People in healthcare need to understand the social model of disability.

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It could have been a scene from a film. Either a remake of the 1967 British comedy “Carry On Doctor” or a possible start to a murder scene from another Faas Kramer detective thriller. It went something like this:

“Hello Mr Kamerling? My name is Assistent Doctor Ivor Thikbrain. I’m from Barcelona and I know nothing…”

Well, those weren’t his exact words and he didn’t sound like someone from Barcelona. Neither was he an immigrant living and working in Torquay. No, this was a fresh trainee at the rehabilitation centre of the University hospital of Leuven and he conducted an initial intake for the doctor as part of my annual check-up. If I would have known his level of proficiency beforehand, I would have stayed away.

Don’t get me wrong. I can accept the busy schedules of overworked doctors; I can forgive them for forgetting we are customers, I can even understand the apparent inefficiency causing us to hang around for three hours in the naive understanding that we have nothing else to do. But what I just cannot understand, nor hardly accept, is such utter buffoonery and sheer incompetence.

doctor-1461911946B29The trainee was tall, dark-haired, keen and polite, wearing a white coat of authority. A typical Belgian who had enjoyed the excellent and unsurpassable education system the country affords. After an initial discussion throughout which the trainee studied my medical record on the computer, probably seeing it for the first time, he asked: “Could you get on the flat-bed please…”

“Sure!” I wheeled away from the desk, transferred onto the flatbed and I swung my atrophied legs up revealing my black compression stockings, hardly sexy, and asked him, “Should I lie down?”

“Wow! That was easy,” he exclaimed as if seeing the birth of cute little puppy dogs. I dismissed the comment as he had obviously not read the part of my record that I was a wheelchair basketball player and physically capable. Surely he didn’t lift all other patients did he?

He touched my leg.

I’m sure he wasn’t a pervert or anything, but he felt it all the same.

“Do you feel that?” he asked.

“No. I am a paraplegic, lesion complete,” I replied. “I cannot feel my legs…”

He felt a little lower down the leg. “How about here…?”

I repeated. “No, I told you, I’m a paraplegic…”

He was now down to my ankle. At this point I felt relieved he went down and not up.

“…and here?”

People will tell you I’m a patient person. They will also tell you that I always remain calm whatever the circumstances. But this was bordering on the ridiculous.

“Doctor, you could stick a pin in my leg and I would not feel it. You could thrust a knife in my leg and I still wouldn’t feel it. You could take a chain saw and cut off a leg and I wouldn’t feel a thing…”

“Oh…” he replied as if understanding for the first time that the earth was round.

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It’s easy to blame the trainee (and I do), but surely education is to blame too. We see the Paralympics on television, we see government programs gearing towards more inclusive education and employment, and we see companies applying a greater sense of responsible business culture. Yet our educational systems seem to be stuck on teaching the Medical Model of Disability; that of care and pity.

One could argue that this is logical, especially in healthcare. But students are also taught that patients are people, and therefore the Social Model of Disability should prevail (see video by UK charity Scope). Life doesn’t stop when someone becomes impaired, it just changes. And trainee doctors should not underestimate their responsibility of being change agents. To have a lack of understanding of both the impairment and the social ramifications thereof is very short-sighted indeed. 

When the young physician took a small hammer from his pocket I instantly knew what was coming. I could have yelled FIRE! I could have called emergency services. But I decided to quietly accept my fate, be it with scepsis and disbelief. “Err, that won’t work doctor. My legs haven’t moved for 35 years. I don’t even have spasms. You should save your effort…”

Words were lost in his youthful and fresh professional exuberance, and he gave a well-measured rap on the knee. He waited for the ultimate reaction and seemed disappointed when none occurred. “Let’s try the other one…”

I couldn’t help myself. “Really…? I have one body and one back. Both legs are connected…” I said perhaps a little too sarcastically. If he was pulling my leg, I would actually have felt that. But he wasn’t. He was as serious as a heart-attack.

Another well-aimed rap on the knee. Still nothing. The would-be miracle worker was disappointed again. Quickly moving on he said, “Well let’s look at your back shall we. Ah yes. I see you have quite a scoliosis.” (I had told him this beforehand). And then as he observed me buttoning up my shirt, he asked: “So who takes care of you at home?”

Is this guy for real? “No one doctor. I take care of myself.”

The man was astounded. “What, you even wash and dress yourself?”

“Well yes. Why is that surprising…?”

Not hearing the question he continued, “So you live alone?’

“No… This has nothing to do with the first. I take care of myself because I can. But I am also married and have a son.”

By this time the trainee had to sit down. He could only deal with so many surprises in one day. He looked at the screen and said. “Wow. You work too…! In administration.”

With indignation I said, “What? Is that what the computer tells you? I’m President of Europe, Middle-East and Africa for a multinational electronics company. That’s a little more than administration…”

I swear he almost fell off his chair. Clearly too much for him to fathom, he ran out of the room yelling for the doctor.

A real one…

 

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