It's Not Over

It’s Not Over: Here I am on My Feet

- Memoir of a Neurologist with a Spinal Cord Injury -

Written by Beomseok (BJ) Jeon Translated by Jay and Jane Jeon

http://www.snumdc.org/memoir About the Author

Beomseok (BJ) Jeon, MD, PhD

Professor Beomseok Jeon is Medical Director of the Move- ment Disorder Center at Seoul National University Hospital. He is the past President of the Korean Movement Disorder Society, and served as the International Delegate of the Kore- an Neurological Association. He also served as the Director of Office of the Medical Policy and Communication, Seoul National University. Currently, he is the President of the Asia- Oceanian Association of Neurology (AOAN) and Past-Chair of Movement Disorder Society-Asia and Oceanian Section (MDS-AOS).

Prof. Jeon graduated from Seoul National University Col- lege of Medicine, and completed his neurology residency both at Seoul National University Hospital (1983-1987) and at the University of Minnesota (1987-1991), and then had movement disorder fellowship under Prof. Stanley Fahn at Columbia University (1991-1993). He also studied basic neu- rosciences under Prof. Robert Burke as H. Houston Merritt Fellow (1997-1998) at Columbia University. Prof. Jeon has ex- tensively studied genetics in Korean patients with parkinsonism, and is currently interested in medical and surgical treatment of advanced parkinsonism. He has published over 400 peer reviewed articles, and wrote three books for patients and families with Parkinson’s disease and ataxia. Man is troubled not by the events but by the meaning he gives them. - Epitectus, an emancipated Roman slave and stoic scholar

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3 Prologue To Those who are in Their Trial

June 5, 2004. It is the day my rock-solid body shattered like glass. Even after 5 years to this day, my eyes close and my breath shallows whenever I think of that day.

An inexplicable hiking accident left me with a quadriplegia unable to lift even a finger. I figured I should leave a record since my fate was uncertain. As I could not write myself, I had someone jot down the memo that I told.

After 9 months of diligent rehab with an unwilling body and a determined mind, I was able to walk out of the hospital on my feet.

Soon after I was discharged from the hospital in March 2005, I opened my sickbed notes many times to write a book. However, something blocked my heart whenever I reached the moments of my accident, and I could not move on. I managed to finish a rough draft by dictating to my secretary by early 2006. But I dithered over the decision to publish it. After a long deliberation I decided to wait until my children went to college and it came to this day. (Two years

4 after publication in 2009, I asked my children who are studying in the States to translate it into English.)

There is a book ‘When bad things happen to good people’. The book is written by a Jewish rabbi Harold S. Kushner, and is about his torment over the loss of his son to progeria (*an extremely rare genetic disease wherein accelerated aging is manifested at an early age. Those born with progeria typically live about thirteen years.) and overcoming the tragedy. Kushner thought of himself as a decent man. Thus he could not understand why God gave him this tragedy. He was filled with re- sentment and anger against the all-mighty God for breaking his heart. In order to accept the loss he tried to think of it as a test and providence of God to make him stronger and more perfect. But that did not give him solace. Then one day he gave up his effort to find the cause and meaning of the tragedy, and just accepted the death of his son as a fact. And then he was able to be released from his anguish.

Everyone in the world suffers from loss. Why should I be an exception? We should ask not why it happened but how to overcome it.

Despair, wrath, blame, regret, self pity.... These do not save us from our suffering. Only by accepting the loss and doing the best in it will we be able to move on from it. I know my body will never be what it used to be just as Kushner’s

5 son will never return. As Kushner became a Rabbi that can sympa- thize for other’s pain and suffering after overcoming his agony, I as a result of my bodily tribulation will try to become a warm-hearted physician that understands my patients’ pains and will teach my students to become one as well.

This diary is a daily record without alteration of the days I was in my sickbed.

This is not a book of sweet triumph. It is an ongoing record of my struggle against my ordeal, and is for those who are still in their trial which may never end. I hope this book may help those who suffer in affliction, their families, and the people who care for them.

Confiding his friendship to Horatio, Hamlet said

For thou hast been As one, in suffering all, that suffers nothing, A man that Fortune's buffets and rewards Hast ta'en with equal thanks. - “Hamlet” 3.2.65-68

In this way we will become a victor that accepts one’s fate and does not succumb to it. Fall of 2009 Beomseok (BJ) Jeon

6 Contents

Prologue To those who are in their trial ◆ 4

Chapter 1

That fateful day ◆ 8

Chapter 2

The start of the long fight ◆ 50

Chapter 3

Back to my familiar and unfamiliar place ◆ 186

Three Years Later ◆ 220

Epilogue The unfinished story ◆ 226

7 Chapter 1 That Fateful Day

8 June 5, That Fateful Day 2004. Saturday

That day began just like any other day.

5:15 A.M. I quietly sneaked out of my bed, and headed downstairs to the kitchen. Four slices of bread and an apple were my breakfast. Skipped a shower, changed my clothes, and left home with hurried steps. 5:43 A.M. Boarded the Line 5 subway train leaving from Olympic Park Station. 6:15 A.M. Arrived at Jongro-3-ga Station. 6:30 A.M. Arrived at the health club at the basement of the Bo- ryung Pharmaceuticals Building. After 30 minutes of uphill tread- mill, I took a shower. It was a usual day just like any other day up to this point.

7:30 A.M. Arrived at the conference room 9321 of the Hospital where the morning report was held. 8:50 A.M. The meeting ended. I entered my office, turned on the

9 computer and sorted through my e-mails. My secretary arrived at the office at 9:00 A.M. I made a quick ward round, and then started on paper work. The professor’s cafeteria on the 13th floor serves lunch from 11:30 A.M., but I went up at 11:25. They serve noodles on Saturdays, which I particularly enjoy. I finished off a bowl of bibimgooksoo (*noodles mixed with spices and vegetables), then considered eating a bowl of moolgooksoo (*noodles in watery soup) as well. But I chose to eat another bowl of bibimgooksoo instead. It was a usual day just like any other day up to this point.

I called Cheol-Woong Kim as I left the office at 11:55 A.M. “Hey, I’m leaving now. So I should be ready by 1:30” People say my phone calls are so short they are impersonal. “Yes, sir.” His answer was short as well. He picked it up from me. I walked to Jongro-3-ga Station, and arrived home at 1:00 P.M. My wife was relaxing in the bedroom on the second floor, and my children had not returned yet. “How about going for a hike together?” I asked an empty question, and she gave the expected response. “No thanks. Go alone.” It was a usual day just like any other day up to this point.

10 By the time I changed my clothes and packed my knapsack, it was 1:30 P.M. In my pack were a months-old chocolate bar, a dried pumpkin pickled with sugar, two pairs of eisen stowed to add the weight, and a spare change of underwear. My hiking pants were a 50 dollars for three pants deal that my wife had picked up in Dongdaemun Market for an earlier trip to Australia; my top was a short-sleeved cotton T-shirt; and my cap had a long visor for shade. Then my cellphone rang. It was a call from Cheol-Woong letting me know that he had just arrived. I thought about taking my cellphone with me as I left. But I did not want to be bothered and left it at home. Cheol-Woong was waiting in front of my apartment in his car. Cheol-Woong is a high school alumnus eight years my junior, and is an accountant. He enjoys workouts, and has played golf with me several times. When I told him I enjoyed hiking, he wanted to accom- pany me. So he joined me a few times.

“It’s usually overcrowded during the weekends. Let’s park near the bathhouse.” There have been an increasing number of hikers recently, and it is not easy parking near the entry to the mountain. We parked near the bathhouse, which is a good distance from the entry. There were a few clouds in the sky. It was not too hot for an early June day.

11 I picked up four bottles of Pocari Sweat and Gatorade from the supermarket that I go to regularly. While buying these items, I applied sunblock on my face. The shopkeeper looked like a college alumna. I asked her last name out of curiosity, but it was not the same.

I bought three cucumbers for 1,000 won (*about a dollar) from an old lady peddler by the brook at the entry of the mountain. It was still early summer so the cucumbers were thick and ripe. The tin roofed store a few steps ahead sells 2 rows of gimbab (*steamed rice rolled in dried seaweed) for 2,000 won. “Don’t slice them please.” It is easier to hold the uncut gimbab and eat it out of the foil. The two slightly plump ladies replied, “Okay, will do.” It was a usual day just like any other day up to this point.

“Let’s take the long route on the right today.” “Yes sir. Let’s go the difficult course again.” The path to the right is the longest and toughest route. It includes a road up and down around the paratroopers’ base and a steep slope at the end.

Around the middle of the steep slope I drank a sip of water. My top shirt was already soaked in sweat. “You sure sweat a lot.” “I’ve been sweating a lot these past few years. It wasn’t like this

12 before. But it just happened recently.” I used to be able to run without losing my breath. My body is not

▲ Map of Namhansansung Red line shows the route I took that day (from left to night).

Road Outside the Wall ▼

▲ Soo-Uh-Jang-Dae

◄ Road Inside the Wall

13 ◄ The West Gate

what it used to be. It took about an hour to reach the rampart near ‘Soo-Uh-Jang- Dae’ (*Royal command center of the fortress). We hiked along the fortress wall to the left, taking the road outside its walls. The road outside has an open view of the surroundings and feels very different from the road within the fortress. “The leaves are much greener than last week.” “Time flies, huh?” replied Cheol-Woong. We entered the fortress through the West gate and out the North gate and arrived at ‘Dong-Jang-Dae’ (*East command center). “Let’s pass ‘Beol-Bong’ and take the road to ‘Han-Bong’” (*Bong means peak in Korean). “Sounds good.” It was Cheol-Woong’s first time to Beol-Bong. “It’s very quiet on this road.”

Beol-Bong is about 10 minutes away from the main rampart. It was a bit past 3:30 P.M. when we reached Beol-Bong.

14 ◄ Beol-Bong

The sign next to Beol-Bong says it was the site where the Army of the Ching Dynasty scouted when Injo (*name of the Korean king in the Joseon Dynasty) and his troops sat-in inside ‘Nam-Han-San-Seong’ (*Nam-Han-San means southern mountain of Seoul and Seong means fortress in

Korean). (*This siege by the Ching army was in 1637.) From the outside the peak looked like a bee and hence the name (*Beol means bee in Korean). We sat next to the stone gate by the wall and ate a cucumber and drank water. “This road leads to ‘Seon-Beob-Sa’ (*name of the temple). There were seldom any people there when I took a road that branched off in the middle. It took me about three more hours to get there. That will be about eight hours, so it will be a good exercise.” Cheol-Woong said with a laugh “That’s going to leave me very stiff. Let’s do that another time”.

“The first time I went hiking with you, I thought I was going to die.” He is talking about the first time we came to Nam-Han-San-Seong.

15 “I had no idea… You should have said something.” “I couldn’t say anything being the younger one. It is okay now that I am used to it” said he. “A friend asked me to join him for a game of golf today. I declined because I have a golf appointment tomorrow.” “Once a week is enough. You are doing a lot of leg exercise today. So you will do well tomorrow.” I rarely decline a game of golf because I enjoy the company of friends. But the exercise intensity is not enough for me. So I hike often. As Nam-Han-San-Seong takes only 15 minutes from home by subway, I go once or twice every weekend. The course takes about five to five and a half hours starting from the Macheon subway station and wrapping around the ramparts. Mountain climbing and going to the bathhouse to eat a bowl of mi- yeokguk (*seaweed soup) afterwards has been a ritual for three years.

On the first hike at Nam-Han-San-Seong, I drove to the South gate and walked the paved road inside the fortress. This took about an hour and a half. It was excellent for light hiking, and I used to go with my students. But it was not enough for me. Dr. Kwon, a college alumnus and a psychiatrist at the National Po- lice Hospital guided me through the major hiking routes. The two and a half hour course from Macheon station to the rampart was a decent route to take for a slight workout. Afterwards I circled around the rampart, which took about three or four more hours. It was not

16 a seriously rough road and had a few inclines making it a great exercise. Along with that, it was only 15 minutes away from home. So for me it was an excellent choice for a weekend workout.

I used to hike with the members of the ‘Joo-Yoo’ Mountaineering club for over 10 years and have gone to Book-Han-San (*northern mountain in Seoul) and to some long distance hikes. But I felt the time of commuting was wasteful, and went to Nam-Han-San-Seong more often. I hiked whenever I had the time, and went alone even when it was pouring without an umbrella. I enjoyed the sound of raindrops falling on twigs and treading along the ‘quiet’ road. I itched for another opportunity to hike on a pouring day.

The summit of Beol-Bong is made up of four large boulders. The course is short but very steep. So I had to maintain my balance while climbing the rocks. An old couple that went before us greeted us from the top. “Looking good there.” “Yes, same for you.” I was answering and tried to put my foot down on the peak. Then I found my body flat on the ground.

I couldn’t understand what in the world had happened to me.

17 Shortly, there was a slight chilly sensation between my shoulder blades, which ran down my back. In no time I realized I was no longer in control of my body. I was very alert though. My glasses were halfway pushed off my face. Two stones smaller than walnuts were visible in front of my eyes. Polished by hikers’ boots, the stones were glowing bronze. The axe of God was small but strong.

In order to get a grasp on my situation, I tried to move my body. But I couldn’t even twitch a finger. I tried to roll my body sideways. But it wouldn’t budge. My legs responded only with a hint of movement of my right big toe but nothing else. Below my neck there was only a sensation of cold numbness. The ominous thought of C5 central cord syndrome (*C5 means the 5th segment of cervical spinal cord. Central cord syndrome is a spinal cord injury

resulting in more weakness in the legs than in the arms. It is usually caused by a se-

vere hyperextension injury. http://en.wikipedia.org/wiki/Central_cord_syndrome)

Area of cord damage

Loss of motor function

Incomplete loss of motor function

◄ Anatomy of the Central Cord Syndrome

18 entered my mind. However if it were a C5 injury, my diaphragm would have been paralyzed, compromising my ability to breathe. However I was able to breathe. “Sir! What happened!” Cheol-Woong, who was following behind me, rushed to me and asked in shock. “You should do as I say. If you don’t do exactly what I say, I’m dead. First, call the old couple at the top.” “Yes, of course.” Cheol-Woong yelled “Help!”. The old couple who were about 10 meters away approached. “You need to carefully hold my head, and they need to hold my legs and torso. Try to turn my body without moving my neck. My neck must not move.” The three carefully flipped my body.

I felt anew of the sky that I had just seen minutes before. Gray clouds were floating mindlessly, and the wind blew gently on my face. But there was no feeling from the neck downward. Despite this, my left buttock felt very uncomfortable. There must have been a rock spout- ing out. I was worried that the rock would swash my skin. But I stayed put in fear of moving my neck.

“You need to call the Emergency Room of Seoul National Univer- sity Hospital at XXX-2373 or 2374. When you get through, tell them

19 my name. Tell them to put on the on-call neurology resident.” Moments later. “Sir, I got in contact with the neurology resident.” “I can’t move my arms. Place the phone next to my ear.” Cheol-Woong swiftly placed his cellphone next to my ear. “I am Dr. Jeon. Who is this? I am at Beol-Bong of Nam-Han-San- Seong. I have a C5 quadripelgia (*cervical cord segment 5 lesion which results in paralysis of the muscles and sensory loss from above the shoulders. Auto-

nomic dysfunction such as voiding difficulty and blood pressure instability occurs.

Paralysis of the diaphragm may stop breathing.) Send a helicopter please. Contact Dr. Jong-Min Kim to take action. I don’t have a phone on me right now. I’ll give you this number to contact me.” Cheol-Woong gave his number to Dr. Yoon-Jae Choi, the on-call neurology resident. I left my cellphone at home which had the number of Dr. Jong-Min Kim of the Seoul National University Bundang Hospital.

After a short while Dr. Kim called me through Cheol-Woong’s phone. “Sir, what happened?” “I’m at Beol-Bong of Nam-Han-San-Seong and have C5 quadriplegia. So please prepare to take emergency measures and send in a helicopter.” “Where would you like to go?” “I might be going to Bundang.” “Yes, sir.”

20 I told Cheol-Woong to contact the ER of Seoul National Univer- sity Hospital and to get the on-call attending staff on the phone. “I have a C5 quadriplegia, and am in need of a helicopter. The loca- tion is Beol-Bong of Nam-Han-San-Seong.” His answer seemed like they were already taking action.

“Should I contact your wife?” asked Cheol-Woong. “It won’t help this situation. So don’t yet.”

Looking at the situation after the phone calls, I was sincerely worried. Will the helicopter be able to come? If so, when will it arrive? Would it spot me quick enough? Will they be able to bring me up safely?

It was obvious what would happen to me if I were carried down the mountain on a stretcher. My spinal cord would take even more damage from the motion, and my paralysis would become perma- nent. That was not an option. A helicopter must come. While waiting for the helicopter, Dr. Kim called to tell that he got in touch with Professor Hyun-Jip Kim of Neurosurgery. Thinking that I had done all I could do and that the rest was up to fate, I became collected.

21 About 30 minutes later I heard the roar of propellers from a distance. The sound grew louder every second. However, the helicopter was nowhere to be seen. I guessed they could not locate me. They called Cheol-Woong’s phone from the helicopter. “We’re to the North. You’ll be able to view us from 5 o’clock!” Cheol-Woong shouted at his phone, directing the helicopter. His phone battery was almost dead, so we had to use the old man’s cell phone as well. The old man murmured in worry. “My cell phone battery is very low too.” I became very anxious. The reception is very poor in the mountains so the batteries run fast.

Alas, the helicopter showed itself over my head. Wind started gush- ing, and dust blew around. Cheol-Woong covered my body with his over 90-kg body in an attempt to block the wind. Four men dressed in yellow came down from the helicopter. I requested my biggest worry immediately. “My neck is hurt and needs a brace.” Fortunately there was a neck brace ready in the copter. After plac- ing the brace they loaded me on the stretcher and carried me up the copter. Cheol-Woong could not get on because of the capacity.

It was quieter inside the copter than I expected it to be. Someone asked me where to go. While waiting for the helicopter I was already deliberating whether to go to the Main Hospital in Seoul or to Bun-

22 dang Hospital (*Bundang is a southern satellite city of Seoul). The main hospital had advantages since it was my workplace. But Bundang Hospital had Dr. Hyun-Jip Kim, the best spine surgeon. However the decision was made for another reason. “To enter Seoul we need to get clearance due to the air defense net- work. It will take about 30 minutes.” It was decided. “Take me to Bundang.”

I did not think they would have it, but I asked anyway, “May I have 10 milligram of dexa (*a form of steroid which can reduce swelling in the injury site)?” “We’re not equipped to make injections.” I thought I would endure a few more minutes.

In less than 10 minutes we arrived at the rooftop of Seoul National University Bundang Hospital. As I was carried off the helicopter, I saw the familiar faces of Pro- fessors Sung-Ho Park and Jong-Min Kim of Neurology. Dr. Park bent down and asked worriedly, “Is everything alright, Dr. Jeon?” I smiled and answered “I have a C5 central cord syndrome. Give me a lot of steroids.”

Dr. Park told me later that he searched for an area for the helicopter to land as soon as he heard the news. They considered landing

23 the helicopter at the nearby middle school schoolyard. But thankfully the Hospital was facilitated for a landing. As soon as I was lowered from the helicopter, I was carried to the ER on a cart. I had no idea what was happening during all the MRIs and other tests. Being carried around the hospital and only being able to stare at the ceiling on the bed made me pensive. I thought of the last scene of the movie ‘Carlito’s Way’ where Al Pacino was shot and facing his doom. He was gunned down when he was about to go straight and find a new life in Bahamas with his lover. His lover was crying right next to him, but he was serene while being carried in a stretcher.

After taking the MRI, Dr. Kim asked. “Would you like to see your MRI?” “No. Just tell me what you see.” I was already picturing the disc rupture between C4 and C5 and hemorrhage in the center of the cord slightly leaning to the left. “C3-4 disc was ruptured and there is a small T2 lesion with increased signal on the left.” “Nothing on the right?” “I don’t see anything on the right.”

I got worried. The injury was a level higher than I expected. But that was not my major concern. Looking at the symptoms I was sure that the lesions were on both sides. The lesion in the spinal cord

24 should be a hemorrhagic contusion. Then why is it not visible on the right side? Then I remembered one of the Case Records of the New England Journal of Medicine. It was a case of a young man who collapsed with sudden quadriplegia. The cause was an ischemic necrosis of the spinal cord caused by a piece of disc material flowing into the blood stream and blocking the vein. Professor Raymond D. Adams commented that there was a similar case in the past and that the prognosis was poor leading to eventual death.

An ischemic necrosis has a good chance of not showing on the MRI in its early stage. I was worried that was what happened to me. It would carry a worse prognosis than a contusion. But the more immediate matter was whether surgery would help the situation. An operation that does not help is better not done. “Did you take a DWI (*Diffusion-Weighted Imaging. An MRI imaging technique which can visualize ischemic lesions in the very early stage)?” “We don’t usually take DWIs for spinal cord lesions. The cord is too small to do DWI. Would you like to see your MRI yourself?” “It won’t be necessary.” It would have been difficult for me to see the images lying down, and it was a matter of interpretation rather than seeing something.

My wife arrived. After the copter left, Cheol-Woong ran down the mountain and picked up my wife. My wife asked “What in the world

25 had happened?” I had a bit of blood on my face, but I had a clear mind and looked fine from the outside. So she didn’t seem to worry much.

