My amazing brother Barkaat- The Story

Summer 2006:

I would like to introduce you to my brother Barkaat. On 31^st July 2006, he celebrated his 22^nd birthday amidst his friends and family. His friends from his college where he was doing his CA were there to cheer him. After dinner, they all sat on charpoys on the rooftop in his small cosy home breathing in the warm Lahore night air. Barkaat sang in his beautiful melodious voice the songs he had written and composed himself, while our younger brother Hasnat played on the guitar, and all friends sang along.

The young carefree group of 20-something year olds were commencing their journey into adult hood: having joined their respective professional institutions as aspiring chartered accountants and engineers. They were all good kids, ambitious, hardworking, sensitive, and aware of keeping up the honour of their white collared families. They were fun loving, but responsible, they joked at each other, but would stick by when needed.

On this particular night, as always, they joked about Barkaat’s increasing weight and at the same time praised him for his eloquence, his command on verbal expression, his fine poetry, his deep voice, his fondness for beauty, in particular feminine beauty and how he blushed when speaking to pretty girls. All in all, it was a very normal night, a very normal bunch of people, a very normal family, a very normal life.

But this was soon to change.

The accident:

On 27^th August 2006, less than a month after his birthday, Barkaat met a road traffic accident and sustained severe head injuries. He was riding his scooter back home after visiting our terminally ill chacha (uncle) in hospital, and he was hit and run: no one knows by whom. He was lying unconscious on the roadside, his helmet thrown off to a distance, and scooter flung in another direction. Some passers by who saw him on the wayside took him to the hospital across the street. They found his cell phone in his pocket, and the last dialled call was ‘home’.  When they dialled this number, the call was received by our mother, who was the first recipient of this news.

It is fair to say that this phone call marked the end of what we, the family, had known of life to be normal, and what was in store for us was unprecedented!

Being in London, it took me 2 days to manage to get a flight to Lahore.  I was told by my parents, Hasnat and my sister Sobia, that when they had reached the hospital, Barkaat was lying in a stretcher, no doctor had touched him, no emergency resuscitation was done, no first aid had been provided as they needed to know first if we could afford the hospital care. It was an ordinary private hospital in Allama Iqbal town, not even adequately equipped, entirely unsuitable for critical inpatient care. My parents were, at that time, completely naïve about medical decisions, In face of the grave situation they put all their hopes on the doctors and agreed with whatever they were being suggested by them. So Barkaat was transferred to their ICU, on a ventilator, with tubes in all his orifices and veins, and the pump breathing for him.

When I reached Barkaat, I found there were several flaws in how he had been managed since being taken into the hospital. For example, a brain scan (CT scan) after 12 hours of admission is a pre-requisite in any head injury patient, and it becomes even more important if the condition of the patient hasn’t improved in that time, as was the case with Barkaat. But it was found that their CT scan machine had gone out of order and they hadn’t even informed us. They were managing Barkaat unaware of what the extent of injury was to his brain! This was completely unethical and naturally, catastrophic to Barkaat.

How we arranged to have another CT scan from another hospital is a different story. When it was done, to my deepest fear it was found that the injury to Barkaat’s brain was extremely serious. He had suffered fractures to various parts of his skull, and that caused several areas of bleeding inside the closed skull cavity, which were increasing with time, pressing on the brain and threatening his life. By this time Barkaat’s condition was critical: he needed surgical intervention immediately or the pressure from the bleeding inside his brain would prove to be fatal.

We could not let Barkaat stay in the same hospital after this. So with a lot of deliberation, he was transferred to what was thought to be the best hospital in the city. A renowned surgeon operated on him. However, severe damage had already been done and more complications were in store for him.

He was in a coma for 2 ½ months with a hole in his neck (tracheostomy) to maintain his breathing. He had to undergo 5 brain surgeries in 2 of the most expensive private hospitals in the city. He had all known complications in the book, from bed sores to resistant lung infections not responding to any drugs.

The three months in the hospital are a long painful account on their own, perhaps the subject of another write up. This was a time of immense hardship for us all: in addition to the constant fear of losing Barkaat, it brought in its wake revelations about the integrity of the health system, the sincerity and professionalism, or lack thereof, of doctors, the politics of power and money, and corruption on each and every level, from accountants to hospital managers and gross negligence of senior consultants.

