Twelve Lessons From Paralysis

Thud! The sound of the impact was the only sensation. I instantly lost feeling and movement below my chin. My eyes darted around the murky water and spotted my lifeless arms. Air escaped my lungs. I had just broken my neck in a diving accident. Friends came to the rescue and kept me floating. Paramedics rushed me to the emergency room, where an MRI confirmed a C5 fracture. Manual tests of each limb confirmed quadriplegia. Surgery commenced on the morning of July 27, 2019. 

A week later, surgeons told my parents that I had an incomplete spinal cord injury and added, “he might be able to walk in a year.” It was nebulous what function would return, and when. I couldn’t move or feed myself; my arms and legs laid idle. Nonetheless, I resolved to achieve a full recovery, and that I was ready to fight for my life. My battle began in intensive care while on life support, just trying to lift my right foot.

After two months of inpatient rehabilitation, I could walk a short distance before collapsing, and was discharged from the hospital. I was still severely limited and required living assistance. Nonetheless, I created my own regimen to target my goal. Over the two years that followed, despite the pandemic, I trained to not only walk but run, sprint, return to sport, find new employment and travel to five different continents.

Like the recovery itself, combing through the hundreds of lessons from my experience is an imperfect exercise. Here are a few that stood out.

We must begin where we are.

Many have asked how I ever managed to run again, which certainly isn’t part of the spinal cord injury syllabus. I make the analogy that my recovery was like building a skyscraper out of Legos. It was slow, tedious, and painstaking. Progress only became possible through mass iteration and failure.

To walk, I first had to fail at standing, then take baby steps while suspended from harnesses, then learn to use a walker, then walk a few feet independently with spotters. For a year after that I made The Tin Man look like a gazelle, but never wavered in my goal to run, and fell many times in the process.

My hands and arms were more frustrating by comparison. I would grit my teeth and envision them moving, trying to force the action I wanted. It took several failed attempts before I was finally able to tie one shoelace in ninety minutes, which was one of the most exhausting things I’ve ever done.

Progress only happens at the margin, which is true of any goal we set out to accomplish.  My task was to meet each moment with the entirety of my effort and do so with consistency. Over time that input accumulated, and I beat my prognosis. Today, I love to lace up my shoes and go for a jog.

I also learned that there is no such thing as a comeback, the world changes during the process and so do we. Our only starting point is the here and now. Most of the time the window of opportunity comes before you’re fully prepared.

Everything you want is on the other side of fear and pain.

Recoveries, career changes, great investments, and other positive shifts often begin in discomfort.

One of my first tasks in intensive care was to simply endure two hours in a seated position, which nurses used harnesses to place me in. The pain induced hallucination. Clearly, I wasn’t walking anywhere soon. I hated the chair and knew well in advance that the pain was coming. Nonetheless, I started spending extra time sitting. Pain was part of the process.

After my hospital discharge, I found that this concept applied to life more broadly. I was required to establish and then give up a series of comfort zones, moving ten times in total to find care, seek optimal environments, and avoid pandemic lockdowns. Once I felt strong, I began to test myself in nature, first by hiking in Utah and then by traveling the world. Entering and leaving each of those phases was accompanied by fear and doubt.

I was initially hesitant to share my story, but reasoned that if I could help someone else, then going public would be worthwhile. After a year of silence, I wrote an update to friends and family. Six months later, an unexpected message arrived in my inbox: someone had read my letter, used the resources I did, and had regained their ability to walk after being unable to do so for five years. It was a reward unlike any paycheck I’ve ever received.

Your loved ones are your lifeblood.

Intensive care felt like attending my own funeral. I was motionless, but friends and family filled the hours with laughs and encouragement. Thanks to them, I had less time to ponder my circumstances and instead channeled my thoughts towards everything and everyone that I had to live for.

When I first tried to stand, my therapist, Brianna, ordered my body to be hoisted from my bed and then lowered into a wheelchair by a mechanical lift. Her instructions were explicit, “I’m going to wrap my arms under your shoulders and on the count of three, I’m going to pull as hard as I can. See if you can push through your legs and stand.” I gathered a few breaths. “One, two, three!” She pulled with all her might. I focused all my energy, willing my legs to push. Nothing. We tried again. Nothing. Then my mom walked into the room; she had slept in the chair by my bed every night under fluorescent hospital lights. We tried a third time. “One, two, three!” Brianna grimaced, pulling with all her might. For two glorious seconds, I stood, wobbled, and fell back down into my wheelchair.