Soon Professor Hyun-Jip Kim came and said immediate surgery was needed. “There is a disc rupture at C3-4 level and there isn’t much space. If the cord swells up in the next two to three days, the situation might get worse so we must remove the disc.” “I have symptoms on both sides but the lesion is only visible on one side. Would it be wise to remove the disc?” “The swelling will start in two or three days. So it must be removed.” There was no choice. I wasn’t sure the surgery would help. But it must be done in order for the situation not to get worse. “Let’s proceed as you suggest.”

Then I remembered something. “Oh, Dr. Park. I promised Professor Hyo-Su Kim of Internal Med- icine to play golf tomorrow. Would you contact him that I won’t be able to make it?” Talking about golf in this situation, Dr. Park gave a forced smile. “Will do.”

We decided not to take a spine CT after a deliberation.

They later told me the operation started around 8 P.M. But I had

26 no sense of time. Shortly after entering the operating room Profes- sor Young-Seok Oh of Anesthesiology said “... I need to intubate you via the nasal route.” I didn’t hear the earlier part of his sentence, which must have been “Since your front teeth are broken...” “Do as you see fit.” With that, everything went dark. I was immediately knocked out from the anesthetics. They told me the operation was over by 3 A.M. The day that flipped my life upside down was over like this.

27 June 6, I am Not What I was Anymore 2004. Sunday

I woke up to find myself in a small room surrounded with white curtains. “I must be in the intensive care unit (ICU).” As soon as I regained consciousness, I checked my body. I was still unable to move anything except for my right big toe. I had no sensation below my shoulders. The surgery has not helped at all. I was hoping my condition would be improved if they removed the disc. So there was nothing that was compressing my spinal cord. The spinal cord must have been mashed. Or a disc has ruptured and caused a cord infarct by blocking the vessels as I suspected. I was very disappointed.

Without time to feel gloomy about the situation, there was a real problem at hand. It was very uncomfortable lying down. After the accident in the mountain there may have been a small rock under my left buttock for 30 minutes. But I lay still without moving in fear of disturbing my neck. For that reason may be, my left buttock felt very uncomfortable.

28 I was unable to move my limbs with a brace on my neck. The pain in my hip got worse every minute. The nurses changed my positions to ease my discomfort. But it did no good. Several months later a nurse told me that they changed my position 15 times or more per hour.

A nurse asked. “Your pants are quite dirty. Would you like them undressed?” I realized just then that I was still wearing my hiking clothes. I told her it was okay to ruin them. She cut them out with scissors. The sound of my clothes ripping was very sharp. But the scissors touching my skin felt just dull. When she got to the groin area, I realized I had Foley catheter inserted into my urethra. Of course. I was in no condition to go to the bathroom myself.

It was a Sunday but the ICU sounded very crowded. I lost track of time. Sometime during the day Dr. Hyun-Jip Kim came to visit. “How are you doing?” “I think it’s the same as yesterday.” “The disc was removed nicely, and we performed an anterior fixa- tion. Try to move your arms. Hmm, still not moving, huh? Let’s try moving your feet now. You can move your right big toe. How are your senses? Same as yesterday? You still feel numb from the shoulder down? It will get better, so do not be worried.” “Yes, I know. Thank you.”

29 But Professor Kim and I both knew. The situation was dire.

It must have been mid afternoon. Many of my senior professors visited. Professor Myung-Chong Lee of Asan Medical Center who himself is on a wheelchair visited as well. Everyone comforted me and told me that the MRI did not seem that bad so everything would be alright. I lay with my eyes closed, and agreed to the comforting words. But I knew too well my situation was very serious. I am no longer what I was.

My wife sitting by my side seemed to have no idea how grave the situation was. I had a small laceration on my face only, and she was told that the surgery went well. So she must be thinking that everything is going to be okay. Professor Sung-Ho Park explained to her that the damage to the spinal cord was more serious. But she would have no idea of the gravity of the condition with her limited medical knowledge. After all, I just look so healthy on the outside.

30 June 7, The Indivisible Days Begin 2004. Monday

Even with the intense pain in my hip I kept dosing off. It appeared that the ICU was in state of emergency over the night as my breathing rate dropped whenever I fell asleep. As my injury was in the C3-4 cord, it was possible that my diaphragm would suddenly be paralyzed resulting in respiratory failure. The ICU team had good reason to be on high alert. I myself had no idea that I hypoventilated because I was asleep.

I checked myself over and over again in hope. But nothing had changed. All I could move was my right big toe. Ah! I was also able to move my right little finger slightly as well. Although it was numb, it was fortunate that I still had a bit of sensation left. I could check my condition.

I kept thinking about what was to become of me. In this condition I will not be able to push my own wheelchair, nor will I be able to walk up and go to the restroom. So I will have to live with an indwelling catheter. A respirator will not be necessary but all I can do

31 will be talking. Will I be able to leave the ICU? Even if I was discharged, I wouldn’t be able to handle living in an electric wheelchair.

As a physician I know the sure means to kill myself. However, I worried that it would be hard for me to end my own life. I would not be able to secure and drink poisons on my own. I wouldn’t be able to climb or jump down from a high place even if I wanted to. I am like a poor trapped animal that can not even try to get out of the depths because its legs are broken.

I told Dr. Jong-Min Kim while my wife was away briefly. “My wife does not know anything, and I trust you will handle everything. I might have to ask for the last business.” Dr. Kim seemed to understand and was silent for a while, then said, “Everything will be all right. Don’t be too worried, Sir.”

I asked what medications I was receiving. I was getting a gram of methylprednisolone (*a form of steroid to reduce swelling) every 3 hours, some antibiotics, expectorants and antacids. “I had a stomach ulcer a few years back. So give me an additional antacid. And give me Vioxx (*anti-inflammatory drug that was usually used for arthritis) and vitamin C.” I was worried if I had ischemic necrosis of my spinal cord. So I requested intravenous solution not to contain glucose.

32 When the nurse flipped me in the evening, my muscles started to spasm. “This must be a tonic spasm.” I asked for Tegretol (*anticonvulsant). At first I took half a pill. But the spasms would start again about an hour later. I ended up taking 3 pills a day. Later I told Professor Nam-Jong Baek of Rehab that I had tonic spasms. He recommended Baclofen over Tegretol. I started with half tablets twice a day, but it did not help. So I took one pill three times a day.

The extreme pain in my buttock must have been from a buildup of excrements. The pain was relieved after I had a bowel movement with a suppository. It was actually quite funny that the pain that tor- tured me so much was gone just like that.

Repeatedly I went over what had happened during the accident and thought about the problems that might come before me. Was my carotid artery (*artery going to the brain) crushed with my neck against the rock when I fell to the ground with my face down? Would that cause a dissecting aneurysm? I was also worried about the vertebral artery within the spine. I choked while drinking water. Was my va- gus nerve (*nerve controlling swallowing and voice) crushed as well?

After a discussion with Dr. Jong-Min Kim, we decided to take an MRI and an MR angiogram on the morning of the 7th or the 8th.

33 They told me that the braces that tightened my incisors would make it difficult to take an MRI. It was only then that I became aware that I had wires in my mouth. But even then I did not realize the skin under my nose was sewn up. “What about a CT angio? I’m worried about an aneurysm. Would it be clearly visible?” “I’ll talk with the radiologist.”

My wife told me that my father called on Sunday night. She told him that I was not available due to a golf engagement. I told my wife, “Do not let them know. The kids must keep quiet a s w e l l .”

34 Jun 8, Keeping Records 2004. Tuesday

I’ve seen things you people wouldn’t believe. Attack ships on fire off the shoulder of Orion. I watched C-beams glitter in the darkness at Tan- hauser Gate. All those moments will be lost in time like tears in rain. Time to die.

This is what Roy, the android, said when he was dying in the movie ‘Blade Runner’. If life is all about experience, I will experience things that no one else ever had. The ordeal will be harsh. But if I do not record my thoughts and situations somewhere, then it would vanish like the morning mist. I asked Dr. Jong-Min Kim to bring me a notepad. Since I could not write myself, I asked my sister and my caregiver to write it down for me.

Since the morning Dr. Kim and I were busy with MRI. Dr. Kim discussed with Yeong-Min Kim the dentist whether to remove the braces that fixated my cracked incisors. He advised me to keep the brace in place for at least a week or two.

35 Professor Jae-Hyung Kim of Radiology suggested to proceed with the MRI even considering possible artifacts. We took MRI at around 7:00 P.M. I requested that they include the thoracic spine as well when they take the MRI and MR angiogram. I had no sensation below the shoulder, and I would not know even if something were wrong down below.

I was moved around a long distance to take the MRI but I had no idea where I was headed. When I was lying within the MRI machine, a grayish relief that I could not color wavered before my closed eyes. The relief-like image that would be in a temple wall kept creeping into my mind. I tried to erase it but failed. The noise from the MRI machine pounded my ear drums. I tried to guess which part of my body was being imaged, or whether contrast media was being injected. I could not figure it out.

No one told me anything after the MRI. I was worried it was bad.

36 December 31, Gloom, Gloom, and Gloom 2004. Friday

Six months have passed already. I am still in a wheelchair and am dependent on others to do anything.

At night I would barely sleep. But I still do what they call ’waking up’ at 6:30 A.M. My body feels heavier since I can not move it. My mind is exhausted and foggy. The ceiling I see lying down on the bed is the same ceiling I saw the day before. I turn my head and look around the room. But nothing has changed as well. The only change is the window that was bright at around 5:30 A.M. when I first enter this room. It is still dark past 7 A.M.

I woke up my private caregiver who was sleeping in the side bed. She had an ‘another day begins’ look all over her face. She washed my face and hands. At 8:00 A.M. breakfast arrived. She picked up the food and fed it to me. My fingers wriggled a bit, however, my arm was not strong enough to pick the spoon up and bring the food to my mouth. Af- ter the meal the caregiver took my dentures out and washed it with

37 water. She brushed my teeth with an electric toothbrush. Without the dentures the empty space where my two incisors used to be would show, and the space in between would tighten up. So I always have to wear the dentures. She ripped a vinyl medication packet and fed the medication (8 pills in total) to me. She removed my urine bag that filled up overnight and emptied it in the toilet, then wrote ‘800cc’ on a paper. It has been 3 days since I defecated. So I am worried. Maybe I need a suppository.

I hurry to make it in time for physical therapy that starts at 9 A.M. But I am always late. As usual I got help from the guardian next door to be moved from bed to the wheelchair. I have no extra guardian to help because I am in a single occupancy room. Maybe I should move to a double or a multi-occupancy room. I can not afford to have 2 private caregivers or have my family with me day and night.

It is the same day at the rehab center. The occupational therapist gets me to pick up and fold papers every day. But I cannot do much. The therapist looks tired. Prior to physical therapy I receive heat therapy to relax my muscles. I lie with hot-packs on both shoulders for about 20 minutes. I would doze off often. During that time the therapist puts gel on my shoulders and uses ultrasonic beams to relieve the pain, and moves my arm so that my shoulder joints would not go stiff.

38 During physical therapy I learn to sit, stand, and roll on my own. My arms would just drop dead as if I were a wooden toy. I try to sit, but my body just collapses to one side. I can barely stand with my walker, but my legs would wobble while I walk. The therapist would yell “Watch out! Be careful!” A walk back and forth 10 meters is enough to get me exhausted.

I got back to my room at around noon. Lunch was already delivered. As usual I was lifted into bed with the help of the guardian next door. I tried to grab the spoon but I could not feed myself. I was asking too much of myself. I had to be fed. Again, my dentures were cleaned and I took medications. My caregiver left to have lunch herself. I rested until 2:00 P.M. The clear sky was visible through the window. I closed my eyes at the sight of the heart-sore blue sky.

The caregiver came back at 2 P.M. “I am sorry but I think I defecated.” The lady was rather glad. It is not a picnic to clean up a middle-aged man’s feces, but it is better than having to deal with the mess that was caused during physical therapy several days ago. I myself felt more comfortable after I relieved myself. I would be fine for a day or two.

I was 30 minutes late to the rehab because of it. I called to tell them that I would be late. But their schedule was always packed, so

39 I had to wait a bit. About 10 minutes later there was a space in the corner. I told the occupational therapist why I was late. The therapist told me “Now you have nothing to worry about. You were concerned in the morning. Now you can focus on your therapy.” and fastened the tortoise on my hand. The tortoise is a wood plate that has wheels. It aids pulling and pushing the arms on it when exercising.

I moved with more vigor thanking the encouragement of the therapist. That did not last long. I was pushing the tortoise with my body, not with my arms.

The next therapy was delayed as well. There is a high chance that being late means no therapy at all. But I am often times excused. I lied on a bed and rolled. I need to be able to roll my body in bed to be able to get up in bed myself. But it is no easy task.

Next I got on a bicycle. My hands and feet were fixed in position with bandages. It takes time and effort to move from one therapy to the next. Transfer seems like more exercise than therapy itself.

At 5 P.M. my wife came to visit. She told me that she bought my favorite fruits. I told her I defecated today. She was glad to hear it. The therapist said “You’re getting better. You should keep at it.”

I was again moved to my wheelchair and back to my room. My

40 wife is no help when moving my body from the wheelchair to the bed. Her shoulder muscle would stretch when she lifts heavy things, and she would suffer for days. It is better that she does not help.

At 6 P.M. dinner came. My wife helped with the meal and the caretaker took a break. Afterwards she washed my dentures, brushed my teeth and gave me medications. My wife told me I should take a bath since it was the end of the year. I told her that washing my hair would suffice. She scolded me that I should take a bath at least twice a week. At 7 P.M. the caregiver returned and moved me to the bathroom. The little plastic stool is very useful here. I tried my best not to lean to one side. My wife sprayed water and lathered my body. She asked me if the water was too hot. It was the first bath in a few days, so it should have been refreshing. As I could not feel a thing, it was rather painful. She dried me with a towel and dressed me. Bathing me is one of the hardest things that my wife does for me. It is pretty difficult as she does it alone. I am at least able to lift my hips or my feet when dressing, which helps a little. I wished she would dry my hair a bit more, but I kept it to myself. The caretaker moved me to my bed again. I can take a few steps with two assistants, which also helps.

My wife said “Tomorrow is the beginning of January, so the children will visit. I will bring them at night”.

41 I told her what the professor from Rehab told me. I was getting better, but it was necessary to plan ahead. I needed a wheelchair, but I couldn’t push it myself. So I needed an electric wheelchair. If I use an electric wheelchair, we need to move to a different house as well. It would be impossible to change the interior of the present house to ac- commodate an electric wheelchair and for me to live in it. It was the first house after we got married. Our children loved it. The thought of moving out of it was disheartening. We spoke a few words about it, and I became mute. My wife also became silent. Just sitting around would do no good, so I told her to go home. “It is the end of the year, so the children will be waiting.” My wife stood up without a word.

After my wife left I wanted to ‘walk off’ my heavy heart by cruis- ing the hallway in the 1st or 2nd floor on my wheelchair. But the caregiver looked tired, so I did not bother her. I rolled my body around in fear of bed sores.

“Aha! I did not call the parents!” I asked my caregiver to call my wife by cellphone. “Let the children say hello to the grandparents.” “I got it. Don’t worry.”

The thought of what I can do and what I will do with my body is

42 quite disquieting. Will I still be able to work at the hospital or teach at the university? I can see, hear, talk and make judgments. So it seems I can do anything. But reality would be very different. I would have no problem in dictating the course material itself. But I would not be able to move down the stairs to give the lectures. Seeing patients would also be very challenging as well. They say I will get a helper. All I will have to do will be just talking. But that will not be as easy as it sounds. Whether I can continue my research is also in doubt.

The glaring eyes of Titan Cronus devouring his children to scape a prophecy. I wondered if that apprehensive and remorseful look from Francisco Goya’s painting would be what I, a beggar holding onto his job just to earn a piece of bread, would become. I can not get up in bed, wash, eat, wear clothes, go to work, travel, return home, or lie down on my own. So what should I do?

Even though I think that I would be better off dead, I have no means of killing myself. I cannot get the drugs, or even take them myself. I cannot climb to high places. I cannot die without the help of others.

I asked for the lights to be turned off at 10 P.M., earlier than usual. The sky outside the window was dark, and the street light on top of the hill was shedding blue lights. My heart was darker and bluer.

43 44 June 9, Preparation for a Long Struggle 2004. Wednesday

With special favor, I was placed into the quarantined facility in the ICU. The space is typically reserved for contagious patients. But as there were no patients in need of quarantining, I became its occupant. I was still able to hear the noise from outside, but I felt more at ease in the shielded space. The MRI from last night showed nothing to worry about. What a relief!

My blood pressure fluctuated up and down throughout the night. My blood pressure had never been higher than 130. But now it went over 190. The spinal cord injury must have compromised my autonomic nervous system. I worried if my blood pressure would become problematic. If my blood pressure rises too high while lying and drops too low upon rising, I would have hypertension while lying down and would faint on standing.

I am able to move my toes better than I was able to immediately

45 after the accident. I can get my right arm to bend slightly. It is already 3 days after surgery, and it is only slightly better. It is no good news.

Professor Hyung-Ik Shin of Rehab visited. He looked young and just became an attending this year I was told. I liked his smiling face.

Professor Shin carefully explained my future treatment plan. A physical therapist would come up once a day for physical therapy. And if time allowed, an occupational therapist would come as well. He also wanted to try an electro-stimulation device to help the rehab. It is crucial to start physical therapy early. But when you’re in the ICU, it is often pushed to the wayside owing to life-and-death situations. I am lucky to have someone come up to the ICU, because in the end there is nothing more important than physical therapy for recovery.

If conditions as in the imagined diary entry dated December 31st were not to happen, I need a strict plan.

First, I decided to get a personal caregiver. It is clear that this struggle would not be over in a day or two. It could be several months, even years before I get out of this situation. Careful preparation is needed. My wife should not be exhausted from taking care of me or should not be able to take care of the children because of me. It

46 would be good if my wife could look after me. But the children need her at home too. If the children drifted apart from us because of my care, it would be a bigger problem, and I would not be able to focus on my treatment. My younger sister was worried if it would be okay to have a non-family member take care of me. I assured her it was for the best. I asked Dr. Jong-Min Kim to find a caregiver for me. He said that it would take a week to 10 days to find a good one. Good caregivers were already assigned to other patients, so they would not be available until their patients were discharged. There are many caregivers to choose from, but it would not be an easy task to find a good one who can be trusted.

My sister dedicated herself to helping me and my wife. She would send my wife home at night and stayed overnight knowing that the children would worry if their mother was not home. Even after I got a personal caregiver, she stayed overnight during the weekends when the caregiver took a weekend break.

I called the children to say that I would be hospitalized for a while. The children did not seem to comprehend the gravity of my injury. I told them in a calm normal voice, so they had no idea. My son said okay and my daughter asked how long it would take. I told her it would be a few months. She asked again, “A month? Three? One?” I just told them I would call often and hung up. I told the

47 children to never pick up the phone, and if they did, they were never to tell anyone else about my condition.

Second I decided that my parents should not know of my condition. I know how much they would worry, and I would not be able to concentrate on my treatments. I took many steps to ensure they did not find out. I told the Hospital to tell my patients that I had gone abroad. If people contacted my office personally, they were to be told that I was abroad as well. Summer vacation was coming, and I would normally visit my parents with the children. So I needed an excuse for not visiting. After much thought I told them that I was going to Germany to study for a month or two and that we would not be able to visit them because of that. I told them I would visit many cities including Munich and my accommodations would not be fixed so it would be hard to contact them. My mother said, “Don’t worry about us. All we care about is that you do well abroad.” (After one month I told my parents that I had to go to New York. I was able to keep this a secret from them for 3 months.)

Third, I decided that I would not have visitors. Many wanted to visit and comfort me. Comforting would help, but what I needed was time rather than comforting. Senior professors could not be told not to visit, but my juniors, students and friends were.

The long fight just began. I will focus on my treatments and nothing else.

Chapter 2 The Start of the Long Fight

50 June 10, The Start of a Different Life 2004. Thursday

Every time I dozed off at around 1:00 or 2:00 A.M., the alarm at- tached to me rang because my breathing slowed down. My sister woke me up every single time. Everyone was worried because my pulse dropped as well. Blood pressure was stable at around 140, but my pulse would drop to about 40 beats per minute. This must be due to the dysfunction of my autonomic nervous system.

I could not move the fingers. But I was able to move my toes and raise my feet a little bit. I gained hope that I might be able to urinate by myself since I was able to move my big toes. I was on a high dose of steroids for five days, so I suggested reduc- ing the dose.

My sister stayed overnight and left at around 7:00 A.M. My wife came at around 8:00 A.M. after sending our son to school. Our daughter would have prepared and eaten her breakfast by herself and left for school. My wife took care of me during the day. Around 9:00 P.M. my sister returned, and my wife left for home for the children. My sis-

51 ter told me that after she goes home in the morning she sends her husband to work and sleeps during the day. She assured me her children being young did not need much attention. My younger sister’s devotion helped my family’s stability. My sudden accident would have made my children anxious. It was good that my wife was with the children.

The physical therapist came. He had a jovial demeanor and looked healthy. He introduced himself as Dong-Gook Noh. My wife was amused that he had the same first name of Dong-Gook Lee, the fa- mous soccer player. Mr. Noh checked the strength of my arms and legs and explained what I was to expect from therapy. He told me that I would work out for about 30 minutes at 2:30 P.M. He taught me how to perform my arm and leg exercises. He told me the importance of persistent and regular exercise. The simple exercise routine required that I move certain parts of my body ten times. It started from my left fingers moving up to my shoulder and then all the way down from my toes to my buttock, which was repeated for the right side. Since my body didn’t really move, I created a mental image of the exercise and did 3 sets 6 times a day, each set taking about 30 minutes.

