MONALI NARAYANASWAMI – Returning to running after a serious accident – Runner’s World, Aug 2025 issue

Like plenty of people, Monali Narayanaswami wanted to mark her 50th year on Earth by taking on a big challenge. An enthusiastic runner since her twenties, she had raced in plenty of 5ks, 10ks and half marathons over the years, but never a marathon. Now was the time.

The training was going smoothly until one morning in early December 2022, when she set out around her local streets of Palo Alto, California, to tick off a 20-miler. It had been raining and the rising sun was at a low angle. She didn’t see the car failing to stop at a crossroads until after it had hit her.

While the driver called an ambulance, Monali managed to phone her husband, Sekhar, who must tell the next part of the story because she can remember barely anything: ‘Basically from December 2022 until the end of February 2023 she was hospitalised, first at a hospital where several surgeries were done, and then in the acute neuro rehab unit,’ he explains. The car had caused fractures to her right leg, ankle and foot, but the real problem came two days after the accident, when she experienced a huge brain bleed followed by a hemorrhagic stroke. She had two emergency brain surgeries that day, then a third two months later after the wound in her skull reopened.

‘Because of the chance of infection, they had to take out the piece of her skull that they had removed the first time, and she was without that piece for about five more weeks,’ says Sekhar. ‘During that time there was a regression in her physical and cognitive symptoms. It wasn’t until more like May 2023 that her full recovery could really start.’

Physically, the car had damaged her right leg, but the brain injury had also affected her right side, making it hard for her to move that arm as well as the leg. Meanwhile she was also suffering from aphasia, struggling to understand language and also to make herself understood to her husband, their teenage children and her parents, who all spent time in the hospital while she recovered. ‘She was able to start speaking a little bit once she got to the rehab unit, but it was very difficult. One time I remember she was trying to tell us to turn the lights off in the room, but she was saying something totally different.’

Monali had attempted one short run on a treadmill a while after the first brain surgeries and just before the setback, and experienced a hint of the old ‘zen’ feeling she loved to get from running. But after the repair to her skull, her next attempt at a jog resulted only in dizziness. ‘Running didn’t offer me anything any more. I was lost,’ she says. ‘I thought, there’s no way I can run any more. I’m done.’

But Sekhar continued to encourage her. ‘I’m an on-and-off runner myself, but for Monali, running is in her blood. She’d been doing it for so long and it was something that brought her so much joy. So I at least wanted to make sure she gave it a fair shake.’ In the summer of 2023, they attempted a lap of a nearby track, slow running and walking as required. Over the next few weeks they got to a point where they were managing a mile at a time and Monali was feeling generally okay. ‘After that I was able to hand her back to her old running partners, who were willing and able to go much longer distances,’ he says.

Even then, there were more setbacks. Recovering after a run was taking Monali several days. She had lost some of her peripheral vision on her right side, which meant she felt too unsafe to run alone. Understandably, she also didn’t want to run anywhere near roads. Then in February 2024 she attempted a 5k run and suffered a seizure. She lost consciousness while running but luckily was with a doctor friend.  She was put on anti-seizure medication but could still experience a ‘cloudiness’ and worsening of her aphasia after runs of 5k or more. ‘I started to realise the problem was not drinking enough water,’ she says. ‘I now carry water even on a short run.’

Eventually, though still unable to return to her job in Product Management at Amazon, she became confident enough to combine a family trip to Europe with entry in the London Landmarks Half Marathon in April this year. She felt strongly that she wanted to raise funds for SameYou, a brain injury recovery charity started by the actor Emilia Clarke, who suffered two brain hemorrhages in her twenties. There were even more problems as the race approached: in November 2024 a car drove into the back of theirs, causing Monali to suffer whiplash and further worsening of her symptoms. Just before the event she was confined to bed for three days with a virus – especially worrying for her because an infection can reduce the threshold for seizures.

But she did it. She didn’t break any speed records but she completed the race without issues. ‘There was such a sense of accomplishment when it was done,’ says Sekhar. Monali is now determined to keep running. ‘I do love the social aspect of running now, because I’m always with someone,’ she says. ‘I’m not back to the zen yet, where I can just run and relax on my own. I’m not there yet, but I hope I will be.’

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