I was in the Changi General Hospital high-dependency ward. It was to be my home for the next 40 days. The left half of my body, which was my dominant side, had been paralysed by an acute stroke.
For the better part of the second day, I stared at the packets of origami paper presented to me by some friends and family members. I was bored, but not in any mood or shape for folding. I was tormented by negative thoughts as I tried coming to terms with the loss of the use of my dominant limbs. I was looking at the loss of my independence and not being able to continue with most of the activities in life that matter to me, including origami, which had been a passion and part of me for the better part of 45 years.
To relieve the grinding boredom, I took a sheet of paper and began playing with it. It was strange and cumbersome folding only with my non-dominant hand. Soon, I was reaching for another sheet of paper. And another. As the crumpled paper balls gathered about me, the negative thoughts receded into the background. Whether by design or by chance, the message that came with the origami paper became clear: I must banish the negative thoughts. Stop feeling sorry for myself, be positive and get to work on recovery. All is not lost.
I tried folding some of the simpler designs from memory. First, I folded a butterfly by Yoshizawa, then a flapping bird and David Petty’s beating heart. Before long, I was happily churning out lots of LaFosse butterflies, followed by Young Lee’s talking lips.
It did not take long for the origami models to be noticed. My fellow patients and their visitors were the first recipients, and it seemed that I was being paid more attention than usual by the hospital attendants, nurses, doctors, and physiotherapists. They were happy recipients of the origami, happy to learn of my passion for origami, and encouraged me to keep on folding. I was to learn that there is scientific evidence that repetitive activity and movement do stimulate the growth of synapses and new neurons. I was also advised to use my immobilised arm and hand whenever possible, even if it was as simple as placing that hand on the table and in close proximity as I fold. Such passive involvement of the affected limb does stimulate brain activity to establish connectivity with the affected hand. I began by using the hand and arm as convenient paperweights, picking it up with my good hand and dropping it where it could be useful.
The knowledge that substantial recovery was possible by engaging in an activity I love gave me hope. I had a clear objective. I was determined to do everything I could to be able to pursue origami again at my former level, and to recover as much of my physical faculties as humanly possible. I went through each supervised physiotherapy session enthusiastically, and repeated as many of the exercises as I could while lying in bed. I also folded and handed out so many origami butterflies that they soon came to symbolise my desire to be free from the restrictive effects of the stroke.
Some of my fellow patients were apparently infected by my enthusiasm. Despite their physical impairments, they cheerfully engaged me in friendly competition in physiotherapic exercises. The enthusiasm and positive attitude were not lost to the hospital personnel. I was to learn of this several months later, in a totally unexpected way.
I was still wheelchair bound when I was discharged from the hospital and referred to the rehabilitation centre at another hospital (St Andrew’s Community Hospital – SACH) for follow-up physiotherapy as an out-patient. My left arm was still as limp as a wet noodle, and the fingers on my left hand were as responsive as pieces of wood.
The first weeks of physiotherapy at SACH were quite uneventful. A significant part of the affected muscles had wasted away. My left arm had popped out of the shoulder joint (i.e. subluxation) as a result, and my left shoulder blade had dropped out of alignment. Physiotherapy at this stage was to stimulate connectivity between the brain and the affected body parts, to strengthen the affected muscle groups that were minimally connected, and build general physical endurance. On the advice of my physiotherapists, I had also undertaken a regimen of simple, daily exercises at home. I continued doing origami as well.
The physiotherapists at the rehabilitation center had learned of my passion for origami by then. I also found myself used increasingly as a role model for my fellow patients. Many of these patients had become withdrawn, inhibited, and disillusioned with life and the possibilities of ever making an eventual recovery. I was often asked to speak with them, to encourage them, and used as an example of the positive effects and possibilities of recovery with supervised physiotherapy. Some months later, I was invited to teach some of the therapists and patients to fold butterflies to be used as door gifts for events at World Physiotherapists Day. I ended up folding most of the butterflies for them as well as a second lot for another event for World Occupational Therapists Day at Changi General Hospital (CGH), where I had stayed earlier.
About a year after my discharge from CGH, I was hugely surprised to learn that I had been named the Most Inspiring Patient of the Year by that hospital. This was followed by a second, somewhat oddly named ‘Public Service Star Customer Award’ for the same year by the Singapore Ministry of Health. The award was presented by the Deputy Prime Minister of Singapore. This would not have happened without origami and the hope of recovery that origami sparked in me.
I was out of the wheelchair after several months and was walking without assistance or use of the walking stick after a little more than a year. My left arm is now sufficiently strong and controlled to allow me to perform 30-degree push ups, and getting stronger by the day.