In the evening Dr. Sun-Joo Kwon, my fellow, and Miss Hye-Jeong Kang, my secretary, visited. They reported to me about my patients. I have been worried as I had some inpatients in serious conditions.

52 “How is Professor ◯◯◯ doing?” “He is stable now.” Being a doctor I often had a chance to treat people who I respected, like the late journalist Mr. Geon-Ho Song. The history scholar who was admitted to the Hospital a few days before my accident was also someone that I respected. I was concerned because he had severe encephalitis. Later I was troubled to hear that he suffered from multiple strokes after he recovered from his encephalitis.

Dr. Kwon was to take care of my patients for three months. She was to tell them that I was overseas. I was worried that if my patients knew of my status, they would tell my parents. I requested that my situation be kept secret. There were research projects that needed to be finished and to proceed on time. I told her of the basic ideas and gave her authority to take care of the projects. I am lucky that I am with people I can trust.

53 June 11, Signs of Danger 2004. Friday

My breathing rate kept dropping at night. Many times when I fell asleep, my breathing rate would fall, the alarm would ring, and my disconcerted sister would wake me up in a hurry. Even in the morning my sister was too anxious to leave me alone. I told her that I was awake by 6 A.M. and that she should go home to her kids. I was able to send her home at 7 A.M. My wife came at 10 o’clock and asked if I had a good night.

Dr. Wook-Ha Kim, neurosurgery resident, came and told me about the surgery. It was the first time I heard about the details of the operation. He told me that they made an incision in the anterior longitudinal ligament and pulled the disc material out. I was worried if the dura mater (*a hard membrane casing the spinal cord and brain) was ripped by the rupture of the ligament and injured my spinal cord. He told me there were no signs of damage in the ligament or the dura mater. He also informed me that the color and pulsation of my spinal cord was good. He finished by saying that they expected a good

54 prognosis because the surgery was done within the spine time (*time between injury and operation. The shorter, the better the prognosis).

I asked why I had symptoms on both sides of my body when the contusion was only visible on the left side on MRI. He said there probably is another contusion on the right side not visible on MRI. However, even if the contusion was severe it still did not explain why my senses were malfunctioning from the C5 region of my shoulders all the way to the S1-2 region of my perineal region. I pictured in my head over and over where the injuries may be. The damaged region that I pictured was between C3 and 4 and was oblique a bit higher on the left side and lower on the right. I expected a lesion in the middle of the spinal cord because I had little control over my fingers and arms when my toes could move better. I specu- lated that a disc ruptured and crushed my spinal cord. But it was not visible on the MRI so there must be something else. It was very disturbing to think that I might die if the ruptured disc made its way into the veins and caused an infarction of the cord as I read in New England Journal of Medicine.

My autonomic nervous system symptoms continued. My urinary bladder would shrink if the urinary catheter were in place for too long. So I asked to clamp and unclamp the tube to keep my bladder elastic. When my bladder filled up to 300 cc to increase the bladder volume, my blood pressure rose to about 190. Normally a bladder

55 can stretch to hold up to 400 cc of urine. But my bladder became spas- tic and the increased bladder pressure over-stimulated my autonomic nervous system.

When I tilted the bed a bit upwards by 30 degrees, my blood pressure dropped and I became dizzy. Tilting the body would normally get the blood vessels in the legs to contract and send the blood upward to keep the blood pressure stable. But my nerves were not in control, so my blood pressure dropped. I will not be able to stand on my own in this state.

Physical therapist Noh moved my shoulders cautiously and warned against the risk of dislocating my shoulder, because my shoulder muscles were very weak. I became concerned that inadequate mobi- lization might cause frozen shoulder.

When I breathed after a meal, I could sense a scratching sound from an area in the mid to lower part of my right lung. Because I could not take a deep breath, I coughed a bit and the sound would go away. This symptom lasted for one to two weeks. Dr. Jong-Min Kim could not hear anything with the stethoscope. But I was sure I had a small atelectasis. I was careful with how I ate and reminded myself to take a deep breath.

I know about my condition more than anyone else.

56 I know what can happen, what might go wrong and cause my death, and what might leave me seriously disabled. A small mistake would setback my rehab, and would lead to my slow but certain death. Right now it seems like I would be fine in no time. But if anything goes wrong by a mistake such as a bladder infection, bedsore or pneumonia, it will lead to serious problems and I will not be able to get out of bed. Complications will delay and lead to an incomplete recovery and will drag out my problems. Then I will be like an animal that is eaten alive or is fallen into a swamp.

I made a pledge with myself over and over. I will use all the knowledge I have, and do the best to get myself out of this pit.

57 June 12, Birthday Present 2004. Saturday

Hye-Jeong Kang, my secretary visited in the morning. I answered her questions about several official documents and gave a few orders about distributing the research funds. As I received the grants, it is crucial that I continue on with my research.

A week has passed and my condition is not any better. I am anguished because I know exactly what that means. Recovery usually occurs in the early period after injury and tapers down as times go by. Not much progress after a week means I cannot expect much in the future. Because I am completely paralyzed, I feel like a fish on a harpoon or an animal that got its leg crippled by a trap.

I have to exercise alone on the weekends because they lack man- power. I thought that only difference was that I could not hear the encouraging words of Mr. Noh that I was doing well.

My wife tells me someone brought sushi. It was a daughter of one of my Parkinson patients, who was actually an acquaintance of Pro-

58 fessor Hyo-Soo Kim. “She is very thoughtful. She brought two sushis; one for the patient, another for the guardian.” said my wife in a cheerful voice. What is the point of staying in constant worry? My wife has a long way to go, so she is better to stay light-hearted.

My younger brother visited at night. He had come the day after the accident and on Tuesday. He came again although it was a very long trip, and he was very busy after just opening up his own new ENT clinic last March. I could not tell him not to visit. All I could say was not to worry.

Today happened to be his birthday. When he massaged my hands and legs, my wrist and fingers moved for the first time. I smiled and said “It must be a birthday gift for you.” My brother replied with a smile. “It is the best present of all.” The only gift that my brother wants would be my prompt recovery.

He told me that our parents were still in the dark, but that there were many around them who knew about my accident. I requested again that our parents must not find out.

身體髮膚受之父母不敢毁傷孝之始也. Confucius (*a Chinese philoso- pher BC 551-479) said that it is the basic filial duty to stay healthy so that the parents are not worried. I was anguished by the thought of how

59 devastated my parents would be when they found out my current health condition and the fact that I might be handicapped for life.

My sister visited at night as well. She saw that I was with my brother, and said she would take a break and left.

60 June 13, Must Eat ... 2004. Sunday

My wife believes that I am weak because I am not eating well. She kept bringing food thinking that eating well would get my strength back up in no time. I still have porridge for my regular meals. She insisted that porridge was not enough and kept bringing fruits and cakes. If I told her I liked one, she would bring it time after time until I was tired of it. Eating so much would only cause weight gain and interfere with my rehab. But it was all with good intentions, so I could not be grumpy.

I was worried my low blood pressure would be a problem. I added soy sauce every time I had a meal. At dinner Dr. Jong-Min Kim brought abalone porridge that his wife made. “My wife is a doctor and not such a good cook. But please try this.” he said. “The caregiver that I have my eyes on will not be available for at least another week.” he added. It may be that the caregivers are reluctant considering my condition and being the focus of attention in the Hospital.

61 June 14, Unspoken Thoughfulness 2004. Monday

“Dr. Kim was supposed to attend the International Congress of Movement Disorders from June 12th. It seems like he gave that up.” said Dr. Park. “He did not discuss this with me.” I replied. “It seems that he just made the decision without asking.” he said.

62 June 15, A Story 2004. Tuesday

A ninth grade boy had a motorcycle accident, and was brought to the ICU the day before I was admitted to the hospital. The nurse who occasionally told me of the news regarding the boy informed me that the surgeons opened up his skull to reduce intracranial pressure. The brain was so swollen that they could not close the incision. I knew that if that was the case, the boy will keep tormenting his parents and eventually die. A week later the boy passed. I could hear his parents wailing. It was his fault that he was riding a motorcycle at such a young age, and more so because he was not wearing a helmet. He went during his prime.

Cheol-Min was still disoriented. It was hard to acknowledge that the body that I was looking at was my own. Although the cuts and the blood on the face were wiped off clean, it was terrifying and gross to see the white brain visible through my open skull. The tube in my mouth was connected to a respirator, and there were needles all over my arms. It must hurt

63 and uncomfortable just to look at it, but strangely I did not feel a thing. I just felt sorry for my weeping mother and father, who were right by my side. I remembered up to the point where I was on the motor bike behind my friend and saw a car racing towards us on Friday night. The next thing I remembered was being thrown about in the middle of a road, covered in my own blood. I followed myself carried by an ambulance, and looked at myself lying in bed as pale as ashes. I cried out in horror while the doctor was removing a part of my skull but no one heard me. My parents came. The mother cried sorrowfully and the father kept his mouth shut not saying a word. I saw the faces of some of my friends from school. They entered the room giggling, ended up frowning at the sight of me in bed, and left the room in silence. It must have been 2 days ago. I heard the nurses speak in a low voice. ” Looking at his brain swollen up that much, it seems like there is no hope.” “Yes. I feel so sorry for his parents. They are so sad.... I don’t think he will last long.”

It was different today. Mother was grieving louder than before, and father was shedding tears. The doctor who visited often in the beginning and less frequently in recent days was standing by the nurses.

64 “We will remove the respirator now.” My parent’s wailing grew louder. The nurse turned the respirator off and pulled the tube and needles out. A man entered the room and covered my face in white cloth and pushed the bed out of the room. Looking at my parents crying so loudly made me weep too.

65 June 16, A Very Small Thing 2004. Wednesday

It has been rather easy to defecate for the past few days. But this morning although I felt the urge, I was unable to defecate. It was quite painful. My lower abdomen was bloated and the intermittent colic was driving me insane. I suspect the cheese cake that my wife brought me the day before was the culprit. After lunch time the pain was just too much to bear. I asked the nurse for Dulcolax or a glycerin enema. Even after the Dulcolax enema, there was no hint of bowel movement and the pain continued. The pain grew more and more intense. Although I could never know the pain of giving birth to a child, the excruciating pain in my abdomen must be like labor pains. I received a glycerin enema as well. The nurse put the glycerin in my anus, but it had no effect. Dr. Wook-Ha Kim, a neurosurgeon who was passing by suggested a finger enema. I declined the suggestion out of dignity. But I could not take it anymore. I called him 10 minutes later and asked for it. He put his finger in my anus and scooped out two hard lumps of feces. Then the pain was gone. Later I was able to defecate normally, and was given laxatives.

66 June 17, Problems, Problems, and 2004. Thursday More Problems

Ten days flew by. Even if you’ve lost all sensation, you will feel uncomfortable if you are just lying down in bed. I asked my wife or sister to move my arms or legs, but I had to endure my torso and hips staying stuck. The nurses changed my positions every three to four hours to prevent bed sores. Four or five people would come in and roll me around like a log to change the sheets or my diaper. They massaged my back while they moved me, which was so relaxing. I wanted to ask for more but did not. I know very well that the nurses are doing their best in the given time that they have. If I asked for more, I would be asking for privileges.

The nurses found rashes on my neck and back while they were moving me at night. I did not feel itchy, so I had no idea I had rashes. I recalled it was a bit itchy on my shoulders the day before. The next day the dermatologist told me I had steroid-induced rashes. It was exactly what I suspected. They gave me Doxycycline and Cleocin ointments.

67 I had a hard time speaking or eating because the wire that was weaving through my front teeth kept digging into my lips. Even when I was eating porridge, the wire would pierce my lips every time I moved my tongue or lips. The wires even interfered when I brushed my teeth after a meal. It was also difficult to remove the food resi- due stuck between the wire and my teeth with a toothpick. I told my sister of these troubles. She told me that when children get braces the wires’ tips get covered in round plastic. In the morning I spoke with Dr. Jong-Min Kim, who made an appointment in the evening with a dentist. Things were much better after the dentist cut off the tips of the wire and changed the directions they were pointing at.

I asked for an eye examination because it felt a bit stuffy. They told me left eye was slightly hyperemic. My nasolacrimal duct was blocked since I could not wash my face properly. They washed my eyes with saline solution and massaged the inner part of my eyes. It felt much more comfortable. Trivial things that a person with working limbs would never worry about were torturing me.

I just found out that Professor Rong-Min Baek of Plastic Surgery sew up the laceration beneath my nose that revealed my gum which was ripped by a rock. He will take out the stitches in two weeks. He gave me an ointment that prevents scarring. My wife was worried about scarring. But a facial scar was not in my long list of worries.

68 June 18, Living Alert 2004. Friday

In the morning I found it hard to defecate again. This time I was almost horrified of constipation. Even after I defecated, it felt like there were still some feces left in my colon. I asked the nurse for a glycerin enema. After the enema, hardened pieces of feces were excreted. From this on I was able to defecate regularly again.

As I had no pain sensation, there was no way for me to know if I had fractures or not. Just to be safe I took an X-ray of my whole body. Fortunately there were no fractures.

Even if I regain mobility, I will need to worry about other things. There are two kinds of sensations; the sense of pain and the sense of position. I still had a sense of position, which would help move around. But without a sense of pain I would have to be careful in every action I take not to get injured.

69 June 19, We are Growing Old 2004. Saturday

It has already been two weeks. The urinary catheter needs to be changed every two weeks to prevent infection. I will check if I can void on my own when they take out the tube. If I am not able to or if I have excess residual urine, I will need to be catheterized again. I decided to remove the catheter in the evening, try to void at night and then measure the residual urine in the morning.

The forecast predicted a storm. I was worried if my brother could not come. At around 5:30 P.M. he called me he would be coming the next day because he missed the bus. I thought it would be nice if my sister could take a break. She stays every night except for Satur- days when my brother comes. So I told him to take the next bus if he could. An hour later he called again. He informed me that he was able to get on a bus. I tried to send my wife home before my brother came, but she insisted on waiting.

It was past 9:00 P.M. when Professor Wang-Jae Lee of Anatomy

70 and his wife visited. He was the match-maker for me and my wife. He was also the one who asked to play golf with him on the day of the accident. I introduced my brother-in-law who was visiting me at the time.

Being a very close friend, Professor Lee was very distressed by my state and scolded me. “We are too old to be working out mindlessly. It is not always good to exercise a lot. Walking is the best for our age. Of course, playing golf is the best choice. Hiking is just too much.” Then he said “You’ll get back on your feet in no time. And if you don’t, so what? Your brilliant brain is still functioning as always. You can handle your outpatients in a wheelchair. You are not a sur- g e on .” His words meant for courage more than consolation. Professor Lee is a devout Christian. He held my hand and prayed for me. Around 10:00 P.M. my brother arrived. So I sent the others away.

My brother sat by me and gave me a massage. The nurses who came to change my position at midnight massaged my scalp. It felt so great that I asked my brother for a scalp massage after the nurses left. It was the first refreshing feeling I had for a long time. I asked for more and my brother washed his oily hands and massaged my scalp with utmost sincerity. It has been about fifteen days since I washed my hair so it must have been very dirty. It was relieving ev-

71 ery time he pressed down on the scalp. I asked him to press harder and said “Massage as hard as you can. I don’t care if I lose my hair”. He commented that my hair did not fall out. “I’m getting farsighted. I have to look from afar like this when I do operations.” My brother pulled his head back as he was saying this. “I lost a lot of hair too.” I turned my head and looked. I realized how much hair my brother lost on the back. Alas! We are growing old.

My brother washed a towel and wiped off the bed beneath my head and massaged my hand. Whenever I fell asleep, my brother would dose off too. I was able to void on my own a number of times till morning. I was even able to defecate at 7:00 A.M. I could not use a normal toothbrush because of the wire on my teeth. I used an interdental brush, but my oral hygiene was terrible.

72 June 20, Disappointment 2004. Sunday

My interest of today, or rather my interest for the past several days is my ability to urinate. I urinated on my own in the morning and had a bladder scan. In the past they used a tube to remove urine and measure the residual volume in the bladder. The development of technology has made life very convenient.

The Foley catheter can be removed if the residual urine is less than 50cc. But it was a disappointing 170cc. It is easy to get infec- tions when there is too much residual urine. I asked the nurse to remove the remaining urine. The nurse informed me that the intern was a female and asked if it would be OK. I told her it was OK. Dr. Wook-Ha Kim was contacted and visited to discuss the option of clean intermittent catheterization (CIC) versus an indwelling catheter. He told me that with me current status I would need six CICs a day. I told him to insert the indwelling catheter again. I was very disappointed. If I failed on the second try in two weeks, I would have to live with urinal tubes or would need CICs. But CIC

73 was not something I could perform alone.

My wife suggests that I should drink a lot of water, raise my blood pressure, and practice getting my body up. She is right. As I could not move myself, she inclined the bed so that my entire body was 10 degrees higher and my head was 35 degrees high. My blood pressure was stable today.

The view of the room was different with the higher viewpoint. I was only looking at the ceiling for nearly fifteen days. So I felt different when seeing the glass partition and white curtains. I still have a brace around my neck, and am not able to turn my head around. If I looked sideways, I would have been able to see the wall, but I had no desire to.

The left side of my nose was itchy. After suffering for quite some time, I asked for someone to look into it only to find out that an eyelash was on my nose. Just because I could not even brush off an eyelash on my nose with my own hands, I had to suffer for so long!

Today I made a progress, but small. I was able to move my hands on top of my stomach. Would I be able to lift my hands to my nose? When would that day be? I talked to my son on the phone. My daughter was studying with

74 her friends in a reading room. They say ‘Children are the fruit of their parents, and parents are the root of their children’. In my state I would not have much to offer my children. They will have to be on their own. I was not planning on raising them as home-grown pets anyway. So they will just go out into the real world a bit sooner than planned.

A 3rd grade kid in the next room will be moved to the general ward tomorrow. He fell from his bike and ripped his liver. He had to be observed in the ICU for six days in fear of bleeding. His parents were anguished, but he was too young to understand his condition and was worry-free.

75 June 21, The Caregiver came. 2004. Monday

I almost choked on a pill in the morning. I was worried if my va- gus nerve was damaged. Because I still have a normal voice, I casted that thought aside.

The caregiver that I had been waiting for so long finally arrived. My wife was pleased that the caregiver looked tidy. Normally the caregivers work 24 hours a day. But my wife arranged it so that my wife would take care of me during the day and the caregiver would work at night.

I told my wife to go to the fitness club she used to go in the mornings and come back after lunch. This situation is not going to end anytime soon, so she has to keep her health. My wife would arrive at around 1:30 or 2:00 P.M., and the caregiver was sent away to rest. My wife left around 9 o’clock after dinner, and my sister or brother- in-law would come to stay for an hour so, then the caregiver would come back after that.

76 The caregiver was coughing often. I was worried she had tubercu- losis. I told her to contact Professor Chun-Taek Lee. She was able to get an appointment right away. Fortunately it was only an allergy.

One nurse came quite often. She had an eyebrow like that in an oriental painting. She was a charge nurse. Her name was Seol-Hee Cho and her voice was very pleasing to the ear.

77 June 22, Diagnosing and Treating 2004. Tuesday on My Own

Word came that the labor unrest at Seoul National University Hospital in Hye-Hwa, Seoul was over. Ever since I got admitted to the Bundang Hospital, the Main Hospi- tal in Hye-Hwa was struggling with the labor unrest. The ICU could not function properly so a lot of patients were transferred to Bun- dang to have an operation. I was told that the patients complained a lot because food had to be brought in from an outside source and because the noise from the demonstrators was very unsettling. Thank- fully I was in Bundang, and I was not directly affected by this tur- moil. Today when my anus was washed with a saline solution, I felt the coldness of the fluid. I wondered if I would be able to urinate on my own.

At night I felt an itch on my upper chest. The back of my ear was itchy and felt warm as well. I asked the nurse to check it out. She told me there was a redness. If it was caused by the steroids it would not have affected my ears. I suspected it must be due to medications.

78 I asked the nurse to discontinue Doxycyline and requested that a dermatologist visit for a checkup.

79 June 23, An Unachievable Goal 2004. Wednesday

News came in that a young man named Sun-Il Kim who was kid- napped in Iraq was killed. It was certain that this tragedy would arouse a lot of noise.

The dermatologist suspected it was the medication as well. He suggested that I would have to consider cutting off Vioxx if my condition did not improve in two or three days. I was taking Vioxx for the possible antioxidant effect not for any anti-inflammatory effect. I was also taking vitamin C. I told him not to prescribe antihista- mines. I could not feel itchiness now, and was worried antihista- mines would cause constipation.

Spasms used to occur only in the early morning, but they occurred intermittently in this evening. They usually occurred in my left hand. The spasms would cause my legs straightened and my wrists and fingers stretch out as well. As I was able to bend my elbow and had spasms in the fingers, I expected that I should be able to move my wrists again soon. My finger flexion and extension strength is only

80 an MRC grade two or three (*able to move against gravity or some resis- tance). I am worried about my wrist strength which is only a grade one or two (*barely twitch or move against gravity). My right thumb is especially weak. It is a big problem because the thumb is the most important finger. For me however, my index finger might be the most important because I work mainly on the computer.

Nurse Ho-Yeon Yoon cared for me in the afternoon. She massaged my shoulders and back very nicely when she changed my position. She told me that she knew what it was like to have aching shoulders. She said, “I’m not married and my shoulders are starting to hurt already.” She also told me that she will be on vacation for the next two days and hoped my condition will improve until then.

My wife pressed that I tilt my body a bit more. I raised my bed so that my entire body was raised by 10 degrees and my upper body by 45 degrees. I felt my right hand was weak, and suspected this was due to the frequent application of the pressure cuff around the elbow to check my blood pressure. We decided to measure blood pressure less often.

