THE ACCIDENT AND TIME IN HOSPITALS

I was studying at a second university when I had the accident. I had already graduated from a school of business administiration for tourism and I was just completing the third year of studying English in the Department of Foreign Languages at Dokuz Eylul University in İzmir, Turkey. I had only one year to finish my studies which would prepare me for a career as an English teacher. But unfortunately this was not to be. A university graduation, the joys of youth, a lifetime of happy and productive years, a satisfying career...all my dreams suddenly turned to ashes, the result of a devastating accident...

It was May 5,1996.Two friends and I had decided to spend the weekend at my friend's family summer house after having taken hard final exams. I thought it was going to be good for me to get rid of the stress of the exams and a weekend away from school was not too much to ask. So when my friend invited me to his family's summer house, I said "I'd love to". After all, my family didn't have a summer house and I wanted to get away for a while.

Friday afternoon and Saturday had passed quickly and I woke up to a clear sunny day on Sunday. As I stepped out onto the balcony facing the Aegean Sea, I could smell the change of seasons in the air. I was very happy! My friends woke up and we had breakfast on the balcony, talking and joking. It was easy to be happy! Not knowing anything about the thing that would happen to me so soon; the devastating accident that would change my life forever.

After breakfast we packed up some things and went to the seashore to swim. Because the shoreline was very rocky, we decided to head for the pier and as soon as we reached the end of the pier we started jumping and diving into the water. We did this again and again until we had satisfied the desire. After the frenzied joy and excitement we sunbathed for a while. I don't remember who was the one who offered to dive into the water for one last time before going back to the house to gobble down some food before heading back to the city. We all agreed and got up for one last dive. In a moment my neck was going to be broken and my life would be changed to one of torture and pain. How could I know?

I walked to the very end of the pier, that was still wet from our earlier diving. This was to be my last dive. I felt very awkward as my foot slid and I couldn't push forward off the end of the pier. Instead I fell down into the water right at the base of the pier where it was very rocky. I hit my head on a rock and I saw a heavy flow of blood in the water before my eyes. It was so quiet in my brain that voices seemed to travel for miles. I could not move myself; I was completely paralyzed and drowning... I felt as if I was passing from this world to the next. I could feel eternal peace welcoming me home, but not just yet.

I was half conscious struggling to maintain consciousness. I faintly remember friends lifting me out of the water and quickly carrying me to the village clinic in the back of a truck which was passing by. I fainted on the way. When I could hardly open my eyes, a stupid government health official was trying to make me vomit, turning my head from side to side thus causing more and more damage to my fractured vertebra and injured spinal cord. All he had to do was to touch the parts of my body and ask me if I could feel him touching me. By doing this, he could have learned whether I was paralyzed or not. At the very least he should have immediately stabilized my neck with a collar or something; but he did not and I could not move even my lips to tell him that he was causing me further damage. If you iive in a underdeveloped country like Turkey, you are often in the hands of non-professionals.

I heard them call for an ambulance from the nearest hospital in the city which was 45-50 minutes away; then I fainted again. I remember being lifted into the ambulance and I could faintly hear some voices which I didn't understand. Friends and other people were telling me things but I could not understand what they were saying. So I listened to my own voice constantly telling me "ENDURE, PLEASE ENDURE. EVERYTHING'S GONNA BE ALL-RIGHT". As the ambulance doors closed, I knew that the life that I had had just one hour ago would never be the same again...

When I heard voices again I was in the hospital. Somebody was stitching the cuts on my head. I realized that my neck was still not stabilized. I vaguely remember the people, yet I vividly recall the feelings and the events. I fainted again...

When I regained just a little consciousness, I was in the MRI unit. It was as if I was in a coffin. I wished I were in a coffin. I knew that being dead was much better than being paralyzed. I fainted...

I was in a bed and they were drilling holes into my skull when I heard sharp grinding voices in my brain. I thought I was being operated on with a drill. Among the many different voices, I could faintly hear one of the people saying that they were fastening a traction device to my skull so that my head and neck would be stabilized against further harm to the spinal cord. It was too late. All the harm had been done at the beginning. My spinal cord had sustained irreversible damage.

About three days after the accident I woke up thinking this was a bad dream. I instinctively tried to stand up, but I could not. I thought I was still having a nightmare and I was struggling to get free. I soon realized that I was in the intensive care unit of Dokuz Eylul University Hospital and that this was not a nightmare but a worse truth. I had been operated on and now I was on a life support machine. I was able to communicate only by blinking my eyes. I desperately needed to tell someone that I wanted to see my mother. I waited for the nurse to come and I looked at her with beseeching eyes suffused with tears. She understood what my eyes were saying and let my mother in. She came by my side and instinctively held my numb hand between her hands but being paralyzed I could not feel her touching me. I wanted to hug her, kiss her, take refuge in her bosom but I could not move even a single finger. We were about to cry. She told me things but I didn't hear what she said; her mere presence was alll that I  needed. The nurse took her out.

