Finding strength

What motivates people to overcome doubts, adversity and life-changing illnesses?

In this two part series, Missourian health reporters searched the Columbia area to find people overcoming odds who would share their stories. We met a cancer survivor and refugee, a college student with a terminal disorder, a recovering alcoholic and a determined science researcher. They have all cleared life’s hurdles and continue to endure.

We found there is no one answer as to what keeps them going. They have learned to accept their limitations, even confront them head-on, and make the most of every day. They seemed to embrace what others of us sometimes forget: that we’re all in this together.

Om Sehgal is a survivor.

He has been since his childhood in India when he had to flee for his life. In 1947, parts of India with a majority of Muslim inhabitants were partitioned to create Pakistan. Hindus were forced from Pakistan to India while Muslims were driven the opposite direction. A Hindu by birth, Sehgal recalled when religious violence surrounded his family’s home in what is now Pakistan.

One day, just before the partition, 15-year-old Sehgal and a friend went for a bike ride. They realized they were being followed by a group of men and dashed into a local market. The market manager told them they were in danger; the boys scrambled over an eight-foot canal and ran home.

A half hour later, while standing in his house, Sehgal watched the same men butcher an elderly Hindu man in the street.

A few days later, Sehgal, his brother, three sisters, mother and father left everything and escaped to the train station. People were everywhere, even on top of the train cars. Somehow, he and his family squeezed inside.

But safety was far away: The Muslim train conductor stopped constantly to let on ambushers. Men boarded the train, stole passengers’ belongings and abducted women and young girls.

The 50-mile train ride to the Indian border took about a day and a half. While all of Sehgal’s family survived the tortuous exodus, India was just as violent as Pakistan. Once they were in India, Sehgal recalled, an angry Hindu man boarded their train and demanded to know if any Muslims were present. A Muslim man tried to jump out and run, but he was caught and stabbed.

“After the train was moving I saw people dancing around his dead body celebrating,” said Sehgal, pausing and sighing. “It tells you that humans can degrade to the level of animals.”

Penniless, Sehgal’s family slowly rebuilt their lives. His father took a job in eastern India and Sehgal studied hard to make a better life for himself.

“It made me aspire for something bigger,” he said.

After excelling in his university program, Sehgal came to the U.S. in 1958 to further his education and career. In 1962, he took a position at MU, taught for 38 years and retired in 2000 as a professor of plant pathology.

Perhaps Sehgal’s childhood experiences of turmoil and survivorship helped prepare him for what was to come almost 60 years later.

In June 2004, Sehgal was diagnosed with stage three esophageal cancer, a rare disease with a high mortality rate. There are about 14,000 new cases of esophageal cancer annually in the U.S., and the survival rate five years after diagnosis is only 20 percent.

Sehgal immediately began a rigorous regimen of radiation and chemotherapy, receiving as much as his body could tolerate. He received chemotherapy twice a week and radiation every other day. After a month of grueling therapy, the cancer was gone. Surgery to remove damaged tissue awaited, but complications arose.

Sehgal lost his appetite and a significant amount of weight. Problems occurred when blood began to clot around the porta catheter, which was used for chemotherapy treatments.

Two months later, when Sehgal was strong enough, a thoracic surgeon at Barnes Jewish Hospital in St. Louis removed two-thirds of his esophagus and one-third of his stomach, joining the remaining organs together.

“Now my stomach is right here in my chest,” he said, pointing near his breastbone.

The doctor also connected a feeding tube to his intestines because Sehgal’s esophagus and stomach could not handle enough food for survival.

Sehgal stayed at Barnes for two months because of more complications. He was retaining large amounts of fluid. His wife, Toshi, said his body swelled so much that he was not recognizable. He had nightmares. He tried to pull out his tracheotomy tube and fight the nurses, whom he thought were trying to wrongfully keep him in the hospital. Even his heart wasn’t working properly: One night, it almost failed him.

When he returned home, Sehgal’s wife became the primary care provider. At night she hooked him up to a pump, which gave him two-thirds of his daily calories through the feeding tube. Slowly, his eating improved until, in March 2005, the doctor removed the feeding tube.

Things were good for a few months. Then in July, Sehgal’s stomach started rejecting food. He suffered from constipation and — again — fluid retention. He was admitted to Boone Hospital Center, then transferred to Barnes, where they reinserted the feeding tube.

“My second confinement to the hospital was very stressful,” Sehgal said. “I lost about 30 pounds.”

After two months at Barnes and two more weeks in a Columbia rehabilitation facility, Sehgal returned home once again.

“I have struggled a lot, and many times I just wanted to give up,” he said, crediting his wife, family and friends for giving him the support he needed to not give up. “It’s amazing how much help your family and friends can give you in times like these.”

For example, a few weeks ago Sehgal had a hard day.

“I wanted to die,” he said. “I thought, ‘my god, I’ve gone through so much in the last two and a half years, and I’m still in the same position.’”

The next day he called a friend, another cancer survivor who helped raise his spirits.

Sehgal’s future is optimistic, but he will always have complications. After surgery, his rib cage did not realign itself properly, which occurs 25 to 30 percent of the time, causing an excruciating amount of chronic pain.

He also remains on a feeding tube at night. Meals that he consumes orally are small and frequent, consisting of concentrated calories. His energy level is low, but he tries to walk at the Activity and Recreation Center at least four times per week. He also has regular check-ups.

“I haven’t completely come out of my cancer problems yet,” Sehgal said. “I still get very pessimistic once in a while, but I’m trying to keep positive.”

Yoga, meditation and playing bridge help Sehgal divert his mind, as does spending time with friends.

“The doctors say I’ve been cancer-free for two years and, in all probability, it will continue on,” Sehgal said. “I feel encouraged by that.”

Sehgal approaches his possibly grim future with a sense of resignation, much like his stance as a 15-year-old boy fleeing from the Hindu-Muslim tension of his homeland.

“If (the cancer) comes back, we’ll handle it,” he said, “because we’ve handled it once before.”