My first occupational therapy session began today as the therapist became available. I was introduced to Mi-Hyun Kim the occupational therapist, who had a slightly chubby face. She told me that I

81 would have an appointment at 2:00 P.M. for 30 minutes. I practiced holding and moving a bandage container, a small ball, and a round stick. She asked if I could feel and recognize the items as she placed them on my hand. Fortunately I was able to recognize the material and the shape of the items. As I could not hold them, she put my hands on top of my stomach and moved them around.

After the therapy session I asked if I could keep the items for practice. She told me they were needed downstairs and took everything but the bandage container. After occupational therapy I started physical therapy with physical therapist Dong-Guk Noh. My shoulder muscles were weak so that there was always a chance my shoulders may become dislocat- ed. He suggested that I do not raise the shoulder over 90 degrees. I was worried that frozen shoulder would develop.

I put my hands together for the first time. It felt like grabbing on a leather glove. But what a relief that I could feel and touch!

Dr. Wook-Ha Kim, a neurosurgeon, visited and told me. “You know what my goal is? I will rotate to the main hospital in Hye-Hwa at the end of this month, and I want to discharge you from the hospital before then.” “I would very much like that. Thank you.” However, I know this is not possible.

82 June 24, Waiting to Get My Hair Washed 2004. Thursday

Today I succeeded in moving the bandage container from my right hand to the left hand for the first time.

Two days ago they told me that they would wash my hair. But it looks like I have to wait until Saturday. It takes six people to wash my hair, so it is almost impossible to make time during the week.

Professor Oh-Soo Han, a member of Joo-Yoo mountaineering club and a psychiatrist from the Asan Medical Center, once said, “The toughest part of my expedition in Nepal was not food or the cold but was that I could not wash my hair. My hair was driving me crazy. It was so itchy by the fourth day.” I will have to endure at least twenty days!

Joo-Yoo mountaineering club goes on overseas expeditions twice a year during vacation seasons. We were planning on trip to Mt. Baekdoo (*mountain between North Korea and China) this summer. Now it is none of my concern.

83 Professor Tae-Beom Ahn from Kyung-Hee University who was my former fellow visited. Research assistants Kyung-Mi Kwon and Hye-Jin Ko were leaving the lab. Miss Kwon was getting married, and Miss Ko was going to the States to study. I was happy to hear the good news, and was thankful that they worked in the lab faithfully for all that time. I left Dr. Ahn to find new research assistants.

“Would you like to do the final interview when I find new research assistants?” he asked. “You will be overseeing the lab anyway. I trust you to do it.”

84 June 25, A Sick Bird in a Cage 2004. Friday

I saw the sky for the first time in a long while.

They tilted the bed to raise my upper torso by 60 degrees and I was able to see the blue sky through the ICU window. It was the first glimpse of the outside world since I was admitted three weeks ago. There was a warning of a typhoon coming, but the sky was very clear. Until now all I could do was stay in bed, get rolled around, and see the white walls, glass partition, and the cart of commodities next to the bed. “When would I be able to leave this room?” I wondered.

I watched bending exercises of my fingers.

85 86 June 26, Concern About 2004. Saturday My Parents’ Worries

Nurse Seol-Hee Cho came in the morning. Looking at my hand, she scrubbed off the dead skin and ended up in cleaning my arms, legs, stomach, and torso with soap. Later five more nurses came in to wash my hair and my body. It should have felt very pleasant. But since I could not feel a thing, I only felt a weird displeasure. Howev- er I was clean again and felt refreshed.

Rolling around and scrubbing a full-grown man who is flaccid like a doll filled with cloth must have been no easy task. It was especially difficult to wash my hair without moving my neck. They first lifted the sheet to move my body to the edge of the bed and placed my head on the stanchion. In order to wash my hair they would have to remove the cast around my neck. I was apprehensive if they would accidently injure my surgical wound. They could not tilt my head back like they do in hair salons so that preventing the water from splashing into my face and neck was very hard. Six people including my caregiver had to struggle for more than an hour to get my hair washed. It was no ordinary luxury. I could do nothing but

87 thank them.

Dr. Wook-Ha Kim from neurosurgery said that he will pull the urinary catheter out next Monday. Perhaps I may be able to start sitting or standing exercises. Profes- sor Hyung-Ik Shin suggested I use an arm sling. My shoulders were very weak, so there was a danger of them dislocating when I practice sitting. I had ankle-foot orthoses on my ankles already. They were there to prevent my feet from pointing downward and getting stiff.

◄ Arm Sling

Ankle-Foot Orthosis ►

At night my brother visited. He suggested I tell our parents about my injury. “Don’t you think we should tell them now? They will be worried even more if they find out from anyone other than you. I told my brother-in-law and cousins to stay quiet for now, but you have patients coming up from our home town, and it would be hard to keep it a secret. They will find out sooner or later.”

88 My sister argued against it. “Don’t you think he should tell when he gets better? His condition is improving, right? I think it will be easier when he is in a better state.” I took both comments into consideration and replied. “I don’t think it is time yet. We should wait on telling our parents. Maybe I’ll tell them after I start walking.”

89 June 28, Small Hope 2004. Monday

The urinary catheter was pulled out in the morning. The residual urine was 87 cc. It was very disappointing. Dr. Jong-Min Kim consulted the urologist multiple times. We decided to try CIC for a while. They would have to do CIC six times a day. I seriously doubted whether the busy interns would be able to do it. But we decided to try it and see the result.

After a while I voided 200 cc of urine and asked for an intern to perform CIC. An intern did not show up. Therefore I measured the residual urine with the bladder scanner to find 56 cc remained. It is safe if the residual urine is below 50 cc. I thought maybe I would be able to void on my own again without a problem. At night the residual volume was only 7 cc. However we need to check the volume in the morning. My wife was amazed by the bladder scanner and checked her residual urine. She had 32 cc.

I tried on the arm sling that my wife bought. My weight was 74 kg when I was admitted. Now it decreased to

90 68 kg. My wife was worried about my weight loss, fed me porridge, and requested a nutritional diet. My sister also repeatedly asked that I eat well. “You got anything you want to eat in particular? You’ll get stronger if you eat something you like.” Although I did not have anything in mind for a while, I suddenly thought of the seol-leong-tang (*Korean beef stew) from Tae-je hill, Bun- dang. My brother-in-law picked it up the next day. But when it got cold, it smelled fishy. I could not eat it. They said that the milk added caused the fishy smell.

My sister-in-law said she would make ox leg bone soup. Cheol- Woong Kim said “My brother just opened up a restaurant in a dry sauna in Soo-Ji area. They have great burners. I’ll make the soup there.” I told him not to, but he had already made his decision.

I received my physical therapy at 3:40 P.M. I was able to stay tilted at 60 degrees for 15 minutes. My blood pressure was stable at 98/60. I was also able to raise my hands up to my neck. I had hope that I would be able to scratch my nose if it was itchy or even to pick my nose. During occupational therapy I moved a bandage container, moved my hand on top of my stomach, and touched my ear with my hands while lying down in bed.

91 June 29, Even in Hell, There are Things 2004. Tuesday to Laugh About

Nurse Kyung-Sook Kim who came in at 6:00 A.M. to change my position said with a laugh, “I am so busy in the recent days that I often turn my underwear inside out by mistake”. I responded, “I have not been wearing underwear for a month. I am wearing diapers, the synonym of dementia“. We had a good laugh. I made a crack that women and patients turn out as much as you care for them. There still are things to laugh about in this hellish situation.

Until yesterday I was wearing special patient pants whose front and back are separate so that it is easier for nurses to put them on for me. I began to wear regular patient pants from today. It is a small step, but it is a big joy for me.

I spent the whole day checking my residual urine. It was 38 cc in the morning and only 8cc in the afternoon. I am in the clear. It appears that I may not need to have an indwelling urinary catheter after all. I may be saved from the voiding problems, which means

92 that I will be less dependent on others. In delight I called many people including my mother-in-law. Everyone congratulated me.

However, emptying my bladder was not as easy as others might think. I made sure I was able to concentrate on voiding without being disturbed. If it felt like my bladder was full, I would bloat my belly up and down to stimulate the bladder. When it was about to come out, I tried to hold it in until the urine was filled to my urethra. I took deep breaths, bloating my belly up and down to maximize the reflexes. Then I voided when I was not able to hold it in anymore. But even with all this fuss my urinary stream was weak like the dribble of the valley at the north side of Nam-Han-San Mountain in the dry season of late fall. It used to be as strong as the fountain in Sang-Am World Cup Stadium…. Taking care of oral hygiene was no easy task as well. My front teeth still felt shaking and the wire left my lips in tatters. I had to pack vaseline gauze in my mouth. I should be brushing my teeth after each meal, but I could not because of the wire. I used a toothpick to remove the settlings between my teeth and used an interdental toothbrush. The parts of my teeth that were wired were the most un- sanitary part. It was a major task to keep my teeth clean. I could not use cotton swabs with disinfectant to wash my teeth. I gargled instead. I dare not ask for bathing and washing of my hair because they were hard tasks for others.

93 Until yesterday I had physical and occupational therapy in my room in the ICU. But today I went down to the therapy room on the first floor. This was another small leap forward.

The therapy started at 3:30 P.M. I had to start preparing from 3:00 P.M. and arrange for a transport cart. Five people including a person to hold my head had to help in order to move me to the cart from the bed. Everybody told me “Good luck” when I was carried out of the ICU through the two doors.

How long it has been since I was trapped in the ICU! I could not tell where I was headed to by looking at the ceiling only. The cart suddenly stopped. I assumed we were in front of the elevator. We had to send 2 elevators off before I was able to get on. There seemed to be someone who recognized me on the cart.

After leaving the elevator at the first floor we went through a door. The man that was pushing the cart notified my arrival by crying out, “The patient is here!” The cart moved left and right and stopped inside a room. I saw patients and guardians passing by. It must have been the entrance. About 5 minutes later, Mi-Hyun Kim approached and started treating me on my cart. It was not much of a treatment. All she did was put some object in my hands, moved my hands to my stomach, and moved my toes a bit.

94 She worked on my right side first and then pushed the cart to the outer wall so she could work on my left side. The therapy was over in no time.

“Come again tomorrow at the same time.” She told me as I headed towards the physical therapy room.

In the physical therapy, I had to practice standing up first.

A therapist hollered “Everyone come here please.” A few men in blue gathered. I figured they would lift me up. I hurriedly warned them about my neck. They answered me not to worry. The therapists moved me from my cart to a T-table (tilt table). They strapped me tight around my knee and chest after I was moved to the table. The strap was there to prevent me from leaning forward when they tilted the table. A nurse measured my blood pressure. 145/90. After I

◄ T-table

95 relaxed for about 5 minutes they started tilting the table. At about 30 degrees of tilting my body felt like sliding and I felt the bottom.

The therapist asked me. “Try pumping with your legs.”

I could not perform as I hoped, but I concentrated on my leg muscles. Pumping is necessary to maintain blood pressure because tightening of leg muscles would prevent pooling of blood in the legs.

“Do you feel dizzy?” The therapist asked. “No, but it feels strange. It feels like I am floating in water.” It really did. I could not balance myself as if I was underwater.

They told me I would stay in position for 10 minutes after they tilted the table to 45 degrees. They took my blood pressure again and it was 104/60.

“Tell me right away if you feel dizzy. You must keep your eyes open.”

I need to keep my eyes open to ensure that I am awake. I might become unconscious if my blood pressure fell too low. At a 45 degree incline I was able to see the room. There were a number of sporting

96 equipments. There were bicycles, exercise beds and pulleys. Patients were walking slowly while holding the therapists by hand. A patient was using the bicycle right in front of me. He was wearing his normal outfit, so he must have been an outpatient. He looked to be in his 60’s. His pedaling was awkward on one side. He must be a stroke patient. When would I be able to exercise on the bicycle? I wondered while pumping my legs diligently.

“Good work.” Dong-Gook Noh said as he was lowering me back to the flat position. “Please go slowly.” I requested it because my blood pressure would suddenly rise if they lowered me too quickly. They put me down and I relaxed for about 5 minutes. A lot of therapists gathered once again and moved me back to the cart. I got back in the cart and returned to the ICU.

“How was it? Good?” I received friendly greetings. “Yes, it was.” Only then I knew that my room was on the left side of the ICU. I was moved back to my bed once I was in the room. The time was 5:30 P.M. Two hours had passed although I had not done much.

Professor Seong-Tae Hong, the vice-dean of administrative affairs

97 called Jong-Min Kim and left a message that the vacation season had begun and I did not need to ask for a sick leave. It was good news.

Last night Professor Hyung-Ik Shin visited and told me that he and Professor Hyun-Jib Kim discussed whether or not to transfer me to Rehab Medicine. Does it mean that I need to move out of the ICU because there are no pressing emergency issues to stay in the ICU? However, I was not prepared to stay in a regular ward in my condition not being able to flip my own body. I told him that I was not ready and asked to let me stay in the ICU for a bit longer.

98 June 30, New Problems 2004. Wednesday

Last night my wife discussed with the nutritionist. They decided that I should receive a high-protein meal. This was because I did not gain as much weight as she had hoped. My fish at breakfast became a bit bigger.

The nurses asked me if I liked my high-protein meal. I answered that I expected beef ribs or chicken but that I only got a bigger fish. A nurse said “Do you favor chicken?” For lunch I got barbecued beef.

Speaking of fish, I love fish. But in my state I could not remove the bones with my hands. It was difficult to enjoy fish when I had to find and spit out fish bones with my tongue. My caregiver or my wife would remove the bones laboriously. But there were always little bones hidden within the flesh that harassed me. I had trouble when some fish bones got stuck in my throat. I could not cough it out since I had very weak breathing muscles.

99 My right eye was congested and both eyes felt stiff. I cleansed my eyes with water and blinked my eyes hard to stimulate the lacrimal glands. Then it felt better. These troubles show up just because I cannot wash my face properly.

The spasm in my left triceps muscle was getting stronger. The triceps is connected to C7. So it is a proof that my spinal cord is re- covering from the shock and the wound is localizing. I just hope that exercise would lessen the spasm. At night I felt a cool sensation on the outer part of my left foot. My sense of touch was relatively intact but temperature and pain sensations were still impaired. I have no idea how much of them I would regain.

Residual urine was 0 cc in the morning. I voided around 200 cc to 250 cc. I need to increase my urinary volume. While waiting in front of the occupational therapy room, I felt an urge to void. I was moved to a small room on the side and urinated in the urine can.

For the past few days I noticed a student who would be carried on a cart ahead of me. I later learned that he had been in a car accident and injured his neck to be paralyzed from the neck down like I was.

Today they raised the T-table to about 60 degrees and my blood

100 pressure was about 95 to 98. I stayed in that position for about 15 minutes, and it was bearable. I needed to keep tightening leg muscles, which I was able to do a little. When they raised the table to 70 degrees, my blood pressure was 106. Upon lying flat, my blood pressure rose to 148. My pulse was 70 per minute when I was up, and 50 on lying down.

For a week, it felt like the world was turning after a second or two every time they changed my position in bed. It felt like I was turning further in the direction I was turned. Fortunately, there was no nausea associated with it. Alas! I must have benign paroxysmal po- sitional vertigo. When I fell, a stone in the vestibular organ for my sense of equilibrium must have dislodged. I told this to Professor Ji- Soo Kim who visited a few days later. “I am lying down most of the time. It is going to be okay.” I made the diagnosis, and did not need any further work up or medication.

Today is the last day of June. The neurology residents will change rotations. I contacted the neurology office to tell no residents make a formal visit.

101 July 1, Doctors have Statistics, and 2004, Thursday Patients have Hope

Last night, my wife and I did not agree on a small issue while I was exercising my thumbs. We had a slight argument. She must be on edge because I was not able to get out of bed by myself for a month. She tried to stay calm throughout my hospitalization. She made friends with other patients’ families in the ICU and shared food with them and appeared calm. But she must have been very anxious. Now she must be realizing the direness of the situation.

Right in front of my bed was a man in his 50s who was barely conscious after a hypoxic brain injury due to severe bleeding during heart surgery. My wife tells me with glee that the man smiled at her. She seems to say hello to patients and share foods with their families whenever she brings in food like a cake.

There was also a middle age woman whose limbs were paralyzed after a surgery of a meningioma (*benign tumor arising from the membrane covering the brain or spinal cord) in the cervical spine. She was dependent on a respirator for almost a year and showed no promise of leaving

102 the hospital. She had had numbness in her arms for years, which was just attributed to “Pung 瘋” (*Oriental medical term which vaguely encom- passes a lot of diseases) and was treated with acupuncture. When she sought medical help, the tumor grew too big to help. Her tumor was located at a higher level than mine and compromised her breathing. I assumed that she was divorced because only her mother was visible in the ward. But I later found out that her husband was busy working and visited once or twice a month. Her children in junior high school would visit once in a while. It must be a relief for the patient that she has a family one way or the other.

Four weeks have passed. I show no signs of significant improvement. However, the fact that I could urinate on my own gives me a big hope.

The gloomy statistics about how much recovery patients may expect when they’ve reached this condition without much progress by their fourth week loomed in my mind. However, I told myself that statistics are just numbers.

When doctors have statistics, patients have hope.

103 July 2, Wheelchair 2004 Friday

Two nurses helped me sit up in my bed and moved me to a wheelchair. My body felt like it was floating in water or on air when I sat on the corner of the bed. I almost panicked because putting my foot on the ground did not make me stable. I felt more relieved when I sat on the wheelchair with my buttocks pushed against the back. Even still, it felt like my body was in the water.

Why is this? At first I thought it was because the vestibular organ of my ear was damaged. But soon I realized it was because my sense of position was compromised due to my spinal injury. I’ve read it in books and heard it from my patients. But only when I actually experienced it did I fully understand how it felt like.

I was taken to the rehab center on a wheelchair. It was the first time I went somewhere on a wheelchair. I was given much more freedom of movement than when I was carried on a bed. Getting on an elevator was difficult before because the bed took up too much space.

104 Now I did not have to wait too long.

I had not worn my glasses since the accident because there was just no need for me to see anything. For the first time I put them back on in the therapy room because I needed to see now.

In the occupational therapy room I tried to move my arms in a sitting position, but the results were quite disappointing. I lay my hands on the tortoise and tried to stretch my arms forward but they only moved sideways. There were only elderly patients in the room. They were indifferent to my presence. They must be pretty occupied with their own troubles to mind others.

Professor Hyung-Ik Shin came to the physical therapy room and watched me exercising. Dong-Guk Noh fastened a waist support on my stomach and led me from my wheelchair to the T-table. I straightened my knees to bear the weight on my bones and took one step at a time very carefully. I was wobbly and it felt like I was walking in mid-air. But I was able to make steps.

They raised the T-table to 80 degrees. My chest would keep leaning forward but I was able to stay in that position for 20 minutes without dizziness. In that erect position I put my weight on each leg alterna- tively like walking. I had the sense that I was swaying and making inaccurate movements. I was leveled down again and placed in the

105 lying position on the table next to me with the help of my sister. Mr. Noh sat me down and worked on my shoulders. He again warned me that I may dislocate my right shoulder, so I should be careful. “Your shoulders are strong enough. That arm sling won’t be necessary” said Professor Shin. Then he suggested that we start working on walking next week.

I was able to see the configuration and rooms of the ICU while being moved around on the wheelchair instead of the cart. There were two automated doors at the entrance. The second was con- trolled at the nurses’ station. There were two rooms with glass par- titions on the left side of the entrance. The one in the corner was my room. As I went in the room, nurses Sul-Hee Cho and Jin-Young Moon greeted me. “It is your first time seeing the room, right? Sit down and have a look around,” said Cho. I saw a storage area, a sink, and an oxygen tab and vacuum aspirator on the left wall of the entrance.

On the way back I met with Dr. Jong-Min Kim. He was pleased to see that I was able to sit. He asked whether I would meet research assistants Kyung-Mi Kwon and Hye-Jin Ko now that I could sit. They had visited before but I asked them not to come in. Mi-Jin Seo, the product manager of Medtronic who I hiked with

106 a couple of times visited. Dr. John Rogers who was my colleague at Columbia University heard of my news when he was visiting the rehab center and sent me a music CD. On the card was written ‘It is very difficult to be dependent on others.’ It is very true. I will have to depend on others to survive from now on. That will not be as easy as it sounds. I sat for about 20-30 minutes more and lied down. My wife clipped my nails.

107 July 3, I can Stand 2004. Saturday

My scalp was very itchy throughout the night. I had it scratched with a brush. In the morning I had it scratched again to get ready for the washing of my hair. Nurse Yoon shampooed my hair. Four nurses came in to scrub me down with soap. It took well over an hour to take a bath.

On Saturdays I can do either occupational therapy or physical therapy only. This is because therapists come in biweekly on Satur- days. The hospital has a five-day workweek. But they come biweekly for the inpatients. It is fortunate for the patients.

Today I practiced balancing with parallel bars. It still feel like I am floating in mid-air while I am sitting or standing. But I am thankful that I can stand with my own legs. They started me on an arm bike. I could not grab the handle on my own. The therapists fastened my hands to the handles with bandages. I was unable to push the handle even at the lowest level which should move with the lightest touch. I tried to pedal for 10 minutes

108 thinking of my children, and I was soaked in sweat. Although I was not able to grab the handle on my own, I never gave up on any of the exercises.

I was surprised at how lean I looked in the mirror in the physical therapy room. They told me I weighed 70kg. I weighed 74kg before. I looked like I was all skin and bones.

