The Shake Up
I was on the phone with my husband when the earthquake hit.
“There’s a….” were his last words, before he dropped the phone and rushed into the stairway. People screamed. Hundreds descended towards the ground. Maher followed, barefoot, in the dark, he slid his hand along the banister for guidance. He was pushed along by nervous men and women, some carrying babies.
As the 30 storey building swayed wildly from side to side, he had a moment of realisation. That he was in an earthquake. A serious one. That this was the end for him, for all those around him, and probably for many more. What he struggled with was disappointment. How could this be it, no light, no big epiphany moment?
He took a deep breath in, and changed his pace to a walk.
When he dropped his phone, I was left with an eerie silence. I called back – two, three, four times. I tried his brother, Marwan. No answer.
I was in Ahmedabad at my nanaji’s (maternal grandfather’s) house in India. We were about to have lunch, the typical Gujarati meal, a vegetable dish with dal and chapati. I waited eagerly for Maher to call me back. Nothing came. We ate, rather quietly. My mind raced. Was it a snake? That’s ridiculous, how could that be, in a city building? It must be an urgent business call… that’s why Marwan didn’t answer his phone either. They were on a work call together…
Maher, a quick thinker, creative, is known to find atypical solutions to problems, which in retrospect seem so obvious, had we only thought of it ourselves! He says he would have been a good warrior in a different era. He is a fighter who perseveres with zest. A fighter who did everything in his power not to join the obligatory military service for young men both in Lebanon and in France at that time, his two home countries.
Hoping for an email I opened up my laptop. Out of habit I logged into my Facebook account. That’s when I realised what had happened on that Monday afternoon, the 12th of May 2008, at 2:28pm, China time.
Sichuan province shook. An 8.0 magnitude earthquake rocked Chengdu, the city we lived in. Those 3 minutes felt like an eternity of uncertainty, and of devastation for millions of people.
When Maher, with all the improbability possible, of making it out alive, saw the bright light of day outside, instinctively, he looked up. To his relief, the buildings around our neighbourhood were all standing. That’s when he saw Marwan rushing towards him. Marwan had run over from the office building to make sure that Maher was ok. They stared at each other for a moment. The ground beneath them had literally shifted, the buildings had swayed and they had escaped serious injury or death by the width of a hair.
Thousands of people were wandering around, lost in the streets. Confused, searching for family and friends. The phone lines in the city were mostly down.
At 3:30 pm Chinese time, I received a call on my grandfather’s landline in India. It was Maher.
“It was an earthquake. A big one. The phone lines in all of Chengdu are dead. I finally managed to get through to you. I’m ok, Marwan too..we are working on a plan now.”
“Should I change my flight and come back earlier?” I asked
“Yes. As soon as you can get a new booking. Come.”
We spoke briefly. It was noisy around him. I could only imagine the panic, families who couldn’t reach each other, children stranded at schools without their parents, workplaces shut down, and for how long? And then, the possibility of aftershocks.
By then Marwan, Maher and his Chinese personal assistant were at the bottom of the office building, contacting staff including factory workers, office workers, Chinese, foreign, their families. They strategising an emergency action plan for everyone.
Maher is young, fit, a strong runner of medium build. He comes from a lineage of prematurely balding men, and he is no exception. His attentive eyes, kind smile and generosity are unforgettable. Maher’s olive toned skin, big nose, warm, and welcoming personality are typical traits of his Lebanese origins. Emotionally, he is level headed, calm, a quick thinker, a natural leader — in the modern sense. Even at his young age of 31, he was well-respected by his employees and their families, some older than his own parents.
We moved to Chengdu in 2005. Maher literally worked days and many nights relentlessly for months on end, to put together a team of people, and with them set up an office, build and run a steel pipe factory in Qin Bai Jiang, a suburban district of Chengdu, 45 minutes outside of the city.
By 2008 the company had hired 900 local factory workers, as well as office staff, engineers, and upper management from China, Lebanon, North Africa, Eastern Europe, and France. Balancing everyone and their interactions, considering their different cultures, needs, and miscommunication was highly challenging, yet something Maher showed immense talent at. He was international in his upbringing and life journey. He had gone from Lebanon to France as an 8 year old, and then to the UK and Canada as a young adult, and more recently to Asia.
