Ramblings on healthcare, medical education, and life with a spinal cord injury
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Blog Relocating! New Address!

I’m moving the blog to a new platform, and with that I am changing the address. From now on, the address to use is http://blog.chrismcculloh.com/ and it is hosted on the Svbtle network. ALL NEW CONTENT WILL BE POSTED THERE! And in order to get things going, I’ve already published a few things there.

PLEASE UPDATE YOUR BOOKMARKS/LINKS! There is a new RSS feed over there. I will keep the current site up as an archive, but I will no longer post anything new here.

Thanks, and see you over at the new blog!

March 12, 2013   No Comments

How We See the World

I’m a fan of the show The Big Bang Theory. It’s absolutely hilarious, and being somewhat of a nerd, I get a kick out of a lot of the humor in the show. At the end of each episode, Chuck Lorre, the show’s creator, briefly puts up vanity cards. They generally contain a paragraph or less of text, and they flash on the screen for about a second. You need to DVR the show or watch DVDs and pause the program to read them, but they’re usually hilarious, or poignant, or completely random. He’s done this with most of the shows he has created. I thought one of his more recent ones was particularly awesome:

CHUCK LORRE PRODUCTIONS, #400

I’ve been told that if you change your mind, you change the world – or at least the way you experience it. Let’s take a moment to examine that. The presumption is, if you thought the world was a hostile, ugly place filled with awful people doing awful things, that is what you’d see. Your mind would naturally seek out confirmation for its preconceived ideas (e.g., if you’re intent on buying a red car, as you go about your day you’ll see lots of red cars). If, however, you were able to sincerely change your mind and see that we are all God in drag, that we are the conscious aspects of a perfect universe which had to create us so we could bear witness and stand in awe before its loving magnificence, then that is the soul-shaking reality you’d be greeted with each and every moment of each and every day. In other words, it is entirely our choice as to what kind of world we live in. With a simple decision, we can suffer in the darkness or play in the light. We can be angry, frightened and enslaved, or loving, joyous and free.

I know. It’s a toughie.

People sometimes ask me how I’ve been able to deal with facing some of the challenges I’ve faced and come out with a positive attitude. I think Lorre has summed it up perfectly. It’s because I’ve chosen to have a positive attitude, which is certainly not always an easy thing to do. Everybody gets down on themselves at one time or another, and it’s very easy to fall into the trap of having negative experiences and beginning to focus on the negative things. But it’s also possible to let the negative things go after expressing anger or frustration, focus on the positive things, and then life begins to appear more bright.

A toughie indeed.

March 2, 2013   No Comments

A Gift

One of the questions I get asked frequently is how I’m able to participate in surgery.  It’s a perfectly valid question, especially when using a manual wheelchair to get around the hospital.  The primary issue when using the manual chair isn’t as much the process of scrubbing itself, although there are inherent challenges to that. But the main problem is how to move around the room while remaining sterile. As soon as I touch the wheels, I’d be contaminated. So the end result would be requiring someone, which would probably end up being the circulating nurse, to move me around as needed.  This is certainly less than ideal.

When I was back in rehab, I wrote about how I might participate in surgery using a standing wheelchair. It was somewhat a treatise in theory and planning. I also referenced Dr. Peter Galpin who has already done such a thing in the 1980s. Two years ago, during my first year in medical school, I contacted Dr. Galpin and we spoke on the phone at length about mechanics and details. He was fantastically helpful, both in sharing ideas and his experiences, and also in offering to write letters on my behalf to anybody that might be helpful. I also spent time in several ORs with surgeons, getting exposure to the environment and the unique challenges I would be faced with.

I quickly came to the conclusion that in order to fully maximize my time in the OR, I would have to somehow get ahold of a standing wheelchair – which is no easy task. It’s not something insurance generally pays for, as it’s not “medically necessary.” They’re out of my price range as a student. They’re not rented, because they’re only required by a very small segment of the population and it’s not cost effective to rent them. So suffice it to say, the only option was to somehow have one purchased or provided to me. I pursued a number of sources of funding, mostly running into dead-ends. Dr. Galpin had gotten state funding through disability services offices, so I started down the path with the Ohio Rehab Services Commission. I’m still working on that after more than a year and a half.