Since yesterday I had the ox leg bone soup that Cheol-Woong Kim brought. I ate my lunch in the sitting position. It was much more comfortable than eating lying down.

109 July 4, Daily Routine 2004 Sunday

My daily routines that repeat over and over again are as follows:

12:00 Midnight. The nurses change my position and massage my back. I gargle and have gauze packed over my gums. Then I fall asleep.

3:00 A.M. They change my position again and give me a massage. I gargle and have gauze packed.

6:00 A.M. Urinate, change positions, gargle, gauze packing, and exercise. I start from my left thumb and move each of my fingers 10 times then turn to the wrist, elbow, shoulder, and then the same for the right side. Then I move to the legs and bend my ankle, knee, and my buttocks. Each set takes about 20 to 30 minutes. I do three sets of them.

7:30 A.M. My caregiver comes in with a washbasin filled with water and washes my hands and feet with a small towel.

110 8:10 A.M. My breakfast comes. After the meal which takes about 30 minutes, I take lots of pills: gaster (*antacid), tocopherol, cobalamin (vitamin), two pills of MgO (*stool softener), ambroxol (*secretolytic agent), Vioxx, two pills of vitamin C, and baclofen. Then clean my teeth with an interdental brush.

9:00 A.M. They change my position once again and change my gown. Then I defecate and they change my diaper. It is fortunate that I defecate regularly. Exercise start after this. 9:30 A.M. My sister comes, and the caregiver is dismissed. The caregiver goes to the guardian waiting room which is three stories below ground.

After two sessions of exercise it is about 10:30 A.M. I have a sweet potato cake and two boiled eggs for a snack and do another set of exercise after the snack.

I take a short nap shortly after 11:00 A.M.

12:00 Noon. Lunch.

1:00 P.M. I take all my medication, then change positions, gargle and pack gauze in my mouth again.

2:00 P.M. Another set of exercises and a pill of vitamin C.

111 2:30 P.M. An apple for a snack. 3:00 P.M I get a thin rice gruel which I eat right away or save for later. 3:15 P.M I start heading for the therapy room. I go through about 15 to 20 minutes of occupational therapy and then 45 minutes of physical therapy.

When I return to the ICU in a cart, it is about 5:30 P.M.

I rest for a while and have dinner at 6:00 P.M. I take my pills once again and brush my teeth, gargle, pack the gauze, change positions, and then exercise. It is 9:00 P.M.

I take another vitamin C pill, and my wife leaves when my brother-in-law comes at around 9:00 P.M to 9:30 P.M. The nurses change my position again around that time. My brother-in-law massages me for 45 to 50 minutes with love and care. At 9:40 P.M. the caregiver returns. She massages my hand. She cleans my nostril every once in a while as well. This is because I cannot pick my nose myself.

I do a light wrist exercise, urinate and fall asleep.

Then at midnight my daily routine repeats.

112 After the surgery my pulse rate would drop to the low 40s. Pro- fessor Hyun-Jib Kim told me about a man whose pulse dropped to 30 after an operation for a hemangioma at C3 level and said my pulse might be low because of the injury. If that were true, then the injury must be getting better since my pulse rate is normalizing.

113 July 5, Dental Appointment 2004. Monday

It is exactly a month since the accident. At least I can sit on a wheelchair.

In the morning I took an X-ray in the dental clinic. As I could not hold the film in my mouth with my own hand, my sister held it for me. The dentist told me my two front teeth were not cracked but broken. All the trouble of keeping the dental wiring in was for nothing.

I was worried if the afternoon dental appointment would inter- rupt my therapy session. Thankfully I was able to choose an appointment time convenient for me. I decided to get my teeth pulled out at 1:00 P.M.

I hurried through lunch by 12:30 P.M and went down to the clinic at 1:00 P.M. Professors Pil-Young Yoon and Ji-Youn Bae discussed amongst each other for a while before starting the treatment. First they removed the wiring, injected a local anesthetic, removed my

114 broken pieces of teeth, and then performed a minor endodontic treatment. They told me they would remove the root of my teeth the next day. Professor Jung-On Hwang who came in at 2:00 P.M suggested that I get implants for both of my two teeth.

My mouth felt empty after losing my two front teeth. The teeth that were large like a rabbit’s were suddenly gone. When I was young, my father would stress the importance of dental health and would let my brother and me open our mouths like a horse and check if we had any cavities. Thanks to my father I never had any cavities. “Your broken teeth looked like neolithic stone axes, and they saved your life.” said Dr. Jong-Min Kim. “I became a tiger without his teeth.” I replied.

When a car crashes, the front of the car including the engine crumples and lessens the impact to protect the driver. If the car is unyielding, the impact would be delivered directly to the driver en- dangering him. When I fell, the two small bronze stones crashed my front teeth first and prevented my forehead from crashing into the ground directly. The breaking of my teeth acted as a bumper and reduced the impact on my brain and my spine. If I dropped head first into the ground my brain would have been severely damaged. It was thankful that my teeth got the first impact. I left my grief behind and headed for physical therapy.

115 A month after lying in bed with my four limbs paralyzed, I am able to put my feet on the ground and stand on my own. I had a lot of visitors because it was the inauguration day of Pro- fessor Heung-Sik Kang to become the new director of the Hospital. I was able to show them I can stand rather than greet them while lying down. I later heard that my colleagues applauded at the news of my standing in the professor’s cafeteria. I was very grateful for them.

116 July 6, A Fool’s Errand 2004. Tuesday

In the morning I exercised in the room.

Later in the afternoon I was supposed to have my teeth removed and I was moody about it. The dentist told me they planned to remove the root of the teeth and give me implants right away. My face is the only part in my body where I still have my normal sensations. And they are going to anesthetize that area and perform the surgery.

In order to remove the root, they will put me down on the bed, sterilize my face, cover it in cloth and then give me a local anesthetic. In that condition I will not be able to tell the dentists if my condition gets worse. I will not be able to speak because I will have my mouth open. I will not be able to signal them because my fingers are paralyzed. Thus I needed to be prepared if there was an accident like anoxia. “I was able to last this long because I had my will. If anything goes wrong in this operation, I don’t think I’ll have the strength to move forward. So I trust that you will make the right choices.” I

117 said to Dr. Jong-Min Kim. Kim understood my gloomy apprehension and told me not to worry about anything.

They moved me to a room labeled ‘minor operating room.’ It took three people to get me from my wheelchair to the operating chair.

The nurse who saw me for the first time gave me a surprised and sympathetic look. After they injected a local anesthetic they started removing the roots out. Removing a body-less root must have been like pulling kudzu roots. They opened up my gum with a scalpel and pulled the roots out carefully with pincers. They told me the roots of my incisors were very deep. People used to tell me my incisors were large like those of a rabbit or like Namdaemun (*The large traditional front gate in Seoul).

◄ Namdaemun

It was taking oddly long. Professor Jung-Won Hwang later told me that they tried to implant the new roots for my implants but they had to pull them out because there was too much empty space. The operation that lasted about 2 hours was a fool’s errand. They sewed

118 up the cut with a needle. The dentist gave me antibiotics and told me that I should gargle my mouth clean and that I should apply an ice pack for several days.

I missed physical therapy. I applied an ice pack all throughout the rest of the afternoon until night. My sister spent a very busy night holding the ice pack for me and massaging my hand.

119 July 7, Bravo, I can Use a Toilet 2004. Wednesday

In the morning the dentist modeled my dentures.

Today I was able to defecate while sitting down on a mobile toilet for the first time. For over a month I had to defecate in diapers while lying down, which was very degrading. Sometimes I waited for over an hour to summon the nurses after I defecated. I felt sorry to summon them because they would come in to change my position every several hours. In the afternoon I felt the need to defecate. I asked to take me to the bathroom. There was a mobile toilet bowl in the ICU. Three people lifted me and sat me down on the toilet. I asked for everyone to leave the room and defecated. I still had to get help from other people to have my anus cleaned and moved to the bed. But it was much more decent than defecating in my diaper in bed.

From that point on I always used the toilet to defecate.

120 July 8, Transfer to the Rehab Department 2004. Thursday

My stool became loose probably because of the antibiotics. I was worried if it would turn into diarrhea. I just started using toilets. I was concerned that I would make a big mistake if the toilet was not ready when I needed it. Moreover, I was scared I might do so while in physical therapy. I was prescribed for 4 days’ worth of the antibiotics, but I took only 3 days’ worth because of the concern for diarrhea.

A month has passed since I was admitted to the ICU. For the past week, discussions were made about transferring me to the rehab department. It is obvious that I need to move to rehab because my neu- rosurgical problems are nearly resolved. However, I need to make sure that rehab patients can stay in the ICU. After I was transferred to rehab, I had an advantage that I did not know before. Before the transfer, I got the therapy only once a day. But as a patient in the rehab department, I was able to get it twice a day. The medical insurance allowed two physical therapy sessions for patients in the rehab department, but only one session for pa-

121 tients in other departments. Any additional treatments were considered overtreatment and were not reimbursed.

I learned that the therapists and nurses were taking their time to learn about the insurance policies. They had to be alert to be fully reimbursed to keep balanced especially because the fee for rehab is absurdly low. I realized that it was not a world where taking good care of the patients was everything.

122 July 9, Going Outdoors 2004. Friday

I got my denture in the morning. It was made by grinding my two broken teeth. Denture was a hassle. I could not put it on or off by myself. My sister would do it for me, but it was awkward for her too. One of my right lower teeth was cracked. I made an appointment to get if filled with resin.

Since I moved to rehab last Wednesday, I have physical therapy two times a day. I still have my diapers on. But I am not that worried during therapy because I have some control.

Since I changed departments, Mr. Dong-Guk Noh was replaced with Mr. Sang-Woo Ahn. He has a big body with a very calm voice and made an amiable impression.

“The weather is pretty nice outside. Why don’t we take a stroll?”

When Ahn mentioned this in the afternoon, I thought I would go to the lobby at most. For the entire month that I was admitted,

123 the only place I went was my room on the 3rd floor, the therapy room on the first floor, and the MRI room in the basement. There- fore it was natural for me to think so.

I was moved through the entrance of the Hospital to the bright outdoors on the wheelchair. I was thrilled and anxious at the same time. The hospital entrance that I saw at its opening was modified and very quiet. It was a rainy season but the weather was very clear for a brief moment in this afternoon. “Is the sunshine too bright or hot for you?” “No, it is good.” He stalled the wheelchair and fastened my waist support and helped me walk for a while. Then he sat me down on the bench and started the therapy.

The cold sensation in my feet was getting worse. I will watch closely to see if it was my senses coming back or if it was dysaesthe- sia. I discussed my concern with Professor Hyun-Jib Kim. “I think my senses are not coming back and are interfering with my therapy.” “We can’t do anything about that. Let’s focus on getting your muscle strength back.” He is right. There is nothing I can do to get my senses back sooner. Although limited, working on my muscular strength is the only

124 thing I can do. Just worrying about my problems would do no good. It is best that I spend that time exercising.

Today all professors are supposed to go to Chuncheon city and attend a college-wide seminar on how to develop College and Hos- pital.

125 July 10, Concerns about Children 2004. Saturday

Jin-Young Han is the nurse for the day. She is very small but is so diligent that it amazes my wife. “I was there when you first got admitted. It’s good to see how much better you got.” Although I am barely able to stand on my two legs and need someone to hold my waist support to balance while walking, it is true that my condition is improving.

In the afternoon, nurse Sul-Hee Cho and my wife bathed me. Cho walked in, looked around and asked me if I could sit down. She said, “It is difficult to clean you while you are on the bed. Let’s go to the nurse’s changing room and sit on a chair to clean.” I did as she suggested. It was much more refreshing to take a shower while sitting than lying in bed. I was very grateful. “Many claim to have gone to hell and back. But I bet no man has ever gone to the nurses’ changing room to take a shower.” I joked.

Today I was able to touch my hair with my right hand for the first

126 time.

It is Saturday, so I received a therapy session from therapist Yoon- Sung Oh instead of Ahn. Therapists work biweekly on Saturdays. The therapists in charge would change, and I would have shorter therapy sessions. Mr. Oh spent a long time with me, and the patient who had to wait sang a song “He lets me wait and doesn’t come” after a popular lyric about a lover not coming to her. Later I found out that the patient was the mother of a head nurse. She used to sing very well and tried hard for several months. But she did not show much progress and left in disappointment. It is a lifelong fight. It is understandable that the patients and their family get weary during a protracted struggle. In occupational therapy I tossed a ball back and forth with an elderly patient. The therapist told me that the patient did not like to exercise. But he worked pretty well with me. I guess that he may have felt camaraderie with a fellow patient.

I called my parents to say that I just came back from Germany and that I would be going to New York for a month. They were worried about my busy schedule and told me to watch out for my health. It seemed like my parents did not know anything yet.

Professor Hyo-Su Kim, a cardiologist came to visit. I was supposed to go play golf with him the day after my accident. He told me that

127 he waited for me at the club house. When I did not show up, he called my house and found out I was admitted to the hospital. On the day of accident, I had asked Professor Sung-Ho Park to contact Professor Kim that I would not be able to make it to golf. It must have slipped Park’s mind through all the chaos. Professor Kim was surprised to see me in bed with my limbs paralyzed because he knew how healthy I used to be. He kept repeat- ing “How could this happen to you!” “My body may be paralyzed but my will is stronger now than ever. I will be out soon. Don’t worry.”

Late at night my brother came. We discussed about informing our parents. As I had already told them that I would go abroad, I suggested we wait another month.

My brother was worried that his sons were not focusing on their studies. I said, “From what I’ve seen, both children are very bright. One in particular has great concentration. You need not worry.” However, even when I was saying those words, I was also worried about my children. Children are our biggest concern.

128 On Children Kahlil Gibran Your children are not your children. They are the sons and daughters of Life’s longing for itself. They come through you but not from you, And though they are with you yet they belong not to you. You may give them your love but not your thoughts, For they have their own thoughts. You may house their bodies but not their souls, For their souls dwell in the house of tomorrow, which you cannot visit, not even in your dreams. You may strive to be like them, but seek not to make them like you. For life goes not backward nor tarries with yesterday. You are the bows from which your children as living arrows are sent forth. The archer sees the mark upon the path of the infinite, and He bends you with His might that His arrows may go swift and far. Let your bending in the archer’s hand be for gladness; For even as He loves the arrow that flies, so He loves also the bow that is stable.

Yes, His will shall be done. It is true that I am worried about my children. But all I should do is to trust them and love them.

129 July 11, Stroll 2004. Sunday

Early in the morning, nurse Yoon asked if I would like to take a stroll outside since the weather was very nice. I was apprehensive, but I left the ICU with the help of Yoon and my brother. The ICU was on the 3rd floor, but there was a passage that linked directly to the outside. There was a walking path behind the Hospital. It was good as I was told. My brother’s firm hand held the waist support belt from behind, and Yoon was right next to me. So I was less worried. About 30 minutes later my legs and body tottered a bit. But a lot of the in- security I had about walking was gone.

In the afternoon I took a stroll down the corridor on the 3rd floor with my sister. It was a good walk, and it was the first time I saw the layout of the 3rd floor. The entrance to the hospital was visible from the third floor. Deep inside the hall was an ICU specialized for kidney patients and a cardiovascular angiography room. It was quite a long hall, about a 100 meters walk back and forth. If I got tired while walking, I took a rest on the bench.

130 My wife brought me many tools so that I could try occupational therapy on my own.

131 July 12, Endurance is the Key 2004. Monday

Congressman L came to visit. I was supposed to see him and discuss his health concerns in July. I had sent a dictated letter because I was not able to write on my own. This visit was a courtesy call. I always thought he was very hardworking and sincere. I now see that he truly is earnest. He could well have ignored my letter. I sent him a message that I was not in a situation to be visited in person and that he should go back.

Today my daughter’s exams are over. I call my children at home every two to three days to tell them I am doing fine. Their replies are a bit gloomy, so I am worried. My wife and I discussed when the children should visit. My wife suggested they come after I leave the ICU. I agreed because I did not want them to be surprised to see me lying in the ICU.

The cool sensation in my feet worsened. They feel colder if they are not covered, so I always keep them tucked in layers of blankets. I have a stinging feeling only without any sensation of warmth when

132 hot water is used to wash my feet. Touching a cold object feels painful. Sometimes my entire body would feel hot or cold. I know very well that this is central pain. Medications could be used, but that could lead to complication. So I decided not to use them. These pains are like hallucinations. I will try to ignore them.

There was once an Olympic gold medalist in a walking mara- thon. The weather in the city where their race was held was scorch- ing hot, so the contestant’s feet must have felt like they were being cooked. When the reporters asked how he handled the pain, the gold medalist answered, “I just endured it.” I too will just ignore the pain.

For the past few days I was urinating while standing up. In the morning I felt like there was a lot of residual urine in my bladder. I had it scanned and there was 125cc. So I lied down and raised my legs to stimulate my bladder and urinated again. My residual urine was decreased to 25cc. Nothing is going by easily.

There was much rain and thunder at night.

133 July 13, Transfer Preparations 2004. Tuesday

Professor Jae-Gyu Roh of Neurology visited with a lunch box from the Japanese restaurant in front of the main hospital in Seoul. For the first time I was able to enjoy a meal from the outside. He asked if I was feeling frustrated although my condition was improving. I had no time for frustration. I was already too busy with all the rehab. He assured me I would recover fully. But I know my situation all too well.

The dentists removed the stitches from my gums. At night Dr. Jong-Min Kim discussed my transfer. He must have been pressured to get me to move to the regular ward. It was fortunate that the ICU was not busy for such a long time. The main hospital in Seoul was having troubles because of the labor strike. A lot of the patients had to be moved to this hospital for operations. Therefore, it would be natural that the ICU would be crowded. However, patients did well without complications and were moved to the regular wards easily. So I was not pressured about the room. However, they need enough vacancies in the ICU to operate

134 on more patients. My protracted stay in the ICU was unwelcome.

I am not even able to get in or out of bed on my own. So staying in a regular ward would be very difficult. We postponed it little by little, and it ended up amounting to about 10 days. I was thinking about having two caregivers, but it was not a good solution. So I asked that they wait a little bit longer for my recovery. I also have to decide whether I am transferred to the neurology ward or the rehab ward. I do not know what the wards are like. So I let my colleagues decide. It is obvious I am going to stay for a long time. I would feel sorry for staying in the rehab ward for too long, but staying at the neurology ward would be uncomfortable for my juniors and residents as well.

In the end, it was decided to go to the orthopedic ward which was right next to the rehab ward because there wasn’t any single occupancy room available in the neurology ward. A single occupancy room was much more expensive. But I had my dignity to keep, and concentrating on my recovery was foremost before any financial issues.

I told nurse Sul-Hee Cho, “My eyesight is bad. The nurses should not feel bad if I do not recognize them outside of the ICU”. Cho answered with a laugh. “A lot of people do not recognize nurses in plain clothes”.

135 July 14, Names 2004. Wednesday

In the morning I took an X-ray of my left wrist and shoulder. My walking is getting much better, but my shoulders are still a problem. When moved passively, my shoulders were very unstable. They made sounds, which was accompanied by a sensation similar to pain. My senses were impaired, so it would be best to check it by an X-ray. The technician greeted me as I walked in to take an X-ray. “I was on duty when you came to the ER. I am pleased to see your condition has improved”. Everyone in the Hospital knew about my situation by now. But my parents should not find out.

Dr. Jong-Min Kim brought the X-ray files on a CD to Professor Gu-Hyun Baek of orthopedics at the main hospital. Baek assured Kim that nothing in particular was wrong.

The nurses came to say goodbye at the news that I was being transferred. I could only recognize half of the nurses’ face and names. I tried to memorize their names and faces during the 40 days of my

136 stay. But I spent most of the time with my eyes closed and without wearing glasses. The nurses in ICU would flip their nametags over on their back because the tags would interfere with their work so that often times I could not catch their name.

One of the nurses looked familiar. I asked her name because I did not get her name before. She told me her name was Hyun-Hee Lee. Su-Hyun Park told me she shampooed my hair on the Saturday the week before, and I did not recognize her.

My caregiver and my wife started moving my stuff from 4:00 P.M. While they were moving, I received my physical therapy and went to the new room on Ward 62 at 6:00 P.M. It was a room with a good view of the small hill in front of the hospital.

While my wife went down to the ICU to get my wheelchair and drinks, Dean Gyu-Chang Wang and the other executive officers of the Medical school came to visit. It seemed like they visited the hospital just in time to see me being transferred. They told me not to worry and that I should focus on recovery. However, after 40 days I am still not able to get out of bed by myself and I need to be fed. I am worried about what I would be able to do with myself. What if I would just be good-for-nothing?

Professor Jong-Hyun Lee from Gwangju Institute of Science and

137 Technology who is an alumnus from high school called me. “I am already at the Hospital. I will go abroad for a year from Au- gust and I want to visit you.” I said no. “I am not dying. I will see you when you get back next year.” He would be more concerned if he actually saw me. It is better that we meet later. I called my friend Young-Kwon Cho, the editor of Maeil Business Newspaper. “You don’t have to know the details, but I am not dead. Don’t try to contact me before I find you.” “Okay, thanks.”

The caregiver left after helping me with dinner. My wife bathed me. The caregiver returned after her meal, and my wife went home. After three sets of my exercise that started from my fingers, it was 11:00 P.M. I lied in bed with the help of my caregiver. I was worried because it was the first time lying down in bed without the help of nurses. I lied down flat with my neck brace on. The brace interfered with my ability to roll sideways during the night.

The caregiver slept on the guardian’s bed next to mine. I urinated twice during the night. With the help of my caregiver I got out of bed and urinated alone and measured the volume.