A month later, my left hand was experiencing its first signs of movement and I was trying to use it to pick up a bead and drop that bead into a container. I couldn’t do it. My eyes burned with hatred for that one menacing bead. Twenty minutes worth of failed attempts passed in futility. Then two friends I hadn’t seen in years entered the room. Smiles all around. On my next attempt, the bead dropped into the bucket.

Call it love, call it supernatural - our connections to those dearest to us bond us to the world we live in and give us the strength to be our best.  

Be grateful for what’s given.

I’ll never forget my first breath of fresh air, my first sip of water, my first taste of real food, my first visitor, my first trip outside for some sunshine. With those ingredients we can create just about anything, but we often take them for granted.

I was immensely lucky to spend nearly two months at Spaulding Rehabilitation Hospital in Boston. Some patients at Spaulding would voluntarily give up their therapy sessions, opting instead to watch tv. I would accept the extra hours every time. If we aren’t grateful for the present moment, then we won’t seize it and grow.

For two years my recovery took precedent over everything else in my life, but gratitude was just as paramount afterwards. Suddenly I had to face choices on where to live, work assignments, relationships, traveling, and keeping it all in balance. At times that was daunting. In those times it was important to be grateful for what I had, and to remember that I couldn’t do everything at once.

Recently, I faced abundance of choice on the opposite side of the Earth, as a solo traveler in Istanbul. I found myself at the crossroads of Europe and Asia with access to dozens of dream destinations. I meditated and opted to visit long-lost family in Lebanon. I had a beautiful experience – celebratory shots on election day, towering Roman ruins, a day in a seven-thousand-year-old city, and in that city a thought that struck during a Catholic mass held in Arabic – be grateful for what’s given.

I certainly didn’t set off on this journey intentionally, but I am immensely grateful for the lessons, new friendships, and unexpected opportunities that it’s provided. I still take a minute to appreciate my first sips of coffee in the morning, and a breath of fresh air. We may only get today.

Dance and enjoy, remember the time you couldn’t.

Injuries and setbacks can be devastating, but they can’t take our capacity for humor. My journey was filled with laughs of all varieties. Self-deprecation was often a useful form of levity. We can always make a joke out of things, and we should, because the same joke will get old, and then we’ll learn the lesson. When I could first dance awkwardly, I resolved to never stop.

I learned to slow down and embrace my journey, and often refer to a Spanish phrase, "sin prisa, pero sin pausa," which means, “without rushing, but without stopping.” It was important to enjoy the process.

A piece of advice I always give to fellow survivors is not to put too much pressure on themselves, which tends to make things rigid and unpleasant. We have a tendency, born from our need for narrative, to force meaning onto impactful experiences. Those answers arrive with time; don’t stop living.

Milestones large and small became cause for celebration. While my world travels were driven by curiosity, they were also an acknowledgment of how far I had come. I recently opened a pickle jar for the first time in years and was ecstatic. I can still be found dancing in New York City jazz bars.

Stay open minded. Try things. The solution you need might be right in front of you.

Some of the best resources I found during my recovery came through chance encounters. My first trainer came by word of mouth. I attempted a yoga class at a local YMCA, and while I couldn’t get up from the ground, I found a practice that eventually enhanced my flexibility and mindfulness. My most trusted physical therapists also came by word of mouth. I embraced acupuncture as a form of active rest, a way to work while I wasn’t moving.

The arrival of the pandemic changed everything but my end goals. I lost access to occupational therapy for my hands but found a Pilates instructor with valuable knowledge; who would have thought? For a while, leg exercises were replaced by marching up my boiling building stairwell in Miami. Intent on running, I asked around for a phone number for a local track coach; Shawn Anderson of Oceanside High answered the call and we stumbled until it happened.

I started streaming live dance classes into my Manhattan living room, bumped into the desk a few too many times, and realized I needed to try something else. I moved to Miami to train with Barwis, where the team applies techniques developed for professional athletes to people with spinal cord injuries. I only knew about Barwis because of an Instagram feed that was first shown to me while speaking with strangers at the beach.

Be present, keep your eyes and ears open, ask around. If we slow down and look, there are little bits of positivity and information everywhere.

You only get one body.

