The students entered, chattering among themselves about their recent break. This is their interviewing and communication class, and today’s guest lecturer is a bit different than the usual physician educator. Speaking today is Linda Long-Bellil, JD, PhD, an expert in educating medical professionals about disability. Dr. Long-Bellil is also a person with a disability herself. I am assisting as well, as a physician with a disability and a wheelchair user. …
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From an Indian parable dated from before 500 BCE:
A group of blind men heard that a strange animal, called an elephant, had been brought to the town, but none of them were aware of its shape and form. Out of curiosity, they said: “We must inspect and know it by touch, of which we are capable.” So, they sought it out, and when they found it they groped about it. …
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COVID has focused attention on the frontlines. However, this focus ignores those with chronic health needs and disabilities. People with these conditions are left unable to continue their care or to seek care for new exacerbations. People are avoiding the ER and dying at home. Needed surgeries are postponed leaving patients with continuing pain and disability. And for many, a fear exists of not only acquiring COVID-19 but of …
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Religion and spirituality play a role in both patient’s and provider’s lives. Despite this, medical school is usually an atheistic experience. I went to a state-run medical school. No consideration of religion happened throughout my entire medical school or residency curriculum. It was a long apprenticeship to the god(s) of science. A survey in 2015 found that although a majority of people felt doctors asking …
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Since childhood, I have suffered from severe stabbing headaches. Then in my first year of medical school in anatomy, as we peeled back the scalp of our cadaver, I saw a nerve poking out of a muscle on the back of the skull. With a flash, I knew that I was seeing the source of my pain. But despite identifying it, it would be another five years before I …
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Stigma towards health conditions interferes with access to compassionate care. Both social stigmas from friends and family and medical stigma from professionals are issues. Perhaps the worst recent example of medical stigma is how people with HIV/AIDS were treated in the 1980s. They were isolated physically and spiritually. While in medical school a professor related that on the HIV floor the food trays were left outside the door like …
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Some children present to me with complex problems or multiple problems that fail to resolve after the typical interventions.
I recall a child with severe abdominal pain. He had tried numerous medicines and had had scopes and studies galore. It had reached the point where he was being scheduled for exploratory surgery to try and see the cause of his pain. I lost track of his case when I rotated elsewhere …
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I have had a complex relationship with music. As a child, I had several instances of feedback that I was “bad at music.” When my class would sing at assemblies, I would get side glances and subtle and not so subtle clues that I should be at the edges and sing quietly.
I played the viola from second to ninth grade. I had fun in orchestra class. For the rehearsals, I …
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I spent the summer between the first and second years of medical school in the emergency department at Cincinnati’s major trauma hospital. More specifically, I spent summer nights there, studying the effects of interpersonal violence. Cincinnati is both a friendly city and a violent city. People say “Hello” when you pass in a corridor. At first, coming from Boston, this mid-West style of friendliness took me aback. At the same …
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Unhealthy behaviors such as smoking, overeating, or lack of exercise lead to chronic health conditions, and many patients wanting to make positive changes to their health may seek the advice of their doctor to do so. But our insurance payment system works against supporting people when they want to act in a healthy way, and some of these payment decisions seem rooted in prejudices against those suffering from certain conditions.
Smoking …
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I have been working in pediatric primary care for nearly 5 years post-residency and truly love my work. I currently am dealing with very painful post-herpetic neuralgia and many people with this quit working. At some personal cost, I have continued my practice because I find my work day so rewarding I simply can’t imagine not being a practicing pediatrician.
On a given day I might see a newborn fresh from …
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Six months ago, I had severe right flank pain. In the ER, I had an ultrasound showing a possible kidney stone. I deferred a CT scan and went home with medication. I fit the textbook picture: I had abnormal imaging, and I was given a treatment and discharged. I was advised to return if the pain worsened or failed to resolve. I briefly improved, but then the pain returned much …
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“Paying attention in a particular way: on purpose, in the present moment and nonjudgmentally.” That’s how Jon Kabat-Zinn, PhD, describes mindfulness. In the book Zen Mind, Beginner’s Mind, another thought leader in mindfulness, Shunryu Suzuki, says that, “In the beginner’s mind there are many possibilities, but in the expert’s there are few.” In my experience, I’ve found that cultivating a beginner’s mind opens doors and improves clinical diagnosis.
Medical training has …
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