Future Reflections July- Sept 1985, Vol. 4 No. 3

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THE BLIND IN MEDICAL PROFESSIONS

by Ramona Walhof

I recently attended the convention of the National Federation of the Blind of Delaware, and a discussion occurred that brought home to me a sharp realization that the Job Opportunities for the Blind program is accomplishing things that no other organization or service can do. The speaker was relating some of the experiences of a blind person who is now the head of the Department of Anesthesiology at New York University. This man became blind while teaching Anesthesiology at the University of Kentucky. He continued to do his work admirably for some time and was offered the position at NYU, which he accepted, and he has worked in his current position for several years. The speaker who related this man's experience said (as an aside to the audience) that: Of course, it isn't reasonable to expect that blind people can be successful physicians. Nobody would want to go to them for treatment. This man is in a very exceptional situation.

Federationists will not be surprised to know that there were individuals present in the audience who took the speaker to task for this statement. They said: What about David Hartman? A lot of people thought he couldn't and shouldn't be permitted to go to medical school and practice medicine. But he did, and he is.

There ensued some discussion. Is it reasonable for a blind person to practice medicine? Are there essential duties a blind person cannot perform? Is it reasonable for him or her to depend on an assistant for some things? Will patients have confidence in a blind physician? What about surgery? What about nursing? Who should make the decision about what is reasonable for a blind person to do in medicine and what isn't?

I realized that Job Opportunities for the Blind has been accumulating data in this area for at least two years and that we have access to and input from blind persons throughout the country. This means that what happens in Kentucky, New York, and ^Louisiana is likely to benefit those in similar situations in California, South Carolina, and Michigan. JOB serves as a national melting pot for collecting and disbursing data about the experiences of blind persons in employment and in preparation for employment throughout the country. It is not the only national service or organization attempting to do this, but its record is more impressive than any other, and its approach is more optimistic and, therefore, it is moving rapidly into new spheres for the blind.

David Hartman, whose story has been publicized nationally, is the blind man who fought to gain admission to Temple Medical School and won. He completed his medical training, specialized in psychiatry, and is now practicing medicine as a psychiatrist. Mark Ravin, the head of the Department of Anesthesiology at NYU, is blind also. Spencer Lewis was a Family Practitioner in Louisiana. When he became blind he believed he could continue to practice medicine. The hospital said he couldn't. His patients wanted him to. He challenged the decision of the hospital and was permitted (with some limitations) to treat patients there.

When this case was brought to my attention, I must confess that I felt some apprehension. I asked one question: How did his patients feel about it? When I was told that his patients overwhelmingly wanted Dr. Lewis, blind or sighted, to treat them, that was enough for me. I said to myself, "If my doctor were suddenly to become blind, would that shake my confidence in him?" I know the answer. My confidence is in the doctor, not in his eyesight, and it would not change. And I said to myself, "Why, then, should I think that blindness might cause problems for a doctor I do not know? Why should I expect a doctor to be more competent if he can see than if he can't?" I have schooled myself to face squarely such questions, even if the path leads me where this one does. The answer has nothing to do with the doctor; it has to do with my attitudes toward blindness. Although I have confidence in qualified blind people as engineers, secretaries, teachers, machinists, administrators, and janitors--I am still subject to society's approach to blindness. Without reasoning it through, my reaction to a blind doctor was one of fear and concern for his competence. Such a reaction has grown from the standard notion that blind people are generally incompetent. I have shaken off this attitude painfully, and bit by bit, but not totally. My reaction to Dr. Spencer Lewis taught me something about myself-- something which causes me to be very careful about saying to blind persons that sight is required or necessarily a controlling advantage. Certainly, it is an advantage, but we must guard against exaggerating its importance--even those of us who are leading the way to try to demonstrate the competence of the blind.

We must also guard against assuming brazenly that blindness does not prevent a person from doing anything. The time may come when technology is such that a blind person can drive a car or pilot a plane, but the time is not now or near at hand, and it would not help anyone especial ly the blind--to pretend that this is not true. If a blind person cannot see to read print comfortably, no pretense or wishing can change the fact. Thus, we must constantly be careful to determine whether seeing is essential to performing a given task, and it's not always easy to know. It is necessary to have knowledge both about blindness and the work to be done in order to have a good chance of finding a method for a blind person to use. I know something about blindness, but I do not know enough about medicine to determine whether a blind person can perform the duties of a doctor or not.

