On Adapting, Evolving, and Why I’m the Perfect Candidate for GPS

“Head south on Main street,” my husband said.

“That means nothing to me,” I said. Which way was south from where I was? And, more importantly, where was I?

I stumbled across this wonderful Salon article penned by a woman with the exact same problem—not your average “I’m bad with directions” problem, but a very real and very pronounced spatial relations learning disability.

Similar to the author’s experience, I got tested for the disability when the humongous gap between my verbal and non-verbal reasoning standardized test scores was too big to ignore any longer. I could read before I was three, I read on an eighth-grade level when I was five, and used my photographic memory to learn all the answers on every card in Trivial Pursuit so I could beat my older brothers that same year.

Yet when the educational psychologist asked a 14-year-old me to put together a basic 7-piece puzzle of the human face in three minutes, I could not do it.

I know what a face looks like. I know seven pieces—a mouth, a nose, two eyes, etc—is not a hard puzzle. So why, in 180 painstaking seconds, couldn’t I put even two pieces together? Or match up a tree to its shadow, or any of the other basic spatial things most people can do?

Because something really screwy happens in my brain when I look at or try to visualize non-verbal images or concepts—they get flipped, reversed, thrown into chaos, and no matter how hard I focus, I cannot make sense of things.

Like the author, I don’t “do” north, south, east, or west. The only way I know where the sun rises is to remember which window the sunlight used to stream into each morning when I was a kid—since it woke me up, I could remember it.

I can’t read a map. I can’t follow directions. I get lost in my hometown, lost in the city I’ve lived in for five years; I get lost so often that almost everything is beginning to look familiar (“Oh, I know where we are, I’ve been lost here before!”) I routinely build in an extra half-hour for lost time, and my family knows to keep their cell phones on for frantic “Where am I?” calls.

It took me years to tell time on an analog clock. I still can’t do puzzles, get riddled with anxiety when navigating the labyrinthine hallways of my office building, and even though I slogged through honors calculus, I can’t add fractions, can’t reverse things in my head, and the “P” on the pepper shaker often looks like a triangle to me. I can’t asseble things, and despite Scrabble scores of 400, I cannot figure out how to put the letter trays back in their slots in the Travel Scrabble edition. Getting the picture?

And yet, like the Salon author, I’ve learned to adapt. I memorize street signs, store fronts, anything with words, so that my landscape is a guidebook of verbal landmarks. I park in the same place when I return to malls, hospitals, or other sprawling places so I can retrace my exact steps. I rely heavily on my memory to re-create scenes so I know where to go, and when I get lost it my own building and bump into people, I pretend I was going to the copy machine.

I’m so used to seeing the world differently and using my dominant strengths to help balance out the glaring deficits that I don’t even think about it too much. Reading this article made me appreciate just how rote many of my coping mechanisms are—so built into my life that I barely notice them.

It’s the same sort of thing we do with chronic conditions, the changes and adaptations and mechanisms we use to deflect or diffuse symptoms. When I get winded from using the stairs on a “bad” lung day, I duck into the restroom to catch my breath. On a much larger scale, when I lost my adrenaline and my lungs spiraled downwards to boot, I focused on building a career with flexibility. At some point or another, every patient with a chronic disease faces similar strategic thinking and adapting.

Everyone’s got something to compensate for in life, whether it’s a learning disability that makes stepping out of a subway exit a daily adventure in disorientation or a serious illness that makes a simple thing like drawing a breath complicated. I really don’t believe “normal” exists—all we can do is live our lives in such a way that we maximize our strengths and minimize our weaknesses. That’s the ideal, anyway, though getting to that point is the harder part.

Grand Rounds, Vol. 3, No 44

Grand Rounds Vol. 3, No 44: It’s All in a Day’s News

As excited as I was to host Grand Rounds for the first time, I had a fair amount of trepidation, too. How was I going to arrange all these posts in an interesting yet logical way, one that did justice to the wide array of topics included and still appealed to all types of readers? The answer arrived on my doorstep in the neatly folded form of my trusty daily newspaper. Of course. I started my career in newspapers, and decided to use elements from my favorite print and online papers for today’s compilation of news, analysis, and debate.

