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Physicians
Hearing
Disabilities
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Doctors told
Dr. Caroline Stern's parents that their 18 month-old daughter,
who was deaf, was never going to accomplish anything; that she
should be sent away to a school for the deaf and not to expect
much. Fortunately, her parents didn't listen and were able to
support her through a mainstreamed education.
When Stern was a teenager, she had an opportunity to work at
Fesden Naval Medical Center's Research and Development Department
as a data entry assistant. Her goal was to gain experience with
computers, but she found that she was much more interested in
the medical data that she was typing. She started taking more
science courses at school, and was fascinated with the task
of a dissecting a cat in an anatomy and physiology class. Her
numerous experiences as a patient under the care of doctors,
audiologists, otolaryngologist and other medical professionals
made her wonder if she could be a doctor. When she met an Ear,
Nose and Throat doctor who was hard-of-hearing, she was encouraged
to go for it.
Stern, who is deaf due to maternal rubella, went through high
school and undergraduate school with minimal accommodations.
Although she was introduced to American Sign Language when she
joined a Deaf dance troupe in high school, she did not use interpreters.
Her only accommodations were hearing aids, seating in the front
of the classroom, and using note takers.
Stern was a bit nervous when applying for medical schools. She
knew she could be successful, but didn't know how others would
react. After interviewing at five medical schools, she chose
Northwestern University, because "they pulled out all the
stops--interpreters, videos, whatever services I needed."
She had disclosed on her admissions applications that she was
deaf, and was surprised that they didn't question her about
it during her initial interview. "Aren't you going to ask
me anything about my deafness?" she asked at the end of
her interview. "We let the applicant decide for themselves
whether they feel qualified for the school," answered the
Dean.
She found that she needed more accommodation in medical school
than she had used previously. She could no longer just memorize
everything from class. She started using an FM system to assist
her in lectures and class discussions. Her school used a system
called Med-Notes, where each student took a turn taking a master
copy of notes and then paid a fee to receive all the notes for
the semester. Since Stern could not take her turn as note taker,
she became responsible for taping all of the class lectures,
which meant she had to attend every day. She also made weekly
appointments with her professors to go over anything she thought
she might have missed. In anatomy labs, she would study beforehand
using books or videotapes, and then she would be able to follow
along while working with a cadaver. Preparation using videotapes
also helped her in her surgical rotation. She started using
interpreters more in her clinical years, and used them in the
OR, but found that she was able to communicate with the other
surgeons just by being prepared and some makeshift signs.
In her third year of medical school, Northwestern started to
complain about the cost of providing interpreters. Stern argued
that since they agreed to provide interpreters upon admission,
and that she had obviously proved herself qualified to attend,
her civil rights were being violated. She filed a complaint
with the Illinois Human Rights Commission. The Commission investigated
how Northwestern was providing access to all of its students
with disabilities campus-wide and found several violations.
Northwestern's Services for Students with Disabilities Office
did not cover the medical school. Upon settling the complaint,
Stern maintained her interpreter services and the medical school
was included for services by the Office for Students with Disabilities.
Stern decided to go into family medicine because it included
a little bit of everything in medicine. This also gave her the
opportunity to work within many different fields in her residency
at Lutheran General Hospital in Park Ridge, Illinois. At the
hospital, she used a vibrating pager instead of relying on the
public address system, and used codes such as 9-1-1 for the
emergency room or hospital room numbers that would be displayed
on her pager. Instead of calling, she would simply go to the
room that was listed on her pager. She also used an amplified
stethoscope that allowed her to get the "basics" of
what was going on with the heart. "I would not choose to
go into cardiology," she explains, "because I cannot
hear the fine detail of heart sounds. But I can tell if something
is not right, and I could then refer a patient to a cardiologist
or grab another doctor to give me another opinion. That kind
of stuff happens all the time, whether you're deaf or not."
During her residency, Stern suddenly became very ill with an
ear infection, and lost almost all of her small amount of remaining
hearing within a few days. She received a cochlear implant a
year later, which brought her hearing back to where it had been
previous to her illness. In the year that she was completely
deaf, she took an opportunity to improve her sign language skills
and become more involved in the deaf community. She decided
to open a private practice that catered to the needs of the
deaf upon completion of her residency.
She set up her practice in a Chicago suburb and started out
with 25 deaf patients. Her husband told her, "if you set
it up, they will come," and that was true. In five years,
her practice grew from 25 deaf patients to 300, with an additional
2000 patients that were family members of the deaf, or other
hearing patients in the community. Her practice employs a staff
interpreter and her nurses know varying levels of sign language.
She provided onsite sign classes for those who wanted to learn
more. Her office also has TTY's and blinking light bulb door
signalers in the exam rooms so patients are not startled when
the staff enters the room. The only drawback was that the practice
was hard for some patients to commute to.
In 1997, Stern attended a conference in Rochester, New York,
which boasts one of the largest populations of deaf people in
the world. She was asked to start a practice there at Lifetime
Health Center, which she decided to do a year later. Although
she does provide health care to hearing patients, she feels
she is offering a unique service to deaf patients. She provides
a great deal of direct education to her deaf patients who were
not given basic information in the past by hearing doctors who
were impatient in communicating with or miscommunicated with
them. She has gotten some criticism regarding the cost of having
a staff interpreter, but she explains that interpreting would
have to be provided for all of these patients if they went to
hearing doctors as well. She often calls and emails her patients
directly, rather than relying on nurses or receptionists--a
benefit that surprises hearing and deaf patients alike.
Stern hopes that in the future, medical schools and hospitals
will see the value of flexibility and will seek to make their
programs universally accessible for a wide variety of learners.
"For example," she offers, "if they would just
caption slides and videos, they could not only save money, but
they would provide another visual way for all students to learn."
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