***Originally from an email***
Please allow me to introduce myself. My name is Meghan Bayer and I am a junior Emergency Medicine and Communication double major at the University of Pittsburgh. I am in the planning stages of my senior thesis in which I am planning to do research on rare diseases, specifically SPS, and the diagnostic process that patients go through. I am planning to use public support groups, online forums, personal testimonies, existing studies, and interviews to extract my research.
Now you may be wondering of all the diseases defined as “rare” by the National Organization for Rare Disorders, why SPS? My logic is two-fold. One, even if the number affected by SPS is higher than the 7000 people estimated to have SPS worldwide (which I believe it is much higher with many people being misdiagnosed and/or going undiagnosed), I still believe that the number of Americans affected would still fall under the “less than 200,000 Americans affected” definition that NORD utilizes. For purposes of this research, a “rare disease” will be a disorder affecting less than 200,000 individuals, in large part because it is the most commonly used definition that I have seen across different specialties. Public resources and support groups are readily available sources of information, straight from the patient, which I believe is important.
Second, for the last five years, I have dealt with several chronic illnesses and autoimmune diseases. For years, it was “focal dystonia secondary to Complex Regional Pain Syndrome”, which quickly became “generalized”. While I don’t doubt that I have some dystonia secondary to CRPS and neither do my doctors, we know it is not the whole story. I know the difference because the spasm patterns are different if that makes any sense. When the GAD65 came back high in serum and CSF, along with elevated levels of several other antibodies, like islet cell, amphiphysin, and thyroid antibodies (with normal TSH) to name a few, we investigated further. On 44mg clonazepam, 160mg of baclofen, and 400mg of dantrolene a day, all my EMGs have come back inconclusive, but showing signs of agonist-antagonist co-contraction and continuous motor unit firing. All 3 QSARTs have come back very abnormal, as did my tilt table test (further evidence of dysautonomia). CT scans and x-rays have been negative for malignancies or any other cancerous process.
We know three things; this is neurological and autoimmune in nature and is more likely than not on that “GAD65 spectrum”. I have almost lost my life several times because of refractory status seizures, profound bradycardia/hypotension from dysautonomia, respiratory arrest, and unexplainable encephalopathy (not consistent with AI encephalitis) to name a few. This fiasco started two weeks after my 16th birthday and the amount of information available on pediatric onset SPS/GAD65 mediated disorders is almost non-existent. My point is that even with all these tests coming back positive or highly suggestive of SPS, it still took over 5 years after they got all those test results back to get an official diagnosis and in turn, a treatment plan. This journey has been long and precarious, but I would like something good to come out of it and I believe that this research will do that. I can see myself continuing with more advanced research after medical school. I figure if this research helps make the diagnostic journey shorter for someone else then it is worth it.
My faculty supervisor and I are currently applying for IRB exemption status, but I was hoping to collect some good resources that are already out there prior to starting. If you could recommend some reputable articles or even share some information yourself, I would greatly appreciate it.
Meghan L. Bayer
I met with my Office of Vocational Rehabilitation (OVR) counselor a few weeks ago. I learned some valuable information that I want to share here:
I could get Schedule A Letter later. This is a letter that would be sent with my application and it would get prospective employers more incentive to hire me by receiving extra grant money.
Grocery shopping in a chair is hard. Pushing a cart is harder. Using a reusable cloth bag to hold groceries in your lap or having a net under the chair can help a lot.
Battery-powered air compressors are helpful for easily keeping wheels pumped up.
Casters are hair magnets. Clean them regularly.
My chair is titanium, so even if the paint gets chipped off, the chair should not rust or have any structural integrity problems.
If insurance won't cover the Smart Drive (power assist) for my wheelchair, OVR can potential cover it.
August 24, 2012... It ranks up there as the third-single most life-changing day of my life, behind the day I was born (obviously!) and the day my hearing loss was diagnosed. At the time, I had no clue I would remember this day for the rest of my life. I mean, why would I remember a random day in August in the summer of 2012?
Today, five years ago, I went to my primary care doctor for my WPIAL sports physical as I did every year and at the end of the appointment I was told I should receive the Gardasil HPV Vaccine. My parents had me vaccinated with everything suggested up to that point, so my mom agreed. I received the first of three injections and I felt sick that night. And the next week. And the next week. I told myself I was just overdoing it playing basketball for hours everyday and that the stress of the hardest year of high school, junior year, was just tiring me out. I wish I was right. I wish it was just "stress" or "exhaustion".
I got sick that night and five years later, I've never felt the same. When my immune system was "modified" by the vaccine (part of the purpose of vaccines in general) to confer immunity from HPV, something happened in the process to turn my body on itself and I can link every single symptom and condition I've been diagnosed with straight back to the now revised Gardasil package insert. There are antibodies in my system now in dangerous levels that I previously tested negative for the year prior. Antibodies that shouldn't be in the body, and if they are, should only be in the blood, that are in my spinal fluid. Of course that spinal fluid covers the entire central nervous system, which has been under siege since and immunologically, we have never gotten it under control.
We've been doing damage-control the whole time. We know that my thyroid and pancreas both are under attack with extremely elevated antibody levels. We have to wait for them to fail, before we can treat it. No one has ever considered what we could do to prevent further thyroid or pancreas damage, which irks me because we know what those antibodies are doing.
My central nervous system is what most providers would consider irreversibly "re-wired" and damaged at this point with the technology and medicine we have now. My autonomic nervous system (controls all the body's involuntary functions) is always in a state of dysfunction. The ANS innervates just about every organ in the body. And the list goes on... All 17 conditions last I counted.
I never did get the last two injections in the series and honestly, I don't think I'd be here today if I did. I'm not going to start rambling with statistics, but they are absolutely horrifying. I wish we could prevent the stuff we can expect will come from the antibodies (that we know about), but medicine today is reactive and not proactive. Just when I think one thing is under control, another 3 go out of control, so I'm always struggling to catch up.
I've learned a lot from the last 5 years that I wouldn't have learned otherwise and that are motivating my research for my senior thesis in communication this year, but it angers me that a vaccine that was supposed to prevent cervical cancer as a result of (four of the 200+strains of) HPV works for a maximum of 5 years, and long term studies that I've seen are inconclusive as to whether or not it actually works. All of that will remain to be seen when long term study results become available, as it has only been on the market since 2006. Had I known what I do now, I never ever would have gotten it and I know my parents wouldn't have either. Unfortunately, in 2012, the accounts of others like me were not available or seen as quackery for the most part.
For a maximum of 5 years protection, I get to spend the rest of my life like this. This is the real Gardasil.