Have at it!

Front Page Stories:
When Blogging Gets You Fired by David Bradley at Sciencebase discusses ways to maintain a blog and still maintain a career, especially pertinent advice if you practice medicine
Why Chernobyl’s Birds Matter by grrlscientist at Living the Scientific Life explores the unequal effects of radiation on bird species twenty years after the catastrophic Chernobyl nuclear reactor disaster—and what this means for humans
For the Love of Strange Medicine by Kim at Emergiblog uses a hypothetical situation to take on what can be a controversial issue of authority in the ER
Making Meaning by Susan at Rickety Contrivances of Doing Good draws a powerful parallel between being a volunteer hospital chaplain and being an English professor

News:
Mirrors Provide New Treatment for Chronic Pain by HowToCopeWithPain discusses an exciting and non-invasive treatment for chronic pain using mirror images
Runaway Costs Can Undermine Health Reform in a Hurry by Health Business Blog looks at a potentially costly flaw in Massachusetts’s health care reform plan
Proof Innovative Thinking in Health Care Exists by Hospital Impact Blog uncovers the proactive approaches one hospital has implemented to improve the patient experience
Suicidal Breast Implants by Shrink Rap provides shownotes for a podcast discussing an increased risk of suicide in women who have cosmetic breast augmentation
Should Rapid HIV Tests Be Mandatory During Pregnancy? by International Network for Ethical Issues in Resource Allocation reviews research that concludes pregnant women shouldn’t be required to undergo rapid HIV infection tests

Op-Ed:
What You’ll Learn in Pre-Med Classes by Dr. Val
& The Voice of Reason
tackles the question that plagues all pre-meds at some point: Are you ever going to use any of this stuff?
Is American Health Care Headed Overseas? by Madness: Tales of an Emergency Room Nurse includes thoughts about the emerging trend known as medical tourism
Web 2.0 and Clinical Genetics in Practice by Scienceroll lends support for the significance of technology in diagnosing genetic conditions
Is Mental Illness Adaptive? by Behavioral Ecology Blog debates Nobel Prize winner John Nash’s statements on the subject

Science/Technology:
Exploding Lips and Other Combustible Pursuits by Ian at Impactednurse offers amusing analysis on the use of lip balm during oxygen therapy
Sex, Lies and Anesthesia by Counting Sheep lays bare the common(and comedic) misconceptions that people have about anesthesia
Beyond the Hype: The iPhone and Health by Tech Medicine shows the medical uses of the iPhone, proving it is more than simply the coolest new accessory
How To Do a Pelvic Exam by Women’s Health News offers candid commentary on a video of the procedure every woman dreads: the pelvic exam
A Placebo State of Mind by Christian at Med Journal Watch is a series that explores the power of the human mind when it comes to placebo treatment
Pregnancy and the HSIL Diagnosis by Fruit of the Womb covers the questions and concerns that accompany high-grade cervical dysplasia
An Unusual Cause of High Serum Amylase in the Setting of Normal Serum Lipase by Inside Surgery is a concise, technical explanation of an uncommon cause of this condition

Your Life:
Don’t Give Up by Amy at Diabetes Mine captures the other “low” of living with type 1 diabetes—and all the reasons why she doesn’t give into it
The Disconnect by Kerri at Six Until Me recounts a grateful reunion with her insulin pump after a week away from its many conveniences
Where Would I Be? by Rachel at Tales of My Thirties reveals the surprising ways living with Type 2 diabetes and anxiety has shaped this patient’s life
Why the Dutch Look Down on Us by Parallel Universes provides commentary on the factors that make people taller or shorter
Can Elvis Cure Throat Cancer? by Dr. Bruce Campell explores rationalism versus empiricism in the context of a postage stamp turned panacea—and why rationalism can still be so appealing, even when we know better