The human body is incredibly tough, but not to be taken for granted. If you listen closely, it will tell you everything you need to know. Do what makes you feel good, and get a good night’s sleep.

The world is a hard place. Be kind towards others and yourself.

As I was discharged from intensive care, we were warned that thieves will sometimes attack weakened patients to rob them. One of my nurses was deep in debt from paying for her medications to treat a chronic illness. I witnessed a teenage girl take a step who was never supposed to walk, but her insurance ceased payment the following day.

Our environment is tough, but our superpower as humans is to connect. Throughout my journey, I was astounded at how many times kindness opened doors and lit the way forward. As I progressed, I felt a sense of mastery that came along with giving back, whether it was through fundraising or working directly with spinal cord patients. Helping others aided me in cementing my own recovery.

We often have no idea what someone else is going through. In one instance, I was struggling with shaky hands to hold on to a few items at a Rite Aid and placed them on the counter next to a man who nearly assaulted me. I don’t know what might have happened to him that morning.

We also need to remember to be kind to ourselves: accidents happen, we sometimes make bad choices, we need to forgive ourselves to make the best of what we have.  

Journal.

Like running after paralysis, these lessons didn’t arrive on paper after a few hours of writing. They were found combing through years’ worth of journals.

After I was discharged from inpatient rehabilitation, I knew that progress would not come easy, so I decided to keep a log of my activity to ensure that I was adhering to my plan. My log forced me to show up on days when I wanted to stay at home. Measurement led to accomplishment.

Later, I broadened my writing to assist with making key decisions and to keep track of my journey in real time. Especially when we get stuck or have a major life event, we can get distracted by focusing on minutiae or the pain of the present. Journaling kept me focused on my long-term goals.

Daylight is coming.

If we can hold on through the hours, days, and months of pain, it will eventually subside. My moments of darkness were many – awaiting Byzantine insurance approvals, feeling stuck, lostness, coping during the pandemic, trying to find home again.  

The pain ultimately relented every time, and growth took its place. In a moment that sounds scripted, I walked alone to the Cape of Good Hope in South Africa two years after my accident. It was cloudy overhead. I walked past ostriches and spring bucks up to a lookout at Cape Point. Everyone had vacated and the park had closed. Then to the West, a gaping hole opened in the clouds and sunlight burst though, setting over the Atlantic. Many trials had led to that moment, but I felt the makings of a new beginning.

Make your own rules. Trust your instincts.

Spinal cord injury, work transitions, ten moves to find care and navigate the pandemic, world travel - my path had so many unexpected plot twists that I eventually came to realize the uniqueness of it. As much as I appreciated outside input, it was ultimately up to me to make difficult choices that oftentimes left others wondering. I second guessed myself and pondered alternatives but trusted my intuition. Only afterwards did certain choices make sense.

We can always say no, and change course if need be. If it makes sense to you, it doesn’t have to make sense to anyone else. Only you know 100% of the facts. We must own our outcomes, separate those outcomes from decision quality, accept that we won’t get it right 100% of the time, and put our best foot forward.

What mattered at the end.

Immediately after the accident, I had about thirty seconds under water that could have been my last. It took only a few to realize what had happened, and that I was running out of air. My first thoughts went to my friends and family; I was grateful to have known and loved extraordinary people. Next came a satisfaction that I had lived a full life of experiences and adventure, it hadn’t been dull. In preparation for crossing to the next realm, I thought I had aspired to decency, but without specificity acknowledged my faults; I hoped I was ready.

Much later on, I was struck by a thought that there are several currencies in life: time, health, money, knowledge, relationships. Time goes one way. The others diminish without health, which also happens to be our only way to buy time. Money is like oxygen; we know when it’s running out and we use more of it in pursuit of our goals. Knowledge improves our ability to enjoy the others and enhances our ability to replace money. Our relationships are a result of how we allocate the others, and in turn are our greatest asset and source of joy. It’s best if we can get them all working in concert.  

First 500 Days

Dear friends and family,

First of all, thank you. As you know from the CaringBridge site that my mom created, my road since 7/27/19 hasn’t been conventional, and the encouragement you provided solidified my will to fight from the onset. It’s been a while since our most recent CaringBridge update, 12/1/2019 to be precise. The reasons for our silence in the interim were many. Also, the time had probably come for me to take over communicating in some form, and as everyone here knows, my mom was an incredibly difficult act to follow. However, my gratitude for this group - for you - has only grown since then, and I now feel compelled to share some updates and words of thanks.