The next day I was taken to a room containing several beds with several patients. My parents and my paternal aunt had come from their hometown and all my friends and my teachers from the university came everyday to visit me. This made me feel great since I was still struggling to stay alive. Even my former girl friend started comings in daily; I wished she had been by my side before. And I was surprised when I saw the girl whom I had just recently met. It was as if we had known each other much longer; she came everyday and spent time with me. I appreciated her staying by my side through all of those hard times. She was an angel; but it's very difficult and not much fun to be with a paralyzed man. She finally went her way. I understand this. Who can love a paralyzed guy!?

I owe a lot to my friends for their care and support in the hospital. I still remember them with deep affection and gratitude. I cannot forget my friends, some are so special to me because they were by my side in my most difficult times in body and soul. Although they are now away from me they still have their unchangeable place in my heart. I miss them so much. Thanks to Hasan, Ejder, Ali Izzet, Armagan, Ali Gecer ... all. Words are unnecessary at times. Wherever you are now, I love all of you fellows, I mean it.

THE TRUTH IS THAT I MUST HAVE BEEN  TREATED WITHIN THE FIRST FEW HOURS FOLLOWING INJURY TO THE SPINAL CORD. THE TREATMENT MUST HAVE INCLUDED  METHYLPREDNISOLONE, A STEROID WHICH SHOULD BE GIVEN PROMPTLY TO PATIENTS WITH A SPINAL CORD INJURY. THIS TREATMENT SIGNIFICANTLY REDUCES THE EXTENT OF NEUROLOGICAL DAMAGE FOR THESE PATIENTS. MOREOVER, TREATMENT SIGNIFICANTLY INCREASES RECOVERY IN SEVERAL INJURED PATIENTS WHO ARE ADMITTED WITH NO MOTOR OR SENSORY FUNCTION BELOW THE LEVEL OF THE INJURY. IN THE FIRST FEW HOURS, THE BODY REACTS WITH A SERIES OF PHYSIOLOGICAL CHANGES OR SECONDARY EVENTS THAT MAY CAUSE DAMAGE BEYOND THAT OF THE ORIGINAL TRAUMA. TRAUMA CAUSES THE RELEASE OF NATURAL SUBSTANCES THAT PRODUCE SWELLING, BLEEDING, INSUFFICIENT BLOOD FLOW, INFLAMMATION AND PAIN. SOME OF THESE SUBSTANCES CONTRIBUTE TO SUBSEQUENT SECONDARY DAMAGE WITHIN THE SPINAL CORD AND ULTIMATELY TO LOSS OF FUNCTION.

I MUST HAVE BEEN TREATED WITH METHYLPREDNISOLONE WHICH HAS BEEN THE INTERNATIONAL STANDARD FOR TREATMENT OF SPINAL CORD INJURY PATIENTS SINCE 1990. THEY DIDN'T TREAT ME IN TIME WITH METHYLPREDNISOLONE. IF I HAD  RECEIVED THE CORRECT TREATMENT, THE PROBABILITY THAT I WOULD HAVE CONVERTED FROM FULL TO PARTIAL PARALYSIS WAS MORE THAN FIFTY PERCENT.

MY CURRENT CONDITION ... HOME ALONE

Well, there's really nothing much for me to say when I want to talk about my daily life. The expression "daily life" suggests a number of different things which occur or are being done each day. Mine is not "daily life" but it is "daily routine". Spinal cord injury to me was something that turned my "life" into my "routine". My life is not really life; it's an unvarying and habitual set of procedures. Always the same thing. That's all that's left of my "life"!

But in a few sentences I can sum up the routine. I wake up at about eight. Then I call my mother; she sits me up in bed and feeds me. Then she puts this strange glove-like object on my right hand so that I can use the computer keyboard. I cannot sit for long at a time. I have to be put into a reclining position soon, otherwise there's a risk of skin breakdown because of pressure primarily over the bones of the lower back and the buttocks. So my mom comes and lays me down. I spend the time waiting, watching TV if I can, trying to sleep if I can...Then at about seven in the evening mom sits me up again and feeds me supper. Then mom lays me down at about eleven pm. Then comes the night, sleepless night.

What a life, isn't it? Since I became paralyzed,  my life can be described in only a few lines. In the good old days before my accident, when I was healthy, I always had much to say when I was asked about life. Life. Ohhh life...

Let me talk about things in general.

Everything becomes so public when your body is almost destroyed, You have no autonomy. You're full of bags and/or tubes, your bodily functions are not within your control. You're completely paralyzed, you are just a pile of flesh. Yes, a pile of flesh.

Imagine an almost lifeless organic structure. That's me! Locked in a body and that body locked in a room. Concrete walls that never talk to you. A television: who can watch TV for years. A radio: nothing more than the TV. You soon come to hate all the images and detest all the sounds. I wake up in this cage everyday, disoriented, desperate, sicker than I have ever been. No feeling in my arms and legs, from my upper chest down; only a vague sense that my whole body is entrapped forever. No movement left or right, up or down. I just have to hope that my mother will come very quickly to change the position of my body. She can do this today; tomorrow I just don't know.

