“Outside the Law” is a column profiling Chapman law students outside of school. Though they all share a common degree and career path, they each come from different walks of life, enriching the Chapman community with their individual experiences. Take away the legalese, casebooks, and briefs, and you’ll find people making the most of life, just like everyone else. These are their stories when they’re not wearing the business suits.

Student blogger:

Minhquan Nguyen (’14)

 

Before he had his first girlfriend, before he began to notice girls in that way, before his brain had developed enough to even understand the concept of love, Ali Bushra already had a broken heart.

No one noticed, at first. When he was born, he seemed like any other squalling baby in Egypt. It wasn’t until he began turning blue that people began to worry. Actually, his shade was a reddish-purple color that suggested blue more than anything else, but between that and his frequent shortness of breath, Ali’s parents felt this condition couldn’t be entirely normal.

The doctor called it tetralogy of Fallot. “Fallot” for the French physician who discovered it, “tetra”—“four”—for the number of defects to the heart, which was more than twice the number of years Ali had lived up to that point. It was a condition you were born with and died by; left to its own devices, tetralogy of Fallot killed most people by their teens.

At the time, its causes were a mystery, which remains mostly the case today. Ali’s mother had been a healthy, intelligent woman who had done all the right things while she was pregnant. Aside from matters of the heart, Ali was otherwise a normal child with no other worrying conditions. It was just one of those things, like hurricanes or gym teachers, that life threw at you from time to time. There was nothing to do except deal with it as best you could.

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Much is made of the human brain, the computer which allows you to do anything, from holding long, deep conversations about the political situation in Syria to dancing with abandon to “Gangnam Style”. But it’s the heart, the body’s engine, which provides that computer power. Cut off the heart, and all your brain’s remarkable abilities quickly seem very, very insignificant.

The heart is essentially divided into two sides, each with a collection chamber and several vessels allowing blood to flow in and out. The left side takes in oxygen-rich blood from the lungs and sends it out to the rest of the body. The right side accepts blood your body has already used and directs it back to the lungs for refreshment. This is literally a life-saving process every time it happens, and yet your heart does it with a consistency and effectiveness that no machine made by man has ever matched—not even the iPhone. The heart does its job so well that it’s only when it stops working as it should that you begin to appreciate what an important appliance you have running inside.

A person with tetralogy of Fallot has four problems to deal with. On the right side of the heart, the vessel that connects to the lungs is narrower than usual, preventing oxygen-depleted blood from leaving its chamber. On the left side, the vessel that brings in newly aerated blood has split into both sides, dispensing half its precious cargo uselessly into the wrong chamber. The two chambers, which are supposed to remain completely separate, now have an opening between them, allowing spent blood to flow back out into the body. To add insult to injury, the extra stress from compensating for all these issues causes the muscle on the right side of the heart to thicken rather unattractively, from an anatomical standpoint.

The bottom line is tetralogy of Fallot forces the heart to work twice as hard to deliver a fraction of the normal payout, a lose-lose situation, no matter how you look at it.

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Had Ali been born just half a century earlier, his family would have had to start saving for a funeral service right then. The good news, as their doctor told them, was that medicine had advanced to a point where tetralogy of Fallot was no longer the death stamp it had been. Nothing a little open-heart surgery couldn’t fix.

The bad news for Ali and his family was this type of thing was best done in the United States, where the doctors had the know-how to perform the operation without killing Ali in the process, and to keep his recovery on track afterward. His parents couldn’t procrastinate on the decision; the surgery had the best chance of success while Ali was still an infant. Leaving Egypt meant Ali’s father would have to bid farewell to his entire family and a good job managing food and beverage services at a hotel in Alexandria. His mother would have to quit her job as an elementary teacher at a private British school. Both had a comfortable life they’d known and built up. They would have to leave it behind if they wanted their son to do the same. Their choice was thus easy, but painful.

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Ali’s parents arrived in their new homeland in the most traditionally American way: with practically nothing. Nearly everything they owned had stayed in Egypt and everything else went to pay for what would turn out to be the first of several surgeries for their son. In one particularly educational episode, Ali’s father sold his Rolex to a pawnshop for $500, only to learn from a later appraisal that it had been worth ten times as much. So early on, Ali’s parents learned that America was a country that could inspire deep, simultaneous feelings of gratitude and resentment.

