Guest Blog by Alexandra Adams: In the face of Medicine: An insight into a medical student’s journey

IN THE FACE OF MEDICINE: AN INSIGHT INTO A MEDICAL STUDENT’S JOURNEY

What I’ve learnt, and continue to learn, is that actually, as the NHS, we are one of the most judgmental, discriminatory and stereotyped institutions out there. And this is doing us no favours for our role in inclusivity or equity. Diversity.

I can only really remember the one doctor during the drawn out time I spent in the hospital bed. I had been bed-bound, on a surgical ward, for 1.5 years, following 20+ stomach surgeries. The first 3 had gone awfully wrong; my vagus nerve had been damaged and I was now facing the complications of numerous open surgeries; feeding tubes, drains and 2 stomas. I was 16.

It was perhaps down to the potent concoction of drugs I was swimming in, the epidural and strong painkillers. But after each ward round, I still knew no more about what was happening to me – what was going to happen. Four senior doctors, along with their accompanying trainees and medical students trailing behind them, huddled around my bed, heads hung low over their clipboards, muttering. It was as though there was an invisible line at the end of my bed, separating me from everybody else. We were in entirely separate worlds. Not a single one of them looked up at me to make eye contact. They then moved on to the next bed.

Except one.

She was an FY2 doctor. After the ward round, she came back to my bed, and she crossed the invisible line. She looked down at me and asked me three simple words: “Are you okay?” My honest answer? I really wasn’t. I was alone, terrified and bewildered. I was uninformed and lost. But before I could nod my head to speak, she smiled and placed a hand on myshoulder. “I know how you feel”, she said. It was those words that changed everything.

She drew the curtains shut around my bed, a bedraggled shard of light piercing through a loose flap where Mr. Sahib had ripped the curtain off the rail in his morning rush around the ward. She placed her stethoscope down and lifted up her blouse, to just above the sternum. Along the widthof the axilla, a braised purple scar stretched across, shiny and perfectly-healed. “I know what you’re going through”, she said again. She too, had experienced a long and gruelling hospital admission at around a similar age to me. She knew exactly how I felt – how scared I was, how worried I was about getting back to education, enjoying my teenage life. She knew. She empathised. And it was that empathy that became the driving force that steered me on, far beyond my illness, and all the way through my medical school education. Because I knew, that’s what patients wanted.

It wasn’t easy getting into Medical School though. Being deafblind, I was repeatedly told by so many not to even bother applying to university, let alone Medicine. Why? Because disabled people like me don’t get into higher education. This infuriated me. I was tired of society underestimating ‘us’, undervaluing us. At the blind school I attended, I saw so many slip through this net, and it hurt. Naturally, I embarked on a route entirely opposite to the direction of their advice. That route was Medicine.

Through the Medical School application process, I realised very soon that decisions and acceptance were based on far more than just grades, numbers – Medical Schools wanted us to be like future doctors; sound like them, act like them, look like them. The perfect model doctor.

The truth? There’s no such thing.

I’ve been told, on numerous occasions, that I don’t look like a medical student, because I carry a white cane and wear hearing-aids. I got rejected last-minute from my first Medical School, having achieved the grades upon offer, only to then be called up one evening, a week before moving into university halls, for them to say “We’ve changed our mind. We don’t want you anymore, because you are disabled”. Another year out. I was, again, left with nothing.

Even now, as I fast approach 4th year of medical school at Cardiff University, the discrimination and stereotyping hasn’t got much better. On my first day of placement, a senior doctor sat me down and said, “imagine you’re a patient. Would you want a disabled doctor treating you?...Absolutely not!” I was then sent home. And to the other senior doctor, who asked me why I was carrying the patient’s cane, only to then have to explain that the white cane was in fact, mine. I am registered blind. I was given a look of utter disgust, and told “I don’t want you touching any of the patients”. In front of my peers, colleagues and a wardfull of patients. If anything, my patients have been far more understanding and accepting of me, and my disabilities, than my own colleagues and tutors – and what does that imply? What I’ve learnt, and continue to learn, is that actually, as the NHS, we are one of the most judgmental, discriminatory and stereotyped institutions out there. And this is doing us no favours for our role in inclusivity or equity. Diversity.

It is arguably these negative experiences that influenced me to begin my campaign, ‘Faces of the NHS’. I wanted so badly to prove that we are, in fact, a diverse workforce, and should be, a diverse workforce. Like the FY2 I met back on the surgical ward, every single one of us has a backstory, our own life experience, identity, and with these backstories, we all carry with us a wealth of both strengths and weaknesses, which together we can combine in the form of teams, delivering a harmonious package of patient care. What’s more, this needs to be heard and known, far and wide, far beyond the workforce itself – out to our general public, our patients. The ‘Faces of the NHS’ is a nationwide portraiture photography project whereby the faces and stories of NHS employees; past, present and future, are captured, so that our differences and diversity are celebrated. In a few years’ time, the ultimate goal is to then represent this positive, celebratory culture of workforce diversity in a hugevisual montage that can be accessed by all, as well as into a book.

I continue to apply empathy, wherever I can, with my patients. After all, I have learnt far more about the art and language of Medicine from my patients, than any textbook, exam paper or test result. I recently came across a young woman on a morning ward round. I was trailing behind a large group of doctors; registrars, trainees and fellow medical students, answer huddled round each bed, at the edge of their invisible lines. Medical histories were skimmed through and action plans were muttered amongst us. The patients, meanwhile, glazed up at us with vacant, pond-water eyes. But I sensed something wasn’t right. After we had swiftly moved onto the next patient, I thought back to the day I met that FY2. I went back to the young woman’s bed and said three words: “Are you okay?” She burst into tears. This young woman had recently arrived onto the ward following an admission to the Intensive Care Unit. Having been on Intensive Care 15 times myself, in the last few years, springing back and forth from the brink of life, I knew how traumatised she must’ve felt. I drew the curtains round, placed a hand on her shoulder, and said “I know how you feel”.

Nobody needs eyesight for this. Nor hearing. Nor a textbook, for that matter. I didn’t have to look like a doctor, or sound like one. I didn’t have to fit into any of those outdated stereotypes. All this patient needed, and wanted, was time, patience and understanding. All I needed to be, was human.

I may not have as much eyesight as most doctors, but I have more insight than many. And I hope that this insight and empathy alone, was enough to help this patient, just like the FY2 had done to my 16 year old self, at the very beginning of my Medicine journey.

By Alexandra Elaine Adams Medical Student / Ex-GB athlete / Writer / Artist / Activist for disability rights.

Follow her amazing photography series on instagram where she shares the portraits and stories of NHS employees, with the goal of representing and celebrating diversity within the NHS @facesofthenhs