Surrounded by doctors and nurses, the man in the hospital bed, paralyzed from his waist down, worried about his upcoming move to a rehabilitation center.
Dr. Jesse Lieberman tried to reassure him.
“There's life after injury,” the young doctor said. “You can do all kinds of stuff.”
Lieberman, who at 31 is finishing his third year of residency at Carolinas Medical Center, knows what he's talking about.
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Five years ago, a spinal cord injury left him paralyzed from the shoulders down.
Lieberman was a third-year medical student at Wake Forest University in February 2003 when he fell three stories from a balcony while helping a neighbor who was locked out of her condo.
But he didn't let paralysis stop him from chasing his dream.
As a patient at Carolinas Rehabilitation, next to CMC, he became friends with rehabilitation specialists who helped him realize he could still become a doctor. Through his experience, he decided to work with others who are facing life after brain and spinal cord injuries.
“I've wanted to be a doctor since I was a little kid,” Lieberman said. “It was going to take much more than this to stop me.”
In August, he'll move to Pittsburgh with his wife, Michelle, and their 5-month-old twins, Saul and Gracey. There, Lieberman will do a yearlong fellowship in spinal cord injuries before returning to Charlotte as a full-time physician at Carolinas Rehab.
Despite his disability – or maybe because of it – Lieberman's colleagues say he's already an exceptional doctor.
“He has experience he can share with patients,” said Dr. Patti Shannon, one of his residency supervisors. “He knows what it's like to be in their situation. It's kind of hard to look at Jesse and say, ‘I can't.'”
A devastating fall
A California native, Lieberman moved to Charlotte with his family when he was 15. With his eye on a medical degree, he focused on science courses at Providence High School and got a zoology degree from N.C. State in 1999.
As a college student, Lieberman discovered bodybuilding. At 5-feet-8 and 215 pounds, he could squat 455 pounds in sets of 10. He was preparing for the Mr. North Carolina bodybuilding contest.
Then on Feb. 15, 2003, he went for a walk with his dogs just before midnight. In the stairwell outside the Winston-Salem condo he shared with his fiancee, Michelle Wilson, Lieberman ran into a neighbor who had locked herself out. The door to her balcony was unlocked, she told him, so Lieberman offered to climb down from his and Michelle's third-floor balcony to let her in.
He was outside the railing and hanging on when it broke in his hands. He fell backward. His feet hit the neighbor's balcony below and flipped him upside down. He landed on his head on the concrete sidewalk.
The injury to his upper spinal cord left his arms and legs paralyzed.
Lieberman was in a Winston-Salem hospital for two weeks. Then he came to Carolinas Rehab, where he was cared for by Dr. William Bockenek, the hospital's medical director.
Bockenek encouraged his young patient to take a year off from medical school so he could recuperate.
“I said, ‘To do what?'” Lieberman recalled. “I'm pretty stubborn.”
Staying on track
So, only 10 weeks after his accident, he was back in school, using a motorized wheelchair, and with lots of help from Michelle, an occupational therapist. Each morning, they gave themselves three hours to make time for her to get him ready and then get herself to work too.
He graduated with his class on May 17, 2004. Then on May 22, he and Michelle married at Temple Beth El in Charlotte.
That July he started his first year of residency, in internal medicine, at East Carolina University. The Greenville, N.C., residency program was the only one that accepted Lieberman, who needed lots of assistance. The teaching hospital, Pitt County Memorial, hired a nurse practitioner to be with him during the day. Friends and relatives raised money to pay for assistants who helped him at other times.
After one year at ECU, Lieberman moved to Charlotte to enter the residency program in physical medicine and rehabilitation at CMC and Carolinas Rehab. Lieberman's injury had dashed his original plans to specialize in anesthesiology because he couldn't use his hands to intubate patients. He considered radiology or psychiatry, but decided to put his experience to better use by working with people who had suffered injuries like his.
Without the use of his hands, Lieberman relied on others to do physical exams of patients. But he did the rest – medical history, diagnosis, treatment – by using his calm voice and careful observation.
Lieberman will complete his training in August, about two months later than his peers. He's making up for time lost when he was treated for skin breakdown, a common problem for spinal cord injury patients who can't adjust themselves in chairs and in bed.
Each morning when Lieberman wakes up, he remembers that he can't get out of bed, and for a moment, he mourns his loss of mobility once again.
But then, when the certified nurse assistant arrives to get him ready for work, he moves ahead.
Early on, he blamed himself for his mistake, for having even tried to climb from one balcony to the next. But others reminded him that he was just trying to help someone else. It was what they would have expected of him.
Pragmatic and serious, he refused to let grief take over.
He focused on the positives: his brain wasn't damaged in the fall; Michelle stuck with him; he could still be a doctor; he retained some movement in his biceps and shoulders.
The doctor's routine
He has enough strength to move his arms, to push his hands against the joystick to control his wheelchair. But he can't move his hands. At rest, his fingers curve toward his palm in a half-fist.
With the help of a wrist splint and special dinnerware, he can feed himself if someone puts his food on the table and cuts it up. He can brush his teeth if someone puts the toothpaste on the toothbrush.
Each morning, Michelle Lieberman packs her husband's lunch and prepares his breakfast while she feeds the twins. The nurse assistant drives Lieberman to work.
“This isn't easy, but we do it,” Michelle Lieberman said. “He'll say he would not be here without me. I agree. But I think I handle it better than most because I'm an occupational therapist. To me, everything is adaptable.”
At Carolinas Medical Center, Lieberman's independence depends on another certified nurse assistant, Patty Aykroid.
“She functions basically as my hands,” Lieberman said. “She's not allowed to do physical exams, but she does everything else.”
Aykroid writes notes as they make morning rounds. She grabs thick patient charts from the shelves, opens them to the right page and sets them on his wheelchair tray. If he needs to dictate notes, she sets a recorder on the tray.
Before he enters a patient's room, she squirts a dollop of white foam cleanser from the wall dispenser and rubs it over his hands. When it's time for his mid-morning protein shake, she pulls a plastic jug out of a lunch box hanging on the back of his chair. He balances it between his wrists and drinks from a straw.
Aykroid and Lieberman have been together for about a year and a half. She knows when to stand back and when to step up. As he put his wheelchair in reverse to back out of one patient's room, she reached out gently – “Hang on, Jess” – to stop him from running into a passing cart.
“I've been doing this for five years,” Lieberman said. “I'm used to being in the way.”
Part of the scene
On the trauma floors at CMC, room after room is occupied by 20-something males who have suffered brain and spinal cord injuries in accidents.
In that setting, Lieberman and his whirring wheelchair don't draw special notice.
He's part of the circle of doctors who regularly discuss cases in the hallway. Some stop to admire pictures of the twins displayed on his wheelchair tray. Patients recognize him and seek his advice.
“Jesse, when you use the power chair, how do you grip it?” asked Joey West, lying in bed with his neck in a brace.
The 23-year-old Charlotte man has been unable to move his arms and legs since June 9 when his Jeep flipped over five times.
Lieberman demonstrated his technique.
“You'll be able to do everything,” he said. “I'll come see you every day over there.”
“Awesome,” West said.
Using his shoulder and biceps, the young doctor reached for the joystick and inched his chair closer to the bed.
Slowly, he lifted his arm.
His curled fingers reached toward the patient.
West slowly lifted his own shoulder and arm until their hands touched.
A fist bump – or as close to one as they could get.
Then, Lieberman backed up and rolled down the hall to see his next patient.