The Braille Monitor _______ December 1997
Food for Thought: Experience of a Blind Dietitian
by Lynn Mattioli
From the Editor: Lynn Mattioli was a 1987 NFB scholarship winner. During the years since that first introduction to the organization, she has moved around the country gathering the necessary academic, professional, and blindness tools to do her life work. At the 1997 convention she told delegates about her adventures in the past ten years. This is what she said:
Imagine a young woman, wearing a hair net, dashing around to deliver meal trays to sick patients confined to bed, prodding them to eat their chicken soup and lime-flavored Jell-O. When people ask me, "What do you do all day?" frequently this is what they have envisioned. However, it is not 100 percent accurate. I wear a lab coat, not a hair net, but I do encourage my patients with poor appetites to eat well.
I work as a clinical dietitian at a 250-bed hospital in South Baltimore. I cover several areas of the hospital, including cardiology, orthopedics, and neurology. So I spend my day working with patients who have heart problems, those who have had surgery to repair broken bones or replace a joint such as the knee or hip, and those who have had strokes. I also cover a sub-acute or extended-care facility (ECF) affiliated with the hospital. Patients go to the ECF when they have recovered enough to leave the acute-care side of the hospital but need more time before they're ready to go home.
Altogether I am responsible for sixty to seventy-five patients on any given day. Basically what I do is gather information about my patients to identify those people who are at nutrition risk. Then I assess the situation and implement strategies to increase food intake or recommend an alternative route of feeding when necessary. The most technical part of my job is calculating the appropriate composition of solutions used to feed patients intravenously. The solutions are approved by the physician and then prepared by the pharmacy. I am also responsible for teaching my patients about their diet. Nutrition education is tailored to meet each individual's needs. Heart-healthy eating and eating for optimum management of diabetes are the two topics I cover the most.
People often ask me, "What do you need to do to become a registered dietitian?" First let me clarify: there is a big difference between being a nutritionist and being a registered dietitian. Anyone of you here today could claim to be a nutritionist. Those people wearing white lab coats at the health food store in your local mall may have been working selling shoes last week.
In order to be a registered dietitian, you must first have a bachelor of science degree in nutrition. In college you will study anatomy, physiology, biochemistry, food science, and nutrition science. Accounting, economics, business management, and social science courses are also required. Then you must obtain hands-on experience through a year-long internship program. Finally you must pass a national registration examination and fulfill continuing lifelong education requirements to maintain your credentials. Depending on what you want to do as a dietitian, advanced education might be good. I decided to obtain a master of science degree in nutrition because I plan to teach at the university level one day. So you can see that it is more challenging than just putting on a white lab coat.
While I was in college, no one ever suggested that I couldn't be a dietitian because of my blindness. The faculty was very supportive. I used alternative techniques such as readers and lab assistants when needed. I had numerous externship experiences while I was in college, so I was able to explore the profession a bit before I graduated. When it came time to apply for my internship program, I decided to set my sights high. I applied for several of the most prestigious programs in the country. There is a limited number of internship programs, so entrance is very competitive. I also decided to apply for some programs that seemed a little more attainable, just in case.
On the application form I did not mention my blindness because I didn't really think it mattered. I didn't want to be excluded from a program because of misconceptions about blindness. Internship directors are looking for reasons to exclude candidates. I didn't want my blindness to be the issue. I was ecstatic to learn that I had been accepted at the Massachusetts General Hospital, a 1,000-bed Harvard-affiliated teaching hospital in Boston. I did tell them about my blindness after I accepted their offer.
I arrived in Boston a few weeks before the program began, to give me time to move in. I made an appointment with the internship director to discuss the program with her in more detail and to have a tour of the huge facility. I wanted to help her to feel comfortable with my blindness. I remember the details of that afternoon as if it were yesterday. I had my tour; then I was introduced to Helen, the head of the department. Helen invited me into her office to have a little chat. After I sat down, she said to me, "Lynn, I want to be honest with you: I don't think a blind person can be a dietitian. I think it would be easier for a deaf person or a person using a wheelchair to be a dietitian than it's going to be for you." We spent an hour discussing how I was going to accomplish specific tasks related to my job. "How are you going to use the meat slicer?" "How are you going to take apart the food chopper so you can clean it?" "Can you turn the knob?" "How will you know if the employees are stealing food or dealing drugs?" "How will you know if a patient is awake when you go into the room?" I answered her endless string of questions to the best of my ability. After the questions were finished, I explained to her that we were going to need to figure out some things when we got to them. I didn't know exactly step-by-step how I was going to clean the food-chopping machine, but I knew how to clean my own food processor. So to me it was the same equipment, only ten times bigger.
As I was leaving the meeting, Helen left me with some friendly advice. "You'd better go home and pray." I remained composed until I returned to my apartment, and then I did what most young adults would do: I called my mother in tears. She was as shocked as I was. We were Federationists by this time in my life, so we knew that discrimination could happen, but now it was happening to me. I'm certain that they would have terminated me from the program if they could have, but I think they were smart enough to know that I wouldn't have left quietly.
I had two choices: I could agree that a blind person couldn't be a dietitian and return home to Pennsylvania; or I could stand my ground, which is what I did. But I needed people to help to keep me standing. I immediately contacted Job Opportunities for the Blind and got in contact with a blind dietitian in Iowa. We talked on the phone. I don't think she told me anything I didn't already know, but she gave me the gift of reassurance that a blind person could do and accomplish what I was setting out to accomplish myself.
I wasn't alone. Throughout that year I had the support of the Massachusetts affiliate and the Cambridge chapter. At the end of the year, though, my confidence was lacking. My supervisors had encouraged me to do my job in the same fashion as my sighted counterparts. It was as if they wanted me to be that sighted person they thought they had accepted into the program. I was uncomfortable trying many alternative techniques for fear my performance might be judged harshly. I knew at the end of that year that I was a good dietitian. I had the knowledge, and I had experience, but I couldn't hope to be an excellent dietitian unless I attained more confidence in myself as a blind person and better blindness skills.
After attending one of the top internship programs in the country, which turned out to be a living nightmare, it was time to attend one of the top adult rehabilitation programs in the country, the Louisiana Center for the Blind. (We all know where the other top programs are located.) This was a dream come true. I was a different person when I left Ruston. An amazing thing happened when I went for my job interview at Harbor Hospital. This was the first real job interview I had as a professional. My blindness didn't seem to matter to my future boss one bit. We talked about it. I remember her saying, "Obviously you know you can do this job, or you wouldn't be here." It will be wonderful when every job interview is like that.
I know that I would not have been able to become an employed registered dietitian if it hadn't been for two things. For these blessings I am grateful--for my parents who were Federationists long before we discovered the organization and for the National Federation of the Blind. As an organization the Federation paved my way by changing society's views of blindness, insuring security, equality, and opportunity. As individuals many of you have personally changed my life. You have been my friends and mentors. I am thankful. If it hadn't been for you, I might have told Helen that she was right. Instead we did not give her that satisfaction.