One of the outlets we tried at the recommendation of my physiatrist here in Cleveland was the Craig H. Neilsen Foundation. They fund programs supporting SCI research and rehab, and so with the help of my physiatrist and one of my deans at school, we applied for an institutional grant (they don’t give individual grants) for the Case School of Medicine. The application was for a power standing wheelchair, to allow students with SCI to fully participate and attain a medical degree.

The application process took over a year from start to finish, but, our grant request was ultimately approved! In late November, I met with the manufacturer and vendor of a particular brand of standing power chair and we went over the various options and specs. The order was placed, and the chair delivered at the beginning of January. Literally on day two of my long-awaited surgery rotation.

So my eternal gratitude goes out to the Neilsen Foundation for the wonderful opportunity they have given to me and hopefully to future Case Western medical students who will also be able to use the chair. It truly is a wonderful gift that helps to further level the playing field and give those with different physical abilities the opportunity to maximize their medical educations. I know it has already proven to be an invaluable asset in the past month on surgery, not only in the OR, but also outside of it in various other clinical settings. It has enriched my education, and I hope it will be able to enrich the educations of future students to follow me. When I think about how many things I would have missed out on without it, it is quickly very clear just how great an asset the device truly is.

And for that, the Neilsen Foundation has done something wonderful. I can only imagine the other ways in which they’ve further helped those living with spinal cord injuries, and I hope they are able to continue funding worthwhile research and rehab projects for a very long time.

February 6, 2012   2 Comments

I Almost Cursed Out an Attending Physician

Hey there. Been a while, huh. Almost a year to the day. I’ve thought about writing more over the past year, as my goal was to document experiences I’ve had as a medical student living with a disability. And I’ve even got several drafts of things I’ve written over the past year that never got finished. It’s certainly been a busy year, but it hasn’t been without time to breathe.

In order for me to get things done, they have to make it to my massive task management list. It’s something I review regularly and it’s the only way I can get anything done. More about that at a later date, but the short of it is, I’ve decided to set a regular deadline for myself to write something here every few weeks. It’s something I really want to do, and that doesn’t seem an overly-impractical goal. Granted, who knows if I’ll be able to pull it off. But that’s the plan. So without further ado, here’s the first.

In late February 2011, I started my third year of med school (M3) with a couple months on neurology and psychiatry. One morning while writing a patient note during my psychiatry rotation, an internal med doc sat down next to me. He said, “Hello!” in a familiar way.  I had no idea who he was, but he sure seemed to know me. The man asked, “you don’t remember me, do you?”  I looked at him somewhat quizzically and shook my head. He said, “one morning, crossing the walkway…” And I knew exactly who he was.

I’ve written in the past about the strange interactions I’ve had with people – but that was mostly about people telling me I need a bell (I don’t), or that I should get a speeding ticket (I don’t go THAT fast), or that I’m quite adept at moving “that thing” (and you’re quite good at working those shoe “things” you have, thanks). One story always stuck with me, but I haven’t written about it before.

One morning I was hurriedly rushing to class at 7:50am, trying to be there by 8:00am. I took my normal route, which happens to pass through one of our teaching hospitals. As is the case for me, I was in my own world. I approached a walkway that had a slight incline, and started to go up it.  As I moved forward, someone asked if I wanted help.  I politely said, “no, thanks.” I wasn’t struggling, and it only takes 5-10 seconds to get up the full length of the incline.

The person again said, “here, let me help you.” And I again declined the offer, albeit not quite as politely as before. But the person persisted, and started to grab on to the back of my chair to push.

Now, imagine you’re walking up a ramp. Imagine someone asks if you need help, asks again after you decline, and then picks you up and starts to carry you. You’d be pretty ticked, right? You might even feel your personal space had been invaded.

I grabbed my wheels and squeezed my hands tightly to lock them in place before turning and angrily telling the person to stop, as I’d said several times I didn’t want help. I came very close to cursing at the guy, as this was very invasive on his part, but better judgment prevailed and I avoided it. Finally, he got the message.