The end of 2019 was one of the most challenging chapters of my journey thus far. I found myself freshly unemployed for the first time since college, which was frightening at the time. Meanwhile, the transition that we had planned to physical and occupational therapy in Miami for a few months was going awry. No number of hours on the phone or waiting at front desks with limbs in need of therapy seemed to be yielding results. Nothing was going right, and our hands were full.  

Thinking back on late 2019 reminds me of a quote that I love from Arthur Ashe, “start where you are, use what you have, do what you can.” Knowing that progress would not come easily, I decided to journal every single day the people that I trained with and exercises I did, so that even if I could not feel the gains day-to-day, I would be able to look back and know that the input was there. I made a habit of measuring progress statistics to stay on track.

Starting where I was, I limped down the street to dinner with John and Catherine Keith. They connected me with Gene Jang, a capable physical therapist with DBC Miami who works with some of the world's top athletes and NBA players. Importantly, DBC provided an inspiring place for me to train while the plan that we originally had in place faltered. On 11/21/19, I hobbled a few blocks further down the street from our South Beach apartment to a yoga studio where I met Sarra Adnani. Yoga, at first limited to child’s pose, became an important part of my recovery. Sarra and I became close friends and still practice together.

Meanwhile, I was making frustrating but small gains exercising my left hand with the occupational therapy staff at the University of Miami. Botox injections helped to relax the flexor muscles that kept my left hand stuck in a fist due to spinal cord damage. A special thanks to Isabel Cantor for working with me. I ordered a color-coded keyboard to re-train myself with typing and tried every hand gadget I could find from modern devices to Baoding balls dating back to China’s Ming Dynasty.  

The new year arrived, and my dad and I decided to give the driving range a try on 1/4/20. I could only hit the ball about 20 yards but did manage to land one in a chipping net. Mom resolved for me that I was going to get my driver’s license back and Judi Hamelburg provided the necessary training starting on 1/8/20. I used this newfound freedom to drive up to NeuroFit 360 in Pembroke Pines, where I found an innovative neurological rehabilitation facility. Guy Romain and his team pushed me in new ways that I didn't think were possible. I told Guy that I wanted to someday run again, and while my body wouldn't allow it, we got to work anyway strengthening the muscles that would be needed. He showed me a photo of a previous client who had gone on to run a marathon, and I redoubled my efforts. I owe a special thanks to Guy and Cristina Thurston for their creativity and dedication. I used the long drives home from Neurofit to listen to Christian sermons and those words gave me strength at a needed time to carry on.

In March 2020, as I was planning to return to New York City, covid-19 swept through the US and once again threw our plans out of balance. Gene and I continued to work out together; we wore masks, changed to a private location, turned off the lights and locked the door. My next round of Botox shots and occupational therapy appointments were delayed. On 3/17/20 I met Christine Rieder, a neuroscience PhD candidate at the University of Miami specializing in spinal cord injury. While Miami’s streets went dark, we walked around my neighborhood, trying to get a few more steps in each time. By the end of April, I could jog a hundred feet or so.

On 4/29/20, mom and I drove in a jam-packed Prius from Miami to our home in Maine, stopping by Spaulding Rehab in Boston for Botox shots along the way. Spaulding will always hold a special place in my heart for the care that I received early in my recovery. Even with covid looming and sadly being unable to visit my doctor and therapists from the inpatient days, I wasn't surprised to see that Spaulding was still operating like clockwork. I will always be grateful to Kevin O'Connor (MD), Rachel Benjamin (PT), Arielle Ziering (OT) and John Lowry (MD) and the entire Spaulding staff for the incredible work that they do and look forward to the day when I can see them in person again.

We made it home but needed to “use what we had” again to find trainers and expertise. In the meantime, I trekked around our beloved Rackliff Island in a snowstorm on 5/9/20 just to keep moving, it took a little over 35 minutes. Angie Vachon trained me in her basement since gyms were closed in Maine. On 5/17/20, I drove to my apartment in NYC to see if it might be a better option. As the brilliant skyline first appeared, the Whitney Houston version of I Will Always Love You came on the radio. The song was originally written by Dolly Parton as a farewell when she left The Porter Wagoner Show to pursue a solo career; perhaps it was a sign that I’d be away from home for a while longer.