138 July 15, Watching Happiness from Afar 2004. Thursday

I got up at 6:00 A.M. and went on a stroll around the ward with my caregiver. Today I went back and forth the hall five times. My caregiver held me from behind with the waist support I borrowed from the rehab. I was able to see the apartments in Bundang through the window at the end of the hall. A lot of happy families must be there….

I carefully sat in front of the sink and my caregiver washed my face. I still had the brace around my neck. So I had to lean my body forward instead of my neck. I was told to keep the brace on for 3 months. It is very uncomfortable during therapy and in bed. But I have to endure it. I ordered western style meals because they are much easier to eat. I am not picky about food and all 3 meals were good enough. With the help of the caregiver I finished the meal and brushed my teeth.

I went to the fitness room at 3:30 P.M to exercise the muscles on my lower body as discussed with Professor Shin last night. I exer-

139 140 cised on spreading and straightening the legs and balancing. My shoulders are more trouble than my hands. This is because my major injury is in C3-C4, which innervates the shoulder muscles. I do not have enough strength to push forward or lift. Shoulders are the axis to any arm exercises. If an axis collapses, it tampers with the whole upper limb movement. They seem fine but the pain soon returns. When I rotate my shoulders, my tendons catch making sounds and causing pain.

I was supposed to get ultrasonic heat therapy today, but time was not available until Friday. The rehab schedule is always packed.

141 July 16, Shoulder 2004. Friday

At 10:10 A.M. I receive the heat and ultrasound therapy on the shoulders. I warned the nurse that I could not feel heat. The nurse padded extra thick towels over my shoulders to prevent burns(Even with these measures, it felt like I was getting minor burns. Eventu- ally I stopped receiving heat therapy.). My shoulders feel a little better after I receive the ultrasound therapy from Ahn. Professor Nam-Jong Baek felt my shoulders and told me they will get better because there is no muscle atrophy.

At night my wife and I discussed bringing in the children to see me. My son will come on Monday afternoon next week, and my daughter on the next weekend.

142 July 17, Crumbling Paper Tissue 2004. Saturday

The rain stopped after a long period of pouring. It is the rainy season so the sky is still filled with grey clouds. People tell me the weather is so wet that they cannot dry their laundry.

I discussed my future plans with Dr. Jong-Min Kim.

I practiced crumbling and holding paper tissues. It was pitiful that I could not properly crush a single tissue. But I was doing it with more ease than a few days ago, and I took solace that I succeeded in finishing it.

I called my father and asked how he was doing in the rain. He does not seem to know about my condition yet.

143 July 18, Have Me Believe You Lead Me 2004. Sunday

Over and over I have been ruminating why this tragedy happened to me. Anyone who goes through hardships would think about the reasons for his or her troubles and blames fate. I also pored over why I got injured.

First I thought of the saying ’what goes around comes around’. Our old teaching (明心寶鑑, a book written by a Korean civil officer in AD1305) say there are three nets in this world. The first is a fisher- man’s net: no matter how dense you make the net, the big fishes will get away and you will not be able to catch all the fishes in the sea. The second is the net of the law: no matter how many harsh laws are put in place, the smartest of thieves will still get away. On the other hand, the net of the Heaven is so loose that no one has ever seen it but no one has ever escaped it (天網恢恢疎不漏).

If what goes around truly comes around, what could I have possibly done to deserve such pain and suffering upon me and my family? Writing in his history that Baek-I (伯夷) and Sook-Je (叔齊)(*Wise

144 men in the Chine history who refused to cooperate with the new regime out of loyalty to the old regime, and entered into the mountain) starved to death and the infamous rogue Do-Chuk (盜蹠)(*a legendary thief in Chinese history) enjoyed wealth and long life, Sama Chun (司馬遷, Chinese historian BC 145-86. His style of writing history and importance may be compared with Plutar- ch) was vexed and questioned the way of Heaven.

The second I could think was pure coincidence. The accident of that day was just a series of coincidences happening one after another. There were many reasons not go to the mountain that day. The golf offer from Professor Wang-Jae Lee was something I would not refuse in any other day. Moreover, I was supposed to attend a meeting as an executive member of the Kore- an Neurological Association, and there was also a reunion from college dormitory.

People assume I tripped on a rock or slipped on a downhill road. However, someone who knows mountains would think it very un- usual that I actually fell at the peak. They also would find it strange that I did not use my arms to protect myself. A simple stumble usually does not result in such a serious injury.

Cheol-Woong Kim, who was right behind me on the day of my accident, tells me that he has never seen someone trip in such man- ner. He described it like a log falling over. Anyone that falls would

145 stretch their arm out to protect their body. Considering how I did no such thing and injured my neck, I must have had a syncope.

They say people drown from water in a plate. People interpret this saying as fate inevitable. But I think it means accidents happen in the weirdest and unimaginable ways. It was a very hot day and I sweated a lot. In the past I did not sweat as much but for the past 2 or 3 years I have been sweating a lot. I drank water, but it must not have been enough compared to all the water I lost through sweating. My blood pressure was usually on the lower side, and it occasionally dropped to 90’s after I went to the mountains. Therefore I must have fainted because of low blood pressure.

It is hard to understand that I climbed the steep peak without trouble and collapsed when I got to flatland. But I figure I must have strained trying to climb the peak, and the blood must have not returned to my heart in time. Also, the extra weight I put in my bag must have given more impact on me. It was fortunate that my teeth took the initial fall. Like the butterfly effect, every drop of sweat and every sip of water decided my fate.

The third I could think of was the providence of God. Just as In-Hoon Choi said in his novel ‘The biography of Raul’,

146 “Would a pottery blame the pottery maker?” Job did not blame God after he lost his family, but he bemoaned to God when he caught a disease. However, if this tragic accident was to happen, I was thankful that this tragedy landed on me, not on any other members of my family, because I can bear the burden. In the book titled ‘Please God, Just say a word to me.’ Wan-Seo Park expressed such a torment of losing her son that I hurriedly read through the memoir in great perturbation because I could not dare to bear the pain that the author was expressing. My misfortune is nothing compared to that.

The world is said to be a parallel universe; and not a universe, but a multiverse. Whenever I pitied myself in this state, I would daydream about what I would be like in another universe. However, this poor thing is the only thing I can feel and know.

God, please let me think that you did not strike me with your strong fist and that you are leading me with your hand.

147 July 19, Son 2004. Monday

My son visited me for the very first time. He grew a bit in the few weeks I have not seen him. He seemed anxious and unhappy that his father who looked fine on the outside was lying in bed for over a month. I had dentures on to make sure he did not find out I lost my teeth.

My body wobbled when Ahn trained me on the stair in the physical therapy room. I kept reassuring myself that I would not fall as long as the Ahn’s fit arm held on to me tightly. But I was still worried.

A few days ago he suddenly took me to a real staircase. Before the accident I would climb 13 stories of stairs just for the exercise. Now the stairs overwhelmed me more than a very steep cliff. He calmed me down and helped me up and down the second floor. After the exercise I felt great and was very proud of myself.

148 July 22, Full-Scale Physical Training 2004. Thursday

Physical training in the ‘Evaluation Room’ was very intense. The room was originally designed for measuring motor strength, but was mainly used for intense physical therapy. Those who came to the room were usually in better condition and were small in number, so I was able to stay longer to exercise. Sung-Jae Lee who was in charge of the room grabbed me whenever he had time and put me through an intense training. He asked me to do 50 sit ups, which would later increase to 150, and then to do a 100 knee kicks on the pole in front of me. I would be drenched in sweat. I wiped it off with a towel, changed my top, and returned to exercise for another session.

Today I walked in the corridor like a cow pulling a plough. Lee pulled my waist support from behind and ordered me to walk with more strength. He pulled me back so that I was only able to walk forward only with my best effort. Patients and their guardians who were walking through the hallway stopped to see me in wonder. Those who knew me when I was

149 admitted to the hospital said in awe, “So it is possible to recover from such an injury!”

150 July 23, Using the Spoon 2004. Friday

For the first time after the accident I used a spoon to scoop up some rice on my own. Until now, I was reliant on other people to feed me. But now I am able to do it alone.

It is also comforting not having to worry about defecating when I go to the rehab. I had some control over bladder control, and there was no need to worry. Compared with the days when I was wearing a diaper to go to the rehab, this kind of improvement was a blessing. I still had to go to the bathroom right away when I had the urge, but I never had an accident. If I did, the psychological damage would have been immense to recover from. A bit later I had the confidence to remove the diaper.

In the therapy room I see many kinds of people. Usually I am too focused on my therapy to notice others. But I see and hear things. One of the patients was a young lady that would only exercise her left wrist by raising it up and down. Mi-Hyun Kim told me she had wrist drop. It is a radial nerve palsy. She is spending 30 minutes a

151 day three times a week here just for her wrist. Therefore it is so natural that even a whole day is too short for me to work on my whole body.

I was the chair of the planning and strategy committee of the Ko- rean Neurological Association (KNA). I wanted to resign from my post because of my condition. Professor Ju-Han Kim at Han-Yang University told me that Professor Kyung-Chun Chung, the president of the KNA refused my resignation. Professor Chung asked me to keep the post and would have Professor Dae-Il Jang, the general secretary handle matters until I recover. I was also the secretary general of the Korean Society for Brain and Neural Science. They also would not let me resign, and arranged so that someone else would fill in for a while. As my secretary roughly knew the matters, I was able to deal with them over the phone. How fortunate I am to have a trustworthy secretary!

152 July 24, A Chameleon’s Poem 2004. Saturday

I was able to pick foods up with a chopstick. I am an ambidexter: I grab the spoon on my right hand, and the chopstick on the left.

Even with my best effort, there is not much progress, so I am very worried. In the comic ‘A Chameleon’s Poem’ written by Se-Yeong Kim and drawn by Young-Man Heo, the main protagonist trains like a Spar- tan enduring massive pain with iron wills. However, there are things that willpower cannot solve. There was no way to give strength to my limbs that hung on my body like those of squids in the market. Moreover, every time the therapist moved my arms and legs, my limbs felt like overboiled chicken legs just about to be pulled apart. Therefore, instead of being vigorous, I had to be very careful in therapy. I was a man that just in April, a blind masseur exclaimed, “You have a very sturdy body!”

153 July 25, 51st Day of Hospitalization 2004. Sunday

In the afternoon my wife and son visited.

I do not seem to make much progress since last week. But I am able to walk around without a wheelchair, which is a big progress. When I was on a wheelchair, I had to wait a long time for the elevator. Without a wheelchair, I am able to get on an elevator much quicker, which helps getting to therapy on time.

From Saturday of the week before, I manage to use a spoon and fork alone when eating meals, albeit very awkwardly.

I did not ask, but Professor Hyung-Ik Shin told me he was 100% certain that I would be able to ‘recover function in full’. I replied with a smile that I hoped so as well. But I know all too well what ‘function in full’ means.

154 July 27, A Mirage 2004. Tuesday

I started aqua therapy that I have been long awaiting. The water tank bursted on its first use last year, so they had to fix it. The aqua tank was like a very big fishbowl, which appears to hold a good 50 tons of water. It is not surprising that the water flooded all the way to the main entrance when the tank bursted.

The water had to stay warm and had to be constantly filtered through a water purifier. It was not suitable for coed use. Days were assigned, and the men got it on Tuesdays and Thursdays. Patients who could not walk were carried on a stretcher and put in the water. I was carried on the stretcher the first day, but I walked up the stairs from the second. It felt nice in the water since I could not feel any stress on my joints. It was excellent to train the respiratory muscles. In the water, I tried to balance myself, improve my arm strength, and perform many other activities.

Dong-Guk Noh was in charge of the aqua treatment in the afternoon. There would be four to five patients in the pool at the same

155 time, so his nerves must be on edge every day. Noh says that staying in the warm water for too long causes excess fatigue and makes the skin very rough.

In the aqua therapy room, I met a young man who was paralyzed from a car accident. They say he was a resident in anesthesiology, and this was his fate. I heard that he got stem cell treatment in a hospital in Gang-Nam (*southern part of Seoul). Noh asked the young man if he got better through the therapy. He replied that he couldn’t tell.

This is very worrisome. As I myself have done stem cell research, I know it is not ready for clinical uses. It is a big problem that some doctors would perform this unproven procedure and receive money for it. I heard they charge hundreds of thousand dollars for a single treatment.

I thought of the mirage in the fairy tales that I read when I was young. The mirage lures camel herders in the desert. The mirage looking like an oasis afar would lure the thirsty travelers astray and eventually lead to their death. The current stem cell treatment is the same. Desperate patients are willing to choose the treatment which is still in the research stage and far from actual use as a final option. Some doctors are taking advantage of that. Patients then stray from the real therapy they should focus on and spend their precious time

156 and money on nothing. As a mirage is an illusion created by the real oasis, the stem cell research may show its worth in time.

Today was my son’s birthday. I congratulated him over the phone.

157 July 29, Visit 2004. Thursday

I was taking a break at 1:15 P.M. when Soon-Bae Hong, my teacher from elementary school visited me. He underwent a spine operation by Professor Hyun-Jib Kim many years ago. He overheard the news of me while waiting in the outpatient clinic. As no one was giving him my whereabouts, he took a great effort to find me. But I almost drove him away. The longer he stays to watch me in bed, the more hurt he would be. I asked him not to tell my parents about this because they did not know yet.

I went to bed very early without even folding the paper into folded-paper crane which I did every night as ‘homework’. I must be very tired through the aqua treatment. I heard that most people would get exhausted after aqua treatment, but I was not one of them. It must be because I had been very fit before the accident.

158 July 30, Stories 2004. Friday

In the therapy room, I often hear the cries of children. They are mostly young patients with cerebral palsy. Often times they are subject to intensive physical therapy after surgery. The therapists would bend the children’s joints to prevent stiffness. The pain must have been too severe for kids. Most children endured the pain and kept their mouths shut tight. But there were several who could not handle it and would burst out.

“Sir, please stop.” “Please forgive me.” “Can we do this later?”

They would scream but the therapists could not stop the treatment. I heard that the children, despite the harsh treatments, never miss a therapy session. Some parents protest to the therapist that they are hurting the children. But who is to blame for this hellish misery?

159 I now am loosened enough to take notice in the world around me in the therapy room. I overhear from many sources what caused their fate.

Today as any other day a young girl was crying tied to the T-table. I heard she was hit by a car in front of her school. Other hospitals said she had no hope of recovery. So her parents wandered many hospitals until she was finally admitted to this hospital. At first she was as good as dead. But she woke up in the ICU here and recovered enough to get physical therapy. Because of her broken teeth she looked like a mischief. But she could just mewl not being able to make a loud cry. Her paralysis is more severe on the right, so she will probably have a language disorder in the future.

Over the span of a few months she made a great progress and started to swallow food, and recognized her parents. She was transferred to another hospital after about 6 months of hospitalization, and everyone missed her.

She was very cute. It is sad to imagine what harsh life she will have. It will be extra hard for her parents as well.

160 August 2, MRI 2004. Monday

I took an MRI again.

It is already two months into hospitalization, and I have not made progress as quickly as I had hoped. So I suggested having an MRI done in fear of syringomyelia (*a cavity in the spinal cord after various injuries. It may expand resulting in progressive symptoms). I postponed dinner because I was supposed to have the MRI at 7:00 P.M. I know there is no need for a contrast. But I just let them inject the contrast agent into my veins.

Professor Jae-Hyung Kim of Medical Imaging was passing by. I asked him to look at the MRI together. The lesion shown on the MRI was tiny. It is understandable why others thought my recovery would be swift and complete. According to the MRI, I should have healed with no problem. However… That small lesion severed my nerve fibers as if it was cutting through an optical fiber cable, and left me in this state.

161 ▲ MRI of the C-spine Arrow shows the lesion

It is so dumbfounding.

162 August 9, Baekdu Mountain 2004. Monday

Today is the day my mountaineering club ’Juyu’ leave for Baekdu Mountain (*the tallest mountain in the border between North Korea and Chi- na). I was looking forward to the travel so much that I signed for it as soon as I heard the plans in Spring. I wanted to see the big pine trees up in the mountain. Now I have to be satisfied with the wild flowers around the brook in front of my house. What is good to com- plain for a blind person not to see a Rembrandt or a deaf person not to hear the works of Mozart?

Professor Jae-Woo Kim from Dong-A University visited and dropped a bonsai tree. My sister was happy saying that the tree was a good kind for a patient’s health.

163 August 10, Things That I Need 2004. Tuesday

The wife of Professor Geun-Hyung Yoo from Preventive Medi- cine sent me a tape of some sermons. Professor Jae-Gyu Roh’s wife wanted to visit with the pastor. I was grateful but I declined.

What I needed now was not the words of God. He has already spoken to me, and all I need to do is to become his arms and legs and rehabilitate as much as I can. I did not lose my courage and am not disappointed yet. A few days ago Professor Kwang-Woo Lee and his wife visited as well, but I almost drove them away.

My caregiver bought me a pillow. It was to make my neck comfortable. I was very thankful.

164 September 11, Getting Ready to Inform 2004. Saturday My Parents

My brother came and we discussed about informing our parents again. The day after tomorrow would be my 100th day of hospital stay. It could not be delayed any longer. During the vacation I could avoid them by saying I was abroad to study. But I cannot avoid visiting them during ‘Chuseok’, the Korean Thanksgiving holiday. Only my parents were in the dark when everyone around them seemed to know already. I insisted everyone that my parents must not know. It seems like everyone kept their promise. My teacher Soon-Bae Hong who was a very good friend of my father said that he could not bear to break the news to my parents.

After discussing with my brother, we decided to bring our parents at the 19th, a week before Chuseok. I told him to bring them between 1 P.M. and 3 P.M., which is right after lunch. If they saw me eating, they would be very worried that my condition was grave. So I made sure they did not see it. I had less problems standing and walking, so I figured they would not worry as much.

165 My father was reaching 70 years of age. I was worried about giving him the news, but my sister assured me that our father was strong.

166 September 19, My Parents’ Visit 2004. Sunday

I had my hair cut, and was preparing myself to greet my parents. At 11:30 A.M. my wife brought the kids. I finished lunch and walked around the ward with my daughter. When I came back at 12:30, my parents were already in the room. They took a look at me and seemed relieved. I sat on the bed and told them I would be out when I was fully recovered. My father was worried about the hospital bill because my room was a single occupancy room. I reassured him by telling him that the University was providing subsidies. I did not tell him that my brother already paid for a part of the bill. He would have been up- set because he would rather have helped himself rather than have we siblings help each other. My mother told me, “Keep a light heart.” My parents insisted I stay in bed, but I walked out to the hospital exit to show them I could walk fine. At around 2:30 P.M. my brother drove them back home.

After my parents left, my sister told me that my parents hid it from

167 me that they noticed and were worried that I was talking strange and my hands did not seem to move right. I hid the fact that I was wearing dentures and I tried to hide my hand motions as much as possible. But they must have caught the loose pronunciation through my dentures and the way my hand waved. I was relieved that they were not terribly worried though.

168 September 25, Hell 2004. Saturday

My wife had the flu-like symptoms since September 17th, and now my nose was stuffy. I went to the otolaryngologist, and was told that I had an allergy. My constitution seems to have changed after the accident.

Each day was exhausting and went by like it was a lifetime. But a week flew by. Every time a Wednesday came, I was worried that I did not make much progress through the week.

There was an article in a newspaper about a man who went through ‘the hellish rehab’ and reentered society. The raised bumps of the road made it impossible for him to move about on his wheelchair. He committed suicide after leaving a will to the Mayor to level the road. How hard the rehab may be, the expression of ‘the hellish rehab’ in the article is not justified. The world is hell and rehab is the road out of hell.

In the therapy room most of the patients lack expressions on their

169 faces, like those of wild animals. Just like the animals cannot afford to have other thoughts other than to focus on surviving every day, the patients cannot have the emotional luxury other than to focus on surviving and getting better.

The first daughter of Jin-Hwan Cho, my former fellow and now assistant professor at Boramae City Hospital was approaching her one hundredth day of birth. I told my wife to get her a pretty dress.

170 September 30, Life 2004 Thursday

Around the time of my accident I was reading ‘Les Miserable’ by Victor Hugo. I watched the movie on TV in this March.

There was a scene where Jean Valjean anguished over whether he had to expose himself and lose everything to clear a perfect stranger’s false charge when he was having a stable life as the mayor of Made- line city. I was struck by the line “a man’s heart is rougher than the sky clear as ever that fills with dark clouds in a matter of seconds, or than the peaceful ocean that a tempest suddenly hits.” I had too many thoughts in my head over the years, so the line moved me greatly.

I had read the abbreviated version in Korean when I was young. But I decided to get the copy in English. ‘Les Miserables’ was not about Jean but about the history of France. Professor Norman Denny, the translator complained in his prologue that ‘Les Miserables’ had so many unnecessary parts. He strongly criticized that it was ‘indefensible’ to have 69 pages on the Waterloo

171 Battle unnecessarily. But was it really unnecessary?

There once was a king. The young king wanted to know about life. So he ordered the scholars to write a book about what life is. The scholars studied for 20 years and gave the king storage full of books. The king was too occupied with his work and asked the scholars to summarize it. Over the next 10 years the scholars com- pressed the contents into 10 books. The king still in his vigor was very busy running his country and did not even have time to read 10 books. The king requested a shorter book, so the scholars com- pressed it even further into a single book. But the old king was already in his death bed. The king asked the scholars to abbreviate the book for him in his dying breath. “A man was born and suffered and died.” The king, hearing these words, nodded and passed away. Sweetness and bitterness are the essence of life.