Barkaat survived:

Barkaat survived. But when he woke up, he was completely paralyzed on his right side, face, arm, leg. He couldn’t even sit straight, couldn’t hold his neck up. The gravest injury to the part of his brain was what is called the ‘speech centre’. Think of this as the hardware of your computer that stores all vocabulary, articulation, words and sentences. So imagine that the computer’s headphones are working but the hardware is destroyed. He had lost his speech function. He could hear everything, but words did not make any sense to him and he could not say anything either. This condition is called ‘aphasia’.

But to say that this was the only thing affecting Barkaat would be a gross simplification. In addition to aphasia, his sound producing apparatus, i.e., his voice box, his cheeks, his tongue were also paralyzed. His swallowing was also affected. He had lost control on his bowel and bladder functions and required adult diapers and complete care, for moving, sitting, cleaning etc. The young man, who was passionately discussing his plans for his future to take over the livelihood responsibilities of the household only a few months ago, was now reduced to complete dependence.

These were the problems that were obvious to us: but what was unknown was the damage to his memory, his cognition, and his intellect, what he was feeling. It was also unknown if he would ever be independent again, sit again, walk again, eat again, or talk again.

The journey: coming home, starting again. Except, you can't really start again!

Barkaat was brought home in this state. I tried to find if there was a comprehensive rehabilitation facility in the country which would cater to such a condition, and was disappointed. At best we were met with sympathy and a lot of it, but what we needed was hope and a helpful commitment matching our own to try and get him better. But this element was severely scarce. It was very scary to find that people in general were easily willing to accept Barkaat as a disabled person, were ready to resign him to a life not as productive as he would have led if the accident hadn’t happened.

It shocked and pained us, but my mother refused to accept this outcome. She said that all she needed was direction and guidance and she was willing to dedicate herself to make him better till her last breath. I was cautious: I knew severe damage was done. I had seen cases less severe than this spending the rest of their lives in dependence. The few anecdotal stories of recovery or finding some means of independence were often in circumstances better than us, in countries with better medical facilities, infrastructure and no bar on expenditure limits.

The three months in hospitals, and several surgeries had expended all of the family funds. By this time, it became evident that monetary problems would affect us in the long run. Whatever the reason, whether it was lack of hope and commitment from outside, or our own limited funds, it led to us forming a rehabilitative facility at home. We all became part of this venture, this mission, and took up different roles. But the bulk of the responsibility came on my parents and younger brother, Hasnat, who became Barkaat’s primary carers.

It was a slow and painful process but the dedication and commitment of my family and a group of close friends made it possible for Barkaat to begin his journey on the path of recovery. When he refused to sit on the specialized wheel chair, this was taken as a very encouraging sign, and efforts focused on getting him on his feet. There was a daily physiotherapy session, a speech therapy session, in addition to regular impromptu exercises which all kith and kin got involved in.

Perhaps the most important role, in addition to my mother was that of my youngest brother Hasnat. Hasnat had always been Barkaat's friend and companion from when they were young. With only a year's difference between them, they did everything together, even being in the same class at school, having the same friends, following the same fashion trends with Barkaat leading the way and Hasnat following. This turn of fate found Hasnat in an uncharted territory. Suddenly, he had to assume the role of the big brother. He had to come out in the front row, organize things and also take charge of Barkaat's emotional and psychological needs and even physical needs. All this was in addition of his own studies and responsibilities. 

I had to go back to London. I contacted my doctor friends and colleagues in  neurology and neuro-rehabilitation, and they became my safety net for discussing options, finding solutions etc. Although I had worked with patients with head injuries, this experience was completely different: it was instructional in so many ways, being on both sides of the story, i.e., being a sister of the affected person, and being a doctor trying to figure out a plan that would work with the limited resources my family had.

It took one year for Barkaat to be able to walk completely independently, albeit with a limp from the paralyzed right side. He started going to the toilet on his own, and no longer needed diapers. His swallowing improved. He laughed and cried appropriately, and started engaging in all social stimuli, responding adequately. All his faculties seemed to be awakened gradually, and what did not wake, his intellect made use of alternate abilities. Hasnat would get all their friends to come frequently to the house, and play the guitar for him, sing the songs that he had written, and generally buck him up.

