Personal Story of Head Injury: A Story Without A Title

Lately, I question everything I do because I forget. You see, in 2012, I suffered severe head trauma that doctors missed. Since then, I had several hypertensive crises and mini-strokes with residual weakness. The first stroke, two months  after the head injury was because doctors continued the meds that raised my blood pressure and caused the head injury.

In 2017, a neurologist finally diagnosed my symptoms as  classic head trauma.  Before that, I carried a diagnosis of “abnormal behavior,” PTSD and HTN. Little mention of the hypertensive crisis or stroke which I think my PCP at that time did not believe was real. I had to change doctors to get the care I needed. In July, I will meet with a brain trauma specialist who I hope will help me.

What was it like to live with undiagnosed brain injury? Painful, very traumatic and destructive to my life and relationships. In the early days after the head injury, I woke up and often forgot to get out of bed. Or I would get out of bed and sit in a chair by the window for hours without moving. I would forget to wash my face, bath, get dressed and even eat. Activities of daily living (ADLs) were challenging, and I was alone without help. Took me 3-5 times as long to do simple tasks.

I also dreaded going out in public because I didn’t want anyone to know I was different. Living in my head and overwhelming fatigue made me an invalid.

I knew something was wrong but couldn’t figure it out. Deep down I suspected brain injury but didn’t want it known. I feared it would be the end of my career and it was.

This post has no title because I’m not sure where it’s going. Maybe it’s an explanation for why I haven’t followed through on many stories or why I have imprisoned myself. Or perhaps it’s the beginning of my recovery.

Be patient  as this story slowly unfolds.  Last year, I was in an extremely dark place when I found a flashlight.


Source of Images: Pinterest

My Medical Journal No 7 : Still Waiting…

Not better
Not better

My Medical Journal No 7

My right foot drop is no better.   I am developing atrophy of those denervated muscles. As the muscle atrophy,  I believe  my leg gets heavier to lift because it requires more effort,  I tire more easily and injure myself more often.   Most alarmingly is the buckling of my right leg/knee when I put my full weight on that leg.   Remarkably,  I am learning to live with this, at times,  I forget and  move too quickly.

Other symptoms noted:

  • Daily cold then numb fingers and toes on touching anything cold– washing my hands under cold water or drinking water from a cold glass. The numbness is discomforting, at times painful, lasting hours with color changes in my fingers and toes. I wear socks on feet and hands to keep them warm. This is getting worse.
  • I think my right leg is numb. When I injure it I do not feel pain. For example, a heavy book landed  on my right foot and I did not feel it or pain,  I do not feel pain when I stub my right toes while I do when I stub my left toes.    I feel pain when I twist my left ankle not my right  ankle which I do often.
  • Finally, I am developing some weakness in my right hand. I drop  things and I have difficulty lifting and holding onto heavy objects with my right dominant hand. The weakness is subtle and does not bother me unless I try to lift heavy objects which I no longer do.

Still no brace…went to the wrong place…they have the prescription and said they would take care of things….I am still waiting. I have two upcoming appointments with neurologists, one with my general neurologist and the other with a peripheral nerve specialist.

I wonder if I have some type of autoimmune process, a vasculitis,  given the numbness in my fingers and toes along with the stiffness in my hands   Not sure if I had an ESR or CRP when I was admitted about 2 months ago. Another thing to check on.   While my back feels better I still have pain that keeps me in bed  and I believe this pain radiates to my lower abdomen where I seem to have more and more discomfort.

Our healthcare delivery system does not make it easy to accomplish simple tasks. I have yet to have social service take a real interest in helping me. When last I checked I called and left messages that was before the new year…I am still waiting. I  have great difficulty and would like social services but I am tired of calling and the truth be known I don’t want strangers around me.

Our healthcare delivery system sucks because it does not deliver HEALTH or CARE….I wonder where does the money go and why are there so many services not available to those who need them.

Tired of waiting....
Tired of waiting….

The Fittest Survive To The End

The Fittest Survive To The End!

By Roald Michel

Invading cancer cell
Invading cancer cell

There was this tiny, beautiful, and lovely cancer cell. Having passed the early stages of childhood, its cancerous parents sent the little one to cancer school to be taught the facts of cancer life. It read Darwin’s “On the Origin of Species” from A to Z and back. After graduation it passionately went out into the world, joyfully participating in the survival of the fittest contest.