The Evolution of America’s TV and Film Doctors from 1960-2017
University of Pittsburgh
22 June 2017
In the mid-1950’s, television viewers were introduced to a new genre of television. The new shows were primarily set in the hospital when doctors and nurses frantically scramble around to save their patients. Sometimes they would be successful in protecting their patients, and sometimes, despite their best efforts and technology, the patient would end up dying. As with most things, medical dramas have evolved since the first one aired in the 1950’s. Starting in 1961 with Dr. Kildare and Marcus Welby, M.D., continuing with Emergency! from the 1970’s, and moving into Awakenings and Patch Adams from the 1990’s, before finishing up with the modern shows like Grey’s Anatomy, House M.D., Private Practice, and The Doctors.
There have been many changes over the past nearly 60 years, but for the purposes of this paper, the following will be addressed: the gender differences of the TV physicians of 1960’s to the TV physicians of 2000’s, the differences in the portrayals of doctors in movies vs. televisions shows, the differences in the behavior of physicians on talk shows vs. those on medical dramas, the transition from a focus on the patient to a focus on the private lives of doctors, the changes made to TV medical dramas in hopes of making them realistic without allowing the show to be boring and modifications to the places in which doctors practice medicine. Doctors are often made out to be savior figures with a God complex because they are in fact handling lives and making decisions that determine who lives and who dies. Also, doctors have evolved, and the setting in which they practice has changed as well. Doctors can practice in hospitals, clinics, and a variety of other unconventional places. With a broad range of media texts covering different types of medical shows, many trends and changes to the role of the doctor on television or the big screen.
The first significant trend I want to explore is the gender differences of TV physicians of the 1960s to the TV physicians of the 2000s. Three of the most popular TV shows of the 1960’s and 1970’s are Dr. Kildare, Marcus Welby M.D., and Emergency!. In all these television shows, the doctors are all males and nurses are all female. The two leading doctors in Dr. Kildare are Dr. Gillespie and Dr. Kildare, who are both males. All of the nurses on the show are women, and the attendants (patient care technicians) are male as well. (Comack, 1971) In Marcus Welby, M.D., the two principal physicians are Dr. Welby and his assistant, Dr. Kiley. Their secretary-nurse Consuelo Lopez assists them. Again, we see that the males play the role of doctor and the females play the role of the nurse. (Victor, 1969) Similarly, in the 1970’s television series Emergency!, the two most prominent physicians Dr. Brackett and Dr. Early are both males, and Nurse Dixie McCall is a female. Even though they aren’t doctors, it is worth mentioning that paramedics John Gage and Randolph Mantooth are both males. In the 1970’s, women were not allowed to serve in emergency medical services (EMS). It wasn’t until the 1980’s that they started to fill that role by proving they could be “one of the guys and lift like the guys.” It is important to note this because this is one of the smaller details that changes across the decades. Women become more involved in a variety of different medical capacities. (Webb, 1972)
In the early 1990’s, we start to see a transition to some female physicians with the release of the movie Awakenings. While the main character, Dr. Oliver Sacks is a male, there are minor supporting roles in which we start to see a few female doctors every once in a while. (Marshall, 1990) Patch Adams, released in 1998 continued the integration of women as doctors with the addition of many female medical students in Adams’ medical school class. While they weren’t technically doctors yet, they were taking serious steps to achieve that goal, something we have not seen much of in the previous 25-30 years. (Shadyac, 1998)
Today, House M.D., Grey’s Anatomy, Private Practice, and The Doctors, like most modern medical dramas, have a mix of male and female doctors, as well as male and female nurses. House’s team consists of himself, Dr. Foreman, Dr. Chase, Dr. Cameron, Dr. Kutner, Dr. Taub, Dr. Hadley, Dr. Masters, Dr. Adams, and Dr. Park over the course of the show. That’s a total of six males and four female doctors in a primary role. Additionally, the head of the hospital, Dr. Lisa Cuddy, is also a woman in a position of power. On the show, there is a mix of male and female nurses primarily in the roles as extras. (Shore, 2004)
On Grey’s Anatomy, the gender of the doctors, residents, and interns is almost a 50/50 split with some individuals from both sexes serving in positions of power. Dr. Miranda Bailey serves as the Chief of Surgery, Dr. Richard Webber serves as the Chief of Residency, Dr. Meredith Grey is the Chief of General Surgery, and Dr. Alex Karev is the Chief of Pediatric Surgery to name a few people in leadership roles. As demonstrated, the split is roughly 50/50 on Grey’s Anatomy for doctors, and while there are several male nurses on the show, it seems that there are more females overall. However, that was difficult to quantify because all the nurses are supporting roles and primarily extras that frequently change. The main character for which the show is named is, in fact, a female as well. Regarding equality on the show, Grey’s Anatomy is one of the most balanced shows currently. (Rimes, 2005)
Private Practice, a television series directed by Shonda Rimes, the same director that brought us Grey’s Anatomy, developed this series as a spin-off of the successful Grey’s series. However, the show was disappointing to many of the people that had fallen in love with the original series. Again, the main character, Dr. Addison Montgomery is the head of the practice and happens to be female as well. The female doctors (Dr. Naomi Bennett, Dr. Charlotte King, and Dr. Amelia Shepherd) outnumber the male doctors (Dr. Samuel Bennett, Dr. Cooper Freedman, and Dr. Pete Wilder) four to three. Also, the practice has a female psychologist, Violet Turner. In this series, Shonda Rimes brings some serious girl power to the entertainment industry. (Rimes, 2007)
The cast of The Doctors is constantly changing, but there is usually at least two females in the group of five to six doctors depending on the episode. The males have always outnumbered the women on the show. (Hermstad, 2008)
One of the most noticeable differences is the portrayals of doctors in movies vs. televisions shows. In both, they are often seen as savior figures because they are supposed to save lives. Doctors seem more human when they get scared or cry, but in the public’s eye, they are not expected to be allowed to cry. They get scared too and research backs this up. Did you notice that most of the conditions that House and his team diagnose are either neurological or infectious in nature? The neurological diagnosis is the diagnosis that they try to stay away from the longest. This is a phenomenon that medical students and young doctors are afraid of diagnosing neurological disorders known as neurophobia. So they will pursue any diagnosis other than the neurological diagnosis. This neurophobia is believed to affect some of the logical processes of doctors. The presence of this phenomenon portrays doctors as being scared individuals. Being scared or having emotions is not always a bad thing either. Emotions are useful for doctors to allow them to connect to their patients. Although these moments are often rare and fleeting, they can be comforting to the patient. Neurophobia is demonstrated in many episodes when the doctors always include lupus in the differential diagnosis. Generally, lupus is not a neurological disorder, which might explain why the doctors are always hoping that it is lupus. It is less scary to them. (Thomas et, al., 2009)
Many of the TV doctors have a God complex or a sense of superiority. Over the last 60 years, differences in the ways doctors treat their patients and their colleagues have developed. For instance, Dr. Kildare starts out as a bumbling resident and eventually becomes an excellent, cool doctor by his third year (season 3) of practicing. On the other hand, Dr. Meredith Grey was smooth, even as a resident, but has more of a God complex. Kildare and his assistant Dr. Kiley seemed more human than many of the modern TV doctors. The same can be said for Dr. Brackett from Emergency!, who is an incredibly kind, humble, and personable doctor. (Webb, 1972) Patch Adams is one of the last movies with a doctor who is not extremely full of himself. He cares for the kids and not only does he want to heal them physically, but he also wants to heal them emotionally too. (Shadyac, 1998)
While Lawrence and Jewett’s have a definition for the classical monomyth and the American monomyth, it leaves the potential for a third category to arise. This third monomyth could be an average person in an average world filled with problems that responds in an incredible (seemingly supernatural or superhuman) way. Some doctors on TV fit this description, in that they are average people in an average world, but they have a capacity to save lives in their line of work. Now saving lives and improving the individual's quality of life is their job. However, it is not something that everyone gets the opportunity to do. Therefore, it could be perceived as “superhuman,” especially when the odds are stacked against the patient and the doctor does something radical to save their life. Some modern examples of this type of monomyth would be Meredith Grey, Dr. House, Dr. Brackett from Emergency!, and Dr. Montgomery. Lawrence and Jewett’s definitions of the classical monomyth and the American monomyth don’t work particularly well to describe doctors. (Jewett et, al., n.d.)
