July 10, 2024 • 55 mins
How do you overcome the obstacles in providing quality healthcare to individuals with disabilities? Dr. Samantha Stallkamp, PGY-1 at the University of Rochester Neurology, shares her journey inspired by her sister with spina bifida and her mother with multiple sclerosis. This episode is a heartfelt exploration of how personal experiences fuel professional aspirations and advocacy.
We discuss a shocking reality: only 40.7% of surveyed physicians felt ready to provide equitable care. Samantha brings forth the concept of the "adaptionary," a transformative video encyclopedia designed to teach adaptive medical techniques to healthcare providers for patients with disabilities. We also highlight the power of interprofessional education and collaboration in improving healthcare for disabled individuals.
You can find Dr. Samantha Stallkamp Tidd on X/Twitter at @SamanthaJSTidd
A new podcast from Top Hat delivering ideas, relief, and joy to the future of teaching.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Michael Kentris (00:02):
Hello and welcome to the Neurotransmitters
, your podcast for everythingabout clinical neurology.
I'm your host, dr MichaelKentris, and I am very pleased
as I always am on this recordingto welcome another excellent
guest.
I have the future Dr SamanthaStallkamp-Tidd with us today
from Cleveland, ohio.
Thank you so much for joiningthe show.
Dr. Samantha Stallkamp Ti (00:24):
Thank you so much for having me.
I'm excited to be on.
Dr. Michael Kentris (00:27):
So you know , as so many of my guests do, I
came across some of your work onTwitter slash X and listened to
some other podcasts you'dactually done recently and you
were talking a lot about kind ofdisability advocacy and
disability in neurology advocacyspecifically.
So I thought we could start byjust talking a little bit about
(00:49):
kind of how you, because Ishould say you know you are just
moments away from graduatingmedical school Congratulations.
Dr. Samantha Stallkamp Ti (00:57):
Thank you.
Dr. Michael Kentris (00:58):
And you'll be heading to neurology
residency up in Rochester and soagain, they're very lucky to
have you.
But, thank you, tell me alittle bit about the path that
led you to this point and howyou kind of navigated your way
to this point in your medicaltraining and slash career.
Dr. Samantha Stallkamp Tid (01:15):
Yeah , I mean that's a great question
to start.
So, um, I it's really familyties is kind of how I got into
this space and I think if I wasborn into a different family I
don't know if I would have foundneurology I hope I would have.
But you know, I grew up in Lima, Ohio, which is a small town in
northwest Ohio.
(01:35):
I have an older sister who's aNICU nurse not neuro ICU she
does the baby one, which I guessis fine.
But you know, I have a more ofUnurse not neuro ICU she does
the baby one, which I guess isfine, but I have more of a soft
spot for neuro.
And my younger sister,kellyanne.
She is a teacher's aid and alsoParalympic athlete, but she has
(01:58):
spina bifida and she was bornwhen I was around three years
old and so I grew up really inthat disability mindset.
It's all I knew.
I mean, I knew that I'd have tomake some adaptations for her.
I knew that people looked at mysister differently when we were
in public and you know, me andmy older sister are always so
protective of her and there werejust things that, as are her
(02:23):
sisters, we made sure happenedso that she could exist in
public, um, and go through herlife the way she wanted to, and
I saw, you know, my parents arejust the biggest advocates for
her.
I mean, my mom advocates, uh,not just for her but for that,
that whole community.
And growing up, seeing hergoing and running sled hockey,
(02:47):
my sister's sled hockey teams,and then seeing my sister get on
the USA women's sled hockeyteam and winning the world
championship, that's pretty cool, insane.
She's very cool, much more coolthan I am.
I'm very proud of her, but mymom just made sure that there
were spaces to where she couldfeel both included and also
(03:13):
experience things that everyoneelse did is I want the world to
be as good of a place that it is.
That like my family has madefor my sister everywhere.
Right, cause not everyone hasthose people that are by them,
their side, and you know wealways talk to like how it is in
(03:35):
our home Isn't always how it'sgoing to be for you out outside
of the home, kelly.
Like she's going to face things.
She's going to facediscrimination and she has, um,
but that's kind of what I'vedecided to fight for.
She's going to facediscrimination and she has, but
that's kind of what I've decidedto fight for.
So I went to Ohio State thirdgeneration Buckeye, big, big OSU
fan.
Dr. Michael Kentris (03:55):
So you mean to say the Ohio State
University?
Dr. Samantha Stallkamp Tidd (03:57):
The Ohio State University.
I didn't know how pretentious Iwanted to be on this podcast.
Dr. Michael Kentris (04:02):
I went to undergrad there as well, so
we'll call it the Ohio StateUniversity and everyone else can
just deal with it.
Dr. Samantha Stallkamp Tid (04:08):
Okay , that's fine, I'm completely
open to that Third generation.
My grandparents met there.
I am ridiculous, but regardless.
I went to the Ohio StateUniversity, majored in
neuroscience, because, again, Iwas going to these neurology
appointments with my sister andunfortunately, my mom was
diagnosed with MS while I wasyoung as well, and so I was
(04:31):
headed up to the ClevelandClinic to, you know, go with her
to her appointments and mysister's appointments at
Nationwide, and traveling,because when you're a kid or you
have a family member and you'rein a more rural area without
specialty care, you have totravel quite a lot and get
pulled out of school becausemaybe the babysitter pulled out
(04:53):
and things like that.
But I thought it was the coolestthing ever what those doctors
were doing, and so I was justobsessed with the nervous system
.
So I thought let's study it.
So I went to undergrad, I wasstudying it and I was walking
around the Oval it's the big forpeople that don't know, it's a
(05:13):
big like green space at OhioState and there was an
activities fair and there was agroup called Abilities.
It was Abilities, an allianceof people with and without
disabilities and I went yes, Iwalked up to it, found out there
were two people in the club andone of them was graduating.
But I said, okay, let's sign on.
(05:35):
I immediately became the vicepresident.
I drug my now husband onto it,several of my roommates and we
just kind of went about growingthis and I got a lot of
inspiration from my mom and whatshe did in our hometown, which
was like a Paralympic experience.
So people from all overNorthwest Ohio came and got to
(05:59):
try out Paralympic sports soboth people with disabilities
and without disabilities to seewhat Paralympic sports were
about.
And every year she had one kidthat would decide to do sports
and then their world would openup and they would be really
entrenched in a community ofsupport.
And that's why I think peopledon't understand that disability
(06:19):
community is huge and warm andwelcoming and it's just
accessing it that can be hard.
So I started throwing them atOhio State and every year we had
a kid who wanted to play sportsin the local community.
We did some other advocacystuff, like we put signs on
handicap bathroom stalls thatsaid, unless this is your only
(06:45):
choice, this shouldn't be yourfirst choice, just saying, when
you go in a bathroom and all thestalls are open, don't go in
the accessible stall Because Ithink some people just
immediately go there and we wantto keep it open most of the
time for people who need it.
We did some other things withpartitioning the bus system that
(07:10):
wasn't doing well, but anyway Iwas so entrenched in that and
it grew and by the time I leftit was thriving and it's still
around.
But they renamed themselvesBuckeyes for Accessibility, but
I'm very proud of that.
So then I got into my dreammedical school, the Cleveland
Clinic, lerner College ofMedicine.
(07:31):
Again, it's like this weirdthread in my life I mean my
mom's doctors which I credit foryou know she has done so very
well and that's because of thecare that she received at the
Cleveland Clinic To then getinto that medical school was
kind of surreal for me.
I think it's also just because,from where I come from, I'm
(07:52):
from a smaller town, you know Iwent to a state school and then
it's like wait, I want, I'mgonna go to the Cleveland Clinic
.
And I did.
And when I started there I knewI wanted.
I was already interested inneurology.
Right, I did neuroscience, Iwas, I was so interested, but
the advocacy stuff I kind of youknow, I was like I'm going to
put this on a back burner alittle bit, just because I got
(08:16):
to focus on medical school.
Medical school is hard, youknow, sammy, you gotta, you
gotta focus, and that lasted foronly a few months.
Really, one of my classmates,really good friend of mine we're
going to her bachelorette partythis weekend.
Actually, she fell and twistedher ankle while rock climbing
and she was on crutches for alittle bit.
(08:38):
We're in this brand newbuilding.
State of the art.
You might have seen it in theworst presidential debate of all
time.
That was my med school.
They just put it in.
Dr. Michael Kentris (08:48):
There's so many contenders.
Dr. Samantha Stallkamp Tidd (08:52):
It was.
Yeah, it was terrible.
And then the president gotCOVID and it was a whole debacle
.
I probably shouldn't be talkingabout it they don't want me
talking about that probably, butanyway, it's beautiful, brand
spanking new building.
And the doors to the bathroomwere so heavy and I noticed it
right away, but I didn't realizehow heavy they were until I saw
(09:13):
my classmate struggling to openthe door to the bathroom.
So anytime she had to go to thebathroom we had to take her
because the doors were too heavy.
And so of course I just emailedand I said hey, I think I don't
think these are ADA compliant,I don't think I think these
doors are too heavy.
And I got an email back andthey just said no, they're all,
(09:37):
they're all compliant.
That didn't sit right with me,so I bought my own pressure
gauge because I don't know whento give up, but they were five
times the legal limit of poundsper.
You know force to open thesedoors.
When they showed them that,they changed it.
And now the doors are, you know, they open fine, which is great
(10:00):
, and it was a big win for me.
But I told this story to my nowone of my greatest mentors and
friends Dr Natavich Marvin, Icall him and he just said let's
make this group.
And so we started a group oncampus and, yeah, it's really
been kind of up since then beenkind of up since then.
Dr. Michael Kentris (10:26):
Now is the.
Is the focus of this group forspecific, like local initiatives
, or is it for education ofother students with respect to,
like the needs of people withdisabilities, or how would you
characterize its mission?
Dr. Samantha Stallkamp Tid (10:36):
Yeah , I mean I.
So it's called the disabilityaction group, we we.
So we started, I guess it.