Maher managed this crisis situation with everyone in mind, with his usual composure, empathy, and strength. Some were terrified, many were emotional. His own fears, his own need for safety and comfort, were never addressed. Instead, Maher listened, talked to his staff, built trust and even friendships with them and their families that have lasted a lifetime.
Unlike other foreign owned and even locally owned businesses, theirs was shut down only briefly. The foreigners with their partners and even some babies and children were resituated to the newly built dorms at the factory site, the key point of that being the rooms were on the ground floor.
On the afternoon of Wednesday, the 14th of May, I returned to Chengdu. The taxi left me outside our residence. The usually over-crowded lift to our 20th floor flat was empty. Maher was at work. It was uncannily quiet. I left my baggage upstairs and ventured out for a walk, in search of evidence of what had happened.
There were tents across Chengdu. The city had turned into a camping site. People were eating, drinking, sleeping on the street level. As aftershocks continued, they spent at least a month living in makeshift housing on the road sides, at university campus football fields, at plazas in front of shopping malls, anywhere that was at ground level.
Greater Chengdu was a city of more than 14 million people at that time, designed in unending rows of towers, 20 – 30 storey high complexes housing both families and companies. During the early 2000’s millions of people across China moved from the countryside to the cities. We were told the view from our flat windows, only ten years prior, were different. The rows upon rows of tall buildings we saw used to be fields of farm land.
On my way back from the walk, I met Maher, Marwan and a co-worker of theirs at the building entrance. On our way up to the 20th floor, they looked at each other uneasily, and barely spoke. Every minute spent up at our flat was a minute too long. Their colleague felt vertiginous when he approached the windows.
“Did you feel that?” He asked, pale, his eyes filled with terror.
“It moved.” He pointed at the suspended lamp in the centre of our living room.
“It’s an aftershock.” replied Maher.
“Yalla, let’s go back down, get what we need and go,” Marwan tried to comfort him.
Even though I had been standing right next to them, I missed that 5.0 magnitude aftershock entirely. There was no way for me to understand what they had been through. I couldn’t place myself in their bodies or minds. Their nervous systems were on high alert. The question now was even though these buildings survived the earthquake, would they now be able to withstand the aftershocks?
Chengdu’s geographical location protected it from the seismic shifts. It is built on a plain, surrounded by mountains. It sits on loosely set soil. This, along with the high quality of the building structures meant our towers were indeed flexible and strong enough to show resilience in the face of the earthquake. And the aftershocks.
Surrounding towns and areas were less lucky. Entire villages were erased, schools and buildings collapsed. 69,000 people died, and 18-20 thousand were assumed missing, caught in landslides and under building debris. Assumed dead. A monumental tragedy in contemporary Sichuanese history.
The Chinese government reacted swiftly. Approximately 148,000 military, police, and reserve members from across the country were sent in as part of the rescue operations. A friend of ours working for the organization Medecins Sans Fronitiers or Doctors Without Borders, had been sent to Chengdu at that time. She explained, the Chinese had managed the crisis impeccably and they had no need for additional international support other than in the mental health department. She was surprised at the lack of attention in that area considering the level of trauma everybody had collectively experienced.
With this tragedy playing out in the backgrounds of all our lives, we were forced to focus on our immediate day to day actions. Maher and his colleagues quickly obtained the necessary safety clearance from the authorities in charge to continue production of their pipes.
Like most others, I temporarily closed my yoga studio. Not only would people refuse to come to classes held in a tall building, but also shock from the event as well as survivor guilt were at play.
Even if counterintuitive in such a devastating period of high need, short sessions of dynamic movement as well as meditative practices are an important, healthy way to better manage such trauma. One quickly gets back into the body and into the present moment, by focusing on the breath for example, with the possibility of moments of toned down anxiety levels. But most people were too busy with more basic problems.
I offered free Saturday afternoon yoga classes for three weeks on the grass at the East Lake Park. A handful of people attended.
