A Escola de Medicina estãotrabalhando para tornar as histórias de sucesso mais comuns para alunos com deficiências, doenças crônicas e transtornos mentais.
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Grace Steward sempre se destacou na escola, mesmo em circunsta¢ncias difaceis. Diagnosticada com transtorno depressivo maior quando ainda era estudante de graduação, ela tirou uma folga, encontrou tratamentos eficazes e voltou a s notas altas.
Então, ela não conseguia entender por que estava tendo tanta dificuldade no inicio de seu programa de doutorado na Escola de Medicina da Universidade Johns Hopkins .
“Eu bati em uma parede em minha pesquisa, diz Steward, que estãoestudando como os transtornos psiquia¡tricos influenciam a tomada de decisão.“ Eu não conseguia me concentrar e não conseguia explicar por quaª. Eu estava tendo dificuldades para cumprir prazos e ser organizada. Eu estava totalmente perturbado. "
Depois que ela foi reprovada em um exame, o professor a incentivou a abandonar a aula. Mas Steward sabia que ela poderia fazer o trabalho.
O obsta¡culo, descobriu-se, era o transtorno de danãficit de atenção e hiperatividade. "Estou melhor", diz Steward, que administra seu diagnóstico adicional com medicamentos e compartilhando estratanãgias de gerenciamento de tempo com outros alunos da Johns Hopkins com TDAH.
"Ainda estou aprendendo como integrar meu novo diagnóstico a minha vida e ao meu trabalho, mas estou me tornando uma história de sucesso, em vez de uma estudante que foi excluada do programa."
A Escola de Medicina estãotrabalhando para tornar essas histórias de sucesso mais comuns para alunos com deficiências, doenças crônicas e transtornos mentais.
"Estamos reformulando para não medicalizar a deficiência, mas sim pensar no que os alunos com deficiência trazem para a nossa comunidade", disse Catherine Axe, que ingressou na Universidade Johns Hopkins em mara§o de 2019 como sua primeira diretora executiva de Servia§os para alunos com deficiência .
Em sua nova função, Ax coordena os servia§os para deficientes fasicos em toda a universidade, transformando um sistema descentralizado em um que colabora e compartilha recursos para criar um ambiente acolhedor e acessavel para todos.
“Estamos procurando maneiras de ser proativos na remoção de barreiras em vez de esperar que alguém venha aténose diga que precisa de algoâ€, diz Axe. "Essa éuma grande mudança e estamos apenas comea§ando."
Bonnielin Swenor , que tem degeneração macular maope, éfundadora e diretora do Centro de Pesquisa em Saúde da Deficiência Johns Hopkins , que reaºne pesquisadores com foco na deficiência e partes interessadas de toda a universidade.
“Estamos mudando o paradigma sobre como a deficiência tem sido vista em ambientes clínicos e de pesquisa, bem como na sociedade em geralâ€, diz ela. “Estamos mudando o escopo de viver com deficiência para prosperar com deficiênciaâ€.
Fasico, mental, emocional
Os Centros de Controle e Prevenção de Doena§as definem deficiência como qualquer condição que limite a atividade de alguma forma. Essas condições incluem deficiências físicas, como deficiência auditiva ou de mobilidade; dificuldades de aprendizagem ou de saúde mental, como dislexia, autismo ou depressão; doenças crônicas como diabetes; e lesões como tornozelo quebrado ou concussão.
"a‰ nosso trabalho como pessoas na educação ajudar os alunos a crescer", diz Ellen Kaplan, coordenadora de deficiência para estudantes de medicina. "Uma acomodação não éum obsta¡culo. a‰ um removedor de bloqueios. Isso permite que esse aluno que estãona minha frente mostre o que pode fazer."
Embora o CDC estima que cerca de 26% da população tem uma ou mais deficiências, os números nas escolas de medicina são muito mais baixos. Um estudo de Swenor e colegas, publicado em 2019, descobriu que 4,9% dos alunos da faculdade de medicina relataram ser deficientes , contra 2,9% três anos antes, mas ainda muito abaixo da população em geral.
Os verdadeiros números, na Johns Hopkins e em outros lugares, são difaceis de saber, porque muitos alunos não relatam suas deficiências, diz Nance. O ethos obstinado que os levou a Johns Hopkins em primeiro lugar muitas vezes torna difacil para eles identificar e aceitar ajuda. Muitos estudantes de medicina e pós-graduação da Faculdade de Medicina simplesmente tentam arranjar acomodações informais, comomudanças de hora¡rio com seus professores. Outros acham que não precisam de suporte ou não sabem que essa ajuda estãodisponavel.
O conselho de Axe para alunos que não tem certeza se querem ou precisam de servia§os de suporte para deficientes: Venha conversar conosco. Ela exorta os membros do corpo docente a entregar a mesma mensagem.
“Quando os alunos solicitam algo que pode cair no domanio da acomodação, o corpo docente pode dizer: 'Temos um escrita³rio inteiro que pode ajudar neste processo.' Eles podem enfatizar para o aluno que este éum lugar confidencial onde vocêpode falar sobre coisas de uma forma que vocênão gostaria de falar com seu investigador principal ", diz ela.
Ela da¡ o exemplo de um aluno com uma concussão que negociou algumas semanas de folga com o investigador principal de seu laboratório, sem perceber que os sintomas durariam meses.