We ended up formally startingmy second year, but we have been
crafting it for a little bitand the original mission was to
address the gaps in thecurriculum when it came to
disability related content.
(10:56):
That has grown a lot to thedisability related gaps in med
ed as a whole and alsoaccessibility things like the
technical standards at ourschool.
It's kind of grown to where wehave a ton of different projects
(11:17):
going all at once and lots ofstudent involvement, lots of
community involvement.
I think it's kind of rare formedical school groups to have
people that are not affiliatedwith the school at all.
I mean, these people are notaffiliated with the Cleveland
Clinic and they're justcommunity members parents of
people with disabilities, peoplewith disabilities themselves
(11:38):
that work in social work orhealth care and some doctors
from different institutions thatjust heard about it and wanted
to help.
So our mission is really justimproving the lives of people
with disability.
I think that's the easiest, Ithink, definition that we could
make and I think that it's justincredibly important.
(11:59):
This is a stat that I wrotedown because I wanted to make
sure I read it just so peopleknow how big of a scale this is,
and I want to ask you what youthink this number is.
So they did a.
Lisa Iazzoni, wonderfulresearcher at Harvard, did a
survey a couple of years ago of714 physicians.
(12:19):
What percent of them do youthink, said that they were
confident in their ability toprovide the same quality of care
to patients with disability?
Dr. Michael Kentris (12:32):
How many?
You mean like self-evaluation?
They thought they could do it.
Dr. Samantha St (12:35):
Self-evaluation .
They thought that they couldgive the same quality.
Dr. Michael Kentris (12:39):
It's probably some ridiculously high
number like 100%.
Dr. Samantha Stallkamp Tidd (12:42):
No 40.
40.7.
Dr. Michael Kentris (12:45):
I was just expecting our profession to
overestimate their abilities.
Dr. Samantha Stallkamp Tidd (12:49):
I don't not with this and I think
it's it's because it's notaddressed.
Um in medical school, like whenwere you taught how to um adapt
an examination for someonewho's using a wheelchair or for
someone with sensorysensitivities because they have
autism?
You just kind of weren't.
(13:11):
And then you get told oh,you'll learn that.
That's what I was.
I would ask and people say, oh,you'll learn that in residency.
I mean these numbers, I meanthere's more statistics.
You don't.
Dr. Michael Kentris (13:22):
It is one of those things where I
definitely didn't learn thatspecifically in medical school.
And it was something that, again, not formally instructed during
residency.
But it's one of those thingswhere you keep getting presented
with different situations andyou have to think to yourself,
how can I adapt this?
And at least in neurology,doing like our child neurology
(13:45):
months and I will definitely tipthe cap to the child
neurologists out there they'remasters of adapting the exam to
different scenarios through theentire, from neonatal up to
young adulthood, and so thosemonths that I spent on my child
neurology thing probablyprovided the most robust
(14:05):
experience in terms of, like Ineed to check their leg strength
.
Well, have them hop on one legor do all these different things
Very much enhances yourobservational skills and things
like that.
But I would agree with you, itis not a formally trained skill
in most definitely not in mostspecialties, but even in
neurology I wouldn't say it'snecessarily integrated into the
(14:27):
curriculum most places.
Dr. Samantha Stallkamp Tid (14:29):
Yeah , and I think the thing I mean
I'm so glad that you've had thatexperience and I think that
just the experience of seeingsomeone think through how they
would adapt something I thinkmakes it easier for you in the
future, because you can't teachevery single adaptation you
could ever do, because peopleare so different.
(14:52):
I mean people have multipledisabilities, people have
multiple things going on, so theadaptations are going to be
individualized, but the factthat we're not even told to do
that or how to do that, it leadsto a worse quality of care.
I mean this is a very sadexample, but one of my sister's
(15:12):
friends he passed away from apressure ulcer that he went into
sepsis and passed away.
That ulcer was not discoveredduring his primary care visits.
No one checked, no one took himout of his chair and full
(15:32):
physicals are often not done.
You can talk to many people Imean, it's an adonal.
I don't know if there has beena formal study, but at least
those I know in the disabilitycommunity they do feel like
they're not given a full exambecause I think people get
nervous about it or they thinkthey don't have time oh, I don't
have time to take them out oftheir chair to do a full
(15:55):
abdominal exam.
Well, you could miss masses.
There's so many things that youcan miss that you would do on
an able-bodied person but you'renot doing in the specific
situation.
So I think that just that fact,as someone who loves someone
with a disability, when I'vekind of thought about how many
(16:16):
people are uncomfortable likeseeing that stat and then
thinking about what tools I wasgiven in medical school, it
scares me.
It scares me because you hearall of these stories from people
with disabilities that they'vehad these experiences and I
think people can do somethingabout it.
I really do.
Dr. Michael Kentris (16:38):
And I think I remember hearing you talk at
one point about kind of a videoencyclopedia that you were
working on.
Is that, is that still ongoing,or could you tell us a little
bit more?
Dr. Samantha Stallkamp Tid (16:49):
Yeah , so the original idea is called
the adaptionary.
So this is.
This is just a a wild dream ofmine that you know it might
happen.
There's a lot of people thathave offered to help.
You know it might happen.
There's a lot of people thathave offered to help.
You know, zach London atMichigan has been great and
(17:10):
given me some tips andessentially what it would be is
either an application or awebsite where it would show
adaptive techniques like invideo format.
We don't read.
My generation does not readLike I am sorry for all of the
people that are in curriculumsand doing this.
We don't read medical textbooksanymore, we watch videos and I
(17:31):
think that having ideas of, oh,okay, if I need to do a strength
exam on an amputee, what aresome ways that I need to assess
that but also examine, you know,their, their stump, like how do
I do these things?
Because I think seeing it andbeing able to just quickly
Google abdominal exam seated,because you can't, you
(17:55):
physically can't, and a lot ofthese things are structural as
well.
If you only have 15 minutes andyou don't have nursing staff to
help you get someone on anexamination table, you have to
work with what you've got, but Ithink some people you don't
have nursing staff to help youget someone on an examination
table.
You have to work with whatyou've got, but I think some
people just don't.
And so, showing examinationtechniques, showing adaptations,
you can't obviously do all ofthem, but I think you could do
(18:17):
quite a bit.
And hearing people talk about itand you know, pm&r, child
neurology all of these peoplehave a lot of really great um
techniques that they can offer,and also those that work with
people on the autism spectrumdisorder, I think, also can
offer a lot.
So it'd be almost like anencyclopedia Um.
(18:39):
We also, you know, we had totry to find see if these videos
existed already.
There's not a lot of goodquality on how to go through the
exam in video format, and so weare trying to develop a very
basic guide that's almost likean introduction ourselves via
video, but the app might be moreof a reading pictures
(19:03):
demonstration, but it'ssomething that I think over time
we can develop and if anyonewants to, I don't care if anyone
takes it from me and does it, Ijust want it to exist.
I want it to be easy to figureout how to adapt examinations
for different disabilities,limitations, all of those things
.
So yeah, that's one of theprojects that we're doing right
(19:25):
now, for sure.
Dr. Michael Kentris (19:26):
No, it's very cool and it does remind me
like in my own medical schooltime.
So, confession I initially wasand did apply to physical
medicine and rehab and so duringthat I did a couple of sub-Is
in PM&R and during some of thoserotations I spent a couple of
(19:47):
weeks with the physical andoccupational therapists.
And you do learn some reallyuseful things, things that I
still use to this day, like as apracticing neurologist, like
how do I transfer a patient fromthe bed to the chair?
Yes, or just these very, verysimple things from the bed to
the chair.
Or you know, just these very,very simple things.
(20:07):
And it's because, you know,obviously we need very often to
walk our patients and see howare they moving.
And so it becomes one of thosethings like how can I walk a
patient, walk with a patient,kind of like as their walker or
you know with or without a gaitbelt and all those kinds of
things, depending on thesituation and relative body
sizes and all that kind of stuff.
But it definitely gives you asense of how to do some of these
(20:30):
things that we don'tnecessarily learn during routine
training and they are very,very useful skills that will
stay with you the rest of yourcareer.
Dr. Samantha Stallkamp Tid (20:41):
Yeah , I think that's such an
important point and I thinkthat's some of the pushback when
people try to put disabilitycurriculum in, like when you
talk about, I mean even like thesocial work aspect of it,
knowing the resources that areout there.
I think as a physician, weshould yeah, we can't replace
social workers but they'll pushback and be like we can't be
social workers, we can't beoccupational therapists, we
(21:02):
can't be physical therapists andI'm just like, okay, but we
should probably know what thosejobs do and where the overlaps
are so we can help ourcolleagues.
Right, social work is sothey're so overworked and that
profession is so phenomenal.
I mean they do such great work.
But literally, just being aphysician who takes care of
(21:26):
patients with certain disorders,I've made this suggestion to a
lot of physicians.
So if you work with patientswith cerebral palsy type in
cerebral palsy nationalorganization or national
association or something onGoogle organization or national
(21:47):
association or something onGoogle, you'll find a billion
organizations that have tons ofresources for your patients that
if you just hand over some ofthat information, it can make
such a difference in someone'slives just to get connected.
And there's so many things goingon in these people's lives that
they don't even think aboutdoing that half the time.
They don't have time, you know,they have to make all of these
appointments.
Even making some of thoseinformation available can really
(22:11):
help both the social workyourself and the patient.
But yeah, ot, pt, I mean evenspending a day with them.
I think I'm such a big proponentof you know some of these
interprofessional educationactivities that schools are
doing, like just studentsworking with students, I think
(22:33):
that's you know it's good to getto know other people, but I
want to know what it's like toactually be in their job.
I want to shadow a nurse andsee everything that she does or
he and same with PT and OT andactually learn from them.
Because, again, there's it'snot a like, it's a Venn diagram
of things that we can learn fromeach other and I think it's
(22:54):
really important that I mean youmentioned that that it's it is
interdisciplinary and it'ssomething everyone just assumes
that the other person is goingto do, but that doesn't always
happen due to time constraintsand such.