The many, many deaths described in the Waterloo Battle are life itself. Jeokbyeog-Ga, (*an old Korean novel on the historic battle in China) describes the deaths during the battle in a comical way. But Les Mis- erables described them in much detail and recorded who they were by name and by their life stories. Victor Hugo visited the Waterloo many times and studied what the generals and their soldiers were thinking while they were fight-

172 ing and dying, and how small coincidences changed the shape of the great battle. He described how the great tides of history won over the personal defeat of Napoleon, who Hugo admired, through chains of coincidences, and lead to the formation of the Republic.

The novel showed not only the lives of Jean, Javert, Cosette and Marius but also the lives of everyone that affected the history of France although from afar.

In the novel, there is a lengthy description about the sewage system of Paris. It accurately recorded how Bruneseau improved the sewers. In what history textbook would there be such a detailed record of a sewer? Hugo, however, chose to devote an affectionate description about a man who accomplished the achievement of improving sewerage system and kept Paris sanitary and safe. History is made not only in sunny places but in rotting pits.

There is a book titled as ‘Le scaphandre et le papillon’ (The Diving Bell and the Butterfly) by Jean Dominique Bauby, who was the editor- in-chief of the women’s magazine ‘Elle’. He had a stroke at a young age of 43, and was paralyzed in a condition called ‘locked in syndrome’. He was conscious but was able to move his left eyebrow only. He learned to communicate with Morse code using his left eyebrow, and wrote the book in 15 months before passing away. There is no telling what would become of anyone. He left his name

173 through this book that he would not have been able to achieve as an editor-in-chief of ‘Elle’.

It was my birthday, a bonus but very exhausting birthday.

174 October 5, A Stroll 2004. Tuesday

On Saturdays and Sundays, I take a walk around the Hospital if the weather permits. Over the past few days I had the rehab outdoors with Ahn. He told me that there is a route down the brook and the route leads to Jamsil. I knew about the route in Jamsil near my house, but had no idea it would go up to the Hospital. “Do you think it will be possible for me to ride a bike down that route?” “I think you can around next fall.” (I thought it was a very long wait when I heard that. But five years from that day I am still waiting for a bike ride.)

It has already been four months since the accident. I discussed my return to work since August. But I did not have the confidence to do it, and kept postponing it. I can delay it no longer. As my lectures for student are scheduled on December 14th, I still have some time.

175 Vioxx which I had been taking was flagged as dangerous to the heart by the FDA. Therefore I switched to Celecoxib instead a month ago. I thought it was silly to worry about my heart in my current condition. But what is wrong with being prepared and preventing any unnecessary complications? A condemned criminal slipped on the stairs walking up the guil- lotine and ejected a sigh of relief. “That was a close one.”

176 October 10, Mother-in-Law 2004. Sunday

I took a stroll down the route by the brook with my sister. I held my sister’s hand and walked down the stairs. It was the season of autumn foliage, and the view was quite splendid. It was a very good route to walk on. The shades were chilly, but it was quite pleasant to walk in the sun. People stared at me in a patient’s robe walking quite slowly. But there were many others like me on the route. I had quite an exercise, having walked for almost 2 hours. My sister suggested we return before the day gets any colder.

My mother-in-law visited and gave me a massage every weekend. She was athletic and very healthy, but is old with high blood pressure and diabetes. She gave me a thorough massage for 2 hours and prayed for me.

177 October 11, Another Kindness 2004. Monday

Professor Jin-Yeop Jeong in Orthopedic Surgery asked me to see one of his patients again. He asked me to see an inpatient a couple of weeks ago. Today I was asked to see the outpatient. I could see the inpatient in the evening after physical therapy. But in order to see the outpatient, I need to go to the appointment during my rehab hour. I am very gracious of him. He says he asked me to see patients because I am the specialist in the area. But I think that he is trying to keep me in touch with patients during this long hospitalization.

178 October 13, A Day 2004. Wednesday

At 6 A.M., a chime ‘In the rain’ from the cellular phone starts my day. I am awake already. But I get out of the bed after 15 minutes of reluctance and walk down to the second floor. The second floor is another rehab center for me. I repeat the routines: walk around the corridor, and leg and arm exercises holding on to the parapet. Sitting and standing up 100 times, swing each leg 30 times, arm stretching 30 times. It is 7:45AM after 3 sessions.

When I return to the room, the dining cart is in the ward or the food tray is already in the room. After breakfast, the caretaker will wash my face. Recently I have been using a sonic tooth brush, which a nurse in the dentistry recommended. It is much easier to use.

8:55 A.M. To the rehab. Begin exercise at the Evaluation Room, which is no different from fitness club. 10:20 A.M. Heat therapy for 20 minutes. 10:40 A.M. Ultrasonic therapy.

179 11:00 A.M. Physical therapy. 11:30 A.M. Occupational therapy. 12:00 Noon. Return to the room for lunch. 12:40 P.M. Finish lunch and brushing teeth. The aid leaves for her lunch. Rest until 2:00 P.M. 2:00 P.M. To the Evaluation Room. 4:30 P.M. Occupational therapy. 5:00 P.M. Physical therapy. 5:30 P.M. I am done with the regular schedule and do the exercise alone in the physical therapy room. 5:45 P.M. My wife comes. 6:00 P.M. To the room. After dinner, my wife gives me a shower. 7:45 P.M. My aid returns from her dinner. My wife leaves. To the second floor. Three sessions of walking the floor, leg and arm exercises. Return to the room at 9:00 P.M. Watch TV until 11:00 P.M., and lie for sleep. During the night, go to the bathroom to void two or three times.

Aqua therapy on Tuesdays and Thursdays. It formally begins at 3:30 P.M., but I begin at 3:15 P.M. if space allows. My wife comes at 4:15 P.M., gives me a shower at 4:20 P.M., dresses me up, and returns home to care for the children.

180 To occupational therapy after a sip of water and vitamin C.

The weekends are a problem. On Saturday mornings, I do the exercise alone until 11:00 A.M. at the Evaluation Room. In the beginning, I was not allowed to use the room because of my unsteady balance and risk of falling. Later they allowed me to use it. 11:00 A.M. Occupational therapy. 11:30 A.M. Physical therapy. 12:00 Noon Lunch. And rest until 2:00 P.M. 2:00 P.M. I go back to the second floor and do my exercises. Time goes by very slowly. 3:30 P.M. I return to my room to rest for about 30 minutes to an hour and exercise again until 6:00 P.M. At 6:00 P.M. I return for dinner, and go back down to exercise at 7:30 P.M. I come back by 9:00 P.M., and sleep at 11:00 P.M.

I get up at 6:00 A.M. even on Sundays. My sister arrives at 6:30 A.M., and would look for me exercising on the second floor when she walks the hospital entrance gate. So I had to hurry. I exercise with my sister until 8:00 A.M., and return to my room for breakfast. My sister would stay until lunch, and go back home at 1:00 P.M., about the time my wife arrives. My wife would

181 stick around until 9:00 P.M. until the caregiver arrives, who takes a break from Saturday evenings to Sunday evenings. She has roughly a full day off.

Recently I felt no need for a caregiver during the evenings. So I asked to get one that would work only during the day. My sister was worried and asked if I was ready for that. I told her I could go to the bathroom alone, and that it was more comforting for me to stay alone during the nights.

182 October 19, It is Up to Me 2004. Tuesday

부인필자모연후 인모지(夫人必自侮然後人侮之) This is a part of a writing for me that I hung up on my wall on October 19th, 2001. A person gets insulted by other people only after he insults himself. It is an epigram that says all fault is on oneself. If truly all wrongs that were caused by me were return to me, what could I have possibly done to deserve this hardship?

But another old saying says, “If good people were always blessed and bad people were always punished, why did Baek-E and Sook-Je starve to death and Do-Chuk live a full life and die a natural death?”

If I lax in my rehab now and my recovery is staggered, the difficulty ahead of me would truly be 夫人必自侮然後人侮之. All faults would be on me, so it is all up to me.

183 October 28, Changing the Caregiver 2004. Thursday

I decided to get a caregiver that only works during the day. She would come at 8:00 A.M., and help with my breakfast, and leave after helping me with my dinner at 6:00 P.M. My wife would come at around 5:00 P.M. to clean the room and wash me. The new caregiver was an old lady with very round eyes, who lived nearby. She told me that caregivers who only worked during the day were usually people who lived near the Hospital that would work part time. She will consider me a bore because I do not have many words.

184

June 10, The Start of a Different Life 2004. Thursday

Every time I dozed off at around 1:00 or 2:00 A.M., the alarm at- tached to me rang because my breathing slowedChapter down. My sister3 woke me up every single time. Everyone was worried because my Backpulse droppedto asMy well. Blood Familiar pressure was stable at around and 140, but my pulse would drop to about 40 beats per minute. This must be due to the dysfunctionUnfamiliar of my autonomic nervous system. Place

My sister stayed overnight and left at around 7:00 A.M. My wife came at around 8:00 A.M. after sending our son to school. Our daughter would have prepared and eaten her breakfast by herself and left for school. My wife took care of me during the day. Around 9:00 P.M. my sister would return, and my wife left for home for the children. My

186 October 31, Back Home after 5 Months 2004. Sunday

Tomorrow I will restart my outpatient clinic that I have been preparing for months. My office hours are every Monday and Wednes- day mornings. After my bath in the evening, and a brief exercise in the second floor, I headed home. As my current LIFE is in the hospital, ‘went’ rather than ‘returned’ home might be the correct expression. For ordinary people returning home would be no big deal, but for me it was a huge occasion.

I was concerned my rehab hours shortened because of work. But I cannot delay my work or lectures or research any longer. I have to move on. My sister visited in the morning, and was worried if I were ready. But at the same time she was glad I am returning to work. In the afternoon I visited the barbershop in the basement. They opened even in the weekends so I did not have to miss any rehab sessions. The barbershop was also a beauty parlor. A pretty young lady owner and a young man kept the shop. The floor was wet and slippery because they had to clean all the hairs often. To me it was something to fear. I was afraid of the slippery floor and the spin-

187 ning chair in the barbershop, so I held on to my wife’s hand tight. However the owner did not even ask why I was so afraid. It must be a common thing in a hospital. How many times would I have to do this to get comfortable with it? There was an advertisement that said every 6th haircut was free. I thought about getting the coupon, but figured paying another 10,000 won (10 dollars) was not much. I doubted I would get my hair done 6 times in this place, but I ended up getting seven haircuts.

I was exercising on the second floor, and my wife insisted we return home. I told her that I would be less comfortable at home, and we stayed longer. All I would be doing at home would be lying down in bed and sleeping.

After I spent some time in the hospital doing this and that, I headed for home at 10:00 P.M. We went down to the underground parking lot. As it was Sunday night, the car was parked right in front of the entrance. Our car is a van and it was very difficult to climb into. However I was able to get on without any help. The road that we raced on was dark with distant lights only. I did not feel any emotion or gratitude.

As our house is on the first floor, there is no need to get on an elevator. When I got home, the entrance was lit up but was dim.

188 “Daddy’s home.” I said while I was entering home with holding onto the hand of my wife. My children’s expressions greeting me were not bright. The only thing that followed was silence.

I went up to the second floor. The house was dark. I figured we needed to repair the house. It was past 11:00 P.M., and I went to bed.

It was the first time I got into my bed at home since I was admitted to the hospital five and a half months ago. The firmness of the papaya mattress that I picked out was awkward, and the ceiling was unfamiliar. As I could not roll myself in bed, I could barely fall asleep.

189 November 1, First Day at Work 2004. Monday

It was still dark outside the window in my bedroom when I heard Schubert’s ‘Serenade’ near my wife’s head. It was her cellphone alarm that was set to ring at 6:00 A.M. My wife is not an early bird, but she woke up even before the first syllable was over. My wife headed down to the kitchen while I changed into the underwear that my wife pulled out. I carefully grabbed on the hinges while walking downstairs. I sat next to the table in front of the kitchen.

Breakfast was 4 slices of bread, an apple and two tangerines. After the meal I took my medications and brushed my teeth. I removed my dentures and carefully brushed my teeth with my electric toothbrush and put my dentures back on after washing it with water. It is still fairly awkward to put back on dentures even after a good period of practice. I use an electric shaver, but I move my head right and left rather than moving my arm.

As I took a bath at the hospital yesterday, my wife just ran some water over my face, dressed me in a shirt and a tie. I am able to put

190 my underwear and pants on my own. My son woke up and put the suit top on me. My wife left the house to start the car. I held my son’s hand and left the apartment. It was 6:55 A.M. when I got on the car.

It was 7:20 A.M. when I arrived at the Hospital. It was early in the morning so that the entrance was very quiet. I struggled to get out of my car and the security guard helped me. I felt more stable when I leaned myself against the crossbar in the elevator. Hye-Jung Kang who is a research assistant and my secretary was nice enough to be in already. I sat at my desk which was familiar and unfamiliar at the same time and handled my files and e-mails. Kang had cleaned up the files during my absence and put them on my desk. Kang and Dr. Sun-Joo Kwon, my fellow took care of my e-mails as well. I was able to make an appointment with the Dean of the Medical school and the General Director of the Hospital only on Wednesday.

My clinic began at 9:00 A.M. My patients who did not see me for 5 months were very pleased to finally see me again. Half of the patients thought I went abroad, so they asked if I had a good trip. The other half who knew about my accident were glad to see my condition improved. Sitting was uncomfortable and talking left me short of breath. But it was a relief that I had no big difficulty seeing the patients.

191 “Did you have a nice trip to America?” asked a patient who was a professor at an engineering college. I answered “I had a trip to the otherworld, not America.” He took it as a joke. I thought it was not proper to mention the otherworld even as a joke to a patient who must be always apprehensive of death. “You haven’t heard about my accident?” I asked. Hearing this he responded that a professor of medicine at his university was recently killed in a car accident and said that I was lucky to be back to work.

I had reduced the number of the patients to 20, and I was able to finish the clinic by 12:00 noon. I called a cab and returned to the Bundang hospital. It was 1:00 P.M when I got back to the Bundang hospital. I had lunch and went down to the rehab. Ahn asked if it was hard seeing outpatients, and I grumbled that I lost time for my own therapy.

192 November 2, Get Used to It 2004. Tuesday

It is my daughter’s birthday.

She must be wanting nothing else but my prompt recovery and discharge from the hospital. Every time she comes in to my room she makes comments about the paper cranes that I folded as occupational therapy. I can sense how worried she is.

Professor Shin tells me that recovery from the spinal cord injury usually occurs by six months and may continue to two or even three years, and then patients get used to the damage.

Get used to it. Get used to it…

I got home at night because I had to go to work tomorrow.

My son and daughter greeted me briefly.

193 September 3, I shall Stand 2004. Wednesday

It is the second day of work since the accident.

I worked on my files, read through my e-mails, and went down to the Dean’s office at 8:30 A.M. It used to take me 5 minutes to get there, but it has become a hike that took over 20 minutes to conquer. I have been gauging which route would be the easiest for me in my head.

The visitation was to report that my condition has improved greatly and that I was back at work even though partially. Dean Wang was in the middle of a meeting. When I was about to leave without waiting as the visitation was for courtesy, I met Professor Sang-Cheol Sung, General Director of the Hospital who just walked out.

I am not fully recovered, and I have a dentist appointment in the afternoon. Thus I reduced the number of appointed patients and was able to finish by noon.

194 I went to the cafeteria at the 11th floor of the Clinical Research Institute with my nurse, resident and fellow. Thinking that it would make others uncomfortable if I pulled my dentures out, I ordered an oyster noodle which was very easy to eat. Everyone else ordered the same. It was an awkward silent meal because everyone was probably conscious of quiet me.

At 1:30 P.M., I had an appointment with Professor Sung-Joo Huh of Prosthodontics. I had to pull out two broken incisors from the accident and needed an implant. Dr. Huh was my junior by one year at the dormitory during our university years, and I have not met him ever since graduation. He cast a mold for the pole to fit in to the maxillary bone, and set up another appointment in 2 weeks. Professor In-Cheol Yoo of Periodontology will be the one who will plant the poles. I visited Pro- fessor Yoo because I met him on several occasions to discuss matters regarding the research center. He was amazed by what I went through.

At 4:00 P.M., I had a meeting with the executive members of the Hospital to make a movement disorder center. That was a project with Professor Sun-Ha Paek, a neurosurgeon since last March. It was on hold because of my condition. Their reaction was positive to our proposal that a center was needed to treat patients effectively.

195 At 5:00 P.M., my wife drove me back to Bundang Hospital. It was a long and weary day without any rehab, but a busy day for me to prepare to stand again.

196 November 17, Step by Step 2004. Wednesday

I see patients twice a week. On top of that, I occasionally have to attend certain meetings. So my work hours are getting longer, and I am concerned my rehab hours are becoming too short.

Nobody has mentioned my discharge, but I will have to return to the Hospital and School at some point. It seems that the Depart- ment had expected my return in 3 months after the accident. But I am delaying it. It is fortunate that my lectures for the senior classes are over in the spring. I need to prepare for the two hour lectures for the 2nd year students on December 14th. I had Dr. Kwon, my fellow to find the lecture files in my computer and make appropri- ate changes. I also had video files edited for the lectures.

197 November 20, A Gloomy Meeting 2004. Saturday

I called Young-Kwon Cho, an editor of Maeil Business Newspa- per to visit. It was Saturday afternoon. We took a walk around the trail that runs around the hospital. “I asked around to get news about your whereabouts because I suddenly lost contact with you. Your secretary would not tell me what has happened so that I had no idea until you called me.” He informed me that he decided to immigrate to Canada, a decision that he has been postponing for years. He sent his family to Canada a few years back, and he had been worried since. Finally he submitted his letter of resignation. It is as gloomy as my news of the accident.

198 December 5, A Stubborn Visit 2004. Sunday

It has been six months since the accident. The first time I got into the hospital it was still shiny even at 8:00 P.M., and it would start brightening from 5:00 A.M. But now it was still dark at 7:30 A.M., and would become dark by 5:30 P.M. (Later I was discharged from the hospital when the season changed and the day began to shine as I woke up at 6:00 A.M.)

Hyun Cho, my alumnus from junior high school visited. He called and told me he would visit. I insisted he not, but he stubbornly came. He said his wife was waiting downstairs. He is a bureau chief of the Ministry of Foreign Affairs and Trade, and is blessed with a fine wife.

It was when he was stationed in Paris that his father-in-law was admitted to our hospital for a second surgery for an aneurysm of the aorta. He was a very healthy man. But after the surgery he became completely paralyzed due to a blocked basilar artery. He was alert but could not swallow, talk, or move any of his limbs. It was a

199 typical case of a ‘locked-in syndrome’. Cho’s wife left him and her son in Paris, and came to Korea to nurse her father. Without anyone’s help, she sat next to her father for 24 hours for almost a hundred days until her father passed away. I told my residents “If she is that loyal to her father, how loyal would she be to her husband and son? You need to find a wife like h e r.”

200 December 14, Lecture 2004. Tuesday

Today I lectured to the sophomores. The lecture room was in a building quite far from the Hospital. I had to be very cautious as the road was frozen and there were stairs. I had to give a lecture for two hours straight so I had to mind my stamina as well.

I could not make my voice as loud as before, and could not make the lecture as entertaining as before. But I had no difficulty other- wise. I had to go to the Main Hospital for three consecutive days, so I did not get much physical therapy.

201 December 25, Memorizing Names 2004. Saturday

Christmas. For me it is just a day that the rehab rooms are closed.

A few days ago there was a performance by the very popular pia- nist Iruma on the first floor. But I exercised in the rehab room instead of listening to the music

Around 3:00 P.M. I ordered pizzas and went to the ICU to see grateful faces. I looked at the photos of the nurses on the wall next to the entrance to the ICU, and tried to memorize the names.

Nurse Ho-Yeon Yoon greeted me with a bright smile. “You used to exercise your fingers even when I thought you were sleeping and now your condition has improved so much. In the ICU I’ve seen so many patients do poorly, and was worried. But seeing how good you look I am relieved.”

202 December 29, What are You Looking at 2004. Thursday

What do you see, nurses, what do you see? What are you thinking when you’re looking at me? A crabby old woman, not very wise, Uncertain of habit, with faraway eyes? Who dribbles her food and makes no reply When you say in a loud voice, “I do wish you’d try!” Who seems not to notice the things that you do, And forever is losing a stocking or shoe…. Who, resisting or not, lets you do as you will, With bathing and feeding, the long day to fill…. Is that what you’re thinking? Is that what you see? Then open your eyes, nurse; you’re not looking at me.

I’ll tell you who I am as I sit here so still, As I do at your bidding, as I eat at your will. I’m a small child of ten … with a father and mother, Brothers and sisters, who love one another. A young girl of sixteen, with wings on her feet,

203 Dreaming that soon now a lover she’ll meet. A bride soon at twenty -- my heart gives a leap, Remembering the vows that I promised to keep. At twenty-five now, I have young of my own, Who need me to guide and a secure happy home. A woman of thirty, my young now grown fast, Bound to each other with ties that should last. At forty, my young sons have grown and are gone, But my man’s beside me to see I don’t mourn. At fifty once more, babies play round my knee, Again we know children, my loved one and me. Dark days are upon me, my husband is dead; I look at the future, I shudder with dread. For my young are all rearing young of their own, And I think of the years and the love that I’ve known.

I’m now an old woman … and nature is cruel; ’Tis jest to make old age look like a fool. The body, it crumbles, grace and vigor depart, There is now a stone where I once had a heart. But inside this old carcass a young girl still dwells, And now and again my battered heart swells. I remember the joys, I remember the pain, And I’m loving and living life over again. I think of the years … all too few, gone too fast,

204 And accept the stark fact that nothing can last.

So open your eyes, nurses, open and see, … Not a crabby old woman; look closer … see ME!!