“Poder conversar sobre a gama de opções com alguém afastado do seu programa acadêmico pode ser muito benanãficoâ€, diz Axe. "Pode ser mais fa¡cil ser mais aberto sobre os desafios ou impacto dos sintomas, e os servia§os de alunos com deficiência podem explicar as opções para gerencia¡-los ou mitiga¡-los, como o uso de tecnologias de leitura para reduzir o tempo de tela que causa dor de cabea§a.
Oportunidades e desafios do COVID-19
Quando o COVID-19 incitou a Escola de Medicina a fechar as salas de aula e laboratórios em meados de mara§o, alguns alunos saudaram a mudança para o ensino remoto. As aulas virtuais com legendas ocultas removeram barreiras para muitos alunos, incluindo aqueles com deficiências relacionadas a mobilidade, audição ou visão. Mas a queda acentuada na interação humana foi potencialmente devastadora para outras pessoas, incluindo pessoas com depressão ou transtorno bipolar.
"Certamente o COVID-19 mudou as coisas, se foi para melhor ou para pior depende da pessoa", diz Anna Moyer, cofundadora de um grupo liderado por estudantes chamado Equal Access in Science and Medicine . “Nãoqueremos forçar as pessoas com deficiência a trabalhar e aprender em casa. Existem desafios específicos para diferentes gruposâ€.
Moyer e sua colega candidata ao doutorado em genanãtica humana Claire Bell lançaram o Equal Access no inicio de 2019 como um grupo de defesa, networking e educação para trainees com deficiências, doenças crônicas e problemas de saúde mental. Um de seus primeiros eventos foi uma palestra do professor de psiquiatria da Johns Hopkins, Kay Redfield Jamison , o aclamado autor e co-diretor da Clanica de Transtornos do Humor , sobre seu transtorno bipolar. O evento de fevereiro atraiu cerca de 150 pessoas.
“Ficamos entusiasmados com o interesse de tantas pessoasâ€, disse Moyer. "Queremos oferecer modelos de comportamento para estagia¡rios com deficiência, porque não hámuitas pessoas que revelam suas deficiências de forma visível e aberta."
"a‰ NOSSO TRABALHO COMO PESSOAS NA EDUCAa‡aƒO AJUDAR OS ALUNOS A CRESCER. UMA ACOMODAa‡aƒO NaƒO a‰ UM OBSTaCULO. a‰ UM REMOVEDOR DE BLOQUEIOS. ISSO PERMITE QUE ESSE ALUNO QUE ESTa NA MINHA FRENTE MOSTRE O QUE ELES PODEM FAZER."
Ellen Kaplan
Coordenador de deficiência para estudantes de medicina
Outro membro do grupo Equal Access éNicole Pannullo, que nasceu com perda auditiva moderada e usa aparelhos auditivos desde a pré-escola. Na oitava sanãrie, sua visão perifanãrica e noturna começou a se deteriorar, e ela foi diagnosticada com sandrome de Usher tipo II, uma doença genanãtica caracterizada por perda auditiva no nascimento e perda progressiva da visão a partir da adolescaªncia.
"De certa forma, sou grato a s minhas deficiências, porque não acho que teria o mesmonívelde motivação para ter sucesso sem elas", diz Pannullo, que estãoestudando doenças da retina no Programa de Medicina Celular e Molecular, na esperana§a de obter uma melhor compreensão de sua condição. "Eu cresci com um sentimento internalizado de insegurança e inferioridade e senti a necessidade de compensar me destacando academicamente. Nãosei se estudaria na Johns Hopkins ou nesta área sem minhas deficiências."
Ela écapaz de ler telas de computador e papel impresso, embora possa eventualmente precisar de programas de transcrição, diz ela. Por causa das precauções contra o coronavarus, Pannullo não consegue mais ler os la¡bios quando estãono laboratório porque seus colegas usam ma¡scaras.
"Posso pedir aos meus colegas de laboratório que usem ClearMasks", diz ela, referindo-se a s máscaras transparentes vendidas pela empresa ClearMask , cofundada pela graduada da Johns Hopkins University Allysa Dittmar, que ésurda desde o nascimento e inspirada por suas experiências como paciente .
Harry Paul, um aluno do segundo ano de MD / PhD que édeficiente, quer ver mais ferramentas como ClearMasks que facilitam a distinção entre pessoas com e sem deficiência, e observa que os pesquisadores com deficiência são os que os inovam.
“A maioria das pessoas não considera a miopia uma deficiência porque todos temos acesso a a³culosâ€, diz ele. "Se projetarmos nosso mundo de forma que o uso de uma cadeira de rodas não o mantenha fora dos Espaços, nem notaraamos quem usa uma cadeira de rodas."
Paul, que usava cadeira de rodas quando era mais jovem, diz que sua curvatura espinhal não émais imediatamente visível, mas o torna mais vulnera¡vel ao COVID-19 porque bloqueia sua capacidade de combater infecções respirata³rias.
“Existem duas opçõesâ€, diz ele. "Me mantenha em casa, ou todo mundo usa uma ma¡scara e fica a alguns metros de distância para que eu possa viver uma vida normal."
Ele diz que políticas inclusivas como o uso de máscaras para evitar a disseminação do COVID-19 trazem mais médicos e pesquisadores com deficiência para os cuidados de saúde. Eles, por sua vez, melhoram o acesso e o atendimento aos pacientes com deficiência.
“Se quisermos tornar nossos Espaços menos excludentes para pacientes com deficiência, os médicos com deficiência são os aºnicos a fazer issoâ€, diz ele.
Este artigo foi publicado originalmente no Dome .