Dr. Michael Kentris (23:07):
I know One of my and again, this is
something that's very innate toPIMA and ours you have these
multidisciplinary rounds wherethe whole therapy team sits and
they talk about every patient,and I had a similar experience
when I was a fellow working inneuromuscular clinics, in the
ALS clinic, and we would havethe exact same thing right.
There would be neurology,pulmonology, hospice and
(23:29):
palliative, ptot, assistivetechnologists, like all like
literally like 15, 20 people.
We would spend an entire like10 hour day seeing all these ALS
patients from the region andthen everyone would go.
We'd go down patient by patientand everyone would have their
input on that person's care, andit's really logistically
(23:50):
challenging but it is sofruitful for these people with
with these complex medicalsituations.
Dr. Samantha Stallkamp Tid (23:58):
Yeah , I mean I I'm smiling over here
because those types of clinicsI mean, yeah, it's so hard to
schedule those things.
I mean I am sure it's alogistical nightmare, but as
someone who has family membersyou know my younger sister I'd
go to the Milo Clinic with her.
It was at Nationwide and she'dsee all of her doctors at once
and she'd only have to getpulled out of school one day,
(24:20):
maybe two, and me myself I wouldgo with them to.
You know, help dependent on youknow what was going on.
And I don't think peopleunderstand how big of a deal
that is.
Um, just because, oh, you haveother, it's not the caregivers
of people with disability.
They have other things to do,and people with disabilities
(24:42):
have other things to do and theyhave lives and jobs and school
and all of these things.
And I think we don't often thinkabout how disruptive medical
care can be to their lives.
When you have so many differentappointments, I think it's hard
for people to kind of scope itout when they're like, oh, I see
(25:02):
my PCP once or twice a year,but if you have eight different
specialist appointments and youhave to leave your work, your
job, I mean people lose incomepeople lose.
It's so hard to be a studentand then get yanked out in all
the different directions.
It was hard for my sister We'dbe doing the homework on the way
(25:24):
there and back from Columbusand it's even more exacerbated
by people being in rural areas.
So, that clinic.
Those clinics are just soamazing and I hope more
institutions make it for moreand more disorder, like more
disease groups, more, more ofthem, because I think it's so
(25:45):
and the collaboration is sofruitful.
I mean it really is.
Dr. Michael Kentris (25:49):
So I'm curious on your perspective to
shift gears very, very slightly.
You know we've talked a lotabout people who need, like,
assistive devices for mobilityor have other like readily
physically apparent disability.
But how do you think folks whohave maybe the quote unquote,
you know invisible disabilities,whether that's, you know, like
multiple sclerosis or epilepsyor a lot of things that you know
(26:12):
us in the neurology field dealwith, have you done a lot of
work with those populations inyour advocacy and, if so, how
does that differ?
Dr. Samantha Stallkamp Tid (26:24):
Yeah , I mean I think that it's it's
a really good question and ourgroup, I mean I'm I'm so proud
of the students that are comingup after me.
You know, when I started thegroup I was like, oh, maybe
it'll survive after I'm gone.
Now I know definitely it'sgoing to survive and continue to
keep going and I'll get to comeback for meetings which is
really cool and cheer them on.
(26:45):
But one of our first yearmedical students, Swetha she is
very passionate about peoplewith chronic illnesses or
disabilities come that are inhealth care, come and talk and
(27:10):
share their stories.
So so far we've had someonewith long COVID in health care,
having to deal with that andbeing temporarily disabled and
also having, you know, they havea lot of like, worst days, good
days, and a lot of stigma isthrown their way.
And then we also had a doctor,pm&r actually who has Marfan
(27:40):
syndrome, not feeling supportedbut then at times feeling like
he had to be better, like evenbetter than anyone who was
able-bodied and wasn't dealingwith chronic illnesses.
And I think it is a lot harderwhen your disability is not
readily apparent.
I think the judgment is there,especially because I mean, you
(28:04):
don't you hear, people withchronic illnesses will tell you
this all the time, like they'vebeen told to their face well,
you don't look sick and thatdoesn't doesn't do I mean
anything for for them and I I'veactually a lot of my research
and my that part of my work.
I worked with the people withPOTS and long COVID and it's a
(28:26):
population that is constantlymaligned, constantly told that
they're making it up, thatthey're anxious.
It's so wild to me because I'mlike this is someone who was
running marathons three monthsago and now she can't walk
across the room.
You're telling me that it's allin her head, some of these
(28:46):
chronic illness stories.
When you hear them and theytalk about their lives, they
feel like they shouldn't be sick.
They should be able to do someof these things and it's really
society's expectations that areput on them that they should be
able to do this in the statethat their body is in.
But a lot of times they mightneed adaptations and it's harder
for them to get those.
It's the same with mentalhealth.
(29:07):
It's so much harder for peopleto even be open about it.
Dr. Michael Kentris (29:16):
Medical students aren't open about their
mental health.
Dr. Samantha Stallkamp Tidd (29:17):
I can tell you most of-.
Dr. Michael Kentris (29:18):
Physicians as a population?
Right, it's like I know youhaven't had to do this yet, but
when you check the boxes, do youhave any physical or mental
disabilities that could impairyour, your ability to practice
medicine?
Right, I mean, it's essentiallya form of discrimination, right
?
Dr. Samantha Stallkamp Tid (29:33):
Well , I mean, that's actually it.
It's exactly what technicalstandards are.
I mentioned that earlier.
So, basically, every medicalschool has this document that
you have to sign almost everyyear.
I don't know if you remembersigning it, but it it.
You have to be able to fulfillthese very specific things, and
some of them.
It's like you have to not getdistracted and you have to be
(29:56):
able to focus on one thing.
And I'm like I have ADHD.
Am I lying to this documentbecause I'm signing saying I'm
good, I'm fine, I've neverneeded accommodations.
I'm a little hyperactive, maybe.
I'm fine, I've never neededaccommodations.
I'm a little hyperactive, maybeI get distracted.
Dr. Michael Kentris (30:08):
I would never have guessed.
Dr. Samantha Stallkamp Tidd (30:13):
Am I lying?
I was in the generation whereno girls were diagnosed and they
diagnosed me in kindergartenbecause they were like girl.
There's something wrong withyou kindergarten, because they
were like girl.
There's something wrong withyou.
But really it feels like you'relying to this document and some
(30:34):
of them are very specific andthey target people with low
vision.
One of my best friends inmedical school has low vision
and he had to sign this documentsaying that he had perfect
vision, basically, or that hehad adaptations to get perfect
visions.
He didn't, but that he hadadaptations to get perfect
visions.
He didn't, but they madeadaptations for him throughout
his career.
But the problem is, this is acontract that people can use to
kick these students out ofschool and so if they became,
(30:58):
you know, let's say that theirchronic illness got worse and
they couldn't fulfill one ofthose things.
If the school didn't want todeal with them, they could say
look, you lied, you signed this.
Bye.
Dr. Michael Kentris (31:09):
Yeah.
Dr. Samantha Stallkamp Tidd (31:10):
Now , I've heard of that happening
before.
It hasn't happened in my school, it hasn't happened in the
school surrounding, but the factthat that's hanging over your
head, I think, is verydestructive.
So there's a lot of people thatare trying to update their
technical standards to make itokay.
We just expect you to be ableto fulfill these criteria with
(31:33):
adaptations, or you have to beable to have a path in medicine
that you're going to be able todo right.
So someone who is blind,visually impaired, might not be
the best pathologist, but theymight be a brilliant internist,
a brilliant, you know,psychiatrist, right, and so
(31:53):
those paths are open to them.
They can be wonderfulphysicians, but some of the
other ones are closed.
Dr. Michael Kentris (31:59):
I do remember reading an article not
too long ago about a P1R doctorwho had about a P1R doctor who
had, like he was legally blindbut he was still performing his
function, like by hearing peoplewalk and physically examining
them, and like he had adaptedhis practice to such an extent
that he was still providing carefor these people, and I thought
(32:21):
that was just wild.
Dr. Samantha Stallkamp Tidd (32:25):
I mean that's I think I think it's
when those people were giventhe tools that they needed.
And I mean, if you think abouthow many patients would be
losing out on having such afantastic physician if he was
told no or if he was kicked outbecause of some health thing
(32:46):
that came on, and it's just soscary with some of these
documents and it makes it sounwelcoming.
And we're trying to rewriteours.
We get our accreditationthrough Case Western, so it's
like this whole.
We have to help them changetheirs.
But Michigan has I mean itpains me to say this as a
Buckeye, to be honest butMichigan has some of the best
(33:10):
technical standards in thecountry and they really are the
benchmark for how to beinclusive without and actually
show what do you need to be ableto do in medical school,
without being blatantlydiscriminatory and opening
students up for getting kickedout of school.
Dr. Michael Kentris (33:28):
Excellent, and we kind of skirted around
this a little bit.
But a thought that occurred tome as we're talking is, if I can
loop a few of our points thatwe've hit along the way together
, that a lot of physicians thinkthat they're unable to
appropriately take care ofpeople with disability, that we
(33:50):
have this system structurally inplace that limits people with
disability from enteringmedicine.
And then we talked a little bitabout this before we were
starting recording, about howmedicine as a profession is
perhaps one of the morediscriminatory professions out
there against our own people.
(34:11):
If you had to tie those threadstogether, what are your
thoughts about this?
Because this is a kind ofperennial online debate that we
see, where the older generationcriticizes the younger
generation for not being astough, for working as hard, or X
, y, z or the other thing.
But where do you see medicinewith the inclusion of people
(34:35):
with various disabilities andwhat are the things that you've
seen that are going well or not,as the case may be?
Dr. Samantha Stallkamp Tid (34:46):
Yeah , I mean, oh, that's such a good
question.
I mean I think, as we seephysicians with disabilities all
the time, I mean Stanford doesa lot of work and they have a
group that and they have thisdocs with disabilities and we
see more like more are beingsuccessful and I think that is
(35:07):
just because we've made medicinea little bit more humane.