In the last two decades or so, a new type of medical show has become popular daytime television. On these shows, real life doctors treat real life patients on the air. This has led to some differences in the behavior of doctors in medical talk shows and those on medical dramas. On medical talk shows, they refer out to other doctors for treatments, like on The Doctors and the Dr. Oz Show. (Oz, 2009) On medical dramas, it’s a story, and within that storyline, patients are treated, but treating the patient is not usually the priority. However, on talk shows, they are dealing with real people that are being affected by real life medical problems. For example, on one episode of The Doctors, a patient with complex regional pain syndrome, a neurological pain syndrome, is featured. On the show, they briefly discuss her history with the syndrome, before offering her several therapies at no expense to her to try and treat her condition. In this case, there’s no do-over if they mess up a treatment or an intubation versus doctors on medical dramas. It can be difficult to compare the two because you are comparing real life doctors with real patients to doctors played by actors to patients played by actors, but there are still some fundamental differences between the two. (Hermstad, 2008)
Another notable transition has been a shift from a strictly professional portrayal of a doctor to a focus on the private lives of doctors. Obviously, doctors are human, so like us, they are going to have personal problems. The shift has been from not divulging any details about the doctor’s own life to telling viewers everything about their personal lives and relationships. Grey’s Anatomy is full of failed relationships and divorces (Callie and Arizona, April and Jackson), marriages between two staff members (Meredith and Derek, April and Jackson), sibling rivalry (Derek and Amelia), death of friends and staff members, traumatic tragedies (plane crash that killed Izzy, injured everyone onboard, and caused Arizona to lose her leg, Derek’s death by car accident), and being sent to jail (Karev). These are some of the major personal aspects explored by the shows, but there are a variety of smaller everyday things the doctors deal with as well. (Rimes, 2005) In House M.D., Wilson deals with a cancer diagnosis, Cuddy deals with adopting and raising a kid, while trying to run a hospital and keep House from getting arrested, House deals with chronic pain, a Vicodin addiction and being arrested, Thirteen is diagnosed with Huntington’s Chorea, the genetic disease that took her mother as a child, Chase deals with family problems, and Foreman deals with racial discrimination as a result of being African-American. (Shore, 2004) They all have issues. In Dr. Kildare, Marcus Welby, M.D., Emergency!, and Awakenings, the doctors were portrayed in a strictly professional manner. The focus was always on the patients, and while the doctor may have personal issues going on, they were never revealed to the patient or the audience. From 1960 to 2017, we have a seen a shift from a purely professional portrayal to the revelation of more details about physician’s personal lives.
In early times, when medical technology wasn’t as sophisticated, the number of errors made on television was substantially less. As a result, we have seen significant changes in the type and amount of medical inaccuracy of TV medical dramas. Today, we see CT scans upside down, nasal cannulas, and stethoscopes on backward, medical procedures being done out of order, and doctors calling out the wrong dosages of medications. The average layperson would not know that a lot of this stuff is happening, so the entertainment industry can get away with these inaccuracies, but for those of us with medical training, it frequently makes us scratch our heads. Many directors hire real-life doctors to provide medical advice for the show to make the show as accurate as possible. The majority of these errors were not issues for Dr. Kildare and Marcus Welby, M.D. because the technology was not yet used and the shows were much simpler regarding illnesses and treatments.
