Braille Monitor                                                 December 2011

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I Thought I Was Oriented, but I Was Mistake
My Odyssey of Orientation and
Mobility Training

by Mary A. Tozzo

From the Editor: Members of the National Federation of the Blind take justifiable pride in our adult training centers in Ruston, Louisiana; Denver, Colorado; and Minneapolis, Minnesota, as well as the growing number of facilities in other states that have adopted to one degree or another our methods and underlying philosophy of high expectations and self-confidence. We recognize, however, that such centers are never going to be able to train every blind adult. Many people will necessarily make traditional rehabilitation choices. Most of these folks will enroll in facilities staffed by dedicated professionals with a range of skills and attitudes underpinning their commitment to effective training. Many Federationists have been dissatisfied with the quality of the rehabilitation they received in such facilities, but it is important to remember that effective training always depends a good deal on the determination of the student. We received the following partial autobiography from a graduate of a training program that, as far as we know, has been uninfluenced by our philosophy and methods. We are publishing it because it demonstrates the good news that mobility instructors committed to instilling independence can achieve successes in training students in any setting. Here is Mary Tozzo’s story in her own words:

From the time I was little, I knew that I had a visual problem. While other children played outside in the evening without regard to the setting sun, I dreaded the twilight because it plunged me into total darkness. Not until more than a decade and a half later did I learn the cause of my visual predicament. When I was a senior in high school, I was diagnosed as being legally blind due to retinitis pigmentosa (RP). Until that point the doctors had been telling my parents that nothing was wrong with my vision and insisting that I was just trying to get attention. They advised my parents that, if they ignored my behavior, it would go away. This declaration turned out to be no more than a cruel misdiagnosis since in reality I was going blind. (The physician that diagnosed the RP later informed me that every textbook symptom of RP appeared in my chart as my complaints throughout childhood.)

I found that finally having an actual diagnosis, although delayed, was comforting. Although there was no cure or treatment for my condition, it was psychologically reassuring to know that there had indeed been a legitimate cause for my visual difficulties. One of the first symptoms of RP is night blindness, which I had been experiencing since childhood. RP causes progressive vision loss. At the time of diagnosis, it was predicted that I would become totally blind somewhere between the ages of thirty and fifty. I was discouraged from pursuing a career in nursing because the doctors believed that I did not have enough visual acuity to be capable of keeping up with the required reading or providing direct patient care. They advised me to become a secretary and be happy with the few years that I would be able to work. I stewed over my predicament for a few weeks and decided that I would go to nursing school anyway. What was the worst that could happen? I would fail and would have to make another career choice. I successfully graduated with a bachelor’s degree and provided direct patient care for over two decades. During those years I advanced my career by becoming a certified medical-surgical nurse, an oncology certified nurse, and a certified diabetes educator. As my visual acuity declined, I went back to school and earned a master’s degree in nursing. I don’t think the doctors could have predicted any of that.

Over the years I have been doing my best to adjust to my decline in vision on my own. I learned to make adaptations as needed and find ways to compensate so that I could live a reasonably normal life. I had been working full time and had planned to continue doing so for as long as possible. I had gone from being a staff nurse to a relief charge nurse to finally a clinical nurse educator. I was recently let go from my job due to my visual decline (which is a saga in and of itself). In an attempt to become employed once again, I sought assistance from the Division of Blind Services (DBS), the state agency serving the blind in Florida. DBS referred me to the Miami Lighthouse for the Blind for vocational rehabilitation training. Part of that training included orientation and mobility (O&M), which has been a truly eye-opening experience.

I was assigned to an extremely kind orientation and mobility specialist by the name of John Clapp. (I assume that all O&M specialists must be extraordinary to have chosen this occupation.) My first challenge was to overcome my personal prejudice about using a white cane. I always thought that using a mobility cane would label me as disabled. I also feared that the white cane would identify me as a target for those who choose crime as their occupation (after all, I do live in the big city). Initially I only agreed to train with a cane because it was part of O&M, and O&M was required in order to apply for a guide dog, which I am currently in the process of doing.

I eventually realized that I was the one labeling myself, and that, rather than the cane limiting me, it provided me with more freedom. I found that it allowed me to explore new routes and destinations with less apprehension since I was able to anticipate what was in my path. It was a new experience to walk a hall that was booby-trapped with wet floor signs without leaving a trail of kicked-over signs in my wake. Using my cane, I have also been venturing out to gatherings such as RP support group meetings and National Federation of the Blind meetings on my own at night, something I would never have done before. Others have also had to adjust to my use of the cane. Not everyone is comfortable being seen with someone wielding a white cane. My new attitude is that, if they cannot handle it, they are no friends of mine.