One day it found an extremely healthy human, full of life and on the road to complete happiness. Cancer cell thought: “Hey, what a nice body to do some wrestling with”. And so it nestled itself comfortably in the human’s liver. And it grew, and grew, and grew some more, battling its competitors, taking over their businesses, and establishing a cancer holding. The day came that cancer cell needed to expand its routine beyond the liver world, and so it went out into the body of the human and invaded the left lung of it, ruthlessly competing with the other cells over there. Having sublime strategic management skills it prospered, and prospered, and prospered some more. It must be admitted, by this time, the revenues and profits were immense. The liver-lung merger paid off beyond the wildest expectations of the cancer board.

cancer cell spreading to a smoker's lung
cancer cell spreading to a smoker’s lung

Addicted to success, awards, greed, and never ending exploitation of other cells though, it had, in the spirit of its master, to compete some more, and more, and after that, even more. And so a cancer empire became a reality, reigning supreme over the (not so healthy anymore) human body. The struggle was over. The fittest survived. Then the body died. And so did the cancer cell and its empire.

The End

Owner/Director, Profar Consultancy NV. Mainly busy with making people to own their life, actions, and thoughts (again).
Owner/Director, Profar Consultancy NV. Mainly busy with making people to own their life, actions, and thoughts (again).

A Story From The Balcony: Group Dynamics


A Story From the Balcony: Group Dynamics | Part 3

The Ideal

Based on the Drexler/Sibbet Model, we went from stage one—orientation—to completing the task without entering the intervening stages. I believe this is usually the case where groups form around short-term projects. The stages required to build trust take time and respect for all ideas.

Drexler/Sibbet Model
Drexler/Sibbet Model

We did not clearly identify  problems,   and most importantly, communicate a common vision for the group. An  consensual agreed-upon structure would have defined the group further and helped develop group norms. Limited time and the need for creativity make different approaches that, in essence, bond people.

A common vision is paramount to jump starting any process of building a relationship or starting any project. The other paramount ingredient is the respect for all ideas. The notion of respect for all ideas is essential to keep all stakeholders at the table lest the table become singular. The above two elements, along with feelings of connectedness, bring transformation with multi-perspectives–the essence of innovation. This encompasses the IDEO model and more. An idea that may sound weird, when flushed out a bit, usually spurs other ideas; suddenly, we are adaptive, thinking of outside-the-box, real, creative ideas.

I disagree with the Drexler/Sibbet model, which notes that trust comes before goal clarification, because people need solid reasons to gather and take time out of their schedule — making framing of goals or intentions very important for getting stakeholder buy-ins. That allows for interactions that, if positive, will lead to trust and relationship building. This strengthens stakeholders’ commitment. A clear vision lends itself to prioritizing goals and aligning them with resources.

When all ideas are acknowledged and discussed, the end result can be creative and innovative. This is facilitated by focusing on common visions whilst anticipating conflict. If a conflict is handled with respect and inquiry, the result will be high-performing teams (or communities) with innovative ideas.

Given the pressure and discomfort with the topic at hand, our class overlooked the above. In my opinion, we went from the task to the solution without understanding the problems. My attempts to understand the problems and the right questions were met with fierce resistance. In my mind, how could we begin to tackle an adaptive problem without understanding the perspective of the afflicted communities and their families? There were basic questions that were never answered. These include:

a) What were some explanations for the large disparity in infection rates between black females and black males?

b) Why was the ratio of sexually active black teenagers similar to white teenagers, while Chlamydia infection rates between the two groups were disproportionately out of whack against black teens? (Sexual activity rate is similar between black and white teens while chlamydia infection rates are much higher in black teenagers than white teenagers. Why? How was chlamydia reduced in white teens?) Those questions were basic research questions that suggested other factors were at play, and that Prof Wang’s lecture did have relevance beyond due mention of subject matter.

Other questions best answered by communities follow. The process of discovering the many narratives behind those questions often lead to trust, better partnerships and collaborative efforts:

a) What were the trusted communication sources within this population? How was information transferred?

b) What were the demographics and cultural dynamics of these communities?

c) What were the access issues to treatment?

d) If the stigma of STD was the sole factor for not seeking care, why did many other cities seek onsite testing?

e) What was the standard of care when sexually active teens presented for a physical? What was it when they presented for screening or an STD? How did those standards compare to non-disadvantaged communities?

f) Were their other medical problems with such racial disparity? These were important questions; unfortunately, I was ineffective in articulating them. Soon, many of my classmates stopped listening the moment my mouth opened.

The Conclusion

Were my actions adaptive? Did I exercise adaptive leadership? Was I a team player? My actions were adaptive; I asked the difficult questions and made people feel uncomfortable. I discovered the power of writing; my use of the Wiki was more  therapy than a way to be heard. It surprised me to discover that my classmates were reading my blog. They were paying more attention to my blog than my spoken words. I used that opportunity to make inroads by providing a narrative for those communities, with some success.