I got to enjoy something I had always wanted to instead, a summer in Maine. My brother Curt and I exercised in our front yard. I was still intent on trying to run and asked Angie if she knew a track coach. She put me in touch with Shawn Anderson, the Head Track Coach at Oceanside High School. Shawn and I met on 6/2/20, became fast friends, and began training several times a week. By then I was able to jog small distances, and each week we kept stretching what Shawn referred to as my speed endurance. Over time these jogs got faster and longer, and eventually I was sprinting, a bit awkwardly but sprinting nonetheless. I'm grateful to Shawn for taking on what must have seemed like quite a strange assignment. Maine gyms opened and I began training regularly with Chris Chacon at CJ Strength, who helped take my conditioning to new levels.

On 6/17/20, I made an unforgettable drive under sunny skies through Maine and across Vermont's Green Mountains to visit Will Morris in the Adirondacks. Somewhere between Middlebury and Keene Valley, I hit 125mph on a straightaway with the top down. On 6/19/20, Will, Jamie Wilson and I along with others hiked to the summit of Noon Mark, a 3,556-foot peak. Jamie and Will came to see me in my early days following surgery while I was in intensive care, but I could barely see them because I was hallucinating from the pain and meds. I wasn't quite sure if I'd make it down but thankfully had Jamie to spot me in case of a fall.

Shawn and I kept training and barely broke our goal of an 11-minute mile with a 10:55 on 6/25/20, a goal that we set arbitrarily but hopefully. On 7/10/20, I drove back to Gibson Island to visit the Daly family. Clinton Daly's actions in the seconds and minutes after my accident saved me from drowning and as my surgeon put it at the time, gave me the opportunity to “maybe walk in a year.” Nick Daly took over for Clinton that night in the ER, and along with my mom organized the CaringBridge site and stream of visitors that gave me the inspiration to fight from the very start. We enjoyed the beauty of Gibson Island together as we had many times before.

I celebrated the one-year anniversary of my accident on 7/27/20 by running with Shawn and walking a few more laps around Rackliff Island. My extended family and I enjoyed a stunning Maine August out on the water, up on the mountains and under the stars. I was also blessed to spend much valued time with my beloved grandmother, Alice Gorman. On 8/17/20, Shawn and I set out to beat our new goal for a 10-minute mile. He jogged in front of me to keep the pace and coached and inspired me the whole way, we finished at 9:25. I swam frequently with paddles attached to my hands to keep them from closing into fists and started to notice my upper body getting stronger.

On 9/6/20, I ran around Rackliff Island in 19 minutes and 59 seconds, just under my goal of 20 minutes and just over half the time that the same distance required in May. Just a few days later, I drove to New York City with the intention of returning permanently. Tucker Pribor and Mary Galbraith greeted me with open arms and helping hands to move back in. Over the next several days, I moved back into the apartment that I had rented just prior to my accident. It was like a time capsule complete with old grocery lists and dusty journals.

I signed back up for Gotham Gym, a favorite place of mine to train, and began working with Karl Eichenfeldt, another highly capable PT who was introduced to me by Gene Jang. I embraced my old habit of jogging down the West Side highway, even if it required far more stops than before. I went to Gotham Gym nearly every day and want to thank Rob, Randy, Chris, Mike, Trisha, Keenan, Steve and the rest of the staff for making it memorable and fun, even as we worked out with our masks on.  

I loved being back in my home and looking out the windows over Bedford Street into the familiar treetops. I saw friends I had missed and dined outside on the sidewalk. About a year prior, my brother Louis had submitted my story to the Peloton Comeback Program, which has a stated mission to, “provide motivation and accomplishment via the Peloton Bike to individuals who may be coming back from adversity in their lives.” I was honored to be selected to win a bike that was delivered on 11/6/20.

Throughout the fall, I saw Instagram posts from a fellow West Village resident, Pat Force, who also had a diving accident and spinal cord injury around the same time as me. I had been following Pat’s story since I had met his friends at the beach in Miami, where their loungers happened to be next to Jack Findaro and I. Pat was training at a facility called Barwis in Deerfield Beach, FL and I was intrigued enough to fly down and see it for myself on 11/12/20. Nick Lucius and Khanh Vo put me through workouts for a week and I realized right away that Barwis could be a game changer.