On a very hot Monday afternoon, an immensely busy work week for Maher, he called me on the phone. It was the 2nd of June, less than a month after the earthquake. He slurred, his voice was faint. He said three words, “I love you.”
Many times in the future through moments of doubt, I have pulled that memory and those three words up to remind me of Maher’s most sincere, true love for me.
Then I heard Marwan’s voice. He had grabbed the phone.
“Maher collapsed. Come to the hospital in Qin Bai Jiang.”
They were in a company minivan on their way to a little hospital, the closest possible. Marwan refused to let Maher lose consciousness. Maher fought hard to keep his eyes open.
I scrambled to find our passports, some money, and my house key. I jumped into the first taxi I could find. During that 45 minute drive from our flat to the town where Maher had built the steel pipe factory, my mind raced from Maher, to our families, to our friends, to our life in China, to…
Maher built the Chinese sector of the company by hiring each person interview by interview.
Roger was one of those people, a young, eccentric Chinese translator who ended up working with Maher for many years to come. We were intrigued by his fresh, energetic way of being. Maher rarely encountered a defeatist, negative, or even hesitant attitude with his young staff in China. There was a vibrancy and a sense of possibility for entrepreneurs there in the mid 2000’s.
As I entered the emergency department of the little provincial hospital, I saw Maher laying in a bed, a white sheet covering him to his waist. His big feet remained exposed. He had come out of a CT scan, and was surrounded by nurses. His colleagues looked at me solemnly.
Maher had lost use of his right arm and the right side of his face was paralysed. His mouth was twisted. When he saw me, he tried to smile, to say something. I heard only incomprehensible sounds.
I was numb. It wasn’t the time or place for emotional outbursts. But I was ready for action, pumped with the adrenaline that flows in emergency situations. I slipped my fingers through his, and joined the support team that included Marwan and Maher’s personal assistant. We were all behind him.
Maher had run 10 marathons by then, including a couple at a sub 3 hour pace. He was a healthy eater with no cholesterol, no blood pressure, he didn’t smoke, and only drank at business dinners. He had no underlying diseases that we knew of.
During the earthquake, everything he imagined of others’ romanticised accounts of near-death experiences were not close to what he had felt. He was dissappointed. “Is this it?” He wondered, “This is how I go – no light, no big epiphany?”
And less than a month later – a stroke. We were confused. Maher was angry. He refused to accept death like this, unable to use his body or voice. He fought hard, refused unconsciousness, refused to go without a fight.
A week after the stroke, with Maher stable, protocol allowed him to fly. We were to be evacuated to Paris, Maher’s home as a young boy and teenager. France remains to be the place he trusts most when it comes to medical attention. It promised him some familiarity and a sense of safety.
I returned to our flat to pack our luggage for the trip to Paris. Having a couple of hours to myself, I pulled out my yoga mat in desperate need to move my body, to feel my muscles work hard and stretch. To sweat, to feel my heartbeat, to breathe, and to regroup. That’s when the scream escaped me. A long wail of agony. And then, the tears.
We spent a couple of weeks at the Salpetriere hospital, an old institution in Paris, composed of large stone buildings amidst vast gardens. Maher was first admitted into the cardiac department. We spent a few nights there, jet lagged. I woke up early in the morning while it was dark outside, quietly pulled out my yoga mat and began my daily practice, both breath work and movement. These were my centering techniques. My time in the day.
By the time the nurses arrived to check Maher’s vital signs at the break of dawn, I would have already showered and folded away my bedding.
The doctors discovered something of interest – a hole in Maher’s septum, the wall between the right and left atria of the heart. In 25% of adults this hole doesn’t close after infancy. “When it doesn’t close, it’s called a Patent Foramen Ovale”, the doctor explained, “quite likely the cause of such a stroke as yours. You are young, and there is no other reason for you to have a stroke.”
If the stars align so to speak, that is, a blood clot that would typically be dissolved by the body, passes through the hole in the heart, is then propelled up into the brain – voila, a stroke. Or another possibility, it is because of the PFO that a clot is formed. The clot then shoots up to the brain.