Travel/Leisure:
DisAdventure: Advice for World Travelers with Disabilities and Chronic Conditions by Jocelyn at Chronic Babeoffers the keys for smart travel—you won’t need a vacation from this vacation
Strange Occurrences by Lemonade Life details wacky blood sugars, misinformed athletic trainers, and other random events in the life of this diabetic
Tales of a Jellyfish by Medicine for the Outdoors
is a stinging account of a marine encounter gone wrong—and what could have prevented it
Better Exercise on the Stairs by The Fitness Fixer shows how climbing stairs can be painless, not punishing
A Travel Destination of Another Kind by Eye on DNA looks at medical tourism and preimplantation genetic diagnosis (PGD)

Thanks for reading today’s edition!* Many thanks to Nicholas Genes for all his hard work in keeping this fantastic tradition going strong, and thanks again to everyone who submitted. You made my run as temporary editor-in-chief a great one.

Don’t forget to check out next week’s Grand Rounds at another Boston-based blog, Health Business Blog

(*For best results, view this blog in Safari or Internet Explorer)

It’s time for some GRAND ROUNDS! (Vol. 3, No 44, that is)

I want your submissions! That’s right, Grand Rounds, that wonderful weekly carnival of wit and wisdom (aka the best of the medical blogosphere), is coming to A Chronic Dose on Tues, July 24th.

Make my first time hosting a sucess and submit, submit, submit! C’mon, you know you want to!

There’s no specific theme for the posts, but the more recent/timely the content, the better.

Please submit your entries by 11 pm on Sunday, July 22, and put “Grand Rounds” in your subject line. Make sure you include your post’s URL and title, the name of your blog, and a brief description of the post.

The “E-mail me here” link is conveniently located on the sidebar to your right, underneath my picture and profile. (It’s also laurieDOTedwardsATgmailDOTcom)

Thanks, and I’m looking forward to reading what you all have to say!

Gregory Hennick/Insulin Pump Update

I promised an update on the Gregory Hennick situation (the Massachusetts man who wasn’t allowed to be become a police officer because he is a diabetic who uses an insulin pump).

I almost missed this article reading the morning paper today, but here’s the latest: after consulting with physicians, officials have decided to end the former (illogical and unfair) policy and will now review each applicant based on the severity of the disease, not simply whether or not that applicant chooses to use a pump to control his/her diabetes.

“Blogger Unmasked, Court Case Upended”

That is the headline of a front page story in today’s Boston Globe involving the medical blogosphere’s own Flea. Read the whole article here.

Given the recent spate of physician blogs shutting down and controversy over who can say what and where they can say it, this case adds even more complexity to the discussion. The more med blogging continues to emerge as a powerful and persuasive tool, the more we’ll see the lines between medicine, law, and politics blur, and the more the idea of anonymity will be tested.

What can we do?

Keep on writing.

Diabetics Need Not Apply

Since diabetes and attitudes towards illness are often on my mind, I couldn’t resist posting about this article: a Massachusetts man, Gregory Hennick, who is diabetic and uses an insulin pump, was offered a job by Northampton Police Department, which later said “it was forced to rescind the offer after learning that he wears the pump,” according to the Boston Globe.

Apparently, anyone using a pump is barred from full-time police work in Massachusetts, yet the same rule does not apply to firefighters or to police officers who switch to the pump after they’ve been hired.

Let me get this straight…diabetics who manage their disease using the pump are not eligible to be hired as police officers. Those who inject insulin are, depending on the severity of their disease. Yet those who get the job and then decide the pump is a better option are still somehow better qualified for the job than people who used the pump previous to their employment? Here I was thinking that whatever method a patient found most effective in managing his or her disease was a good thing.

Is anyone else struggling to wrap their heads around the misguided logic at play in this policy? It’s not enough to treat diabetes as a disability, but to be so arbitrary and conflicting in who is allowed to patrol our streets, protect us from danger, or rescue us from burning buildings is maddening.

Hennick is filing complaint of discrimination on the basis of a perceived disability…I’ll try and keep you posted.