Part of leadership is orchestrating the process of change. While I did turn up the heat and increased the awareness of some of my classmates, many were unprepared for the discomfort. I worried my last blog would undermine the project. I am glad it did not. It will take practice to develop the art of orchestrating conflict, especially with younger ones. 🙂

In conclusion, group dynamics inevitably leads to conflict. It is important to  anticipate conflicts; never ignore them.Conflicts represent opportunities for greater understanding and bonding within  groups.  Never ignore conflicts lest they become future minefields.

Part 1:  A Story From The Balcony

Part 2:  A Story From The Balcony: The Disconnect


Things seems so different now...
Things seems so different now…

The tree of knowledge of Good and Evil

my little totekkie has many faces... Image by Roald Michel
my little totekkie has many faces…
Image by Roald Michel

Trusting me to do the good thing by Roald Michel

Remember me saving that baby iguana? Here’s another story from my encounters with animals. This one was originally published on a so called Christian site discussing evil. You’ll see it’s quite appropriate to see the light of day in this Syrian thread as well. And not to forget the “fear negotiating” one.

I entered my garden one day to get rid for a while of the usual cacophony that surrounds me on a daily basis. Waving palm trees, luscious flowers, singing birds, hard working ants, and cool fish, were greeting me as I made my way to the pool. And then I saw it: A totekkie drowning, desperately trying to climb out of the water, but to no avail. So I took the little one out. My good deed for the day. While still holding it in my hand, she asked: “Are you God?” Totally caught off guard by her question, I hesitated a bit, but then I said: “No, I’m not. Are you?” “Of course I am, and so are you!” she replied a bit impatiently.

Together we sat down in a cave close to the pool, and she explained: “You see Roald, we all are God, or if you will, God is in all of us. See that rock over there next to the shower? That one is God too. And that precious trupial cleaning its feathers on a high-voltage cable outside on the street? Yes, that one too.”

The sun was setting, and soon we could see the moon and the stars. Still wondering I said: “Is Venus God too? And the moon? And Antaris? And……..” She looked up to me, and I could feel her annoyance with me now. Then she said: “Hmmmm, you didn’t get it yet, eh? Must be because you’re a human. Animals, plants, and even lifeless objects have no problems at all being God. They never argue about it either. They simply are what they are. I mean being God, eh? Yeah, come to think of it, only humans are constantly babbling, bickering, fighting, and killing each other over God. Guess it’s because they fear to be divine, or something.” She caught a stray fly and devoured it. Bewildered I said: “How could you do that? You say you’re God, no? And God is good, no?” She licked her lips, smiled, and replied: “Yes, of course I did that. And it was good too, hehe!”

We were silent for a while. She enjoying the cool trade winds and ready to kill yet another daredevil God passing by, and I engulfed in spiritual chaos.

Finally, when she was half asleep already, I dared to ask: “If we all are God, how come there’s so much evil, misery, and sorrow in this world?” She yawned, and said: “Roald, that kind of stuff only exists in the human world, your world, not in the rest of it.” I could only stare at her, confused, angered, and helpless. “What nonsense is that?” I replied with elevated voice. “Are you telling me that when you torture, kill, and even eat your victims alive, this is not evil, not creating misery and sorrow?” “Nah, not at all” she said. “It’s just the way it is, and in human terms, all good.” I couldn’t believe my ears! There she was, claiming to be God, while murdering all kinds of small living things (Gods too in her conception) without the blink of an eye or the tiniest sign of remorse. Pure evil that one!

A dark cloud moved in front of the moon, darkening my world even more.

“Humans are a mistake” she suddenly said. “Well, not really a mistake at creation, but they grew into it so to speak. They never should have eaten from that tree, you know? Yes, you know what I’m talking about, don’t you? It’s that tree of the knowledge of good and evil. Well, that’s how you people tell the story. Thank God, we never ate from it. Only humans did. And as far as I know, still do. Along the way, humans also picked up yet another brilliant fruit, called it ‘free will’, ate from it too, liked its taste, and got addicted to it. Since that time you people are slaughtering each other in the name of it. Freedom fighters and free thinkers contaminating and polluting the place everywhere now. Talk about evil.”

At that moment, she grinned, jumped off my lap, caught another unsuspecting God, swallowed it, and laughed like only a totekkie can laugh.

“Free will by itself is not so bad”, she continued. It’s the way humans handle the thing which made, and still is making, a mess out of it. Not that I would want to have it though. Doesn’t taste well, I’ve heard, and would make me vomit. I rather stick with plain choices. I make choices all the time. And all of them are perfect, because I don’t have to bother about good and evil like you humans must. What makes it even worse is that even if you know you made the wrong choice, you’re coming up with all kind of excuses and rationalizations to still make it look good, while actually it’s dripping from pure evil. Yeah, free will at its best!”

She nestled herself in my lap again, looked me straight into the eye, and whispered: “Still you and the rest of humanity are God, you hear! Maybe a bit twisted deity, but God nonetheless. There’s simply no other way Roald, even if you deny it.” Then she mumbled something about atheism I believe, but I couldn’t grasp it, because she fell asleep, trusting me to do the good thing. And so I became her guardian angel for the night.

