Wednesday, September 26, 2007

Do You Decry Your Doctor's Dyslexia?

The same op-ed section from the Boston globe that I quoted in my earlier post "Medicine Hates Moms" contained the following question from Janet James of Lunenburg, MA:

"Should students with dyslexia and attention disorders be allowed into medical school?"

The comments section under "Medicine Hates Moms" has taken an interesting turn thanks to a thoughtful, articulate reader who got me thinking about medicine and learning disabilities, particularly about the issues raised by James's question above. A lot of my thoughts on the subject can be found in that section, so I won't rehash those here, except to say that I think a lot of people erroneously equate "disability" with "inability," and I think this does people with learning disabilities and ADHD an injustice.

I'm interested in medical education and curious to know more about people''s thoughts on this. Please feel free to comment on the subject if you'd like, but please, please, please, in the wake of having had to delete a comment already due to obscenity and extreme disrespect, I ask that folks refrain from being acrimonious, disparaging, contemptuous, condescending, obscene, or insulting, even if offering criticism. Please express your opinions graciously, whatever they may be - with passion and even indignation if you feel them, certainly, but never without respect for fellow-readers and writers here.

In particular I'm interested to know

-Do you know professional people with learning disabilities?

-Do you think people with learning disabilities should be excluded from any particular profession? Why/why not?

-What about neuropsychological disorders?

-Where do you draw the line in terms of excluding people with shortcomings from the medical profession?

-What measures are appropriate for predicting whether someone will be a good physician or not? Or IS a good physician or not?


Elaine Fine said...

Any person with dyslexia knows that s/he has to work extremely hard at everything. I would imagine that an intelligent person with dyslexia who wants to go to medical school would be well aware of what s/he would have to do to succeed (or even survive) in medical school. I would probably give extra consideration to the opinion of an M.D. who made it through medical school with dyslexia. I know how hard s/he would have worked and how much dedication s/he must have had and probably still has to the profession.

The only professional person I know well who has dyslexia is a musician. He is a principal player in one of the finest orchestas in the country, and has been in his position for 40 years or so. Since he is not a good sight-reader (obviously, dyslexia puts a real damper on sight-reading), he has to practice twice as much as any other professional musician in a comparable position; but that extra practice and drive to get at the essence of music is one of the factors that makes him a tremendous musician. I don't think that any of his colleagues know about his dyslexia.

They just think that he is dedicated, driven, and remakable.

T. said...

Yes! Difficulties just require harder WORK for some. My son is a numbers guy and hates "writing workshop;" my daughter's a writaholic, by contrast. I've found learning languages fun and pretty do-able, whereas I've seen people really struggle with the task. Every brain is different, with different strengths.

I just think it's unfortunate the stigma about, and prejudice against, learning disabilities is so strong that people have to even ask if people who have them should be "allowed" in certain professions.

speducator lvc said...

Want to really start questioning those preconceptions?

This is an interesting place to patient with the first few minutes and you may find yourself surprised by this woman's dual world.

The video is remarkable, if sometimes arrogant or indulgent (it's hard to be called a freak for so long and not begin to revel in it at times, I imagine).

There are countless professionals out there who have a variety of learning "disabilities" like ADD/ ADHD, dyslexia, discalculia, or Asperger's syndrome. Most work through those challenges alone, so we can't pick them out of a crowd. I'll go so far as to suggest that we shouldn't really be trying to, anyway.

Our kids are said to be "technology natives," growing up in a digital world. We may soon find that the standards by which we judge ability and disability are outdated, since the digital world allows the playing field to be evened in remarkable ways, and the demands of technology shine their light differently on our skills and short-comings.

Thanks for the forum.

lawyerdude said...

Besides any stigma, prejudice, and just plain ignorance about what some of these disabilities mean, the fact that another person gets an accommodation (as can be required by law) can easily be seen as unfair to those who do not, especially if they are prejudiced or ignorant about the disability. E.g. "That person has a recognized disability and requires more time for a test - they must be kinda stupid, and btw, I'd like to have more time too!"

The concern for fairness in professional examinations is legitimate, but "reasonable accommodations," as required by law in this country, are meant to address the format of question and answer presentations, not the measure of knowledge. I think the public perception problem comes from a stark information gap about the kinds of real-world practical hurdles intelligent people with disabilities have to overcome to practice a profession.

BTW, I have worked in the past with a deaf attorney who is a partner in a large national law firm. Does his disability require some accommodations and make his practice more difficult? I'm sure. But he is also one of the most astute, experienced, and honorable legal advocates I know.

speducator lvc said...

Well said, lawyerdude! Bravo!

AATF Eastern Massachusetts said...

The Dean of Faculty who hired me (and all of the early faculty of my campus) some 40 years ago had a sever stutter. He was also a Professor of History, a scholar and highly respected classroom teacher. Whenever he spoke, whether in class or before the Faculty Senate, whatever he had to say was so well worth the wait, as he struggled to get it out, that no one begrudged him the extra time it took him. He was a fine example to colleagues and students alike.

Just another lawyer... said...

I agree with Elaine that most people with disabilities (diverse learning styles) work very hard to accommodate themselves to conventional norms. I would add two observations:

First, this trait is not limited to the "professional" world. Experience teaches me that many people in so-called "blue collar" professions work equally hard to succeed in the face of their own challenges.