Dr. Spencer Lewis did continue to practice medicine, and his practice increased in size. How can anyone doubt his competence in the face of evidence such as this? If he continued to treat most of his former patients, and new patients came to him as well, (which is what happened)--he was certainly successful as a blind doctor.

When the hospital relented and permit ted Spencer Lewis to treat patients there, they did not permit him to deliver babies. Again, he and his patients considered this unreasonable, and he did deliver babies at home and in the clinic. In fact, he delivered a baby for Federationists Joanne and Joseph Fernandes—new patients who got to know him after he became blind.

In the spring of 1982, Dr. Lewis died, and he is missed by those he treated. The work he did lives on, for it is conclusive evidence that a blind person can practice medicine successfully and that he can gain the confidence of large numbers of patients. And the work of Dr. Spencer Lewis lives on in another way as well.

He realized that it is important for the American Medical Association to recognize that competent performance as a physician need not be impaired by blindness or other physical handicaps. Therefore, he and his wife set about contacting blind doctors and those who are losing vision throughout the country. JOB will carry on the effort to help blind doctors gain acceptance in practice. We believe that more than twenty blind doctors are currently practicing medicine successfully in this country.

But there are numerous other types of work in medicine, and blind persons have been discouraged, if not barred, from entering most of them. This, in spite of the fact that there have been a few isolated successes in almost every area of employment and training. Anthony Burda is a trained pharmacist, and he is blind. When he applied for a license as a pharmacist in Illinois, he was told that as a blind person he could not be licensed. With Federation assistance, Tony Burda was able to receive his license as a pharmacist, and he is now employed in the Poison Control Department of St. Lukes-Presbyterian Medical Center in Chicago.

Some states have regulations denying licenses to blind persons who are qualified to be occupational therapists and physical therapists. We know of blind people who are successfully employed by hospitals doing both types of work. The Federation has actively fought legislation and regulations which would limit job opportunities for the blind in these areas, and we will continue to do so. Job Opportunities for the Blind will continue to be in touch with blind persons who are in training and who are employed in these professions. We are in touch with blind nurses. One is now the Director of the School of Nursing at Mercy Hospital in Des Moines, Iowa. One has experience in the administration of a nursing home. We are also in touch with blind nurses who are competent, but have not yet been able to obtain employment. In addition, we know blind persons who would like to become nurses, but thus far have been unable to gain admission to a school of nursing. Job Opportunities for the Blind is working on this matter. It is not reasonable to deprive a blind person of an education just because there may be some positions in the field that do require sight. There are also many which do not.

The April, 1982, edition of the JOB Recorded Bulletin carried two articles which are relevant to the success of the blind in medical professions. One dealt with employment opportunities in pharmaceutical sales. This is clearly an area where blindness would not be a disadvantage. A Bachelor of Science degree in nursing or a degree in pharmacy is important to anyone entering the field. Another article from the JOB Recorded Bulletin for April dealt with the expanding scope of nutrition in health care—again an area where blind people should be able to compete with no difficulty, given the opportunity.

It will take some study and experience to determine exactly which jobs in medicine can be performed competitively by the blind and which cannot. It is clear that we do not yet have all the answers. JOB will continue to work with blind persons, training programs, and employers to develop new opportunities and determine what is reasonable. However, it is clear from the few examples cited here that the horizons for the blind in the medical field are more far-reaching than most people (including many competent and forward-looking blind persons) have thought. There was a time when blind persons were encouraged to enter the field of chiropractic medicine. That time is no more, even though blind chiropractors have been and are extremely successful. There are those who say that blind people cannot now compete because the field of chiropractic medicine is being upgraded. It is depending more on X-rays and other lab work. Blind chiropractors regard this upgrading as a good thing, for them as well as for the sighted. They resent and deny the implication that the blind cannot meet the higher standards.

Blind persons are doctors, pharmacists, nurses, therapists, and chiropractors. What is true of employment for the blind in the medical profession is what we have known for many years about employment for the blind generally. The biggest problem we face is an attitudinal one. We must fight for the opportunity to compete. Once we get the opportunity, there is no doubt that we can succeed.

Job Opportunities for the Blind is actively working to develop new and better opportunities for blind persons in the medical professions and in all other kinds of work. If you know of persons who have encountered difficulties because of blindness when they wished to continue or begin employment in any of these professions, refer them to JOB. If you know of blind persons who have experiences that might be beneficial to others, please tell JOB about them. We are moving ahead in the development of more and better employment opportunities for the blind because of cooperation from thousands of persons across the country. We must keep the momentum going. We have too much at stake to stop.

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