And now, while entering my patient note into the computer two years later, here was the same person sitting right next to me. Wearing a white coat. Oops. Good thing I kept my tongue in check that morning.

We talked for a few minutes, and he told me how the brief, chance interaction early that morning, coupled with a story he saw on TV later that evening about an individual living with a disability, changed how he views and interacts with people living with a disability. He realized that, although well-intended, forcing assistance on people wasn’t the right idea. He realized that a big part of living with a disability is being able to retain control over the aspects of one’s life that one actually can still control. And that when people force help on you, it serves to take away certain parts of that.

He felt quite a bit of remorse for how he’d acted that morning, which was even evident two years later. And we ended up having a nice chat. We’ve since run into each other around the hospital any number of times, and it’s worked out to have been a positive experience for all parties. And every time I see him, I think how happy I am that one summer morning, I didn’t unleash a tirade that would have made a sailor blush.

You never know when you might cross someone’s path again.

Edit 2011-07-06: This post was recently selected by Doctor Fizzy for inclusion in Grand Rounds. To new readers, welcome! Have a look around and I hope you’ll come back and stick around for a while!

June 10, 2011   1 Comment

I Don’t Need a Bell for My Wheelchair

So I was reading over a blog post by Eva, about how people react to her approaching in her wheelchair.  Her blog is very interesting, and she has a camera attached to her chair, often recording the odd interactions she has with people. In this case, the women reacted appropriately – she just moved her cart out of the way, didn’t make any inane comments and didn’t make a big deal out of it.

If only everybody were like that.

Her post reminded me of the countless times I’ve had similar interactions with people and the poor judgement they’ve expressed in commenting or reacting. It’s a subject I’ve pondered writing about a lot in the past, and she’s provided the spark with which to do so.

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April 12, 2010   3 Comments

Patenting Your Genes

Before I begin, a caveat: I am not a lawyer, and my comments do not reflect a foundation in scientific law.  They’re purely opinion, unless cited, and should be treated as such.

I had an interesting discussion with some friends recently over the concept of gene patents. If you hadn’t heard, U.S. District Judge Robert Sweet in NY struck down a patent that had been granted to Myriad Genetics for the BRCA1 and BRCA2 genes present in many cases of breast cancer.  (The NYTimes has also covered this quite well).  He stated that regardless of the form of DNA being used, the fundamental bit of data is still human DNA, something that occurs in nature, and something that is inherently not patentable.

This is huge.

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March 31, 2010   2 Comments

Walking Progress Updates

Rather than add a new post every time I want to add new stats on walking, I decided to make a separate page that will contain graphs showing my progress walking.  If you look on the left navigation menu, you’ll see a new link for Walking Progress.  I’ll update the graphs on there at least once every few weeks, and at the top of the page will be the date on which the page was last updated.  And there’s been some decent improvement since the last time I posted the graph.  So check it!

December 11, 2009   3 Comments

Screening Mammography

Far be it from me to attempt to solve a complex matter like the current debate on screening mammography.  I’m a first-year medical student and haven’t had extensive experience treating patients dealing with cancer. But the climate of the current debate is troubling for a number of reasons, not the least of which being the knee-jerk reactions many people are having that fail to take into consideration a lot of the science behind it all.  I’ve been talking about this with a lot of people lately and figured I’d share some of my thoughts on the matter.

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November 27, 2009   1 Comment

My Other Life

Just a quick post.  As many of you know, I’m leaving the computer security/UNIX/development world for medical school. But since that will surely still be a big part of my life and I wanted to document some things I’ve been working on, I setup a new, separate blog to post random technical bits.  If you’re so inclined, please check it out! :)

http://bitdrop.st0w.com

May 19, 2009   2 Comments

I Broke My Knee

That’s right, I broke my right knee. Let me tell you the story. A few weeks ago (just after I last posted, so about three to four weeks), I was walking on the walker with a PT and Richie, one of the aides. After about thirty or forty feet, my right knee buckled and Richie caught me. The right knee had been feeling a bit strange prior to that, but nothing so unusual that I was worried about walking. After catching me before I had the chance to hit the ground, I sat and rested for a bit while collecting myself.

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April 15, 2009   5 Comments