I think that we've been able tosee more people with
disabilities enter the field andI think it'll only increase
because I think people will feelinspired, like other people
with disabilities will feelinspired to go and become
(35:28):
doctors themselves.
You know there's a famousneurosurgeon again at Michigan
who has spina bifida.
My sister was so inspired byher but then she realized she
hated science so she threw thatout the window.
But it really opens uppossibilities.
When you see someone who hasgone through the same health
(35:48):
struggles that you did and nowthey're helping patients with
the same thing, I mean it's so.
I think it's so overwhelminglygood for that population who
they're constantly told youcan't do this, you can't do this
, and that's why I think I love.
I'm very passionate aboutParalympic sports.
I'm terrible at all thingsathletics, but my sister is
(36:08):
obviously quite good.
She's a Paralympic athlete, butit really can change someone's
mindset when they look at thepossibilities.
You know my mom actually wrotea book about my sister.
It's called Sports Set Me Free.
And they're doing like thisbook tour where they're talking
to kids with disabilities aboutall of these different um sports
(36:29):
that my sister was able to do.
And when you see thepossibilities, um that when you
make good at adaptations right,we took off the bottom of her
crutch and put a golf club in itso she could golf with us you
know you can see.
See, I mean you can there's somany different ways you can
adapt and you can overcome thesethings Um that when you see
(36:50):
doctors doing that andperforming at the highest level,
I think it can only increase.
But I do think there is.
You're talking about pushbackto a lot of these things I mean
from the other generation.
Oh, it's soft.
You know 24 hour calls youlearn better.
I mean we talked about that.
You know there's soft.
You know 24 hour calls youlearn better.
I mean we talked about that.
You know there's science, thatI mean you don't, you can't.
(37:14):
Basically, after 15 minutes in alecture, you're not really
learning that much anymore,right?
I mean, it's so true and Ithink that, as I think this
generation is reshaping medicineto remind all of us that we're
people first, and I think onlygood things can come of it.
You know, like I never want tobe a doctor that is so obsessed
(37:37):
with working and my job and sodedicated to it that I forget
what it's like to be a humanbeing, Because I also think
that's dangerous.
If you can't put yourself in apatient's shoes because you
haven't lived your life at all,I think that's a little
dangerous.
(37:58):
I really do, and I think havingthese people that have been
through chronic healthconditions, that have been
through these things, they havean understanding.
No one else does that have beenthrough these things.
They have an understanding.
No one else does.
I mean I only know so muchbecause I, you know, am a
sibling of someone with adisability, which we're in a
we're very specific group.
We have very specific quirksabout us.
It's really interesting whenyou talk to siblings with people
(38:20):
with disabilities.
We have very similar likeissues, all these things.
But I think that it's thatdiversity of experience and I
think that is only common recentyears, when we're celebrating
that and I just hope that wecontinue to include and talk
about this, this set ofdiversity, people with diversity
(38:43):
of experiences in healthcareand disability and those things
because I think that they makesuch fantastic physicians.
I really do.
Dr. Michael Kentris (38:54):
No, I think that's an excellent point and
it's something that I think it'simportant for us to remember.
If we look at the majority ofmedical students, they're young,
relatively healthy people whohaven't been in the healthcare
system, and it's very likelythat at some point in all of our
(39:14):
lives we will be patientshopefully for just a brief time,
but some of us for longer.
And, if I may wax philosophicalfor a moment, I think this
concept of human frailty and theyou know, the memento mori of
it all is very important.
You know that I always think ofI forget what hospital it is
(39:38):
but those who are online toomuch like myself.
There's a picture of somemuscle bound guy holding a, a
caduceus holding back the grimreaper with one outstretched arm
in front of him, like he'sgoing to stop death oh yeah, you
know what I'm talking aboutyeah, I think yeah and I think.
I think that is just like thepeak of hubris.
Uh, that's that medicine.
(39:59):
You know you cannot stave offdeath.
Um, you can help people andhopefully correct problems, but
eventually it's very much thatall of us will pass away at some
point.
I'm not so much of a futurist,transhumanist type person to
believe that immortality is justaround the corner, but I think
(40:21):
it's very important for us toremember that we are all human,
as you said, and we are allsusceptible to injury.
It's like there.
But for the grace of God, go.
I right, most of these people.
It's random chance that they'vebeen dealt the hand that they
have.
It could just as easily be anyone of us, or you could be
walking across the street and itcould be.
(40:43):
So I think it's one of thosethings where it's very easy for
us it's the easier thing not tothink about.
You know, these, these bodiesthat we all have during this
life are are also frail, andjust one of a million things
could go wrong and it couldchange our entire lives.
Dr. Samantha Stallkamp Tid (41:01):
Yeah , I think that that's such a
great point.
I think it's it's so.
I have such a differentperspective than my classmates,
right, like I've I've hadconversations with them, and
something that many of my peersfear is becoming disabled.
Oh, if I, if I became disabledlike, oh, I'm a surgeon, if I
lost a hand I'd be dead.
(41:21):
There's nothing, I can't goback.
My quality of life would benothing.
And as someone who you know hasbeen in this community, I'm like
I, you know, some of thehappiest people I've seen are
quadriplegics.
You know, I met, I met the.
I think he was, I think he wassecond in the world in adaptive
bocce.
(41:41):
What he does is he sets up aramp, he can angle it, he has
someone that helps him angle itand he wears a helmet and he can
use his neck muscles and hetips it in just right and plays
bocce and is phenomenal at it,and he had so much joy in his
life and most people would lookat him and say, oh, I would
(42:03):
never want to live like that.
Well, I don't.
I think that sometimes peoplehave these assumptions about the
quality of life of people withdisabilities.
That, as someone who lovessomeone with disabilities, is
scary.
I mean we saw during COVID Imean there's a I think it's a
New York Times article that wentthrough this that people with
(42:23):
disabilities were more likely tohave their care withdrawn
during COVID.
And you know that it reallyaffects me, you know, when I
read things like that and Ithink as doctors we have this
inflated.
A lot of doctors have thisinflated concept of what quality
(42:43):
of life means and it isdifferent for every person.
But I think that also comeswith experience of knowing oh, I
can actually adapt.
I remember having thisconversation with my classmates.
We were like I like it'sliterally I.
You know, ms is not genetic thatwe know of, you know, but it
also is environment.
It's like maybe, you know itdepends, it has factors for both
(43:06):
, but it's not.
It's not like, because my momhas MS, I'm going to have MS,
for sure, right, but I also grewup in the exact same area as my
mom.
So maybe those factors allalign and I get MS.
Maybe those factors all alignand I get MS.
I'm not really scared of thatbecause I know that I'll be able
to adapt.
I've seen my mom adapt.
I've seen my sister adapt.
(43:27):
I've seen people who becameamputees later in life,
quadriplegics later in life.
I've seen them adapt and behappy and I think a lot of this
can be really fixed by justhaving exposure to people with
disabilities outside of thehospital, because you see people
with disabilities as a doctorin some of their lowest points.
(43:49):
They don't want to be at thehospital.
You know they're not going tolook happy.
You don't see the joy that theyhave in their life.
That's actually why we I'mreally it's probably the thing
I'm most proud of my group doingis we developed this curriculum
that's in its pilot right now,called the Disability Buddy
Program, and it's five sessions,three of them.
(44:09):
All you're doing is hanging outwith a buddy with a disability
right.
So we had a luncheon where theyjust where there's a dinner
where they came.
We ate barrio tacos and playedboard games with med students,
two of them, two on one, it was.
It was a great time.
And then the next time it was apanel where they got to ask the
(44:31):
med students got to ask us anyquestions, both people with
disabilities, not their buddies,this was a separate thing and
people that cared for peoplewith disabilities.
And then, third session, theyhad it last week they went out
in public to an art museum withtheir buddies.
So they went to the ClevelandMuseum of Art.
They got to see what it waslike walking with someone
(44:52):
disabled in the space.
Them, you know, wrotereflections on the fact that
they never had to think aboutwhere the elevators were or the
ramps or things like that.
And they're going to thinkabout that next time.
They you know they have apatient that's running late for
an appointment.
Oh well, you know what?
Those?
That one elevator?
(45:13):
It's slow as heck.
There's no way that they wouldbe able to get up here in time.
I should have, like, warnedthem in advance before they came
to this appointment.
There's many things that cancome.
Then.
Our next session, which I'mreally excited about and
planning for it, is we're goingto go through different cases of
.
Here's a patient vignette whatcan you do to adapt a exam for
(45:36):
this patient?
And just keep going through it?
Because it's really once you.
It's like anything when youstart in HPI.
When you learn the HPI the firsttime, I remember being so
terrified I was like, oh, how amI going to remember medication?
Like I came up with all thesemnemonics and I was terrified.
Then you just keep doing itbecause it becomes habit.
(45:57):
If you think, every time I walkinto a room I'm going to make
sure I adapt this exam as bestas I can and it's just a part of
your routine, that's when Ithink we change things for
people with disabilities.
And then the last session, we'regoing to do dinner in public.
I don't know, we haven'tdecided on the restaurant, maybe
(46:18):
Cheesecake Factory or somethinglike that.
I don't know.
But I think it's really justgetting to know people outside
of the hospital withdisabilities, because you get to
see, okay, there is a wonderfullife that you can have and we
can focus on their quality oflife.
And it's not, it's just itbothers me because we talk about
quality of life.
(46:38):
And it's not, it's just itbothers me because we talk about
quality of life.
So much in neurology, some ofthe things I've heard just as
someone who's exposed to so muchdisabled joy, if you have to
give it a name it reallydistresses me, but it's because
people aren't exposed, they justaren't.
Dr. Michael Kentris (46:58):
No, I think that's the exposure things it
brought to mind.
A, I would say, semi-relatedthing, a criticism of family
structure in America, as opposedto, say, european or other
countries, is themulti-generational household
when you as a child growing up,you are with your grandparents
(47:19):
and you see them as they arebecoming aged and developing
medical issues, and so youdevelop this closeness with
different infirmities or otherkind of things that they might
be having as they go through thelater stages of life, stages of
life and it is something that Ithink that we don't see as much
(47:40):
in the United States.