This poem that is hung up on the wall of my office is from a book titled ‘Dementia’ by Ki-Hwa Yang, a pathology professor in Catholic Medical College. He says that the poem was found amongst the articles left by a deceased old lady who died in a Scottish nurs- ing home.

The people I meet at the corridor while exercising during the evening changed one after the other. However, two people were still there from Summer. One was a middle-aged lady who stayed in the ICU relying on a respirator to breathe. She was paralyzed after the surgical removal of a tumor from her cervical spine. I used to greet her ever since I got into the ICU, but her condition has not improved much so that she had to be moved around in a wheelchair.

The other was a lady in her 30s that I would see in the physical therapy room. Her limbs were paralyzed after a disc surgery on the neck. She had been in a wheelchair and had had a urinary catheter inserted. But she recovered a bit and could walk around fine, although with a cane. She must have been devastated turning from a healthy young lady to a cripple, but she always exercised with a smile.

205 For the past few days an old lady in her late 50s would visit the therapy room in a wheelchair. Her limbs seemed to be paralyzed. She had a hard time breathing, and every once in a while a spasm would twist her hands and feet. Out of habit, I diagnosed her on my own, and concluded that she must have a tumor in her high cervical spine. I asked Mi-Hyun Kim about her because she was also a spine patient. Kim told me that the patient came from LA. Although she was admitted for 3 months, the diagnosis was not known. She also told me that Dr. Jong-Min Kim saw her. I called Dr. Kim, who told me that they suspected a tumor around the cervical spine but they could never confirm it because her MRI was unclear. She returned to the States two days after I took interest. I regret that I did not take more action for a proper diagnosis and management.

There was also a young student whose legs were paralyzed by a fracture in the thoracic spine she sustained from a car accident in Canada. She was strengthening her muscles in the Evaluation Room and in the Aqua Therapy Room. I was worried if her conditions will not improve. People told me that she was treated with oriental medicine and did not take any proper physical therapy after she came to Korea. I pitied her because I knew she lost her chance. Alas, she is such a pretty girl!

206 December 31, Long Way to Go when Sun is 2004. Saturday Setting(日暮途遠)

Today is the end of the year, but it is just another Saturday for me. A Saturday when physical therapy is only in the mornings...

When I think of the diary of the December 31st that I imagined right after the accident, I am relieved that I have escaped the worst. But I still have a long way to go. The road to full recovery is long- drawn-out when time to recover is getting shorter.

I need to get back to the Hospital and the University to work. Doing so would limit my time for therapy. But after 6 months, I cannot stubbornly ask for more time when considering how little my condition will improve in the future. To others, I may look like a man with minor difficulties. I am able to walk as quickly as my caregiver and do most activities on my own. For me, everything is extra difficult, something that others cannot understand. Now is winter vacation, but I have to prepare to formally get back to work by March.

207 January 1, People Who Look Upon Me 2005. Sunday

Every week, my son and daughter take turns to visit me. My son sometimes helps me when I am in physical therapy. He stands next to me with a worried face and appears to turn his head away when I have difficulties at therapy. Whenever I grab my daughter’s hand or pat her buttocks, she would say with a happy voice that my grip is stronger and my arms are faster. She must be keenly watching my condition. How worried sick she must be! I need to get better soon.

My sister’s family visited as well, so we had a meal at the hospital cafeteria. My high school alumnus Sang-Chae Choi, who is a practicing law- yer in Washington D.C. forced his way into my room to say hello against my repeated objections. Professor Chang-Gyo Kim of Soon- Chun-Hyang University, Professor Jin-Hoo Hong of Chosun Uni- versity, and Yong-Duk Choi who runs an oriental medical clinic would come and sit next to me every once in a while.

208 Many people called to ask if it is okay to visit me. I always tell them that it is appreciated, but they should not visit.

209 January 6, A Penny and a Dollar 2005. Thursday

A carer of an old patient in his 60’s that sat next to me made a deep sigh that they had to transfer to another hospital. The patient was in the hospital for over two months. It is not easy to stay in the same hospital for more than 3 months. If a patient stays for more than 3 months, the hospital is not fully reimbursed by the insurance. As hospitals lose money when patients stay long, they have to let the patients go. Thus families would des- perately look for other hospitals to go.

A college student with a neck injury who was admitted to the Hos- pital around the same time as I was had already been transferred to a different facility. Fortunately the hospital he was transferred to was a specialized rehab hospital. For patients, staying at a single hospital is better for stability and recovery. A hospital near their home would be better.

The lack of rehab facilities is a big problem. It is easy to understand considering the low fee for rehab. It is difficult to make ends

210 meet to run a facility. Thus who in their right mind would invest in a rehab center and its recruits? Public rehab facilities are already booked full for months, and moreover, they are selective about patients they admitted.

Since there is no room in proper facilities for patients to get proper treatment, it is natural that desperate patients would waste money and time on other questionable treatments. The saddest part is that patients waste precious time getting improper treatment that they should be spending in physical therapy, thus losing the opportunity to recover.

Patients lose a dollar because of a system that tries to save a penny.

211 January 11, Time Flies 2004. Tuesday

When the New Year came, my physical therapist was changed to Mr. Dong-Il Jung. This is because the therapists rotated duties in turns to see the outpatients and inpatients. It is good for me because the contents of physical therapy change as the therapists change. However, time keeps going by but my condition does not seem to change much. Each day was the same day, every week was the same week, and each month felt like it was the same.

The facts that I knew before Professor Shin told me: patients would recover within six months and recovery would stall; my condition would not improve much even if I give it my best effort; in other words, I will have to adjust to my current state and adapt. The apprehension once vague snaked into my heart slowly but with cer- tainty.

Dr. Jong-Min Kim came to discuss about Dr. Sun-Joo Kwon. I did not give her a good training for the year because of my acci-

212 dent. But it is time for her to leave fellowship and find a job. I worried she may find job hunt more difficult as a woman physician. Fortunately there was an offer from Baek Hospital affiliated with Inje University. However Dr. Kwon was hesitant about the decision because there was no replacement for her. She was worried to leave without leaving someone behind to help me.

I told her “It is an opportunity that you would not want to miss. Don’t mind me and accept the offer.” Luckily, Dr. Han-Joon Kim who would be discharged from the army service was able to replace her. “Han-Joon will be back by May.” said Jong-Min. Probably he particularly added this remark to make a note that I would not have a fellow between March and April. Dr. Kwon will handle my affairs until February. Thus if I did not return to work by March, they will feel the vacuum too large. I myself had planned to be back by March. As I did not mention this plan to anyone, he must have been wondering about how to prepare.

Staying longer in the hospital would be too much a burden to the Hospital and the University. No one has asked for the specific date when I would be coming back. But everyone would assume I would be back by March just like Jong-Min Kim who asked what I would do about March and April when Han-Joon Kim is still in the army. It was unsettling to think about leaving the hospital which felt like

213 home for such a long time. However, I decided to be discharged by March when school calendar starts.

My sister who said that I should stay as long as possible for my condition to recover acquiesced to my plan to return to work by March. “You should get physical therapy at the Main Hospital while you are working, then your condition could improve more.” She must be worried in her heart but agreed that returning to work is also important.

Yes! It is not over yet. How thankful it is that I am able to go back to work!

214 February 8, You Will Not Be Able To Go Back 2005. Tuesday To Your Hometown

Lunar New Year is approaching. Every Lunar New Year and Thanksgiving I went to the hometown to visit my parents even with the immense traffic. However in 2004, I could not go for the Lunar New Year because of heavy snow. My father called to give me a strict order not to visit because the road was a mess. Other than my time studying abroad, it was the first time I missed the ancestral rites.

Now, with the condition my body was in, I will not be able to make the trek down to my hometown. I thought of the novel titled ’You Will Not Be Able to Go Back to Your Hometown.’ by Moon- Yeol Lee. In the novel, the hometown of the main protagonist was gone; but in my case I could not go because of my physical condition. When will I recover to be able to go down and serve the ancestral rites?

I asked my sister to have a nice family dinner on the Lunar New Year.

215 February 28, Returning Home on Foot 2005. Monday

Discharge. The procedure was simple. My wife got to the hospital at about 10:00 A.M. and packed my be- longings. A single box was more than enough. We moved the half- filled box to our car in the parking lot. I said bye to the nurses as I passed the nurse station. The business office on the first floor had its window facing towards the outside of the hospital. My wife used a credit card to pay the bill. After nine months, 298 days, of hospitalization, it took less than an hour to get out. The bill I had to pay was one hundred mil- lion won (about 100,000 dollars). Most of the bill came from the single occupancy room charge. My brother, my private insurance and the Hospital will help with the bill.

I have been preparing for this day. But when it came to it, it felt like I was thrown into nowhere. Now I have to return to the real world, which is both familiar and new at the same time. As long as I work at the University, I have to continue teaching, research, and

216 patient care. Will my body be able to cope with it… Until now I only had to focus on my physical rehab. Now I will be focus on so- cial rehab. A new battle has begun, and I will be victorious.

I returned home feeling the slight warmth of the coming spring rather than the residual cold from winter.

A hushed rumor that went around in my apartment complex. “The man downstairs went to the mountain and never came back.” There was no welcoming ceremony, but I returned home on my own feet.

For the past 9 months I gave it my best and have no regrets.

217 March 2, Official Return to Work 2004. Wednesday

Today is my official return to work. My schedule is as follows.

At 6:00 A.M. I wake up. It is about 6:50 A.M. after a shower and breakfast. I dress up and get in the car by 7:00 A.M. It is about 7:30 A.M. when I arrive at the Hospital. I turn my computer on and scan through my e-mails and my secretary arrives at 9:00 A.M. In the morning I take calls or go to the clinic. At 12:00 P.M. I have lunch. I take a break until 2:00 P.M. and go down to the physical therapy room at 3:00 P.M and receive therapy until 5:30 or 6:00 P.M. At 6:00 P.M. I make my ward round. 7:00 P.M. I have dinner. 10:00 P.M. I am off work and it is about 10:30 P.M when I get to Jong-Ro 3-Ga station. 12:00 A.M. I go to bed.

218 I slackened after discharge from the hospital in exercising alone. I tried to exercise on time, but I have become lazier. The time I put into my exercise is getting shorter, and I can’t help time just sitting or lying down is getting longer. In addition, my work has been increasing so that the time for exercise and physical therapy keeps getting shorter.

Going to the physical therapy room is like going to school. It would be nice if we could study on our own without going to school. But you can work hard only with the person leading you and with those around you in a similar condition. So it is crucial to keep going to rehab. I have seen many patients while working in the hospital, and those who got better were usually those who made consistent visit to the therapy.

My dental implants are scheduled to be done by fall.

219 Three Years Later

220 May 31, I am Standing 2008. Saturday

In a few days it will be the 4th anniversary of my accident.

In March 2005, the Movement Disorder Center was opened. It is thanks to Professor Sun-Ha Paek who worked diligently on the project. The Center provides an environment where we can do better patient care and research. With the dedicated employees and space, all I have to do is diligently use my brain.

I am enjoying the fact that I have many tasks to do. On Wednes- day evenings the Center is filled with current and former fellows who themselves are now professors to hold seminars, discuss cases, and review research projects in progress.

In March 2006 we held the first annual symposium at the Center. I invited my mentor Professor Stanley Fahn from Columbia Uni- versity.

221 Dear Professor Fahn:

You probably heard that I had an accident resulting in quadriplegia.

Thanks to God and the prayers of you and many others, I now am completely independent and active in my clinical, research, and teaching.

I started a Movement Disorder Center with neurosurgery this March. It is a four bed monitoring unit and serves for drug adjustment and DBS. It is going very well.

I have been giving movement disorder seminar every year since 1994 except this year. The seminar is for all neurologists interested in movement disorders. 2006 seminar is scheduled on March 11. I would like to invite you as an honorary lecturer at the symposium.

Knowing your schedule too well, I will not be disappointed if you may not be able to accept the invitation. Therefore please do not overstrain your schedule. The seminar has been held every year on the second Satur- day of March, and is flexible for 2007.

Please let everybody know I am physically good, and spiritually excellent. My family got stronger through this event too.

Sincerely Yours

222 He did not know of my accident until very late and was shocked but congratulated me after hearing that I had recovered from it.

In 2007 and 2008, we continued the annual symposium and invited researchers from overseas.

In July 2007, my mother-in-law, who was very healthy, suddenly passed away. Just like my father-in-law Professor Kwang-Ho Lee, the former Dean of the Medical school who died of kidney cancer in August 1998 and donated his body for research (his heart is in the Medical Museum of the Hospital), she donated her body to the Anatomy Department so that the medical students could study.

My daily schedule is always the same as if it is written in stone.

6:00 A.M. I wake up. 7:40 A.M. I arrive at the hospital. 4:30 P.M. I receive my physical therapy. 10:00 P.M. I get off from work. 11:30 P.M. I arrive at home. 12:00 A.M. I go to bed.

An exception would be on Sundays, when I would go to the Hos- pital at around 2:00 P.M. I have a bicycle in my office and my living room which I use to

223 exercise. I am usually on the bicycle if I do not have other business. Professor Moon-Seok Bang kindly arranged a half an hour of physical and occupational therapy at the end of the afternoon when it is quiet and is more convenient for me to visit. Although I am not as I used to be before the accident, these small considerations helped my condition to where I am able to do most activities alone. At first glance it is hard for others to notice my physical difficulties. Unless the weather is foul, I take the subway to work.

We had an annual hiking event last Sunday. The event used to be a heavy hike to Nam-Han-San-Sung before the accident, but I changed it to a light stroll around Olympic Park. There were a total of 34 people including my current and former students, research assistants, and their families. Professor Jin-Hwan Cho’s daughter Je- Ah is already five years old, and gave me a pretty deep bow.

My body does not allow me to have fun, but it allows me to work. I have become more efficient in working and can finish tasks sooner. I try to decline extra work. But I figure there must be a reason when they ask me knowing my condition, so I accept. I ended up in charge of the Office of Health Care Policy of the Medical School, and became the executive member of two academic societies and worked in several committees.

This year, I received the outstanding research award and the out-

224 standing teacher award as well. I must have done well without being other’s burden.

My children are growing up to be fine adults, and my wife is healthy and handles things at home nicely. What else do I need?

225 Epilogue

226 Epilogue The Unfinished Story

If people call unexplainable events miracles, then my accident that is hard to explain is a miracle as well in a sense that it was a unexplainable misfortune. On the other hand, it is another miracle that I went through such a horrible accident and recovered from it.

There were many factors involved in the miracle I experienced. My accident caused the C3-4 disc to burst and crushed my spinal cord. The nerve that regulates the movement of the diaphragm which is the most important in breathing originates from the C5 level. A malfunction at C5 may lead to immediate death caused by respiratory paralysis. It was a miracle that I did not have much of a breathing problem even though the injury was located right on top of C5. Artificial respiration was impossible at the peak of Nam-Han Mountain where the accident occurred. If I had any respiratory difficulty there, I would have died at the site of the accident.

Second, I was an accident victim who knew a lot about spinal cord injury. The Hennepin County Medical Center in Minneapolis where I did my internship was Class I emergency care center so that I was

227 well-trained in spinal cord injury. That was why I had people around me to protect my neck at all cost. It was fortunate that the helicopter had a neck brace as well. In 1993 I came back from America and had to attend traffic safe- ty classes to get a driver’s license in Korea. In the educational video, I saw a scene where an unconscious victim in the driver’s seat was pulled out of the window. The neck is the most vulnerable body part in car accidents. So if the patients are dragged out forcefully it could cause even more severe neck injuries. After the class, I informed Professor Hwang who was in charge of the lecture that it would be better if the patients had casts around their neck before they were pulled out. Now, through the efforts of the Emergency Medicine, emergency care providers handle the patients’ neck with the proper care.

The third factor involved in my miracle was the helicopter. At the time I figured that I would not be able to survive without a helicopter. They told me that ER of Seoul National University Hospital requested helicopters from multiple sources on that day. The helicopter that carried me came from the air-borne unit in Kyung-Ki Province, but other helicopters came afterwards as well.

The fourth was that I was in a place which was accessible to a helicopter. If I was in a creek, it would have been impossible to move me without injuring my neck even further.

228 The fifth factor was that I was moved to Bundang Hospital. I was lucky that I went to Bundang instead because I could not fly to the Main Hospital in Hye-Hwa due to the No-Fly zone in Seoul. My wife’s brother and my sister lived in Bundang and helped greatly so that my wife was able to manage her time. My sister stayed by my side after the accident almost every night in the early period and was considerate enough to let my wife rest over the weekend. My wife was able to take time off and stay with my children. If my wife had to stay with me 24 hours a day and had to neglect the children, I would have been uneasy. Most of the professors in Bundang Hospital were junior to me, and it was easier for me to refuse their visits and focus on my treatment.

Sixth, Professor Hyun-Jip Kim who is the top spine surgeon was in the hospital. As the time of my accident was Saturday, the operating room and ICU were readily available. Thanks to that I was able to have an immediate operation.

Seventh, there were no other serious patients in the hospital while I was in the ICU. A serious patient drains the attention to that patient. Because there was no such patient, I was able to receive more meticulous care. I heard that there were a series of critical patients that kept the unit very busy after I left the ICU.

229 Eighth, I knew all about my illness so I was able to prevent and avoid almost all of the complications that result from it. Once a complication starts, it is like falling into a sand pit. I was cautious while drinking water and about taking deep breaths to prevent as- piration pneumonia. I always tried to stay in the right position to prevent bed sores and compression injury to the nerves.

Ninth, I was very healthy before the accident, and I had the stamina to go through the crisis without much trouble. When you fall from the cliff, you need the strength and stamina to hold on to the rock until someone comes to help you.

I also had many advantages being a professor of Seoul National University. I hope that no other patient was neglected on my behalf, and I know that to be true.

I thank everyone, including those that I have not mentioned by name, who cared or visited me and also the ones who prayed for me even if they could not visit me. I also thank the Hospital and the University for letting me stay in the hospital for nine months.

I was also lucky that I did not have a hemorrhage in my brain or a contusion, which often times occur as a result of a traumatic forehead injury after a fall from a syncope. My two incisors contacted the protruded rock first and acted as a bumper and eased the im-

230 pact on my head. Although my body was severely damaged, my brain, the most important part to lead a life and do work, was un- harmed.

An aged man is but a paltry thing, A tattered coat upon a stick, unless Soul clap its hands and sing, and louder sing For every tatter in its mortal dress. - Sailing to Byzantium, William Butler Yates

Even though my body is hurt, it is good enough that my will is still alive. After writing the book ‘Sagi(사기, 史記: History)’, Sama Chun said “The castration that I had to endure was only a drop in the ocean.”

I experienced almost all the pain and suffering that a neurology patient may have, and am still with them. The inconvenience of not being able to walk, eat, dress or wash on my own, the difficulty of relieving myself, the unbearable pain, facing death itself, were all my experiences and are still a part of my life. I recovered much more than the Korean pop star Won-Rae Kang who was paralyzed from a car accident or Christopher Reeve. But I know well how my life will end, although God always knows faster roads to my end.

231 I keep on thinking. I keep on thinking what the meaning of my life is, and why I have to live from one harsh day to another.

My life is like walking on a water mill, where I would fall into the water if I do not keep stepping. If I do not exercise diligently, my body would stiffen, and I would lose my strength leading to even further difficulties. However, exercising itself is very painful. It is like hell where the torment is endless. Moo-Gan Hell(무간지옥 無間地獄) is a place where pain and pun- ishment does not end. As it is uncomfortable even when I am lying down, my life is Moo-Gan Hell where I have nowhere to rest. But would it still be hell if I keep my head up?

I recovered from a severe injury like a miracle, and I can do anything if I wish. I am able to care for my patients, perform research, and teach my students. The only difference is that my exceptional strength and stamina that I once enjoyed are no longer there. How- ever, it helps me think from the patient’s perspective and I am able to teach this to my students.

For that, I was able to revise ‘The Parkinson’s Disease Guide for Patients and Their Families’. I also translated ‘Ten Years To Live’, an autobiography of a family that suffered from cerebella ataxia (*written by Henry Schut), which I had been putting off for almost ten years, with

232 my student Jae-Sung Oh, and am currently recommending the book to doctors, students, patients and their families.

‘松柏之茂隆寒不衰 송백지무융한불쇠 A pine tree is thick and does not wither in the cold.’ A patient wrote this for me, and I mounted it and hung it up in my room. It is a quote from Seung-Man Lee, the Late president of Korea which says that a pine tree is thick and would endure even the coldest winter, just like the persistence of our Korean people. The patient started calligraphy after he was diagnosed with Parkinson’s disease. It is an excellent piece of calligraphy with strength in every stroke. It probably is a writing that expresses his will, but it could easily pertain to me as well. But wouldn’t 松柏之寒不衰茂隆 be better, that a pine tree does not wither in the cold and even thrives?

‘Kalepa ta Kala.’ It is a Greek meaning that good things are hard to achieve, and it is also a title of a novel written by Moon-Yeol Lee. He described the downfall of Greece initiated by a small whisper, and said good things are hard to be fulfilled. However, the civilization continued in Alexander’s world and the Roman Empire. No matter whether the narrator liked it or not, history is made this way. People leave behind their genetic and information codes. I have unyielding children and superb students. My story is not over yet.

233 It’s Not Over: Here I am on My Feet - Memoir of a Neurologist with a Spinal Cord Injury -