While I have no doubt that origami played a significant part in my road to eventual recovery, I am equally convinced that managed and supervised physiotherapy is indispensable in my recovery.
The extent of my recovery so far is due largely to supervised physiotherapy. However, from the early days of my hospitalization, origami gave me the hope of making a recovery. Origami gave me a goal to focus on, kept me active mentally, and helped in the stimulation of connections in the brain.
Recovery from an acute stroke is a complicated, slow, and gradual process with many pitfalls along the way, which is best left in the care of trained personnel. Among a host of other possible repercussions, the weakened and wasted muscles tend to contract, and lose some elasticity. In the recovery process, different parts of the brain are stimulated to connect with the individual muscles of the affected parts of the body and have to be ‘taught’ to take over the controlling functions of the damaged part of the brain. Care must be taken to ensure that the correct exercises and amounts of resistance are introduced at the right stage of muscular recovery. For example, engaging in inappropriate exercises or using heavier than appropriate resistance can result in ruptured ligaments or pinched nerves, which could retard recovery.
A major concern of the stroke was the effect it had on my cognitive abilities. Thankfully, I was not too adversely affected in this regard. However, I did sense that my ability to concentrate had deteriorated to a certain extent. My mind will start drifting after awhile.
I decided to try addressing this problem with creative origami. However, there is only so much that I could do with one hand. I had to start with something simple, and not entirely original. I began by experimenting with different combinations of elements from Michael LeFosse’s butterflies. From there, I found that I could use these ideas to modify Akira Yoshizawa’s butterflies, with some innovations of my own as I went along. Before long, I had about 50 butterfles with unique wing designs.
My next project was a little ambitious. I wanted to design something with a fresh approach. And it had to be something fairly complex; I decided to design a tiger. Never mind if I was then not able to fold the beast yet. I had to visualize much of the folding process in my head, and to do the set of diagrams from the visualized folding process. Then I had to convince some of my origami pals to test fold the tiger from these set of diagrams. The first part required a great deal of mental focus and concentration on my part. The second part required some courageous souls willing to undertake my challenge.
Just two – Nicolas Terry and Gilad Aharoni – of the ten people who received the diagrams managed to fold credible tigers, Some errors were detected, not unexpectedly, and some improvisation on their part was required. Encouraged, I went on to design a rabbit in the same way, which was folded by Nicolas.
As time and my recovery progressed, I used origami as a way to develop better coordination with the fine muscles of my left forearm and fingers. This is probably the most complex and involved aspect of recovery and remains very much a work in progress.
As the arm became slightly stronger and more controllable, I tried moving it on its own to weigh down larger portions of the paper while folding with my right hand. This action helped to strengthen the muscles of the upper arm and shoulder further, and aided in the control of the arm, especially the forearm. In time and with improved control, I could position my hand to weigh down smaller portions of the paper during folding. It was particularly helpful when the rotator muscles – which turns the hand at the wrist – became more responsive.
As my left hand began to recover, ever so little by little, I began using it as much as I could, by attempting more involved origami designs, but sometimes without success.
I managed to fold Kawasaki’s rosebuds, which required the cupping of the rosebud in my left hand, while twirling the petals with my right. If I hold the rosebud too tightly, the rosebud will be crushed. If it’s held too lightly, it will be dislodged when the petals are twirled. It had to be cupped with just the right amount of pressure.
I was elated when I could manage this, and folded enough roses for everyone at the rehabilitation centre, with many more to spare.
Another difficulty I face is to get my thumb and index fingers to work together, as when we hold or pick up something small. The thumb and index finger are not yet able to come together without help. I am working on this problem with modular origami. Having folded the modules in advance, I will place each module between the thumb and index finger of my left hand, and position the left thumb, index finger and module appropriately with my right hand. Picking up another module with my right hand, I then bring both hands together, to insert the tabs into the slots of the respective modules. It is a very slow and tedious process. I attempted assembling a 6-piece, Fuse modulars first, and worked my way through larger assemblies. The assembly of a 48-piece Fuse modular – which most modular origami folders would usually assemble in an hour or less – required four days of effort, aching shoulders, frazzled nerves, spring clips and (shhh…) glue. Still, the effort was worth it for the mental stimulation and exercise in physical control.
Apart from inadequate use of my left hand and a gimpy gait, I am able to live my life almost as independently as before. The stroke may have been a traumatic experience, but it has given me a new dimension in the use of origami and in life. The experience and origami have enabled me to reach out to others in a similar situation, bring them a little joy, and – more importantly – hope.