There were two views at the time. One group of doctors would perform open heart surgery to “close” the hole, another would argue that the most up to date scientific studies show no particular benefit in “plugging” the hole, especially according to the leading doctors at the Salpetriere Hospital who were followers of the latter theory.
Upon listening to the advice from the doctors and after some internal debate within the family, Maher decided not to operate.
As part of a continued in depth study to understand why Maher had the stroke, the head doctor sent him to the neurosurgery department. The atmosphere there was different. As part of the protocol, every inpatient member had to spend 24 hours strictly in the hospital bed upon arrival, and only then could the investigations begin. Maher had his mobile phone, bedpan, food and water close. Family was permitted during visiting hours. Only. I was firmly denied overnight stay.
Maher needed the time and space to reflect on his life, his second escape from death, to understand his new situation. In fact, he preferred that no one stay with him. He was introspective and uncommunicative. He spent long hours playing on a Nintendo Gameboy, and pulled out his classical flute, a great way to work on his fine motor skills.
The doctors had been phenomenal in getting him through the stroke itself, but no one sat him down and explained how he was to move forward. He saw a psychologist two or three times.
The heart specialist at the hospital warned him against marathons. The sheer exertion needed to train and then run for that long a time was too much stress on the body. The word “stress” came up a number of times. Other than that, after Maher left the hospital, he felt he hadn’t enough answers, enough guidance. Physically he was almost all healed, even if uncharacteristically tired, but mentally and emotionally he was in the unknown.
The chief concerns were how likely was it for Maher to have another stroke, and how best could he prevent or delay that? Maher needed numbers, some kind of certainty. He made appointments with specialist doctors, outpatient. He dug deep, read every study out there, interrogated experts who accepted to see him.
According to these doctors, the recurrence rate was 4% per year, incremental. That meant he had a 16% chance in 4 years and so on. He was on aspirin for life. It was to keep his usually thicker blood due to high levels of red blood cells and platelets, thin. Since cholesterol is a risk factor of stroke, it’s standard procedure to prescribe anti-cholesterol medication, even though Maher’s cholesterol was lower than normal.
For a few years to come, Maher would wake up in the middle of the night, he would clench and unclench his right hand, his breath rate was high. He would pace around the room. “I think it’s happening again.” He would say. “It must be a warning sign.”
When this happened, I woke up too. I breathed with him, one hand on his belly as we watched it rise and fall with every inhale and exhale. “Lengthen your exhales,” I said.
The panic attacks were most frequent the first year post stroke. When he realised the control he had over them simply by breathing differently and putting his awareness on it, he was empowered. With every following panic attack he could see it more clearly for what it was. He put his hand on his abdomen and controlled the length of each breath slowing down the overall pace, and improving the quality of his breath. In turn his nervous system would follow and calm down.
Ten Years Later
We were at a charming, simple 2 star hotel in Krabi, Thailand, before our 7 year old son Rahul’s football tournament the next day. We drove from our then home of Koh Samui, to Krabi, as part of a convoy of parents and organisers from our football club, Samui United. Maher and Rahul were in one room. Our daughter Leila and I were in another along the corridor a few doors down. It was barely 9 pm, and both our children were long asleep after an exhausting day. We had taken the ferry from Koh Samui to the mainland, and then the car for another six hours. It was a hot Thai day. Maher had driven all the way.
The phone in my room rang. It was Maher.
His voice was faint. He spoke slowly, but calmly.
“I’m having a stroke. Come.” Click.
“Are you sure it’s a stroke?” I asked bursting into his room.
He was sitting meekly on the bed, a bottle of Singha beer next to the phone on the bedside table.
“Call an ambulance,” he advised.
He was looking at his right hand, trying to clench and unclench it. “My hand is tingling, and I can’t speak, same as last time.” His lips weren’t moving freely.
“I was drinking my beer, and couldn’t swallow any more.”
He was unable to squeeze my hand.
I woke up a couple of our Thai friends, who could communicate with the hotel receptionist and hospital staff to arrange an ambulance. Quickly.
I moved Rahul into my room, and left both kids in the care of a friend. Maher waited patiently.