Obviously, there's people whohave immigrated and they still
kind of may maintain those closefamily ties.
I know, growing up, my family,my dad's side, is Greek, so we
lived in very stereotypicalfashion for many years right
next door to my grandparents,very stereotypical fashion for
(48:01):
many years right next door to mygrandparents, and so when I
would come home from schoolafter kindergarten, I would go
next door until my parents camehome from work, and so we would
spend all afternoon with ourgrandparents, day after day
after day, and it is one ofthose things where a lot of
people probably have somethingsimilar, but we see more and
(48:21):
more people like moving on toall corners of the country.
Families become fragmented andyou don't see that like.
You know why.
Why would a you know, a 10 yearold, a 14 year old, spend all
this time with someone in theirseventies, eighties, nineties,
you know, unless there was a youknow close family tie or
something of that nature?
And I think it really doeschange your perspective in those
(48:43):
very, very formative years.
You know, by the time we are inour early 20s, much of our
mindset is already kind of set.
And I think it goes back rightthat early exposure through life
with someone who hopefully youcare deeply about, exposure
(49:03):
through life with someone whohopefully you care deeply about,
really helps to mold thatempathy and the way you see your
fellow human.
Dr. Samantha Stallkamp Tid (49:07):
That is such a good point and it is,
I mean it's the same way with,I mean, one of my friends
growing up too.
Her younger brother has autism.
She's occupational therapybecause that's what she was
guided by her experiences andneurology.
(49:28):
We work with elderly quite alot and maybe that is kind of
some of what has led you to thispatient population.
I know for a fact the reason Ilove the patient population is
through my sister and my mom andseeing it and seeing, just like
the resilience of you know, thehuman spirit and how much you
can, the impact you can make onsomeone by helping their quality
(49:51):
of life, I think I'm very.
People are like, oh my gosh,you sound so PM&R.
I'm like, well, it's so similar.
I think that I think it's verysimilar.
There's a lot of there's a lotof crossover.
But yeah, I mean, I thinkgeriatrics is definitely another
you know area that I think itdoesn't get a lot of attention
at all.
Pediatricians that are tryingto be more involved, and that
(50:19):
population.
I mean I love my grandparents.
I call my grandparents everyweek, both sides.
I've been blessed to have allfour still with me and it really
has.
I think, both my exposure tomultiple generations of
individuals in my family andthen also through my sister, all
(50:46):
of her friends, that I think ithas shaped me in a certain way
to practice medicine a certainway.
And I mean it's so right thatnow, with how separate everyone
has become and even that wespend less time together, you
know with, I mean not to soundall you know crotchety with the
oh, you know, these days we onlytalk over the phone.
I mean we're recording thisover the phone, right, I mean.
But technology, I think there'ssomething about human
(51:06):
connection that we do miss withtechnology and I'm a big
proponent of telehealth becauseit really helps rural
communities.
But I think something needs tobe said about some of these
in-person experiences andactually getting to know people,
not just 2D but 3D, I don'tknow, maybe holograms will help,
but I don't know I'm not readyto go full metaverse with my I
(51:30):
don't think.
I am either.
I just imagine people poppingup at times that I do not want
them in my head.
You see it in the movies.
It doesn't seem like you cananswer the phone calls, so I
really hope that they work outthat bug when they make it in
real life, you know.
Dr. Michael Kentris (51:45):
Awesome.
So I know we've been talking alot about various subjects.
It's been very enlightening forme as well.
For folks who want to learnmore, where would you direct
them?
What are some good resources?
I are folks who want to learnmore.
Where would you direct them?
What are some good resources?
I know you mentioned lookinglike X syndrome association.
I know that's been superhelpful for me in the past as
(52:07):
well.
But any more broadly sweepinggroups that you would recommend
people look to?
Dr. Samantha Stallkamp Tidd (52:14):
Oh, yes, so Stanford.
So they have a great group.
Docs with Disability is a greatpodcast that highlights doctors
with disabilities Is it just inthe name?
The University of Michigan,their family medicine department
(52:35):
, has a page with a lot ofresources on education materials
, and disability has a page witha lot of resources on education
materials and disability,largely focused in primary care,
but they really do spread out alot and they've come up with a
lot of work.
University of UPenn has adisability group that have been
putting out some good stuff.
And Harvard as well Dr Tolkien,dr Iazzoni there's a lot, of, a
(52:58):
lot of interest over there.
And then the Cleveland Clinicwe're trying to.
We might get social mediaeventually, but you know we were
really, we wanted to.
You know, have a product firstand we're getting through this
pilot.
But they can also reach out tome on, you know, twitter, or
yeah, twitter's probably thebest to reach out to me, just
(53:19):
because my emails are.
I have like eight emails nowand I don't know how to and I'm
about to get another one, so I'mnot sure how to handle that,
but I can always.
It's connected, honestly,twitter has.
So I know X Twitter.
I know people have opinions onit, but I honestly I have
(53:40):
learned about so many groupsjust by being on there and just
searching disability, med, ed ordisability, and there's a bunch
of people doing really greatwork.
But yeah, I mean it's there.
It's just people have to findit and I think we're getting
louder and louder as time goeson, which is really wonderful.
Dr. Michael Kentris (54:00):
Awesome.
Thank you so much for coming on.
I really appreciate you takingthe time to come and talk with
me and talk with everyonelistening, and hopefully we'll
get some more medical studentsinterested in engaging with some
disability advocacy.
Dr. Samantha Stallkamp Tid (54:16):
Well , thank you again and thank you
for all you do for MedEd.
You really are an inspirationfor everyone who wants to go
into it.
So thank you again and thankyou for all you do for med ed.
Dr. Michael Kentris (54:20):
you really are an inspiration for everyone
who wants to go into it, sothank you.
Dr. Samantha Stallkamp Tid (54:24):
Well , I mean, I'm blushing over here
too it was a great conversationand, um yeah, I hope to talk
again soon awesome.
Dr. Michael Kentris (54:31):
thank you, uh, and thank you for listening.
If you've made it to the end ofthe podcast, congratulations.
Thank you for taking the timeto spend your precious, precious
time with us.
You can find me on Twitter,slash X, at Dr Kentris,
d-r-k-e-n-t-r-i-s, and you canalso check out our website,
theneurotransmitterscom.
Thanks again for listening andwe will see you next time.
Hello and welcome to the Neurotransmitters
, your podcast for everythingabout clinical neurology.
I'm your host, dr MichaelKentris, and I am very pleased
as I always am on this recordingto welcome another excellent
guest.
I have the future Dr SamanthaStallkamp-Tidd with us today
from Cleveland, ohio.
Thank you so much for joiningthe show.
Dr. Samantha Stallkamp Ti (00:24):
Thank you so much for having me.
I'm excited to be on.
Dr. Michael Kentris (00:27):
So you know , as so many of my guests do, I
came across some of your work onTwitter slash X and listened to
some other podcasts you'dactually done recently and you
were talking a lot about kind ofdisability advocacy and
disability in neurology advocacyspecifically.
So I thought we could start byjust talking a little bit about
(00:49):
kind of how you, because Ishould say you know you are just
moments away from graduatingmedical school Congratulations.
Dr. Samantha Stallkamp Ti (00:57):
Thank you.
Dr. Michael Kentris (00:58):
And you'll be heading to neurology
residency up in Rochester and soagain, they're very lucky to
have you.
But, thank you, tell me alittle bit about the path that
led you to this point and howyou kind of navigated your way
to this point in your medicaltraining and slash career.
Dr. Samantha Stallkamp Tid (01:15):
Yeah , I mean that's a great question
to start.
So, um, I it's really familyties is kind of how I got into
this space and I think if I wasborn into a different family I
don't know if I would have foundneurology I hope I would have.
But you know, I grew up in Lima, Ohio, which is a small town in
northwest Ohio.
(01:35):
I have an older sister who's aNICU nurse not neuro ICU she
does the baby one, which I guessis fine.
But you know, I have a more ofUnurse not neuro ICU she does
the baby one, which I guess isfine, but I have more of a soft
spot for neuro.
And my younger sister,kellyanne.
She is a teacher's aid and alsoParalympic athlete, but she has
(01:58):
spina bifida and she was bornwhen I was around three years
old and so I grew up really inthat disability mindset.
It's all I knew.
I mean, I knew that I'd have tomake some adaptations for her.
I knew that people looked at mysister differently when we were
in public and you know, me andmy older sister are always so
protective of her and there werejust things that, as are her
(02:23):
sisters, we made sure happenedso that she could exist in
public, um, and go through herlife the way she wanted to, and
I saw, you know, my parents arejust the biggest advocates for
her.
I mean, my mom advocates, uh,not just for her but for that,
that whole community.
And growing up, seeing hergoing and running sled hockey,
(02:47):
my sister's sled hockey teams,and then seeing my sister get on
the USA women's sled hockeyteam and winning the world
championship, that's pretty cool, insane.
She's very cool, much more coolthan I am.
I'm very proud of her, but mymom just made sure that there
were spaces to where she couldfeel both included and also
(03:13):
experience things that everyoneelse did is I want the world to
be as good of a place that it is.
That like my family has madefor my sister everywhere.
Right, cause not everyone hasthose people that are by them,
their side, and you know wealways talk to like how it is in
(03:35):
our home Isn't always how it'sgoing to be for you out outside
of the home, kelly.
Like she's going to face things.
She's going to facediscrimination and she has, um,
but that's kind of what I'vedecided to fight for.
She's going to facediscrimination and she has, but
that's kind of what I've decidedto fight for.
So I went to Ohio State thirdgeneration Buckeye, big, big OSU
fan.
Dr. Michael Kentris (03:55):
So you mean to say the Ohio State
University?
Dr. Samantha Stallkamp Tidd (03:57):
The Ohio State University.
I didn't know how pretentious Iwanted to be on this podcast.