Roald Michel

Roald Michel, Owner/Director, Profar Consultancy NV. Mainly busy with making people to own their life, actions, and thoughts (again).
Owner/Director, Profar Consultancy NV. Mainly busy with making people to own their life, actions, and thoughts (again).

A Story From The Balcony: The Disconnect

The Disconnect
The disconnect

A Story From The Balcony: The Disconnect

The Team

The stage was set perfectly for controversy. We were given an impossible challenge where our competitive nature and need to shine in front of important people were at risk if we did not complete the task. Each of us had our own agenda and needed to be a leader. The problem was the same beliefs and actions that contributed to health inequities or disparities were cherished values, foundational beliefs of the teams–that was the culture of our group dynamic. The ground rules were quietly cast aside, despite our tense discussion and agreement on those rules on day one.

We divided into six stakeholder groups in an effort to gather information, but we never identified the problems or set clear goals. There was no shared vision, only a sense that certain members were the decision makers. Their ideas, good or bad, received attention and recognition. My ideas were not received in the same manner. I felt people heard but did not listen, because they already knew where I was coming from.

The rate of gathering information varied, resulting in decisions without an adequate understanding of the issues. This led to the right answers to the wrong questions. Our stakeholder group did not make contact with a youth group until the last moment. We did a focus group with a wonderful group of lively, non-sexually active, honor students, trained to educate their peers who were sexually active, non-honor students. {One immediately appreciates the lack of thought and evidence that go into designing these programs. Money WASTED in the name of good.} While they were not the ideal target, they offered a unique, non-stereotypical view. Given the discussion in class, I was excited to let my teammates know such Afro-American teenagers exist. This information was not given the deserved respect or attention by the team–I guess they didn’t believe.

While we were conducting the focus group, I noted an older black lady quietly sitting with her head bowed, but eyes peering carefully at us, making sure no harm came to her teenagers. In engaging her, I realized she could provide a wealth of information, and she did. Her alias is Ruby. We had a great conversation about her community, STDs, and the healthcare delivery system in her community. Her suggested solutions were brilliant in their simplicity; however, the class rejected this information. She was over 50–how could she possibly know what teens are up to working in a teen center?

My teammates did not believe that a black woman – a parent, a grandmother, living and working in the target community – is reliable or resourceful. Her story was not what they expected. I was even accused of falsifying data by one of my teammates while the professors watched on. {Also her truth did not align with the DATA.}

The real problem was time; to my teammates, this woman’s story shattered theirs, believing her meant re-thinking our solutions: Chlamdyia bracelets, T-shirts bragging, “I am Chlamdyia free”, and Readers Digest. On that day, I felt the class had gone too far in disrespecting Ruby, the target community, and me.

The Disconnected
The Disconnected

The Disconnect

Here on the balcony, it was inevitable. It was inevitable that my outrage would lead to lack of understanding and the inability to communicate my concerns clearly. My classmates had a task and the clock was ticking, but for me, this was not just a project. I desired deeply to correct some of the misconceptions about Afro-Americans, and to share with the class how well intentioned programs can be just as harmful as doing nothing. This was “the disconnect” between my classmates and I.

The Chlamydia articles left me with many unanswered questions. The interchangeable use of cases and rates per 100,000 was very confusing. I got the impression that over 95% of Afro-American teenagers and young adults were infected. It was difficult to find the actual percentage. These articles seemed to imply that black teenagers’ early and frequent sexual encounters were the root cause of the problem. Yet Prof. XYZ articles implied that this racial disparity in Chlamydia infection rates was symptomatic of the various forms of discrimination: systemic, internalized, interpersonal, and structural. Here was the sine qua non of the problem; our opportunity to dig deep and understand the problem from another perspective. Instead, however, we glossed over it, creating a huge disconnect. We identified the problem as adaptive but thought only of technical solutions.

As the story continues…

A Story From The Balcony Introduction Part 1

A Story From The Balcony: Group Dynamics  Part 3

The Disconnect limits views and creates myths...
The Disconnect limits views, creates myths…and is harsh.

A Story From The Balcony

from the balcony...
from the balcony…

A Story From The Balcony


Leadership! My actions left me questioning my ability. The rationale behind those actions was similar to those of the Colonials in the American Revolution, standing their ground and creating their own rules of engagement with the British. Could they have read, “The Art of War” by Sun Tzu? I don’t know, but on that infamous Thursday when I was ambushed and bludgeoned, the lessons from that book raced through my mind, giving me the strength to strike back. So, now, I stand on the balcony, in control and with new appreciation and understanding for my teammates. Continue reading “A Story From The Balcony”