Appleasing the gatekeepers

I just finished putting together my Step 2 Clinical Skills (CS) (standarized patient exam) Packet. I have to have permission from the National Board of Medical Examiners (NBME) to take my wheelchair and hearing aides with me into the exam.

Over break I went through my medical records (I have my own small archive of films and records taking up an entire corner of the attic) for the first time as a medical student. It was surreal, the words were familiar to me. I speak the language fluently now, grammar, the note structure, the acronyms all make sense. I was looking for my original audiogram (hearing test) and the Kniest diagnosis paperwork.

I had never read the 10 page genetics paperwork fully. Anyone who has ever had any exposure to genetics knows that geneticists are meticulous (I spent a week on it during peds). They look at ever freckle, every toenail  and scrutinize it for answers of what  kind of biochemical diaster you are… I found it, read it, copied it and put in my folder with my audiology stff (hearing aide stuff), letters from the Dean, my high school IEP (plan for accomdation for a student K-12), Wake and my Rheumatologist’s letter. Today I stuffed it in an envlope with a personal statement (yes they require this) explaining my disease, my good standing as a medical student, species, etc. And for some odd reason I felt violated.

I mean the whole thing is ridiculous…I mean would anyone really tell a disabled person they couldn’t take their wheelchair or hearing aides….I mean this exam (which 95% of US grads pass) is one of the tests that decides if I get to be a doctor to deprive me of my hearing aides in particular would severely hurt my chances of doing well. The fact I have to prove to the NBME I need them is just flat out laughable….or is it…see sometimes I forget.

I have forgotten the awkward admission questions, the fact that my friends get rejected because of their disabilities, i forgot the surgery attending who stopped me on the elevator last July to ask how the heck I thought I was going to pass his rotation or the int med attending who stopped rounds half way through on my first day on the service to ask what my limitations were (in front our entire team, nurses, etc) or the peds attending who is a former AAP president who asked me in the middle of morning report what page are YOU on in Smith’s Book (the illustrated peds bible of  genetic syndromes…I am pg 412 (I think)  of the newest edition).  Oh right…I have forgotten I am actually reinventing wheel…

I’m sorry but is it too much to ask to have something sacred here??? Is it absolutely necessary that the people who write my medical liscene have to know every freaking birthmark, freckle and toenail I have???  Do I have no right or privacy…HIPPA applies to everyone except patients who want to be doctors (or lawyers from what I have been told).

and unfortunately its not just the NBME…This week I e-mailed my Rheumatology (arthritis doc) fellow  a question, he is a really decent doc who I really respect. I mentioned my pain had been worse in the past few months on medicine. He wrote me back an answer to my question and then mentioned that my medicine clerkship director (NOT RHEUM) happened to be sharing clinic space and overheard the fellow talking to the Rheum attending about me.  She apparently had a conversation about me with the Rheums, about my work (good, she says) and her sincere desire for me not to be abused on her rotation (good intentions yes).  I know she meant well but if I wanted her to know I would have e-mailed. her .  You know maybe I didn’t need the person writing my medicine grade and comment summary to know the imtiate details of my chronic pain issues.

sigh.

I could go into a long rant about power issues and about history and how such information could be used aganist me by insurance people or yes gatekeepers who have often historically been physicians who made decisions for my tribe without our input. But really its not about that.

I am not ashamed of any of it, I am not afraid of persecution, there is nothing to really hide…I just would like to be a student doctor…who yes happens to use a wheelchair but who mostly just happens to be a  third year medical student who is a decent one at that.

Yes I really would just like to be a medical student.  Why must I keep proving my right to do that?

yes I am a medical student  with a wheelchair, and a big medical file and hearing aides and FLK on my birth certificate.

it time for the world to get over it…I mean at least by the time I graduate.