Lying in his bed at a rehabilitation hospital in Salem, Muktar Alkhazmi used his right hand to raise his outstretched left arm. He grimaced.
Annette Coté, the physical therapist, touched his quivering shoulder, then frowned.
“How many repetitions have you been doing?’’ she asked.
“Khamzeen,’’ Alkhazmi replied. “Fifty,’’ said his Arabic-English interpreter.
Coté chastised her patient; he was supposed to do 15, and he was risking another injury.
“You’ve done amazingly well,’’ she said, “but you’ve just got to give it time.’’
“Inshallah,’’ Alkhazmi mumbled with a sigh. If God wills it.
He didn’t have time. The 37-year-old was impatient to return home to Libya, where last year he joined the fight to overthrow the country’s dictator, Moammar Khadafy. In August, while liberating captives in Libya’s largest prison, Alkhazmi was shot by a sniper in his left shoulder.
Unable to get adequate treatment at home, he was one of 22 Libyan men flown to Spaulding Hospital North Shore in October under an arrangement coordinated by Libya’s National Transitional Council and the US Department of State. The hospital took pains to adapt to the visitors, creating, for example, a prayer room with a sign pointing toward Mecca.
Alkhazmi’s collarbone and shoulder blade were fractured, and his arm hung limp. He underwent surgery and began to regain some feeling and wiggle fingers. Still, doctors insisted last month that Alkhazmi stay in Salem to get the quality care he was unlikely to find in Libya.
His mind was made up, however. With or without a functioning arm, he was ready to go back - to his small town, his family, and his brother.
His country, he said, needed him.
Growing up on a farm in a desert town, Alkhazmi was one of 13 children. He had five brothers, and two of them were close to him in age: Ismail and Mubarak.
On June 17, 2006, those brothers disappeared.
Ismail, a petrochemical engineer who was then 30 years old, was arrested at work. Heba Morayef, a researcher for the international activist organization Human Rights Watch who investigated his case, said officers did not show a warrant and never gave a reason for the arrest.
For 10 months, Alkhazmi’s family made trips to Abu Salim prison, hoping to get word about Ismail and Mubarak, who was 26 at the time and had also been arrested.
“They were against the system,’’ Alkhazmi said of his brothers. “The government, they don’t give you a reason. No one knew what was happening.’’
Finally, in April 2007, prison officials summoned Alkhazmi and his family to Tripoli. Ismail was dead, they informed the family, from a heart attack suffered five months earlier.
Alkhazmi’s father insisted that his son did not have a heart condition. He demanded a second autopsy.
It showed that Ismail’s heart was healthy, according to the autopsy report, which was obtained by Human Rights Watch. Medical examiners determined that Ismail’s death was actually caused by injuries from “blows with a hard, blunt object of some sort.’’
He had “bruising and contusions all over the body,’’ the report said: The skull. The arms and legs. The feet. The genitals.
“It was torture,’’ Alkhazmi replied when asked about it during his hospital stay, reluctant to say more.
In vain, Alkhazmi’s father pushed Libyan officials to investigate his son’s mistreatment. Ismail’s body stayed in the prison morgue. His family did not reclaim it until after the start of the revolution.
Alkhazmi missed the burial. By that time, he had joined the rebellion.
Alkhazmi knew his wife would never let him fight - so he didn’t tell her.
He was an unlikely rebel fighter, the father of three small children - Fatima, 5; Ismail, 3; and Omar, 1.
He lived in the same place he grew up, a town called Bani Walid - about 100 miles from Tripoli, hardly an epicenter of the revolution.
And Alkhazmi was a government accountant, crunching numbers for Khadafy’s regime. It paid the bills, which is why he stayed in the job despite deep hatred for Khadafy and the government after his brothers’ arrests.
At the end of February 2011, he packed a bag and told his wife he was going on a business trip to Tripoli. He did not return for months.
The revolution that he joined, he recalls, was improvised and ceaseless. Neighborhoods became battlefields. Local families housed rebels.
Alkhazmi manned checkpoints once Khadafy’s soldiers had been expelled from Libyan towns, and attacked government buildings to drive out pro-Khadafy forces.
On Aug. 24, Alkhazmi said, he was one of thousands who stormed the notorious Abu Salim prison to free prisoners trapped in cells for years - including his brother Mubarak.