Dr. Michael Kentris (04:02):
I went to undergrad there as well, so
we'll call it the Ohio StateUniversity and everyone else can
just deal with it.
Dr. Samantha Stallkamp Tid (04:08):
Okay , that's fine, I'm completely
open to that Third generation.
My grandparents met there.
I am ridiculous, but regardless.
I went to the Ohio StateUniversity, majored in
neuroscience, because, again, Iwas going to these neurology
appointments with my sister andunfortunately, my mom was
diagnosed with MS while I wasyoung as well, and so I was
(04:31):
headed up to the ClevelandClinic to, you know, go with her
to her appointments and mysister's appointments at
Nationwide, and traveling,because when you're a kid or you
have a family member and you'rein a more rural area without
specialty care, you have totravel quite a lot and get
pulled out of school becausemaybe the babysitter pulled out
(04:53):
and things like that.
But I thought it was the coolestthing ever what those doctors
were doing, and so I was justobsessed with the nervous system
.
So I thought let's study it.
So I went to undergrad, I wasstudying it and I was walking
around the Oval it's the big forpeople that don't know, it's a
(05:13):
big like green space at OhioState and there was an
activities fair and there was agroup called Abilities.
It was Abilities, an allianceof people with and without
disabilities and I went yes, Iwalked up to it, found out there
were two people in the club andone of them was graduating.
But I said, okay, let's sign on.
(05:35):
I immediately became the vicepresident.
I drug my now husband onto it,several of my roommates and we
just kind of went about growingthis and I got a lot of
inspiration from my mom and whatshe did in our hometown, which
was like a Paralympic experience.
So people from all overNorthwest Ohio came and got to
(05:59):
try out Paralympic sports soboth people with disabilities
and without disabilities to seewhat Paralympic sports were
about.
And every year she had one kidthat would decide to do sports
and then their world would openup and they would be really
entrenched in a community ofsupport.
And that's why I think peopledon't understand that disability
(06:19):
community is huge and warm andwelcoming and it's just
accessing it that can be hard.
So I started throwing them atOhio State and every year we had
a kid who wanted to play sportsin the local community.
We did some other advocacystuff, like we put signs on
handicap bathroom stalls thatsaid, unless this is your only
(06:45):
choice, this shouldn't be yourfirst choice, just saying, when
you go in a bathroom and all thestalls are open, don't go in
the accessible stall Because Ithink some people just
immediately go there and we wantto keep it open most of the
time for people who need it.
We did some other things withpartitioning the bus system that
(07:10):
wasn't doing well, but anyway Iwas so entrenched in that and
it grew and by the time I leftit was thriving and it's still
around.
But they renamed themselvesBuckeyes for Accessibility, but
I'm very proud of that.
So then I got into my dreammedical school, the Cleveland
Clinic, lerner College ofMedicine.
(07:31):
Again, it's like this weirdthread in my life I mean my
mom's doctors which I credit foryou know she has done so very
well and that's because of thecare that she received at the
Cleveland Clinic To then getinto that medical school was
kind of surreal for me.
I think it's also just because,from where I come from, I'm
(07:52):
from a smaller town, you know Iwent to a state school and then
it's like wait, I want, I'mgonna go to the Cleveland Clinic
.
And I did.
And when I started there I knewI wanted.
I was already interested inneurology.
Right, I did neuroscience, Iwas, I was so interested, but
the advocacy stuff I kind of youknow, I was like I'm going to
put this on a back burner alittle bit, just because I got
(08:16):
to focus on medical school.
Medical school is hard, youknow, sammy, you gotta, you
gotta focus, and that lasted foronly a few months.
Really, one of my classmates,really good friend of mine we're
going to her bachelorette partythis weekend.
Actually, she fell and twistedher ankle while rock climbing
and she was on crutches for alittle bit.
(08:38):
We're in this brand newbuilding.
State of the art.
You might have seen it in theworst presidential debate of all
time.
That was my med school.
They just put it in.
Dr. Michael Kentris (08:48):
There's so many contenders.
Dr. Samantha Stallkamp Tidd (08:52):
It was.
Yeah, it was terrible.
And then the president gotCOVID and it was a whole debacle
.
I probably shouldn't be talkingabout it they don't want me
talking about that probably, butanyway, it's beautiful, brand
spanking new building.
And the doors to the bathroomwere so heavy and I noticed it
right away, but I didn't realizehow heavy they were until I saw
(09:13):
my classmate struggling to openthe door to the bathroom.
So anytime she had to go to thebathroom we had to take her
because the doors were too heavy.
And so of course I just emailedand I said hey, I think I don't
think these are ADA compliant,I don't think I think these
doors are too heavy.
And I got an email back andthey just said no, they're all,
(09:37):
they're all compliant.
That didn't sit right with me,so I bought my own pressure
gauge because I don't know whento give up, but they were five
times the legal limit of poundsper.
You know force to open thesedoors.
When they showed them that,they changed it.
And now the doors are, you know, they open fine, which is great
(10:00):
, and it was a big win for me.
But I told this story to my nowone of my greatest mentors and
friends Dr Natavich Marvin, Icall him and he just said let's
make this group.
And so we started a group oncampus and, yeah, it's really
been kind of up since then beenkind of up since then.
Dr. Michael Kentris (10:26):
Now is the.
Is the focus of this group forspecific, like local initiatives
, or is it for education ofother students with respect to,
like the needs of people withdisabilities, or how would you
characterize its mission?
Dr. Samantha Stallkamp Tid (10:36):
Yeah , I mean I.
So it's called the disabilityaction group, we we.
So we started, I guess it.
We ended up formally startingmy second year, but we have been
crafting it for a little bitand the original mission was to
address the gaps in thecurriculum when it came to
disability related content.
(10:56):
That has grown a lot to thedisability related gaps in med
ed as a whole and alsoaccessibility things like the
technical standards at ourschool.
It's kind of grown to where wehave a ton of different projects
(11:17):
going all at once and lots ofstudent involvement, lots of
community involvement.
I think it's kind of rare formedical school groups to have
people that are not affiliatedwith the school at all.
I mean, these people are notaffiliated with the Cleveland
Clinic and they're justcommunity members parents of
people with disabilities, peoplewith disabilities themselves
(11:38):
that work in social work orhealth care and some doctors
from different institutions thatjust heard about it and wanted
to help.
So our mission is really justimproving the lives of people
with disability.
I think that's the easiest, Ithink, definition that we could
make and I think that it's justincredibly important.
(11:59):
This is a stat that I wrotedown because I wanted to make
sure I read it just so peopleknow how big of a scale this is,
and I want to ask you what youthink this number is.
So they did a.
Lisa Iazzoni, wonderfulresearcher at Harvard, did a
survey a couple of years ago of714 physicians.
(12:19):
What percent of them do youthink, said that they were
confident in their ability toprovide the same quality of care
to patients with disability?
Dr. Michael Kentris (12:32):
How many?
You mean like self-evaluation?
They thought they could do it.
Dr. Samantha St (12:35):
Self-evaluation .
They thought that they couldgive the same quality.
Dr. Michael Kentris (12:39):
It's probably some ridiculously high
number like 100%.
Dr. Samantha Stallkamp Tidd (12:42):
No 40.
40.7.
Dr. Michael Kentris (12:45):
I was just expecting our profession to
overestimate their abilities.
Dr. Samantha Stallkamp Tidd (12:49):
I don't not with this and I think
it's it's because it's notaddressed.
Um in medical school, like whenwere you taught how to um adapt
an examination for someonewho's using a wheelchair or for
someone with sensorysensitivities because they have
autism?
You just kind of weren't.
(13:11):
And then you get told oh,you'll learn that.
That's what I was.
I would ask and people say, oh,you'll learn that in residency.
I mean these numbers, I meanthere's more statistics.
You don't.
Dr. Michael Kentris (13:22):
It is one of those things where I
definitely didn't learn thatspecifically in medical school.
And it was something that, again, not formally instructed during
residency.
But it's one of those thingswhere you keep getting presented
with different situations andyou have to think to yourself,
how can I adapt this?
And at least in neurology,doing like our child neurology
(13:45):
months and I will definitely tipthe cap to the child
neurologists out there they'remasters of adapting the exam to
different scenarios through theentire, from neonatal up to
young adulthood, and so thosemonths that I spent on my child
neurology thing probablyprovided the most robust
(14:05):
experience in terms of, like Ineed to check their leg strength
.
Well, have them hop on one legor do all these different things
Very much enhances yourobservational skills and things
like that.
But I would agree with you, itis not a formally trained skill
in most definitely not in mostspecialties, but even in
neurology I wouldn't say it'snecessarily integrated into the
(14:27):
curriculum most places.
Dr. Samantha Stallkamp Tid (14:29):
Yeah , and I think the thing I mean
I'm so glad that you've had thatexperience and I think that
just the experience of seeingsomeone think through how they
would adapt something I thinkmakes it easier for you in the
future, because you can't teachevery single adaptation you
could ever do, because peopleare so different.
(14:52):
I mean people have multipledisabilities, people have
multiple things going on, so theadaptations are going to be
individualized, but the factthat we're not even told to do
that or how to do that, it leadsto a worse quality of care.
I mean this is a very sadexample, but one of my sister's
(15:12):
friends he passed away from apressure ulcer that he went into
sepsis and passed away.
That ulcer was not discoveredduring his primary care visits.
No one checked, no one took himout of his chair and full
(15:32):
physicals are often not done.
You can talk to many people Imean, it's an adonal.
I don't know if there has beena formal study, but at least
those I know in the disabilitycommunity they do feel like
they're not given a full exambecause I think people get
nervous about it or they thinkthey don't have time oh, I don't
have time to take them out oftheir chair to do a full
(15:55):
abdominal exam.
Well, you could miss masses.
There's so many things that youcan miss that you would do on
an able-bodied person but you'renot doing in the specific
situation.
So I think that just that fact,as someone who loves someone
with a disability, when I'vekind of thought about how many
(16:16):
people are uncomfortable likeseeing that stat and then
thinking about what tools I wasgiven in medical school, it
scares me.