Some shows are very realistic, but the majority are overly dramatized. Now, dramatization is critical to the success of most medical dramas, but Scrubs is proof that it does not have to be the whole series. Statistically speaking, Scrubs is the most realistic modern medical show, from the way the doctors act toward their patients, the way they act towards each other, the medical procedures, and the general running of the hospital. (Lawrence, 2001) It is not as dramatized as some of the other modern shows, like Private Practice or Grey’s Anatomy and it has the lowest average of medical inaccuracies. (Tapper, 2010)
One fundamental difference that we have seen in medical dramas from 1960 to the present is the setting in which the medical care takes place. For most of their history, medical dramas have been traditionally set in a hospital. Then, in 1972, the world was introduced to the very successful military medical drama, M.A.S.H. One of the main reasons why M.A.S.H was so successful is because not only did it focus on the military, but it also came during the period where the United States was involved with the highly controversial war in Korea. However, the launch of M.A.S.H marks one of the first times that medical care is taking place outside of a hospital in a large tents or field hospitals. Many of the patients on the show are younger men who have been injured in the line of duty. Almost all of them require surgery. The majority of the show is spent addressing the war and the number one injury on the show, gunshot wounds. There is minimal variability in the conditions that these medics are treating, which is believed to be a part of the reason the show lost some steam with the American public after running for 11 seasons. With the change in the medical setting, we see a shift in the credentials of the people treating patients. In the Army, the majority of medical personnel are medics, meaning they've received extensive medical training, but most have not gone to medical school to become a doctor. There are a few doctors on the show, but the majority are medics, and this was a new concept for TV viewers. While M.A.S.H was very successful, the repetition of the same injuries each episode combined with the lower level medical skills of the characters led to the show's end in 1983. (Gelbart, 1972)
One of the lesser known, but still successful medical shows is a British television series called Doc Martin. The pilot episode premiered in 2004, and it ran for seven seasons. The main character, Dr. Martin Ellingham is a surgeon in a London hospital when he suddenly becomes afraid of blood. This causes him to move to the small fishing village of Portwenn and open up a clinic. His social awkwardness and bluntness frequently get him in trouble. He pushes everyone that cares about him away until he finds the love of his life and they have a child that he comes to adore. During this main storyline, he is taking care of patients in his surgery. As long as there's no blood, he is fine. The sight of blood causes him to gag and sometimes vomit, an irony that makes the show so amusing. While he is working in his small freestanding clinic the majority of the time, occasionally he will head out into the community to care for people in their homes. This clinic is several hours from a hospital, so Dr. Ellingham is forced to deal with the majority of medical cases, no matter how big they are. The series ends with the family of three living happily ever after. The majority of Doc Martin after the pilot episode is set hours from a hospital and that makes for an environment challenging to even the most skilled of physicians. This is the single most impressive aspect of the series. There is speculation that the series will be revived within the next year or two and it remains to see what is up with Doc Martin, his family, and the people of Portwenn. (Minghella, 2004)
2009 brought Royal Pains, the popular medical drama featuring brothers Hank and Evan Lawson. Dr. Hank starts out at a hospital in New York, and when he decides to save a kid over the hospital benefactor, his superiors are angered, and he is fired. After a year of pouting, he is convinced to come to The Hamptons and open up a concierge medical practice. This means that while Hank is occasionally at the hospital and can send patients to the hospital for additional testing, he primarily sees them in their home or wherever they are when illness or injury strikes. While Hank always has at least one patient with a dramatic past, he is always on standby for an older man with a fatal genetic disease. Because of this gentleman, Boris, is so rich and people want him dead, there is always drama in Hank Lawson's life. The show is about 50/50 medical and personal life. In his own life, Hank is dealing with girlfriends, Boris, his brother's awful financial advice, and the repeated imprisonment of his father. Just when he thinks he has life figured out, something else happens to rock the world again. This split between a medical drama and a comedy made the show successful, as it ran for eight seasons before concluding its run. (Rauch, 2009)
In 2011, the TV show Hart of Dixie premiered, and it featured a young, ambitious surgeon named Dr. Zoey Hart who is brought to Alabama against her will to run her father's medical practice with his unpleasant longtime partner. In the heart of the south, the medical clinic is small, freestanding facility in a town called Blue Bell. There's no hospital affiliated with it and the capacity to perform procedures and tests more than something simple is severely limited. In fact, other than a few small exam rooms, a waiting room, and a reception desk, the clinic is not all that big. In fact, it serves as a primary care place for routine checkups more so than for acute care. While Dr. Hart and her partner are capable of caring for many ailments and injuries, the facility is not very sophisticated, thus limited their scope of practice. This differs drastically from other modern shows like Scrubs and Grey's Anatomy where they are always near the next level of care, machines required for testing, specialists, and nearby operating rooms that are available should they become necessary. (Paymer, 2012)
Additionally, it is not infrequent that someone in town is seriously injured, for instance, in a farming accident, and they get trapped. Whenever there is a substantial injury, Dr. Hart is usually called to the scene to help out. The medical care is coming to them, which is not an unusual thought as we have EMTs and paramedics in most areas. However, the average doctor does not make house calls. All of this leads to exciting drama, and as I mentioned earlier, there is a heavy focus on the personal lives and interactions of the doctors versus the actual medical aspects. Hart of Dixie is so different from other medical dramas, and it has such a heavy focus on the personal issues instead of the medicine that I am reluctant to call it a medical drama, but there is certainly a strong medical component. (Paymer, 2012)
Call the Midwife premiered in 2012 and it is currently in its seventh season. This show is unique in that while it is filmed in the 21st Century, it is set in the early to mid-1950s. Set in one of the most impoverished areas of London, Call the Midwife follows the journey of a young nun living in a convent that specializes in providing midwifery to lower income women. The focus of the show is primarily about the struggles of the sisters to keep their facility running more than personal turmoil. However, every once in a while, an episode will focus on the private lives of the midwives. The medical care provided is always exclusively midwifery, and the nuns make house calls. Very rarely does someone come to their facility to give birth. The idea is that they got to where they are needed the most in the community. (Lowthorpe, 2012)
The medical sophistication is non-existent. There are a few simple tools they keep in their bags, but they rarely use them. Most of the time they can get by with ordinary household items like towels, blankets, hair clips, and scissors. Unlike the other two TV shows I mentioned, all of the medical care in Call the Midwife takes place in the patient's own home, which in the mid-1950’s is not as radical of a thought as it is now. This series has found ongoing success because the ideas behind it are so novel to us today. If someone were to watch this period drama in the 1950’s, they probably would not find it as appealing. (Lowthorpe, 2012)
Many complex changes and trends have taken place over the past 60 years, but some of the most notable ones are: the gender differences of the TV physicians of 1960’s to the TV physicians of 2000’s, the differences in the portrayals of doctors in movies vs. televisions shows, the differences in the behavior of doctors on talk shows vs. those on medical dramas, the transition from a focus on the patient to a focus on the private lives of doctors, the changes made to TV medical dramas in hopes of making them realistic without allowing the show to be boring, and changes to the setting in which doctors practice. There is no shortage of media texts consisting of various types of medical shows which allow us to track and study the many trends and changes to the role of the doctor on television and the big screen.
Comack, J. (Director). (1961, September 28). Dr. Kildare [Television series]. New York CIty, New York: NBC.
Gelbart, L. (Director). (1972). M.A.S.H [Television series].
Hermstad, L. (Director). (2008, September 8). The Doctors [Television series]. CBS.
Jewett, R., & Lawrence, J. S. (n.d.). The American monomyth in the new century.
Lawrence, W., IV (Director). (2001). Scrubs [Television series].
Lowthorpe, P. (Director). (2012). Call the midwife [Television series]. BBC.
Marshall, P. (Director). (1990). Awakenings [Motion picture on DVD]. Great Britain: Yorkshire Television.
Minghella, D. (Director). (2004). Doc Martin [Television series]. BBC.
Oz, M. (Director). (2009, September 14). Dr. Oz [Television series]. Syndication.
Paymer, D. (Director). (2011). Hart of Dixie [Television series].
Rauch, M. (Director). (2009). Royal Pains [Television series]. USA.
