Center For Self Determination

Use of Intermediaries is Common
Practice in Medicine, Says Doctor

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Medical Professions

Visual Disabilities

Dr. Stanley Wainapel says "Any fourth-grader can learn CPR, but can a fourth-grader do advanced CPR, or know when and how much epinephrine to give, or when to defibrillate? A quadriplegic doctor can direct a code, use his expertise to save a life without ever touching a patient." Doctors are decision-makers, according to Wainapel, and they direct nurses, residents, or physician assistants how to treat patients all the time. Doctors with disabilities are no different.

Wainapel practices general physiatry as the clinical director of the Department of Rehabilitation at Montefiore Medical Center in New York. In addition, he has particular interest and expertise in alternative medicine and acupuncture. As a physiatrist much of his work with patients is done almost completely by feel. This works well for Wainapel, who has very little use of his sight.

Wainapel went into physiatry before he lost most of his sight to choroid uremia, a disease that he has had since the age of eight. He picked rehabilitation medicine as a specialty because he thought his own disability might give him insight into what his patients were feeling. "It has, in fact, made me more compassionate and more able to see what abilities my patients retain, rather than simply what they have lost," he says.

Wainapel uses relatively few accommodations in his work. He uses a white cane to get around, special non-glare lighting, and a computer with screen reading software that speaks out loud to him. He also occasionally is assisted by his secretary to go over charts, test results, and a few bits of other reading. He chose an academic setting because he knew there would be secretaries, nurses, and residents that were available to provide some assistance. However, he found that he only rarely asks for assistance from another colleague or resident to perform an examination, because most of his examinations are entirely verbal and tactile.

Wainapel says that his use of "intermediaries" or assistants in his work is not that much different than the commonplace teamwork that occurs in a hospital. Most of the time, he can interpret and make decisions about X-rays based on the radiologist report. Just like other doctors, he does sometimes ask for a second opinion. When he does ask for assistance from other hospital personnel, it is usually just to give him information by reading or describing something.

Wainapel believes that one of the myths that causes roadblocks for health professionals with disabilities is the notion that doctors are superhuman. He said, "All doctors are humans working within human limitations, just like everyone else. One doctor may be unable to see; another doctor may have problems with his own prejudices. Prejudice to me is one of the great handicaps. A person's prejudices can paralyze them and they cannot move in any direction. The best thing a doctor can do is to keep an open mind."