The glimmer of hope:

His dominant right hand remained weak and his speech continued to be a problem. The speech deficit posed a lot of frustration: it was as if he was imprisoned in his own mind, unable to express himself, and not always able to understand others.

It was heart-wrenching that a person endowed most with expressive abilities, eloquence and with such command over language would be most affected with this predicament. The results of the speech therapy were slow, inconsistent and insufficient. Then one night, he shut himself in his room, crept underneath the covers and started sobbing inconsolably. Mom finally managed to get inside the room, and when he emerged from his blanket, he took a paper and struggled to write with his left hand ‘suicide’.

Needless to say, this brought a lot of tears. Things looked bleak, patience was wearing thin, resolve was dwindling, and all our efforts seemed fruitless.

When the night is dark enough, you can see the stars. But one must have the vision to appreciate this. ‘Barkaat’ is a word that means blessings, and by virtue of his name, blessings accompanied each problem that he was faced with. The fact that he could attempt to use his left hand to write gave us a new direction.

I encouraged my parents to let him take up drawing with his left hand. And this brought results that took us all by surprise. The first few crooked lines that he drew, were an attempt to make a pair of hands raised in prayer! Gradually, he took this exercise as his life-line. He started spending long periods drawing things, improving control of his left hand. It was as if a door had been unlocked. He felt that he could do something. We all found solace in this new hope that had rescued us from succumbing to the despondency.

Within weeks, the improvement of his drawing was awe-inspiring. The tenderness of expression and the sensitivity of subject were remarkable. Dr Ijaz Anwar, the award wining artist, has been friends with my dad since their college days. He offered to take Barkaat under his wing. He was so moved and touched by this amazing boy’s quest to make sense of his life, that he became fully involved and started giving him lessons. Barkaat also accepted Dr Anwar as his mentor and saviour. He spent hours studying his pictures, copying them, following his instructions, learning from his art. This became a poignant, exquisitely heart-warming relationship between the teacher and the student. The teacher understood that art meant life for this young man who had already lost so much in the battle of existence. And the student found hope, understanding and a sense of belonging in the face of the teacher.

Dr Ijaz Anwar, the Pride of Performance, a true artist, knew talent when he saw it. He was quick to judge that for a person with such severe brain injuries, creating art of such calibre is nothing less than a miracle! Not only was he using his non-dominant hand, but also he was tackling subjects of complex nature and portraying multifaceted themes.This led to the next step when Dr Anwar proposed to our parents to try and get him admission in one of the leading art institutions of the country.

The transformation of Barkaat from being a patient trying to recover from his head injuries to an artist engaging all his faculties, finding means to seek a purpose in his life, and to dedicate himself to that purpose is an extraordinary and an uplifting journey that we all feel proud to have been a part of.

Summer 2012:

I would like to introduce you to my brother Barkaat. Today, July 31, 2012 is his 28th Birthday. He is a truly amazing person. He survived a near-fatal head injury. He endured extreme brain damage and suffered paralysis of his right side and lost his speech. But he became the axis of a mission for us to see him get better, and he surprised us by finding a path for himself, and leading us all on it. We are all now living a new life.

Barkaat is doing his Bachelor in Fine Arts with Honours from University of the Punjab. He is in 3^rd year now. He takes the bus to the university and back home on his own. His right hand is not very strong, but he can move it. He uses his left hand to draw, eat, and do most things. He has lost more than 50 kilos in weight, and is now of a slender physique. He loves his old friends who have seen him through this journey, and has made lots of new friends also at University, including several damsels, around whom he still blushes. With his friends and new acquaintances, he mainly communicates by writing. He sends text messages, writes emails, does his written exams all on his own. With us, he also speaks and gestures. He often jokes to his old friends that because of their persistence regarding his weight issues he had to undergo this entire ordeal to lose weight!

Barkaat has had one exhibition in Lahore which was immensely well received: all of his work was sold. He wants to be a role model for people who face such grave difficulties in life to never give up. He wants his art to be a symbol of hope and determination, and a belief that Allah bestows the courage to face any trouble He brings you to. He is looking for a pretty girl to marry him and when he does, he will have 3 children!

P.S: to see more of Barkaat's work and his pictures, please visit and like his page on facebook : www.facebook.com/Barkaat.M