Rhimes, S. (Director). (2005, March 27). Grey's Anatomy [Television series]. New York CIty, New York: ABC.
Rhimes, S. (Director). (2007, September 26). Private Practice [Television series]. ABC.
Shadyac, T. (Director). (1998). Patch Adams [Motion picture on DVD]. USA: Universal Pictures.
Shore, D. (Director). (n.d.). House M.D. [Television series]. FOX.
Tapper, E. B. (2010). Doctors on display: The evolution of television's doctors. PMC. Retrieved June 5, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943455/.
Thomas, R. “House Calls.” BMJ: British Medical Journal, vol. 339, no. 7735, 2009, pp. 1416– 1417., www.jstor.org/stable/25673523.
Victor, D. (Director). (1969, September 23). Marcus Welby M.D. [Television series]. New York City, New York: ABC.
Webb, J. (Director). (1972). Emergency! [Motion picture on DVD]. United States: NBC.
House M.D., Diagnosis, and Inference
Meghan L. Bayer
University of Pittsburgh
28 March 2017
When we are, sick or injured, most people turn to doctors for help. The conversation might look something like this: “Doctor, please help me. I do not feel well.” Doctor: “What seems to be the problem?” Patient: “Well, I am tired all the time. I am coughing frequently, have a fever and I am very achy. What is wrong with me?” In this situation, the patient is presenting with very general symptoms, which may indicate something like the flu, a bad cold, or some other type of common virus. This is a common scene that plays out every single day all over the world. While we may have some ideas of what might be wrong, we usually do not know for sure. When the doctor has listened to the patient and conducted a thorough physical examination, they got through a series of steps to find out what is ailing their patient. The media plays a large role in how we portray doctors, how we expect them to act, and how we are supposed to act while interacting with them. That being said, how does House M.D. produce a particular vision of diagnosis and inference in medicine? For the remainder of this paper, various forms of reasoning will be discussed, examples from the show presented, the options of experts studied, and an exploration into why Dr. House and his brilliant team have so much success as diagnosticians. (Shore, 2011)
When they have reached their conclusion or diagnosis, the doctors should know how to effectively treat their patient. Sometimes, a disease is so rare or so obscure that a physician may not have the tools or the knowledge to effectively identify and treat the condition. While it is possible that a lack of knowledge on the condition is a possible cause for the delay in diagnosis, sometimes there is a flaw in the logical process. This process, which is known in medicine as diagnostics, is the inferential process by which physician reaches their conclusions. There are many different types of inferences like induction, deduction, and hypothesis, which will be discussed in greater detail throughout the remainder of this paper.
One such brilliant diagnostician is a doctor by the name of Gregory House. Now, if you have seen the show House M.D., you know that Dr. House is a stellar diagnostician. While his methods by which he reaches his diagnoses can be somewhat questionable, he has mastered the art of diagnosis, which is, in some ways, a form of the art of logic. While Dr. House and his team are fictitious characters in popular television show, there are many real elements of the show, including the diseases covered and the process by which a diagnosis is reached. For many people, especially those that go undiagnosed for long periods of time, Dr. House and his team composed of experts from many specialties, may be seen as the ideal medical team. In the following paragraphs, we will explore the perception of diagnostics that is portrayed by the television show and the specific rhetorical and logical elements of the diagnostic/inferential process.
Diagnostics is an inherently rhetorical situation, meaning that there is a problem somewhere in the human body and it is up to the physician to figure out what the problem is and treat it. Unlike some cases of real-world medicine, by the end of the hour-long episode of House M.D., a diagnosis has been reached, the patient has been treated, and they are usually ready to go home. For more common conditions, it is reasonable to believe that this is case. However, the show is misleading in that it leads the viewers to believe that a diagnosis is always identified, the condition is always treatable/curable, it is done in a timely manner, and that the patient doesn’t normally die. While this may be the case in some cases, this portrayal of diagnostics by the mainstream media can be somewhat inaccurate in real-life.
While you do not need a brilliant, Vicodin addicted, diagnostician with some pretty serious narcissistic personality disorder and a chronic pain issue to get results, there are three major reasoning strategies that Dr. House and his team use to identify their patients’ mystery conditions. (Shore, 2011) These are inductive reasoning, deductive reasoning, and hypothesis. Before I provide examples from the television show, I want to briefly explain the definitions of inductive reasoning, deductive reasoning, and hypothesis.
In Steven Beebe and Susan Beebe’s popular public speaking textbook, A Concise Public Speaking Handbook, inductive reasoning is defined as “reasoning that uses specific instances or examples to reach a general, probable conclusion”. (Beebe et al., p.263, 2015) A popular example of inductive reasoning is “Socrates is a man. All men are mortal. Therefore, Socrates is mortal.” As seen in this example, we started with Socrates, one very specific individual. Eventually, an assessment of the mortality of all men was made and because the first two parts are related and true, the third part about Socrates being mortal is correct. Inductive reasoning is not as common in medicine, simply because you need symptoms and evidence of dysfunction to be able to diagnose most conditions. However, medical knowledge is founded on inductive reasoning. In some cases, doctors may be able to jump to the diagnosis, but that is not always the case.
Stephen and Susan Beebe define deductive reasoning as “reasoning that moves from a general statement or principle, to a specific, certain conclusion”. (Beebe et al., p.261, 2015) A common example from rhetorical studies is “All men are mortal. Socrates is a man. Therefore, Socrates is mortal.” This time, we start with an assessment of all men and work our way down to the one specific person being referenced, which in this case is Socrates. In season 7, episode 18 of House M.D., House and his team are faced with a patient that has excruciating joint pain, fragile skin, easily bruising skin, and frequent joint injury. They are starting with the general symptoms and working toward the diagnosis of Ehlers-Danlos Syndrome from general to specific. (Shore, 2011) When using inductive or deductive reasoning especially, you must be careful that all facts are correct. One wrong part makes the entire reasoning false. A common pitfall to reasoning, one that Dr. House and his team frequently find themselves doing, is a causal fallacy. Just because something makes sense and is possible, does not mean that that is the true reason for the issue. For instance, a patient having pain could have a psychiatric problem making them think they are in pain when they are not, but in the case of season 7, episode 18, Ehlers-Danlos Syndrome (EDS) is the more likely cause of the pain. (Shore, 2011)
The third form of reasoning is hypothesis. For the hypothesis, you do not start with the most general idea or the most specific idea, rather you start with the middle concept. Using that concept, you can make more inferences. A common example of hypothesis from rhetorical studies is “Socrates is a mortal. All men are mortal. Therefore, Socrates is a man.”