It scares me because you hearall of these stories from people
with disabilities that they'vehad these experiences and I
think people can do somethingabout it.
I really do.
Dr. Michael Kentris (16:38):
And I think I remember hearing you talk at
one point about kind of a videoencyclopedia that you were
working on.
Is that, is that still ongoing,or could you tell us a little
bit more?
Dr. Samantha Stallkamp Tid (16:49):
Yeah , so the original idea is called
the adaptionary.
So this is.
This is just a a wild dream ofmine that you know it might
happen.
There's a lot of people thathave offered to help.
You know it might happen.
There's a lot of people thathave offered to help.
You know, zach London atMichigan has been great and
(17:10):
given me some tips andessentially what it would be is
either an application or awebsite where it would show
adaptive techniques like invideo format.
We don't read.
My generation does not readLike I am sorry for all of the
people that are in curriculumsand doing this.
We don't read medical textbooksanymore, we watch videos and I
(17:31):
think that having ideas of, oh,okay, if I need to do a strength
exam on an amputee, what aresome ways that I need to assess
that but also examine, you know,their, their stump, like how do
I do these things?
Because I think seeing it andbeing able to just quickly
Google abdominal exam seated,because you can't, you
(17:55):
physically can't, and a lot ofthese things are structural as
well.
If you only have 15 minutes andyou don't have nursing staff to
help you get someone on anexamination table, you have to
work with what you've got, but Ithink some people you don't
have nursing staff to help youget someone on an examination
table.
You have to work with whatyou've got, but I think some
people just don't.
And so, showing examinationtechniques, showing adaptations,
you can't obviously do all ofthem, but I think you could do
(18:17):
quite a bit.
And hearing people talk about itand you know, pm&r, child
neurology all of these peoplehave a lot of really great um
techniques that they can offer,and also those that work with
people on the autism spectrumdisorder, I think, also can
offer a lot.
So it'd be almost like anencyclopedia Um.
(18:39):
We also, you know, we had totry to find see if these videos
existed already.
There's not a lot of goodquality on how to go through the
exam in video format, and so weare trying to develop a very
basic guide that's almost likean introduction ourselves via
video, but the app might be moreof a reading pictures
(19:03):
demonstration, but it'ssomething that I think over time
we can develop and if anyonewants to, I don't care if anyone
takes it from me and does it, Ijust want it to exist.
I want it to be easy to figureout how to adapt examinations
for different disabilities,limitations, all of those things
.
So yeah, that's one of theprojects that we're doing right
(19:25):
now, for sure.
Dr. Michael Kentris (19:26):
No, it's very cool and it does remind me
like in my own medical schooltime.
So, confession I initially wasand did apply to physical
medicine and rehab and so duringthat I did a couple of sub-Is
in PM&R and during some of thoserotations I spent a couple of
(19:47):
weeks with the physical andoccupational therapists.
And you do learn some reallyuseful things, things that I
still use to this day, like as apracticing neurologist, like
how do I transfer a patient fromthe bed to the chair?
Yes, or just these very, verysimple things from the bed to
the chair.
Or you know, just these very,very simple things.
(20:07):
And it's because, you know,obviously we need very often to
walk our patients and see howare they moving.
And so it becomes one of thosethings like how can I walk a
patient, walk with a patient,kind of like as their walker or
you know with or without a gaitbelt and all those kinds of
things, depending on thesituation and relative body
sizes and all that kind of stuff.
But it definitely gives you asense of how to do some of these
(20:30):
things that we don'tnecessarily learn during routine
training and they are very,very useful skills that will
stay with you the rest of yourcareer.
Dr. Samantha Stallkamp Tid (20:41):
Yeah , I think that's such an
important point and I thinkthat's some of the pushback when
people try to put disabilitycurriculum in, like when you
talk about, I mean even like thesocial work aspect of it,
knowing the resources that areout there.
I think as a physician, weshould yeah, we can't replace
social workers but they'll pushback and be like we can't be
social workers, we can't beoccupational therapists, we
(21:02):
can't be physical therapists andI'm just like, okay, but we
should probably know what thosejobs do and where the overlaps
are so we can help ourcolleagues.
Right, social work is sothey're so overworked and that
profession is so phenomenal.
I mean they do such great work.
But literally, just being aphysician who takes care of
(21:26):
patients with certain disorders,I've made this suggestion to a
lot of physicians.
So if you work with patientswith cerebral palsy type in
cerebral palsy nationalorganization or national
association or something onGoogle organization or national
(21:47):
association or something onGoogle, you'll find a billion
organizations that have tons ofresources for your patients that
if you just hand over some ofthat information, it can make
such a difference in someone'slives just to get connected.
And there's so many things goingon in these people's lives that
they don't even think aboutdoing that half the time.
They don't have time, you know,they have to make all of these
appointments.
Even making some of thoseinformation available can really
(22:11):
help both the social workyourself and the patient.
But yeah, ot, pt, I mean evenspending a day with them.
I think I'm such a big proponentof you know some of these
interprofessional educationactivities that schools are
doing, like just studentsworking with students, I think
(22:33):
that's you know it's good to getto know other people, but I
want to know what it's like toactually be in their job.
I want to shadow a nurse andsee everything that she does or
he and same with PT and OT andactually learn from them.
Because, again, there's it'snot a like, it's a Venn diagram
of things that we can learn fromeach other and I think it's
(22:54):
really important that I mean youmentioned that that it's it is
interdisciplinary and it'ssomething everyone just assumes
that the other person is goingto do, but that doesn't always
happen due to time constraintsand such.
Dr. Michael Kentris (23:07):
I know One of my and again, this is
something that's very innate toPIMA and ours you have these
multidisciplinary rounds wherethe whole therapy team sits and
they talk about every patient,and I had a similar experience
when I was a fellow working inneuromuscular clinics, in the
ALS clinic, and we would havethe exact same thing right.
There would be neurology,pulmonology, hospice and
(23:29):
palliative, ptot, assistivetechnologists, like all like
literally like 15, 20 people.
We would spend an entire like10 hour day seeing all these ALS
patients from the region andthen everyone would go.
We'd go down patient by patientand everyone would have their
input on that person's care, andit's really logistically
(23:50):
challenging but it is sofruitful for these people with
with these complex medicalsituations.
Dr. Samantha Stallkamp Tid (23:58):
Yeah , I mean I I'm smiling over here
because those types of clinicsI mean, yeah, it's so hard to
schedule those things.
I mean I am sure it's alogistical nightmare, but as
someone who has family membersyou know my younger sister I'd
go to the Milo Clinic with her.
It was at Nationwide and she'dsee all of her doctors at once
and she'd only have to getpulled out of school one day,
(24:20):
maybe two, and me myself I wouldgo with them to.
You know, help dependent on youknow what was going on.
And I don't think peopleunderstand how big of a deal
that is.
Um, just because, oh, you haveother, it's not the caregivers
of people with disability.
They have other things to do,and people with disabilities
(24:42):
have other things to do and theyhave lives and jobs and school
and all of these things.
And I think we don't often thinkabout how disruptive medical
care can be to their lives.
When you have so many differentappointments, I think it's hard
for people to kind of scope itout when they're like, oh, I see
(25:02):
my PCP once or twice a year,but if you have eight different
specialist appointments and youhave to leave your work, your
job, I mean people lose incomepeople lose.
It's so hard to be a studentand then get yanked out in all
the different directions.
It was hard for my sister We'dbe doing the homework on the way
(25:24):
there and back from Columbusand it's even more exacerbated
by people being in rural areas.
So, that clinic.
Those clinics are just soamazing and I hope more
institutions make it for moreand more disorder, like more
disease groups, more, more ofthem, because I think it's so
(25:45):
and the collaboration is sofruitful.
I mean it really is.
Dr. Michael Kentris (25:49):
So I'm curious on your perspective to
shift gears very, very slightly.
You know we've talked a lotabout people who need, like,
assistive devices for mobilityor have other like readily
physically apparent disability.
But how do you think folks whohave maybe the quote unquote,
you know invisible disabilities,whether that's, you know, like
multiple sclerosis or epilepsyor a lot of things that you know
(26:12):
us in the neurology field dealwith, have you done a lot of
work with those populations inyour advocacy and, if so, how
does that differ?
Dr. Samantha Stallkamp Tid (26:24):
Yeah , I mean I think that it's it's
a really good question and ourgroup, I mean I'm I'm so proud
of the students that are comingup after me.
You know, when I started thegroup I was like, oh, maybe
it'll survive after I'm gone.
Now I know definitely it'sgoing to survive and continue to
keep going and I'll get to comeback for meetings which is
really cool and cheer them on.
(26:45):
But one of our first yearmedical students, Swetha she is
very passionate about peoplewith chronic illnesses or
disabilities come that are inhealth care, come and talk and
(27:10):
share their stories.
So so far we've had someonewith long COVID in health care,
having to deal with that andbeing temporarily disabled and
also having, you know, they havea lot of like, worst days, good
days, and a lot of stigma isthrown their way.
And then we also had a doctor,pm&r actually who has Marfan
(27:40):
syndrome, not feeling supportedbut then at times feeling like
he had to be better, like evenbetter than anyone who was
able-bodied and wasn't dealingwith chronic illnesses.
And I think it is a lot harderwhen your disability is not
readily apparent.
I think the judgment is there,especially because I mean, you
(28:04):
don't you hear, people withchronic illnesses will tell you
this all the time, like they'vebeen told to their face well,
you don't look sick and thatdoesn't doesn't do I mean
anything for for them and I I'veactually a lot of my research
and my that part of my work.
I worked with the people withPOTS and long COVID and it's a
(28:26):
population that is constantlymaligned, constantly told that
they're making it up, thatthey're anxious.
It's so wild to me because I'mlike this is someone who was
running marathons three monthsago and now she can't walk
across the room.
You're telling me that it's allin her head, some of these
(28:46):
chronic illness stories.
When you hear them and theytalk about their lives, they
feel like they shouldn't be sick.
