoped,” said Schuster. “And then we heard about this other one that was, frankly, quite expensive and ADA didn’t require it.”
This chair would enable Aslam to straighten his body into a standing position to perform examinations. It would also collapse to fit in his car. While the Medical Partnership was not required by ADA to provide the chair, Schuster helped a family friend of Aslam’s negotiate a reasonable price from a manufacturer.
Asrar Ahmed, president of Home-Health Pavilion, provided the chair at cost to Aslam’s family friend, who wishes to remain anonymous. Ahmed opted to forgo a profit and instead asked for a “promise from Hammad that he will pay him back by serving others.”
Moving outside the medical school
Although Aslam’s medical education is their official concern, his professors have taken a broader interest in his well-being. During Aslam’s first year, Schuster referred him to UGA’s Exercise Vascular Biology Laboratory, where equipment includes a functional electrical stimulation bicycle. This makes it possible for Aslam to get a lower-body workout as electrode pads stimulate his thighs, calves, and glutes.
He has also bonded with Kevin McCully, the kinesiology professor who runs the lab, and the graduate assistants who work there. Aslam spent the summer between his first and second year of medical school as part of the lab team—studying exercise in patients with spinal cord injuries—in other words, himself.
“I never thought I would be interested in research because I always wanted to interact with patients,” said Aslam, “but after working with Dr. McCully, I saw how incredibly social he is and how he interacts with his test subjects. And it’s really interesting. It’s not something I would completely disregard.”
Setting precedents to answer big questions
During the coming year, Aslam and his classmates will begin clinical training that will shape their future careers. Some of his mentors have urged him to pursue relatively sedentary specialties, such as radiology or pathology.
But Aslam is holding his ground and remains determined to work directly with patients. Administrators and professors at the Medical Partnership know the challenges he’s taken on, but they are supporting Aslam’s journey.
They’re also sharing what they’ve learned with others—including faculty at GHSU in Augusta, where the entering class includes a student who relies on a wheelchair.
The questions that arise in educating students with disabilities remain as those students move on to careers as doctors. For instance, some medical schools report having graduated blind students who have succeeded as physicians, provided someone tells them what they’re looking at.
“Those are actually questions that we don’t answer very easily in this country. How far do we accommodate a disability before we suggest that someone with multiple skills and abilities choose a different career path?” said Schuster.
In Shuster’s opinion, Aslam has all the skills and abilities he needs to succeed. She says:
“You have to be determined and very passionate to confront a major change in life and then to continue with your dream. And I’m very proud of him for that. A bit stubborn, and that has been a bit obstructive at times, but it’s also what has allowed him his success.”