September 29th, 2016

Invisible Disability

By Andrew M. Harrison

By Andrew M. Harrison

The time: January 2010. The place: The barren cornfield-tundra (then tundra) of Rochester, Minnesota. The setting: Other applicants and current students enjoying drunkenly sliding along the sheets of black ice, but you are in pain and hiding a back brace under your clothing from a spine surgery two weeks ago. Do you: (A) join along and hope nothing goes wrong, (B) point out you are weak for the aforementioned reasons and risk judgement, (C) act uptight and risk a different form of non-weak judgement, or (D) cry and risk every judgement?

I am not a fan of "fancy" words or terms, but this is known as invisible disability. When I broke my neck a few years later, the subsequent J Collar was not invisible disability. (Iconic survivors of this sort of injury, at least in my mind, include Arnold S. Relman and Dave Brubeck.) However, some disability turns out to be more visible than others.

Kaur-Harrison

Dr. Kaur and Andrew in Kodiak, Alaska (August 2016). Can you tell who holds the record for more lifetime joint dislocations? What about joint replacements?

I recently had the pleasure of breaking my foot. The details are unimportant, except to extend my thanks to Drs. Erik R. Brodt, Judith S. Kaur, and Dave R. Baines for providing me with the experience of a lifetime on the island of Kodiak, AK. In the process, hopefully we made some progress recruiting Indians Into Medicine (I am not a fan of political correctness either) and increasing awareness of the need for colon cancer screening in the Alaskan Native population, but these are stories for another time.

Wheelchair

Andrew (one of my first attempts at "the selfie"). Do "ortho shorts" match with the scrubs top? I discovered the next day leather gloves help to prevent the wheelchair from ripping apart the hands, but do fashionable forearm protectors exist? Note: The impalement injury to my right leg is old. Older (and even less visible) is the neuropathic damage to this "good" leg.

In the relatively rapid transition from walking on a broken foot for 2 weeks (I hate doctors) to "the boot" to crutches to wheelchair to [cast + knee scooter + iWALK], I experienced disability for at least one day. I learned some things this day:

  1. One day is more than enough for me. People with years to decades of experience, feel free to chime in with additional tips and/or thoughts.
  2. I was already aware the average human lacks the spatial IQ to make efficient use of corner/curved mirrors, omnipresent in most buildings, but now I really wish some human-factors engineer would improve upon this design by lowering this spatial IQ burden.
  3. Perhaps I am just incompetent, but it seems to me, in buildings with the luxury of "handicap accessibility", if automatic swing-door operation is even present (and functioning), the time-delay on many of these doors can stand to be increased slightly.
  4. People like to ignore you. When I am in a suit or scrubs, my research colleagues walk past me. When I am in my hobo clothes, my physician colleagues walk past me. When I cannot walk, almost everyone walks past me. In fact, more stories for other times, I had some of the most interesting conversations in these days with the few people who did not (or could not) easily walk/hobble/crawl past me.
  5. People like to NOT ignore you. Please, thank you, and "you're welcome" (confirmation of affirmation of words of limited value to begin with) are very common, and even more exhausting. From the East Coast to the Midwest: How or why exactly do you think I need or want your help? My thanks to Ted (custodian of Mayo Clinic's Mitchell Student Center) for laughing at me, which was what I needed most.
  6. Unsolicited "help" (genuine or otherwise) is often dangerous. The most extreme case: Random people I have never met before (and hope to never meet again) who step in front of me as I am racing down corridors to (seemingly seriously) ask "what's wrong?" Honestly, I do not know what is wrong with you. However, you are endangering not only my safety, but your own, and everyone else around us.

Baines

Dr. Baines, a one-legged Indian, as he prefers to be addressed, busy teaching his son the importance of not forgetting the fishing poles.

I am a vain man. Out of necessity, I think the most important lesson I quickly learned was to abandon vanity. For pushing me over the train tracks early one morning (do this backwards or the front wheels of the wheelchair like to get caught), I dedicate this post to Charles, survivor of Guillain-Barré Syndrome, as he prefers to be addressed. When he simply could not tolerate my second thanks, his profane words were what I really needed to hear that day. For better or worse, not all disability is easy to hide.

Airport

I am not sure exactly what is happening here. To bastardize the words of former President George W. Bush: I wish to be judged not when I am at my best, but when I am at my worst. I am not fit to pass judgement on others. However, as I struggle in the airport on my peg leg, loading my scooter onto the plane for the beaches of Mayo Clinic Jacksonville, which are not cast friendly, the cruel laughter: How do you wish to be judged, and what disabilities are you trying to hide from me?

Andrew M. Harrison is one of the co-managers of Mayo Clinic’s Diversity in Education Blog and a student in the Medical Scientist Training Program at Mayo Clinic.

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