My next challenge involved learning orientation using north, south, east, and west. Since I had never driven a motor vehicle, I saw little need to be aware of what direction I was traveling. I have always maintained that I am directionally challenged and had never seen any need to overcome this deficit. When I researched the word “oriented” on the Internet, defined it as being “adjusted or located in relation to surroundings or circumstances.” I had always assumed that I was oriented enough, but I found that I was mistaken. The stated definition applied to me in two ways. Coming to terms with my visual decline required an adjustment to my circumstances, while being aware of my directional placement was crucial to being able to orient myself in unfamiliar territory. In O&M, as I mastered the use of my cane, I was required repeatedly to navigate the second floor of the Lighthouse while blindfolded. My goal was to be able to map out the layout and state in what direction I had been traveling on each leg of my route. I could not believe how satisfying it was finally to master this task.

My training was then moved outdoors. The Lighthouse for the Blind is located in a neighborhood that I was unfamiliar with, so I first had to find a way to picture where I was in relation to the surrounding streets. Despite the number of times that John repeated the names of the surrounding numeric streets, avenues, and terraces, I found them difficult to recall. I finally realized that, despite my lack of truly usable vision, I was in fact a visual learner. John has told me that he learned from my experience that he needed to inquire what method of learning each student believed would work best since he had been under the impression that I would be able to visualize my surroundings mentally, as many students had done in the past.

I requested a map of the surrounding neighborhood, with the Lighthouse designated as the focal landmark. Using a 20/20 pen, John created a map that met my needs. Once I had this tool, I was able to visualize which direction I was traveling in and could plot my anticipated course. We then proceeded to practice locating addresses. I usually planned my route with my trusty map in hand and succeeded in locating desired destinations. Next I practiced planning alternate routes both going to and returning from designated addresses. Once I was able to orient myself as to the direction in which streets increased and decreased in number (Miami is generally laid out in a grid pattern), I quickly succeeded in mapping new routes.

Another task involved relearning how to cross streets. Until this point, despite my visual decline, I continued to cross streets without special training. I tried to cross at corners with traffic lights whenever possible to lessen the risk. Unfortunately, at some corners the lights do little to minimize that risk. I am sure many visually impaired people can identify with the challenges I faced attempting to cross a thoroughfare. One challenge involves the right-turn-on-red law. Drivers are supposed to come to a complete stop before making a turn. Not only do many drivers fail to stop, they don’t even slow down. Others run over street corners, cutting them short when turning. This makes it challenging for pedestrians to find a place to wait safely when attempting to cross.

I was horrified to learn that, not only are many drivers unaware of the White Cane Law (which provides that a driver shall not approach a crosswalk, or any other pedestrian crossing, without taking all necessary precautions to avoid accident or injury to a blind pedestrian carrying a white cane or using a guide dog), but many judges are unaware of the law as well. In O&M I was taught how to assess traffic patterns and judge when it is safe to cross both with and without a traffic light. Other students kidded me because I tended to swing my cane in a wide arc when crossing the street. I joked that, if any driver dared get too close to me, the result would be a demolished headlight because many drivers trespass into the designated crosswalk and would have only themselves to blame.

I originally shied away from riding a bus or using other public transportation because I have had negative experiences in the past. I have been yelled at for accidentally stepping on someone’s foot by mistake or almost sitting in someone’s lap when I could not tell that a seat was already occupied. I agreed to try riding mass transit as part of my O&M training. Boarding the bus for the first time in over a decade (and with less vision than in the past) was frightening. It made me feel like a toddler being dropped off unaccompanied in the middle of Grand Central Station. Of course I knew that John was trailing not far behind to assure that I was safe, but it was nerve-racking none the less.

I was surprised to find that most bus drivers are now kinder and gentler and willing to provide information as needed. They are prepared to help find a seat (although now I know how to assess the location of an empty seat using my cane) and announce desired stops if requested. I have also found that many of the general population are eager to provide assistance as well. While I have been exploring with my cane, many people have offered advice, notifying me when they think it is safe to cross a street or proceed across a driveway. Others have inquired about my destination, eager to escort me if needed. I then have to resist the urge to say, “Did I ask for help?” In these situations I remind myself that they are just trying to be helpful. My response is a simple “Thank you, I am fine.”

As part of my O&M training I recently rode the Metrorail system, Miami’s rapid transit system. My first task was to locate the track from which my train would depart. I was unable to find an employee to ask, so I scanned the crowd to locate a friendly, or at least nonthreatening, face. I eventually asked a young man where to wait, and he ushered me to the correct platform. He then disappeared. When the train pulled in, the same gentleman reappeared and escorted me onto the train and to a seat. When I reached my stop, he again reappeared to ensure that I disembarked safely. I found the kindness of this stranger touching. I still don’t know if I would dare venture to travel the rails alone, but it is nice to know that I could do so if needed.

Orientation and mobility training has enriched my world in many ways that I never dreamed possible. Cane use has also led to greater freedom and mobility. My next challenge will be training with a guide dog, I hope, another adventure that I believe will open new opportunities for growth. I am grateful that I have been blessed to make the acquaintance of all of my instructors at the Miami Lighthouse for the Blind. They are truly capable of teaching someone who is visually impaired how to do everything short of driving a car. You just have to be willing to try.

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