The brothers’ reunion was joyful, Alkhazmi recalled - they spotted each other in the prison courtyard and embraced. Alkhazmi drove Mubarak and a cousin who also had been rescued to the nearby house of a family member, then returned to the prison to free others.
Soon after, pain pierced his shoulder. He had been hit by a progovernment sniper in a guard tower, he said. He was bleeding, and he could not move his left arm.
But he did not care, he said. His brother was free.
Other soldiers took Alkhazmi to a hospital in Tripoli. As he was rushed into the emergency room, a TV cameraman caught a shot of him.
His son Ismailsaw him on television that night. “Look, Daddy’s on TV!’’ he cried out to the rest of the family. That was, Alkhazmi said, the first his family learned of his involvement in the revolution.
More than two months passed before the post-Khadafy government selected Alkhazmi for treatment in the United States. Hamid Golkari, Alkhazmi’s primary physician at Spaulding, could barely feel a pulse on his wrist when he arrived. The hand was cold. He could wiggle only his thumb, Golkari said.
Some of the other men had more serious injuries, including from torture. Most exhibited symptoms of post-traumatic stress disorder. (The hospital estimated later that rehabilitative treatment for the men cost between $1.5 million and $3 million - not including surgery and their travel costs. Libya’s National Transitional Council paid for the medical care, said hospital spokesman Timothy Sullivan.)
Spaulding transformed itself to make the men feel welcome. Arabic-English interpreters were available 12 hours a day. Therapists learned numbers in Arabic, doctors’ sported Arabic translations on nametags, and English vocabulary was placed around the hospital. On a framed print of Vincent van Gogh’s “Irises,’’ a yellow Post-it read: “Painting.’’
Many of the men, who ranged in age from 16 to 49, spent their afternoons posting messages on Facebook or watching videos on YouTube. They played soccer on a Wii video game console or competed at foosball.
But Alkhazmi, a slender man with a neatly-trimmed beard, mostly stayed in his room. He worshiped alone. He politely asked that therapy sessions be moved to accommodate his five-times-daily Muslim prayers. Other than during therapy, he rarely talked to the staff.
Alkhazmi’s arm surgery on Dec. 9 at Massachusetts General Hospital lasted nine hours. Surgeons removed scar tissue around the nerves, then performed a bypass from one artery to another.
When Alkhazmi returned to Spaulding, Golkari felt the gentle thrum of a pulse in his wrist. The surgery was successful.
Even so, when it came to physical and occupational therapy, progress was slow despite his dedication.
“He’s one of our toughest, pain-wise,’’ said Lori Beal, his occupational therapist. “He was probably one of the most motivated guys.’’
By January, he was able to move his five fingers and slightly twist his forearm. At the same time, his spirits improved.
He began to call Coté, the physical therapist, “sister.’’ He gave her a rubber bracelet with the Libyan flag. He tried to cheat when he and Coté engaged in “arm wrestling’’ therapy, using his right hand to pull down his left arm.
“I win,’’ he deadpanned.
When Dr. Glenn LaMuraglia, his vascular surgeon, asked him a list of standard questions, including whether he drinks, Alkhazmi said no - his religion bans alcohol.
“But if I have to stay here any longer, then I’m going to start drinking!’’ he said, through an interpreter. The doctor laughed.
Alkhazmi grinned: His joke wasn’t lost in translation.
Against his doctors’ advice, Alkhazmi decided to return to Libya last month. Physical therapy, he reasoned, was something he could do in any country. Once home, he figured, he could return to work as an accountant, this time for the new government.
“By myself, of course, I can’t do much,’’ Alkhazmi said. “But together, we can do something. If God wills it, we will be a real democratic country under real laws and a constitution.’’
As much as Alkhazmi wanted to leave the hospital, he found it hard to go.
On the morning of Jan. 11, he packed six large suitcases, two with gifts for his family - clothing, perfume, and two remote-controlled race cars - and four bags he was delivering for local Libyans. Hospital staff quizzed him to make sure he had his travel documents, his belongings, his medicine.
Finally, the time came for goodbye. Alkhazmi wanted photos to commemorate the moment - one with his therapists, one with doctors, another with the Libyan patients staying behind.
“Yalla, shabab, yalla!’’ the interpreter urged. Come on, guys, come on! Alkhazmi was going to miss his flight.
He responded in English. “OK,’’ he chuckled. “One more!’’