Another important part of the logical process of diagnosis is inference. In the A Concise Public Speaking Handbook, inference is defined as “a conclusion made based on the available evidence or partial information; an evaluation that has not been directly observed.” (Beebe et al., p.263, 2015) This is exactly the kind of process that would occur in diagnostics. You establish the general problem, run tests to get evidence as to what is going on, and you use that available evidence to develop a conclusion/diagnosis. As with inferences, a doctor does not always have all the information, which, like many things, can be restricted for a variety of reasons. Sometimes the diagnosis can only be proved by treating the patient’s symptoms and if they respond to treatment, it is reasonable to believe that the diagnosis is correct. This is useful when diagnostic tests are inaccurate or there are several conditions that cannot be ruled. Most diagnoses begin as inferences obtained through various forms of reasoning.
Analogy is also an important part of the diagnostic process. Doctors spend years memorizing the many triads of symptoms that are indicative of a disease when they show up together in a patient. Every person is getting compared to cases they have seen, treated, or read about in the past. For instance, if you see symptoms x, y, and z show up in a patient and it is indicative of a particular condition, using past experiences with patients in a similar situation can be helpful. Part of the issue that poses a major barrier in diagnostics is the patients’ ability or inability to articulation what is happening. People that are more readily able to articulate what they are feeling are more likely to have an easier time then someone who cannot articulate what they feel. (Kuchinskaya lecture?) During the season 7, episode 18, the young woman with Ehlers-Danlos Syndrome, a rare connective tissue disorder that affects the strength of muscles, tendons, and ligaments, could effectively convey was she was feeling, which made obtaining a diagnosis somewhat easier. House and his team also deal with either/fallacies, which happens when they say it’s one condition or the other. We cannot figure it out, but it cannot be both. When they are restrained by this fallacy, patient outcomes are generally more poor, as we see in season 7, episode 18 with the young woman. (Shore, 2011)
Dr. House is famous for his abundance and frequent use of ad hominems, which are instances where one does not attack the argument being made by another, but rather the person and their character. Throughout the eight seasons that the show ran, House was attacking someone or calling them “stupid”, “idiots”, etc. when one of the other doctors presented an idea for a diagnosis that was so obviously far-fetched and wrong. This can be seen at least once an episode. (Shore, 2011) While often disconcerting for his team, it was his effective way of encouraging the search for the proper diagnosis.
Dr. House is also notorious for his disregard for the rules of Princeton-Plainsboro Teaching Hospital, the facility by which he is employed. This means that he does not listen to the head of the hospital, Dr. Lisa Cuddy at all. This paints an extreme example that may lead viewers of the show to believe that doctors do not follow the rules, when in fact the kind of behavior Dr. House displays would not be acceptable in most real-life hospitals. This may be a fictitious character, but the problems caused and portrayed in the show are very real problems faced everyday by doctors and patients alike in the process of diagnostics. Per Czarny, "The portrayals of physicians and the ethical issues they faced in televised medical dramas may influence popular attitudes, beliefs, and perceptions. Studies indicate that television viewing has a measurable influence on certain beliefs and practices. Inaccurate or unrealistic depictions of ethical issues and a lack of professionalism by television physicians adversely affect public perceptions as well as healthcare professionals in general." (Czarny et al., pg. 203, 2009) This goes to say that how the public sees physicians portrayed on television may affect their perception of doctors. In the case of House, he is not sending a positive message consistent with an upstanding physician, but he is extremely bright. This helps lead people to believe that obtaining a diagnosis is quick and easy, when many times it is anything but easy. This perpetuates the notion that doctors know everything, which like any other human, is false. In their paper, Thomas et. al agree with this conclusion developed by the Czarny and his colleagues. This is a popular idea among researchers in this field. (Thomas, 2009)
House and his team spend a lot of time discussing different possibilities as to what is causing their patients’ problems. They engage in direct persuasion, mostly in cases in which there are not as many different potential diagnoses. Direct persuasion occurs when people work to convince others to believe what they believe using the available logic and facts. This is always occurring when each member of the team makes a case for a certain illness that is it their specialty. (Jacoby, 2009) During this process, the team brainstorms possible diagnoses and they all work to refute conditions that do not fit the profile.
The dynamics of House’s team are obviously dramatized for the purposes of entertainment, but the process by which they we reach their diagnosis and the reasoning strategies they employ throughout are still very important. Dr. House is portrayed as a socially awkward genius with a God complex, but not all doctors in real-life are like that, nor do average doctors diagnosis conditions as quickly as Dr. House. The logic and reasoning applied to the show are excellent examples of real world processes, even if the speed of the diagnosis and the characteristics of the team are dramatized for entertainment purposes. Over the eight seasons that the show ran, millions of people watched the show and has their perceptions of physicians altered, consciously or unconsciously. The show is a more subtle way to encourage people to look at physicians differently.
As you can see, House M.D. paints a very distinct picture of how diagnosis occurs in the world. However, there are some elements that are just simply not the case. This television show shows the average person the many ways conclusions can be reached and some of the dangerous pitfalls to logic and reasoning causing misdiagnosis or a delay in the diagnosis. Most people will probably take the show at face value and not read into it the way I just did, but if you do consider it more carefully, you can see the many ways that real reasoning strategies are used. House M.D. creates an accurate portrayal of the process to diagnosis, just in a more compact amount of time. If viewers can understand that the process, which shortened for the purposes of entertainment, they can really get a much better understanding or what goes into the diagnostic and inferential process and understand the image of diagnostics and inference in House M.D.. (Jacoby, 2009)
Beebe, Steven A., and Susan J. Beebe. A Concise Public Speaking Handbook. Boston, Pearson, 2015.
Czarny, Matthew J, et al. “Bioethics and Professionalism in Popular Television Medical Dramas.” Journal of Medical Ethics, vol. 36, no. 4, 2010, pp. 203–206., www.jstor.org/stable/20696763.
Jacoby, Henry. “Chapter 5.” House and Philosophy: Everyone Lies, Wiley.
Shore, David. “Season 7 Episode 18.1.” House M.D., FOX, 11 Apr. 2011.
Thomas, Rhys H, and Naomi J P Thomas. “House Calls.” BMJ: British Medical Journal, vol. 339, no. 7735, 2009, pp. 1416–1417., www.jstor.org/stable/25673523.
“Another potential reward or being an ‘anonymous expert’ [in the context of Wikipedia] lies in the ethos this generates. If an author’s name is not attached to her article, ownership of the work is uncertain. If personal ownership is uncertain, the expert can claim that she donates the work [selflessly] to the public, in a sense offering it for the greater good” (Hartelius, Rhetoric of Expertise, 147).- Anonymity of expertise- expert donates the idea; which displays a type of ethos, because the expert is licensed to speak to non-experts in the field.
