Audio & Video Reading from the Podcast
"Life as a Patient Doctor"
We don’t need to look sick to still be sick and suffering.
We need to change the culture of medical education to normalize that medical students and physicians are humans and can take the time to address their health!
Medical professionals are people too! That means we can have physical and mental illnesses which are not always visible to the naked eye. In the disability world we like to call these "invisible disabilities" compared to ones that are blatantly obvious because of mobility devices (like a wheelchair) or how we interact with the world around us.
In the "AAMC Medical School Graduation Questionnaire 2020 All Schools Summary Report" 7.6% of graduating medical students self reported they had a disability. Of these the top three were ADHD, Mobility, Chronic Health Disability, or learning disability
According to the In the "AAMC Medical School Graduation Questionnaire 2020 All Schools Summary Report" only 52.6% of students with disabilities reported being provided accommodations from their medical school.
The top reason for people not being provided were because they selected they "felt they didn't need accommodations" or "for other reasons."
Thankfully the ones who did request accommodations only 2.9% reported being denied!
We need to advocate and educate medical students to seek disability accommodations when they are struggling in class or in the clinical environment.
Check out my blog post: Requesting Disabilities Accommodations and Accessibility Needs
I understand why people wouldn't request disability accommodations, our medical community see's it as a taboo topic and see's it as a sign of weakness. Read more on my blog post: "Surviving the Taboos of Medical School"
Unfortunatly, there have been multiple situations where I felt out of place for having a disability. Frequently, I have heard residents talk about themselves not going to their own doctors, as they know they should, because they are young and healthy. It has made me feel uncomfortable because I have so many medical conditions and on the outside I also look “young and healthy.”
Read below some journal entries I had during my 3rd year clinical rotations where I struggled with balancing my health and being a medical student.
Feeling out of Place in My Neurology Rotation
Today, I felt embarrassed when I had to sit down in a chair while the head neurologist attending, my residents, and peers stood and leaned on the wall. But I knew my body, and knew I could not stay standing still that long. I know I can stand in place during short rounds where we only stay with each hospital patient for about 5 min at a time. However, with this attending they do almost hour long rounds with each patient. It is just too much for my body. At the end of each week I seem to flare up with pain all around my body, especially in my low back, and my legs feel like lead.
I get so nervous and self conscious that I am being judged when I sit down. Which in some sense they are judging me, because that is the point of medical education. Constantly being judged for our behavior which then affects or evaluations and grades. Therefore, I don’t know how much I can be myself and acknowledge my own needs.
Reading my accommodations letter- I am allowed health breaks, it doesn’t say bathroom so me sitting down in clinic could be considered a health break. That makes me feel a bit better. Also, we know that sitting down with patients at their eye level, especially during difficult conversations, is more comforting, makes them feel heard, and feels like they are spending more time with their doctor.
I had an interesting interaction today where some of my classmates really wanted to see the CT & MRI machines. I was very confused why they were so excited, and then I realized that they have never been inside one before....
Same thing happened with getting an EMG... been there and done that haha
Endometriosis & Chronic Pain Flare:
Some days I get home, collapse and sleep for 1-2hours. Other days I can manage to help cook, go on a short icecream/dog walk. Although after dinner I lay on my couch fighting to keep my eyes open as I try to do my UWorld Practice questions with a heating pad around my low back and my legs elevated.
This week was difficult with the 90+F heat on the 12th floor of the hospital tower. I would sometimes get hot flashes if I wore my white coat during rounds and sometimes had to use a wet paper tower to lower my body temperature. I also wore my nicer scrubs or light weight tops and hoped my attending wouldn’t care that I was the only med student without my white coat on (we don’t have to wear it- the residents don’t- but some attending really like us to wear it).
Today I woke up in a full flare with all my muscles, aching and feeling like I was going to throw up from the pain.
Do I call in sick tomorrow?
What do I even say? I can't say "I am in pain" Society and the culture of medicine, and COVID has told me I have to say "I have fever, food poisoning, etc..."
However, that is not fair, and I do have the right to take both a health and sick day. It is just so hard emotionally to say I am to weak or in pain to go to clinic/the hospital.
Goals and Plan going forward:
- Keep notifying new residents and attending about my accommodations letter- Sit near patient when interviewing them or during rounds (can even bring in a stool from nursing’s station)- Keep Dr appointments scheduled in the late afternoon when we are usually dismissed- Make more dr’s apts to make plan on adding in more Neuropathic Pain meds (we have been considering adding in Gabapentin)
- Be brave enough to notify my team I am taking a health day...
Flare while on Clinical Internal Medicine Rounds (update)
I woke up at 4 AM this morning almost screaming in pain in my right lower abdominal quadrant and low back. I went to the bathroom and then just collapsed on the floor hoping that the coolness of the floor would provide some relief. It did as in it provided me the energy to stand back up grab my heating pad and fall back asleep until my alarm went off at 6 AM. I probably kept putting on the sleep mode until 630. I knew I had to get up because I had post call rounds and had to be at the hospital by 7 AM.
I gulped down my pain meds and the rest of my daily medications and headed into the hospital to do my prerounds. When I was talking to my patients to see how they were doing I was able to distract my brain and the pain pills momentarily helped me remain standing for the quick check in. However, by the time we came back together to do our rounds as a team I could feel myself starting to drift off and the pain came back. I kept blinking my eyes to prevent myself from crying or letting my team know that something was wrong. I tried to listen to my residents present their patients, but my brain was foggy and I felt like I was listening through a door. I tried to keep myself busy and focused by reviewing the CT‘s and x-rays of the patients they were talking about, but eventually I realized that we had moved on to another patient. My stomach was enlarging by the minute and pressing on my scrub pants elastic band. I put my legs up on a chair and tried to straighten out my body and messaged the abdominal muscles spazzing in response to the flair.
I texted my senior resident across the room and told her that I had endometriosis and was having an Endo flare. She reassured me I could go home, but I responded that I wanted to stick it out until after rounds (only an hour left right?)
I tried to wait it out...
But it got to a point that I had to get up to go to the bathroom and prevent myself from vomiting, bursting into tears, or collapsing in the middle of the hospital general medical floor hallway. This is when I knew I had to go home-- NOW
I debated calling in this morning (we have sick and wellness days) but my ego said that I would be able to push through today. It was a Saturday post call so we would only be here 6 hours instead of 12hrs like the night before. Instead I went in for 3.5 hours and wasted that time where I could’ve been sleeping and healing.
i touched base with my senior resident and attending, grabbed my things and dragged myself to the elevator , down 9 floors, and a long walk to my parked car ....What would have been worse calling in or suffering and leaving mid rounds....?
We (me included) need to put our own bodies and health first. Especially those in the healthcare field, how can we give 100% care to others when we ourselves are not even at our 50%?
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