new symptoms, including a distended abdomen, vomiting, early sati-
ety, dangerously high blood pressure and trouble breathing. His nurse
practitioner refused to schedule a GI appointment for him despite his
repeated requests, and his primary care physician did not examine
him, saying he couldn't get Michael out of his wheelchair even though
it easily adjusted to a supine position.
I got Michael's permission to intervene and pressured his primary
care physician to order a CT scan. That led to a diagnosis of what
turned out to be a 15-lb. tumor. It was compressing both his femoral
veins and causing thrombosis. His diaphragm was also feeling pres-
sure, causing his breathing problems. I believe Michael's providers
had assumed that PPMS caused his symptoms. I call this "diagnostic
overshadowing." They might have also failed to recognize the worth
of his life. This story has a happy ending by the way: A year after his
cancer diagnosis, Michael and I rolled over the George Washington
Bridge and up through Fort Tryon Park into the Cloisters above the
Hudson River.
Q
What about accommodating disabled surgeons and staff?
A
This is a complicated issue. Some disabilities are disqualifying
for some roles in health care. Blindness, Parkinson's disease or
severe arthritis in the hands might make being a surgeon impossible,
for instance. But people with disabilities can absolutely provide all
sorts of health care, and when they can, medical schools and health-
care facilities need to accommodate them.
The sad and worrisome part is that disabilities remain stigmatized in
health care. I experienced that firsthand at Harvard Medical School.
The problem is that there's heavy pressure not to reveal your disabili-
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