-When you’re an expert, that is not important
-“I’m in pain”- everyone is an expert on themselves (which is where the idea of patients and their families being experts on themselves comes into play. Consistent with Hartelius’ beliefs)
Idea of eloquence- patient’s articulation of their signs and symptoms can make or break the diagnostic process. Can impact the diagnostic process for the elderly and the younger, two populations that be harder to diagnose due to their possible inability to articulate their feelings, signs, symptoms, discomforts, etc.
Exploration across different kinds of rhetoric- diagnostics would be considered a type of rhetorical situation according to Bitzer. Only apply to untreatable/incurable diseases?
Dr. K- anti-House in large part because of the idea of operating under the assumption that everyone lies. House MD- Everyone Lies, which they do, but it isn't always to be deceptive, sometimes could occur because someone doesn't have the word to eloquently explain what they are feeling/perceiving with their senses. Not the manner in which the people who wrote the show intended it; but may not be as far from the truth, contrary to my initial belief. This concept is twisted in a way so that the show is most entertaining (more fun for the viewers if the doctor is sarcastic and rude to his patients and accuses everyone of lying), so it is not the most accurate portrayal of diagnostics.
Lots of doctors gain their initial interest from shows like House, Grey's Anatomy, Scrubs, ER and other reality medical TV shows. *Interesting study Dr. K mentioned that House was #1 for influence and the rest of the shows followed after that, see if I can find that
Interested to see if Grey's Anatomy has overtaken House MD since it came off the air and how this has influenced the perceptions of doctors inspired by one or the other, could be an interesting question. How are aspiring doctors influenced by popular medical TV shows?
Doctors not believing patients, thinking they are lying, accusing them of functional, psychosomatic, or somatoform disorder is an all too real part of obtaining a diagnosis for many people with rare diseases. Even if it is not the patient, their caregivers may be accused of faking symptoms (Munchasen's by Proxy, common with children of minor age, medical kidnapping (Justina Pelletier vs. Boston Children’s Hospital case), etc.)
As a person that does taekwondo in a wheelchair, I get a lot of weird looks and questions. I want to address two of them here. I get this question a lot, usually around testing time, each cycle: "What's it like doing taekwondo in a wheelchair? Isn't it easier?" Well, yes and no. It is easier in that I don't have to worry about stances and footwork.
It is harder to move around and evade other when sparring and I can't move laterally, which is pretty important. Every time I go to move the wheelchair in sparring, I have to drop my hands, which allows my opponent to kick me in the head. Same situation in combat, when I go to move the chair, I'm leaving myself wide open to get hit. I do miss jump kicks and spin kicks a lot.
The timing on a form from a wheelchair is different too and sometimes it is really challenging to learn it when the only form you see is one done on the feet. There really isn't a standard on video of what my form should look like.
Doing taekwondo from the wheelchair is definitely restricting in some ways too. Doing ssahng joel bongs, the jahng bahng, and occasionally the Sam dan bong, are extremely challenging. At this time, I have not found a good way to do the nunchucks in the chair. I'm not sure there really is a good way honestly. I'll stick to my stool for now. Every single one of my kicks is restricted, some worse than others and unfortunately, doing a technically correct kick doesn't always happen depending on my position. My kicks don't get as high as I'd like them to be be. Certain stretches, while modified, aren't as effective.
Now, one might think that sitting down makes balancing so easy. It's easier, but not easy. When I do any kick other than a front kick, I am balancing on one hip. Remember, that cushion under me is very dense. That is all pure core, back, and hip muscle strength keeping me from falling one way or another.
When doing a taekwondo form in a wheelchair, the pressure is on to make it look like I'm not even moving the chair. After all, the chair is the tool I'm using and I'm what I want people to see, not the chair. Like any martial artist, I want to make others believe that I am fighting someone during my form.
I would say that there is extra pressure to have strong, crisp hand techniques with good timing when doing a TKD form in a chair. In my mind, it compensates for the lack of stances or footwork. I mean there is definitely wheelchair handling involved too. I guess that makes up for the footwork in some ways. Handling the chair on the mats is definitely harder than typical footwork in my opinion.
All that being said, it's made me a better martial artist and instructor. It drives me crazy that almost 10 months later, I'm still in the wheelchair, but I know that it will be all worth it in the end. So it is easy? Definitely not. Is it easier? Depends on the circumstances and what technique you are referring to. It's a complicated answer just like me!
In a week, I will be an "only child" again for the first time since 1998. I cannot believe that Evan is heading off to college and I am thrilled that he is attending Pitt-Johnstown to start. The Pitt family legacy lives on and I'm so excited that he is excited about his coursework.
I think the hardest part for my parents is letting my brother and I fly on our own knowing perfectly well that we will inevitably make stupid mistakes. Plenty of them. I'll have my phone ready to take calls when Evan is freaked out the night before classes start (because that happens to everyone), I'll be ready to explain the Krebs Cycle for General Biology 1, and I'll be the first to drive him crazy if he gets behind. I'll also be there when he just wants to talk college or life. I really think the time apart will make us even closer.
Evan is majoring in Biology on the pre-medicine track at the University of Pittsburgh at Johnstown (UPJ). He has an apartment and a packed semester of 17 credits ahead. Ah that Pre-med life!
As for me, this semester will straddle junior and senior year, as I'm a half semester behind due to the Mayo disaster. Minor will be done this fall, my major will probably be done in the spring, and my certificate will probably be done in December 2018. I can't believe I'm about 30 credits from my undergraduate graduation. I've had to look at college as a block of 7-12 random credits at a time. I couldn't plan ahead. My health is/was so unpredictable. It wasn't until I looked at my official transcription the other day that I realized that I am so much closer to my goal than I thought. Crazy how that works honestly.
I've finally allowed myself to believe that I will graduate from undergrad and that graduate school for Disaster Relief, Emergency Management, and Homeland Security will be a reality. I know what I want to do now for the first time in a long time and whether God intends for me to walk flat footed again or not, I can have a job in the field regardless. I've finally broke through that mental wall and that is huge!
I've been on an emotional roller coaster the last couple days. With the loss of my high school algebra teacher, my 21st birthday, the quickly approaching 5 year anniversary of my Gardasil HPV vaccine injury, and the start of my second half of my junior year of college, there's been a lot on my mind. Thankfully, my pain management doctor agreed to keep writing for the medication I need and my neurology appointment got moved from November to September 5th. I'm still doing IVIG every 28 days and it's hard on my body, but for the three days it works a month, it works pretty well. We need to adjust the treatment plan at the next appointment as I am getting worse.