He smiled at me. I was surprised at his calm. I assumed he’d be upset like he was after the first stroke. But instead there was a hint of sadness in his eyes and a deep acceptance of the situation. An understanding of the impermanence of life.
“Make the kids strong,” he said.
I bit my lip, swallowed, and breathed in.
I managed a nod.
The doctor on call at the emergency department listened to my story about Maher’s past stroke history. He checked Maher’s right hand by asking him to squeeze his fingers. The doctor swiftly put Maher on an IV drip.
A CT scan confirmed it – stroke. Exactly 10 years after the first one.
By midnight, only 3 hours later, Maher had mostly regained use of his right hand and his speech was improving. What luck I thought. I get to have him, we all get to have him for a little bit longer.
The next morning I brought the kids in to visit him. They played with the drip, tried on some surgical gloves and masks, asked if their papa would die, and threatened to tell the nurses if I snuck in a coffee for Maher, against the doctors’ orders.
Maher was given yet another chance at life. He improved rapidly. He used his right hand to hold the coffee cup I secretly handed him, and he managed to speak, slowly and sparingly, but surely. As usual he joked with us, his way of lightening any heavy moment.
With help from family and friends – from caring for our kids when we were occupied, to putting us in contact with leading experts in the field around the world, the next few weeks went as smoothly as possible. After the three days minimum of doctors and nurses closely monitoring Maher in hospital ICU, followed by another four days at a hotel, we were given the go ahead to fly to Singapore, a short, two hour direct flight from Krabi, Thailand. The risk of a follow up stroke, like an aftershock, is quite high during the first weeks after the event. We saw that in the 2008 Sichuan Earthquake. The aftershocks can be just as devastating if not worse than the event itself. But having been warned by the event, it would be foolish not to take precautions for the near future. So we took it easy and listened to expert advice. Maher managed the earthquake with great poise and a fighting spirit. It had been a great lesson in managing a stressful situation, and now after a lifetime of growth, children, and better self awareness handling this stroke was less scary.
The leading expert in the field in Singapore, strongly advised us to close the PFO. According to the latest scientific studies carried out by researchers in France, a PFO must be closed to prevent future strokes. It is a relatively simple, but only recently more practiced procedure. They no longer needed to perform open heart surgery. A catheter is introduced from the groin up into the heart, and the PFO closed. Much less invasive. One or two nights in the hospital is all it takes.
Since there was a waiting list of a few months in Singapore, the doctor recommended Paris. “They have a good track record with this procedure, one of the best. If you can go there, do that. I highly recommend it.”
We had a place to stay in Paris, family and friends, and a familiarity with the medical system. It was a convenient option. We shopped for pants and coats, boots and socks, and off we went. Paris in October.
One day towards the end of the month, as Maher ordered his contact lenses at the optician down the road from his parents flat, I admired myself in a pair of designer Chloe sunglasses. I peered into the mirror. They were flattering. Coyly, I showed them to Maher.
“You want to buy me a gift?” I winked.
“Nice. They look good on you. How much do they cost?” He asked, looking at the price. “Ah!” He laughed. “If I live through the procedure tomorrow, I’ll get them for you!”
I threw my head back and laughed. He gently held my hand, smiled, and we exited the store.
A few days before the kids 8th birthday on the 1st of November, we went back to the optician. I walked out, proudly flashing my new sunglasses.
Maher and I continue to live in Koh Samui, Thailand with our children. Maher never stopped running. His runs are pleasurable now, not competitive. And since 2008, no marathons. Sleep is a priority. Coffee consumption is down by half. He is running a community football club for children in Koh Samui, as well as an academy for Thai kids, scouted from across the country, who will become professionals. They are taught by world class Thai and International coaches, all individually picked and hired by Maher and his team. He’s building professional football pitches and a major sports complex, a hotel and apartments that will host kids and their families for sports camps. All this along with running the steel pipe factory in China, remotely now, with Marwan and others more involved in the day to day busy-ness of its management.
He teaches Rahul and Leila by example — how to persevere. “I don’t care if they are the best at anything, just that they don’t give up trying when things get tough, or ‘boring’”, be it the piano, football, or simply showing up at school, everyday.
And he continues to say those three words to me. I love you.