Upon returning from Barwis, I could sense that the covid situation in NYC had the potential to worsen and close gyms. Our family cancelled our planned Thanksgiving in Maine and we celebrated my dad’s 60th birthday via Zoom call. My cousin Ellie and the Smith family graciously invited me out to Far Hills the evening of 11/25/20, and I waited in line for 3.5 hours on 14th Street on Thanksgiving Day for a rapid covid test to make sure it was safe to join them; a folding chair, Amazon Kindle, and a turkey club from the Waverly Inn helped pass the time. Spending a long weekend with the Smith clan was worth every minute, and I'm grateful to all of them for their unwavering support.

After Thanksgiving, I made up my mind quickly that I was going to return to Florida and train with the team at Barwis, knowing that I needed to “use what I had” and that I now had something special. Within days, Jack and Pat Findaro looked at places for me to stay in Miami Beach and I secured a lease. On 12/1/20, I boarded a one-way flight to Miami with two rolling duffel bags. I'm enormously grateful to my uncle, Charles Bingham, for helping to make this part of my journey possible.

Since landing in Miami, I've been training with Nick Montoni and the Barwis team four times per week, 2.5 hours per visit. The sessions are brutal, but the results are adding up. Oftentimes, there isn't a good weight or band for a particular exercise, so Nick, Khanh and others use their bare hands to supply resistance. The evaluations and plans for each day that the Barwis team create are deeply thorough. Meg Sundstrom trains clients for 12 hours each day and then goes home to write my program. The environment is also highly unique, with professional and Olympic level athletes from all sports training alongside neuro clients working to improve from spinal cord injuries and other neurological challenges.

On 12/13, Adham Koura and I went to go hit on the squash courts; I almost canceled the night before but decided to try. Ordinarily, I’d have no business challenging Adham, and now here I was whiffing and moving like I was wearing a lead vest. He made the game fun and I gained faith that maybe I could play again. He also introduced me to Daniela Schumann, a former squash pro who now trains me once a week. My speed and coordination today are much improved from that first lesson, and I’m no longer whiffing.

Christine and I ran an 8:56 mile together on 1/2/21. I began the new year feeling fortunate to be surrounded by incredible friends and family, and to have the ability to “do what I can” in the form of a regimen that I believe is optimized for gains going forward. A large part of me wishes I had found Barwis earlier; it turns out Pat Force found Barwis by chance word of mouth as well. Such is life and I’m grateful to be here now.

This past Tuesday, 2/16/21, I was training with Nick Montoni and sat down for lunch in the lobby afterwards, drenched from my workout. A hand slapped me on the back and a voice said, “you’ve been working your ass off in there, you’d beat me in a race these days.” It was Chris Chambers, former wideout for the Miami Dolphins.  

I’m not planning to dial back anytime soon. If history is any indication, my physical address is bound to change many more times but as Sarra Adnani often reminds me, “your body is the only home you have.”  My left hand still gives me trouble, my left side is still lagging the right, and my upper body is lagging the lower body, but those gaps are closing. In the 513 days since I was discharged from inpatient care, I've journaled physical activity on 415 of those days, and worked with a professional on the majority of them. I’m building back my home.  

Why write this now? Some of the most positive turning points in this journey (e.g. finding Gene, Shawn, Barwis) have come from sharing my story openly. There is no replacement for relationships and the unexpected doors they can open. I've also been mindful every day of the immense gratitude that I have for those who have supported me. A recent experience with friends reminded me of the value of shared connection, something we're all a bit starved for at present. Finally, I’ve witnessed the unanticipated benefits that can occur when people like Pat Force share their stories, which in turn helped me. If these notes end up helping someone else working through a spinal cord injury or another difficulty, then they were worth sending.

Of course, I must close with a special thanks to my mom and dad, and brothers Louis and Curtis, who have been with me every step of the way. Not long after I was born, my great-grandfather, Charles Tiffany Bigham (MD), gifted me a copy of Rudyard Kipling’s If. The poem lays out a series of things one must do along the road to self-actualization, including the need to “fill the unforgiving minute with sixty seconds’ worth of distance run.” Thank you for running by my side during this unforgiving minute. I’m looking forward with optimism to many prosperous and healthy years ahead.

With love and gratitude,

MTO Jr.

Note: Some names have been altered for privacy.