Second, much as we are in a rush to overpathologize children (e.g. a child who was formerly called "rambunctious" would now be diagnosed with ADHD and medicated), so too with adults, I fear. Some children (and adults) definitely benefit from treatment/ accommodations. However, I worry that with both children and adults, we are so narrowing our conception of what is "normal" that we are losing respect for individuals' differences. Once we do this, I thik we lose valuable perspectives by labeling folks "disabled" and then "helping" "them" to be more like "us." To take an easy example, the perspective of a teacher who has had to struggle to learn to play the oboe (for example) is often more helpful to students than that of a person who emerged from the womb with fully formed musical skill.

T. said...

Thank you SO much, Another Lawyer, for your well-articulated wisdom about accepting one another's differences - and for giving us an oboe example! NICE!

Once when I was a beginnig resident struggling with some anesthesia tasks my first residency advisor said to me, "You're too hard on yourself. You'll have a lot more to offer students for having had to work at some of these things than the person who falls 'thunk' into place 'naturally,' every time."

I'm beginning to see that the folks who are quick to judge / criticize / label out there may not understand that having to work hard at something doesn't make you incapable or unworthy of doing it...

medrecgal said...

Short answer: yes, absolutely! Longer answer: the degree of extra work required--and the generally skeptical and/or derisive attitudes out there that are still too plentiful--may be a serious hindrance.

I was basically prevented from pursuing a pre-med track in college by the inability of many educators to offer any sort of useful help when I'd ask questions. They were so totally confounded by my particular learning disability (I am not dyslexic; in fact, my problems are the exact opposite of this) that they couldn't find any ways to enable me to properly express the information I knew was in my head somewhere.

I have also, however, been told on more than one occasion that I certainly have enough intelligence to attend medical school; the paradox left us all a bit confounded, so I was left trying to find a different niche somewhere in an allied health sort of field. The search for the right job after surviving college is a whole other story, however. Let's just say they still don't quite "get it". If there are people out there with any sort of LD who can manage to navigate the system and still become physicians, I say more power to them.

T. said...

One of the biggest misconceptions I've seen from people prejudiced against those with learning disabilities is the mistaken notion that learning disabilities mean decreased intelligence. There are many people with learning disabilities and ADHD who also have extreaordinarily high IQs, grades, or school performance. Some are exceptionally talented. Sadly,there is a persistent preoccupation with labels in our society, as well as a horror of perceived "defects." Until people can grown out of their ignorance, prejudice, arrogance, and contempt, the disrespect and sometimes downright nasty invective against those with learning disabilities is likely to continue.

medrecgal said...

Yes, indeed, people do make an unfortunate assumption much of the time that there is some connection between decreased intelligence and learning disabilities. What's ironic about that is that it completely underscores their lack of understanding because BY DEFINITION, a person with a learning disability is at LEAST of normal intelligence. Then I've seen situations where they say something like, "Well, you're obviously bright, why can't you do this to our standards?" That can be just as bad, IME.

As for people "outgrowing their ignorance, prejudice, arrogance and contempt"...I don't see that happening in my lifetime. That would make life so much easier, but for some reason there's this tendency to use these negative reactions towards others to inflate the ego and make the self seem more important. A different aspect of the problem I have seen up close and personally is that society does not want to expend extra resources (particularly not their all too precious time) to actually help a person with any sort of learning problems get a handle on situations that would help their independence (like training on a job, for instance, where I was once told "we don't have the time or resources to help you, so we're canning you" after only 2 weeks!).

Guess it's too bad about our dedication, hard work, obscene amounts of time, and passion we put into things, isn't it? (Sorry, this kind of stuff brings out a little snarkiness because I'm SO fed up with it!)

Anonymous said...

Janet James here. I just googled my name and was astonished to see that an impulsive letter-to-the editor came back to haunt and embarrass me.

To Medrec on your comment “As for people "outgrowing their ignorance, prejudice, arrogance and contempt"...I don't see that happening in my lifetime.”

I am humbled and edified by what I have read on T’s blog and all the links. I am so grateful that she (and her readers) considered my question so carefully and thoughtfully rather than dismissing it as “just an arrogant ignorant person”, and that she provided a forum for such discussion (though I discovered the forum long after it went dormant over a year ago). I am also impressed that as busy as she is, she moderates her blog and keeps the standards up by deleting posts that fall below standard.

When I mentioned being embarrassed, it wasn’t because I regret voicing a real question. It was because it was published in the Globe with my name and I feared backlash, and indeed the next day a very indignant reply followed (which also included my full name). One of my co-workers is dyslexic and I worried that she would see my question and hold it against me. And, well... it just made me squirm with fear.

Sometimes one just has to “ask a stupid question”, and the community helps you find your position. If you can take the heat! Thanks.

T said...

Dear Ms. James,

Thank you so much for stopping by here. I think questions that engender fruitful discussion are real treasures, even if they cause discomfort at first (either to the questioner or the questioned). If no one had bothered to ask (and answer!) any of the civil rights questions - Should women be allowed to vote? Should black people go to the same schools as white people? - we'd all be the worse for it.

Thank you for getting us all thinking and reflecting, and ultimately, learning from one another!