The purpose of the first surgery was to fix several of the structural defects in Ali’s heart and to insert a pacemaker that would even out his heart rate. By all accounts, it was a great success, almost mundanely so. Despite the skill required and the stakes of the operation, it represented a relatively brief, albeit extremely anxious, period of his parents’ lives. This was soon overshadowed by the hard work of making a life in the U.S. while waiting for their son’s heart to develop enough for his next surgery.

They were luckier than most. Ali’s great-grandfather on his mother’s side had come to California decades earlier for his college studies, and her sister still lived in the state, in El Centro, one county away from San Diego, where Ali’s medical work would be done. This gave the Bushra family a decent place to stay while they got their feet off their ground.

In all other respects, Ali’s parents started from scratch. Ali’s father worked at a gas station, and his wife stayed at home to look after their recovering son. Two years later, the family could afford to move into their own apartment in San Diego while Ali’s parents took up jobs at a local IHOP, his father as a manager and his mother as a server.

Ali’s condition aside, he grew up a very normal American boy. He was social and athletic, qualities that got repressed a bit during his stay-at-home period. Although he was allowed to do a very little swimming, he really wanted to play football, a sport out of his reach. There was the usual head-shaking toward roller-coasters and other activities that might be overly exciting.

ali-doctor


Ali, as a child, with his doctor



These were sad disappointments, but temporary ones. When he was eight, he had his second surgery. The doctors replaced his pacemaker, then inserted another heart valve to replace the one already been worn out from years of making up for defective parts. The new valve was a human one, donated by the family of a child less fortunate than Ali himself. He never found out the identity of the person who still has a place in his heart today.

After that, it didn’t take long for Ali to throw himself completely into living a normal life. It took his parents much longer. Though Ali’s father never did learn much English, he distinguished himself with his sense of presentation, integrity, and work ethic, universal values that are never lost in translation. Ali’s mother was no less diligent, teaching her son at home while he was still too delicate to go to school and slowly earning her credential so she could teach other children.

There came a time when both parents got back the jobs they had given up to save their son. His father managed food and beverage services at an Embassy Suites hotel; his mother got a full time job as an elementary school teacher. They finally bought a house and had their remaining furniture in Alexandria shipped over to fill it. The moment Ali was diagnosed with tetralogy of Fallot, it was like their lives had been put on pause; only ten years later could they press the play button again. But now their son was in high school, he was healthy, and they were living in America. The long delay was worth it.

Then the recession hit. In short succession, Ali’s father lost his job, had a heart attack and a stroke, and discovered he couldn’t start over again like he had once done. In the new, gasping market, his limited English, Middle Eastern heritage, and lack of technical skills guaranteed that he wouldn’t be a part of it. Ali would come home and see his once vital father, staying at home and living on a pension after years of making something of himself. Life or fate or society had treated his father badly, Ali thought. He felt very strongly that something should be done, if not on behalf of his father, then at least for the sake of the human condition, but he couldn’t think of how to do it. And then he started thinking about law school.

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Right before he started college, Ali had his third surgery, mainly to replace the battery in his pacemaker. He didn’t want to, at first. It was too sharp a reminder that he wasn’t entirely normal. His doctor convinced him by pointing out that once the procedure was done, Ali would be entirely normal. Considering the odds against him when he was born, this was nothing less than a remarkable result—“exceptional.” That was the word the doctor used. Ali was exceptional.

Ali Bushra


Ali Bushra today



He keeps that in mind nearly every day and knows how blessed his life is, a miraculous product of technology, human generosity, and his own stern stuff. When he visits his parents, he feels an unmeasurable love for what they did to make him possible. He often stops to watch the sun as it rises on his way to school, and watch it set as he leaves class. Quite frequently, he walks the halls of his law school and spontaneously burst into song, his pleasant tenor ringing against the walls. And through it all, his heart keeps a steady beat, assuring him that it’s still going strong.

Ali Bushra is a third-year student at Chapman University’s Dale E. Fowler School of Law. He is a student ambassador and member of the Student Bar Association. He externs at Jafari Law Group.

About the Author:

Minhquan
Minhquan Nguyen is a third-year law student and the current President of the Public Interest Law Foundation (PILF) at Chapman University School of Law. He went to the University of California, Irvine to receive his undergraduate degree. Minhquan likes to tell people he watches Game of Thrones and Mad Men, while he actually prefers Downton Abbey and Cougar Town.

The views expressed in the student blogs are those of the author and not the law school.