I must admit that I don't have a close caring family except for my mother. I owe her a big debt that I can never pay back. She possesses heroic qualities. Without my mother, I would have never survived to  this day. She is now pretty old and lacking physical strength, vigor and vitality and I have fears and doubts about my future. If she dies before me or if something bad happens to her, I know there will be no one else by my side. Sometimes I feel like the last man on earth, and paralyzed...I can't get these feelings out of my mind because there seems to be no way out.

My father is just an indifferent man to me, almost always unwilling or refusing to pay any attention to me. He is so apathetic, showing little or no emotion towards me. I feel like I never had a real father; the meaning of "father" in my book is so very different from the way he acts.

I have two brothers; one is no more than my father. The other brother is a relatively good person. My brothers got married and left home long ago. One of them very rarely drops in and only on special occasions. Thank God the relatively good brother comes by to see me on the weekends and takes me into the bathroom for a good bath. Only a "wash-and-go" thing; he washes me and goes.

Since I came home to Gaziantep I've had many illnesses, especially urinary tract infections. When your being has little physical and\or spiritual strength, you can easily become ill. I've had four major operations within the last two years, not to mention the minor ones. I had a colostomy operation; that create an opening from the colon to the surface of the abdomen to function as an anus. I had skin breakdowns called decubitus ulcers as a result of excessive pressure, primarily over the bones of the lower back and the buttocks. Following a spinal cord injury, increased stiffness, vascular alterations and alterations in muscle tone combine to significantly reduce the skin's ability to withstand pressure. Because of a very large decubitus ulcer I had to have two operations in which surgeons grafted a large flap of skin of my body to the large area of the bed sore. And I had a kidney operation. Following the spinal cord injury my kidney started to malfunction and several large kidney stones developed. So I had another operation in which surgeons removed eight kidney stones from my right kidney. Although I try to drink a lot of liquid to keep the kidneys flushed out I worry that more stones may be forming because this is still a paralyzed body and not functioning.

Once I attempted to commit suicide wishing to put an end to all my and my mother's sorrows, suffering and grief. I was alone in the room. They had forgotten my antidepressant pills on my bed. I cannot use my hands, I cannot grasp things but moving my elbow and forearm I drew the bottle of antidepressant pills onto my body, then towards my chest, then into my mouth. This took me nearly ten minutes. In my mouth I managed to take out the cap of the bottle and swallowed all the pills. The taste was disgusting. I tried hard not to throw up. I can only remember the 5-10 minute period of conscious time after swallowing the pills; I only wanted to die to put an end to my and my mother's endless sorrows. I could not even succed in dying. After two days I was alive again and opened eyes in a hospital room only to resume the same old sad life. It was my only chance but somehow it didn't work. God knows that if I had the chance I would try again, but it's almost impossible for someone like me to commit suicide because you need at least one functioning hand to do this job. Someone who is "nothing but a non-moving mass of flesh" cannot even kill himself.

Living in Turkey, being in Turkey, perhaps even being born in Turkey can be a big problem. Turkey is still in the stone age in many ways, especially in the area of health care and especially the care of the disabled. I don't have my own insurance. My mother has government health insurance because she is a retired primary school teacher. The government compensates only certain kinds of medical supplies and not some of the medicines that I need. Unfortunately in Turkey there is little or no specialized health care and health insurance available to the disabled. I don't want to speak ill of the country in which I was born but truth is truth. I am now thirty years old and politicians are still telling us lies, giving us false promises and false hopes. I'm fed up with living in such a country whose political leaders behave unjustly towards their people in the presence of Allah. I wish I lived in a better country where human rights are more widely practised. I know that in the Quran, Allah says "And whoever flies in Allah's way, he will find in the earth many a place of refuge and abundant resources..." (4:100) "And those who flies for Allah's sake after they are oppressed, We will most certainly give them a good abode in the world and the reward of the hereafter is certainly much greater, did they but know." (16:41) "Yet surely your Allah, with respect to those who fly after they are persecuted, then they struggle hard and are patient, most surely your Allah after that is Forgiving, Merciful."  (16:110)

Do I believe in God? I do believe in God but the miserable conditions of my present life have seriously shaken my belief. Since I became paralyzed I have been praying to God for myself and for all the people like me, but it is very frustrating and tormenting as I realize that nothing is changing. Instead things are frequently getting worse and worse. God is not a sadist but still I can't explain why He lets these kind of things happen to people, especially to good people. I don't know why He tolerates this. On this subject I am at a loss for words to adequately express my feelings. You know, in good times the spirit of God is around you in the air that you breathe and His glory in the light that you see. Well, just don't ask me about dark, cloudy, stormy weathers, just don't...Only God knows what He is in fact doing.

Well, I've said a little of this and a little of that. All in all I've tried to tell you something about myself. If you have things that you would like to say to me, please use my email, alikarabulut@gmail.com. Your thoughts and opinions really count and are very important to me.

Ali Karabulut