People participate in journal clubs or book clubs. Geek Club is my affectionate term for documenting summaries of all the geeky stuff I read. I work as a physiatrist at the East Orange VA hospital in NJ. This may also serve as a resource for the residents who rotate through there.

Friday, July 23, 2021

Phorest & Trees July 2021

 

Phorest & Trees

Every month I share stuff I’ve been reading. This month I’ve added the new R1s and a number of alumni to the list. Those of you receiving this for the first time can access the old ones here.  Hope you enjoy!

A Bit of (Personal) Good News

Thanks to all of you for your kind words about my recent promotion to Clinical Professor. Copious gratitude to Drs. Kirshblum and Foye for their persistent tenacity, encouragement, and filling out the copious paperwork, without whom this wouldn’t have happened.  Thanks to Chae for supporting me formally and behind closed doors in ways I probably don’t even know about.

Some have asked why I bothered with this considering there are no accompanying financial benefits whatsoever attached to a non-tenure clinical promotion. I am happy to share my motivation. I did this for my dad. He was so proud of me when i got the "assistant professor" designation 15 years ago. When he passed in 2016, I decided to work toward this in his honor. So hopefully he's smiling with pride somewhere in the universe...

AANEM and EDx

 

On ReachMD, DOXIMITY & MedPage

Pain, Sports, MSK & Rheum

Ableism – an inherently physiatric topic to consider

 

Being physiatrists, we pride ourselves on being knowledgeable advocates for patients with disabilities.  This editorial tells one pediatric neurologist’s perspective and is full of clickable references to support her assertions. After diving into small but growing literature into it (only 312 references since 2006), I have some developing and conflicting thoughts on the topic which we can discuss in person. Some stuff worth sharing:

 

 “[i]mmediately, and from early life and thereafter, people perceive individuals with disability as ‘vulnerable’ and of low competence, and, accordingly, treat members of this group differently.”1 Consequently, people with disabilities often continue to experience social devaluation on account of their disabilities (i.e., ableism), despite the fact that the last few decades have seen an increased awareness and a decreased social acceptability of discrimination based on other characteristics such as race (i.e., racism) and gender (i.e., sexism). People with disabilities thus remain subjected to ableist attitudes in many sectors, including — often especially  the health care system. 

 

Another says

Disability scholar Fiona Kumari Campbell defines ableism as “a network of beliefs, processes and practices that produces a particular kind of self and body (the corporeal standard) that is projected as the perfect, species-typical and therefore essential and fully human. Disability then, is cast as a diminished state of being human.”3 Campbell delineates an inherent link between this deficit-based construction of disability and a “biomedicalist stance,” which, since the Age of Reason, has “played a critical intervening role in the lives of people with disability and people with anomalous bodies or mentalities. Medicine has operated as the primary paradigm not only for the treatment of disabled bodies but has also shaped the way decision makers, legislators, families and society in general think about and sense disability.

 

If you’ve done any research, you’ve probably looked at quality of life as an outcome measure. The very notion of QOL is scrutinized in this context

At the heart of such decisions is what disability scholar Joel Reynolds has termed the “ableist conflation” of disability, suffering and death: “wherever operative, the ableist conflation flattens communication about disability to communication about pain, suffering, hardship, disadvantage, morbidity, and mortality.

 

Medicine is, at bottom, a discipline that thinks pathologically. According to a velocity of knowledge that has exponentially increased since the 18th century via scientific experimentation and technological advance, medicine functions according to the basic idea that “healthy” is “normal” and “unhealthy” is “abnormal.” The information medicine vends as truth is predicated on this distinction. In a recent piece in CMAJ, Heidi L. Janz writes that disabled people “remain subjected to ableist attitudes in many sectors, including — often especially  the health care system.”7 The reason, as Janz correctly identifies, is based in medicine’s presumption that “not normal” is the same as “unhealthy.” I wish to include ill physicians in Janz’s formulation, for the same oppressive forces medicine wields against its subjects, it also wields against itself.”

 

“In science, technology, engineering, and mathematics (STEM) fields, disabled people remain a significantly underrepresented part of the workforce. Recent data suggests that about 20% of undergraduates in the United States have disabilities, but representation in STEM fields is consistently lower than in the general population. Of those earning STEM degrees, only about 10% of undergraduates, 6% of graduate students, and 2% of doctoral students identify as disabled. This suggests that STEM fields have difficulty recruiting and retaining disabled students, which ultimately hurts the field, because disabled scientists bring unique problem-solving perspectives and input.” 

 

Even though the topic is relatively new to me to consider, there is a curriculum for medical students

 

Trees

  • A lecture on “Improving Interdisciplinary Gait Deviation Assessment and Treatment Plan Among Lower Limb Prosthetic Users” Direct TRAIN Link (Non-VA)
  • A lecture on Lower extremity Residual limb care: Challenges and solutions
  • We have used the iFIT socket for BKAs at the VA; they are adjustable and relatively less expensive. It was developed by Dr. Timothy Dillingham. There is now an AK version as well and I have attached the brochure.
  • A heartwarming reminder for many of us to decenter once in a while by looking for beauty.
  • Comics intersects PMR: The PUNISHER didn’t accurately represent TBI severity? No….