I feel so incredibly blessed that God answered my prayers today! I ventured up to Cleveland to see my pain management doctor with my dad. I was prepared to fight for a treatment, but thankfully, I didn't have to. I did extensive research on CRPS treatments and medications that I haven't tried. Benefits, risks, efficacy in clinical trials... Really all of it. During the drive up, my dad and I discussed different options and came up with a few, but none as good as my existing treatment plan.
At my last appointment, I was told that the one medication that has been keeping me functional, allowing me to work, go to school, have a social life when I want to, volunteer, and participate in sports was going to be discontinued. At that appointment, I was by myself and it was a huge blow. I was not expecting the appointment to go as badly as it did, so I went by myself. Big mistake on my part. I really just think the doctor was having an off day, so that's why he said the stuff he did.
I pled my case. This medication is the difference between going to school and not, working or not, being able to care for myself independently or not, being able to do sports and hobbies or not... Overall, being functional or bedridden. It was pretty simple and obvious that without it, I'd be a skeleton of myself and we know that when my body gets to a certain level of pain, instead of my heart rate rising, it drops dangerously low, which can cause a whole bunch of problems, some life-threatening like Mayo.
I always thought that because I have never taken (and never will take) opioids for chronic pain management (they don't work anyway and I'm allergic to them) and because I use my medications responsibly, I didn't think that the opioid crisis and the Ohio Heroin Control Law would affect me. After all, I don't take opioids and heroin is an illicit substance with no true medical use. Additionally, the medication is not controlled as tightly as opioids. So why did it affect me? It's because doctors are too afraid to prescribe any medication to people, even those who use it responsibly. Opioids and heroin are big problems right now, but the DEA should not be scrutinizing prescriptions for some of the least addicting schedules of medication. It is absolutely ridiculous and I've been told to makes them fearful to even write a prescription for an acid reducer for acid reflux, something that can be generically obtained over the counter. This is getting plain ridiculous.
But nevertheless, I have another six months of medication that will allow me to continue to live my life. At 21 years old, that's huge because I have things to do, people to see, sports to practice, and people to help. I'm not ready for my life to be over because I can't get the treatment I need to stay healthy.
I couldn't get the medication for a while because of the doctor, not the insurance company. I've been paying out of pocket for the medication for a year now, ever since UPMC and my secondary insurance decided to stop covering it.
A fantastic trip the dentist the other day! No cavities and they were careful not to dislocate my jaw due to hypermobility or keep it open too long and have it spasm shut. Afterwards, the hygienist put a warm washcloth on my jaw and massaged it until everything settled down. Good experience overall.
I think that's all for me. Until next time!
Growing up I required the help of a hearing support teacher. I've had two of them my whole life and this letter is to my most recent hearing support teacher in high school.
the Hearing Support Teacher that never gave up on me,
When I met you for the very first time when I was in 5th grade in the "office" that was actually a broom closet, I had no idea how much of an impact you would have on my life. On that chilly September morning, I remember that I wasn't expecting to meet with you, so when I got called to the office, I was kind of confused. Prior to you, I'd had one early intervention specialist that worked with me immediately post-hearing loss diagnosis and then another hearing support teacher that worked with me from first to fourth grade. In addition, I had just moved into the area, so I really still didn't know anybody at that point.
Over the next three years, you would patiently teach me how to read my audiograms, care for and troubleshoot my equipment, how to define different types of hearing loss, reading comprehension practice reading The Hunger Games series, spelling and vocabulary practice, organizational skills, and the meaning of different legislation protecting individuals with disabilities (ADA, FAPE, and IDEA). I still remember!
But most importantly, you taught me how to advocate for myself and I fought you every single step of the way. I think it is safe to say that meeting after school after I had expended all my energy listening in school all day was not the optimal time, but that's what we had to work with at the time. So we dealt with the meltdowns almost every meeting. I'd be good for the first 10 minutes or so, but the fatigue set in and that was the end of that. It makes me shudder when I think about awfully I behaved. Yikes. I'm glad I grew up and matured!
However, you slowly but surely managed to work the self-advocacy skills into my head. You helped me take more responsibility for my equipment. You helped me maintain a organizational system that worked for me. You made sure that I used my student planner to write down assignments. Including me in my IEP planning meetings was one of the most important steps toward improving my self-advocacy skills. One of the most valuable tools was teaching me how to ask my teachers for help or accommodations, a skill I use to this very day. The day I figured that out, everything changed.
In 8th grade, just before my graduation, you helped me to collect handouts and other information on cochlear implants for me to give to give to my new teachers in high school. We sat down and composed that introductory letter introducing me and telling them about my hearing loss. It was a tremendous help and the teachers loved it. In fact, it was such a huge hit, I used it all four years and tweaked it as necessary.
Going into my freshman year of high school, I was adjusting to life with bilateral Cochlear Implants, having received my second implant just days before school was to start. That entire first year, you helped me make the transition from a grade school class of 11 people that I had known for years to a class of 88 people, none of which I knew. By practicing listening skills religiously each week, my transition to completely bionic hearing was almost unbelievably smooth. My transition to high school was amazing academically and socially. I played basketball on my school's team, participated in service clubs and other community service opportunities, and I joined a youth group that allowed me to go on mission trips.
After my freshman year, you retired after a long and successful career. I was supposed to be assigning a new hearing support teacher, but I never requested one. And do you know why that is? You had successfully taught me how to advocate for myself; skills I use 8 years later in college.
Thankfully, my initial refusal to acknowledge my hearing loss or advocate for myself hasn't held me back in the long run. I now serve as a hearing center auxiliary volunteer, where I get to share my story with parents of newly diagnosed children and answer their questions. I'm also blessed to have the opportunity to help other deaf children along this educational journey. This is all so ironic to me, because I was an absolute nightmare about practicing self-advocacy skills.
Now we can look back on the chaos I caused, but in the end, the job was completed and done well. Your job was not easy at all, but it was a critically important one.
Thank you for being my hearing support teacher, advocate, and friend!
I am a 20 year old junior at the college of my dreams. I am studying Emergency Medicine and Communication Rhetoric and minoring in the Administration of Justice and National Preparedness and Emergency Management certificate. At some point, I want to go and get my paramedic certification when my health allows. I have several chronic illnesses and this blog and website serves as a place for me to share my journey fighting CRPS and my other conditions. I hope that this blog can also serve as an outlet for raising awareness for rare diseases. Thanks for reading and I hope you enjoy! Feel free to comment; I'd love to know what you think!