They should be able to do someof these things and it's really
society's expectations that areput on them that they should be
able to do this in the statethat their body is in.
But a lot of times they mightneed adaptations and it's harder
for them to get those.
It's the same with mentalhealth.
(29:07):
It's so much harder for peopleto even be open about it.
Dr. Michael Kentris (29:16):
Medical students aren't open about their
mental health.
Dr. Samantha Stallkamp Tidd (29:17):
I can tell you most of-.
Dr. Michael Kentris (29:18):
Physicians as a population?
Right, it's like I know youhaven't had to do this yet, but
when you check the boxes, do youhave any physical or mental
disabilities that could impairyour, your ability to practice
medicine?
Right, I mean, it's essentiallya form of discrimination, right
?
Dr. Samantha Stallkamp Tid (29:33):
Well , I mean, that's actually it.
It's exactly what technicalstandards are.
I mentioned that earlier.
So, basically, every medicalschool has this document that
you have to sign almost everyyear.
I don't know if you remembersigning it, but it it.
You have to be able to fulfillthese very specific things, and
some of them.
It's like you have to not getdistracted and you have to be
(29:56):
able to focus on one thing.
And I'm like I have ADHD.
Am I lying to this documentbecause I'm signing saying I'm
good, I'm fine, I've neverneeded accommodations.
I'm a little hyperactive, maybe.
I'm fine, I've never neededaccommodations.
I'm a little hyperactive, maybeI get distracted.
Dr. Michael Kentris (30:08):
I would never have guessed.
Dr. Samantha Stallkamp Tidd (30:13):
Am I lying?
I was in the generation whereno girls were diagnosed and they
diagnosed me in kindergartenbecause they were like girl.
There's something wrong withyou kindergarten, because they
were like girl.
There's something wrong withyou.
But really it feels like you'relying to this document and some
(30:34):
of them are very specific andthey target people with low
vision.
One of my best friends inmedical school has low vision
and he had to sign this documentsaying that he had perfect
vision, basically, or that hehad adaptations to get perfect
visions.
He didn't, but that he hadadaptations to get perfect
visions.
He didn't, but they madeadaptations for him throughout
his career.
But the problem is, this is acontract that people can use to
kick these students out ofschool and so if they became,
(30:58):
you know, let's say that theirchronic illness got worse and
they couldn't fulfill one ofthose things.
If the school didn't want todeal with them, they could say
look, you lied, you signed this.
Bye.
Dr. Michael Kentris (31:09):
Yeah.
Dr. Samantha Stallkamp Tidd (31:10):
Now , I've heard of that happening
before.
It hasn't happened in my school, it hasn't happened in the
school surrounding, but the factthat that's hanging over your
head, I think, is verydestructive.
So there's a lot of people thatare trying to update their
technical standards to make itokay.
We just expect you to be ableto fulfill these criteria with
(31:33):
adaptations, or you have to beable to have a path in medicine
that you're going to be able todo right.
So someone who is blind,visually impaired, might not be
the best pathologist, but theymight be a brilliant internist,
a brilliant, you know,psychiatrist, right, and so
(31:53):
those paths are open to them.
They can be wonderfulphysicians, but some of the
other ones are closed.
Dr. Michael Kentris (31:59):
I do remember reading an article not
too long ago about a P1R doctorwho had about a P1R doctor who
had, like he was legally blindbut he was still performing his
function, like by hearing peoplewalk and physically examining
them, and like he had adaptedhis practice to such an extent
that he was still providing carefor these people, and I thought
(32:21):
that was just wild.
Dr. Samantha Stallkamp Tidd (32:25):
I mean that's I think I think it's
when those people were giventhe tools that they needed.
And I mean, if you think abouthow many patients would be
losing out on having such afantastic physician if he was
told no or if he was kicked outbecause of some health thing
(32:46):
that came on, and it's just soscary with some of these
documents and it makes it sounwelcoming.
And we're trying to rewriteours.
We get our accreditationthrough Case Western, so it's
like this whole.
We have to help them changetheirs.
But Michigan has I mean itpains me to say this as a
Buckeye, to be honest butMichigan has some of the best
(33:10):
technical standards in thecountry and they really are the
benchmark for how to beinclusive without and actually
show what do you need to be ableto do in medical school,
without being blatantlydiscriminatory and opening
students up for getting kickedout of school.
Dr. Michael Kentris (33:28):
Excellent, and we kind of skirted around
this a little bit.
But a thought that occurred tome as we're talking is, if I can
loop a few of our points thatwe've hit along the way together
, that a lot of physicians thinkthat they're unable to
appropriately take care ofpeople with disability, that we
(33:50):
have this system structurally inplace that limits people with
disability from enteringmedicine.
And then we talked a little bitabout this before we were
starting recording, about howmedicine as a profession is
perhaps one of the morediscriminatory professions out
there against our own people.
(34:11):
If you had to tie those threadstogether, what are your
thoughts about this?
Because this is a kind ofperennial online debate that we
see, where the older generationcriticizes the younger
generation for not being astough, for working as hard, or X
, y, z or the other thing.
But where do you see medicinewith the inclusion of people
(34:35):
with various disabilities andwhat are the things that you've
seen that are going well or not,as the case may be?
Dr. Samantha Stallkamp Tid (34:46):
Yeah , I mean, oh, that's such a good
question.
I mean I think, as we seephysicians with disabilities all
the time, I mean Stanford doesa lot of work and they have a
group that and they have thisdocs with disabilities and we
see more like more are beingsuccessful and I think that is
(35:07):
just because we've made medicinea little bit more humane.
I think that we've been able tosee more people with
disabilities enter the field andI think it'll only increase
because I think people will feelinspired, like other people
with disabilities will feelinspired to go and become
(35:28):
doctors themselves.
You know there's a famousneurosurgeon again at Michigan
who has spina bifida.
My sister was so inspired byher but then she realized she
hated science so she threw thatout the window.
But it really opens uppossibilities.
When you see someone who hasgone through the same health
(35:48):
struggles that you did and nowthey're helping patients with
the same thing, I mean it's so.
I think it's so overwhelminglygood for that population who
they're constantly told youcan't do this, you can't do this
, and that's why I think I love.
I'm very passionate aboutParalympic sports.
I'm terrible at all thingsathletics, but my sister is
(36:08):
obviously quite good.
She's a Paralympic athlete, butit really can change someone's
mindset when they look at thepossibilities.
You know my mom actually wrotea book about my sister.
It's called Sports Set Me Free.
And they're doing like thisbook tour where they're talking
to kids with disabilities aboutall of these different um sports
(36:29):
that my sister was able to do.
And when you see thepossibilities, um that when you
make good at adaptations right,we took off the bottom of her
crutch and put a golf club in itso she could golf with us you
know you can see.
See, I mean you can there's somany different ways you can
adapt and you can overcome thesethings Um that when you see
(36:50):
doctors doing that andperforming at the highest level,
I think it can only increase.
But I do think there is.
You're talking about pushbackto a lot of these things I mean
from the other generation.
Oh, it's soft.
You know 24 hour calls youlearn better.
I mean we talked about that.
You know there's soft.
You know 24 hour calls youlearn better.
I mean we talked about that.
You know there's science, thatI mean you don't, you can't.
(37:14):
Basically, after 15 minutes in alecture, you're not really
learning that much anymore,right?
I mean, it's so true and Ithink that, as I think this
generation is reshaping medicineto remind all of us that we're
people first, and I think onlygood things can come of it.
You know, like I never want tobe a doctor that is so obsessed
(37:37):
with working and my job and sodedicated to it that I forget
what it's like to be a humanbeing, Because I also think
that's dangerous.
If you can't put yourself in apatient's shoes because you
haven't lived your life at all,I think that's a little
dangerous.
(37:58):
I really do, and I think havingthese people that have been
through chronic healthconditions, that have been
through these things, they havean understanding.
No one else does that have beenthrough these things.
They have an understanding.
No one else does.
I mean I only know so muchbecause I, you know, am a
sibling of someone with adisability, which we're in a
we're very specific group.
We have very specific quirksabout us.
It's really interesting whenyou talk to siblings with people
(38:20):
with disabilities.
We have very similar likeissues, all these things.
But I think that it's thatdiversity of experience and I
think that is only common recentyears, when we're celebrating
that and I just hope that wecontinue to include and talk
about this, this set ofdiversity, people with diversity
(38:43):
of experiences in healthcareand disability and those things
because I think that they makesuch fantastic physicians.
I really do.
Dr. Michael Kentris (38:54):
No, I think that's an excellent point and
it's something that I think it'simportant for us to remember.
If we look at the majority ofmedical students, they're young,
relatively healthy people whohaven't been in the healthcare
system, and it's very likelythat at some point in all of our
(39:14):
lives we will be patientshopefully for just a brief time,
but some of us for longer.
And, if I may wax philosophicalfor a moment, I think this
concept of human frailty and theyou know, the memento mori of
it all is very important.
You know that I always think ofI forget what hospital it is
(39:38):
but those who are online toomuch like myself.
There's a picture of somemuscle bound guy holding a, a
caduceus holding back the grimreaper with one outstretched arm
in front of him, like he'sgoing to stop death oh yeah, you
know what I'm talking aboutyeah, I think yeah and I think.
I think that is just like thepeak of hubris.
Uh, that's that medicine.
(39:59):
You know you cannot stave offdeath.
Um, you can help people andhopefully correct problems, but
eventually it's very much thatall of us will pass away at some
point.
I'm not so much of a futurist,transhumanist type person to
believe that immortality is justaround the corner, but I think
(40:21):
it's very important for us toremember that we are all human,
as you said, and we are allsusceptible to injury.
It's like there.
But for the grace of God, go.
I right, most of these people.
It's random chance that they'vebeen dealt the hand that they
have.
It could just as easily be anyone of us, or you could be
walking across the street and itcould be.
(40:43):
So I think it's one of thosethings where it's very easy for
us it's the easier thing not tothink about.
You know, these, these bodiesthat we all have during this
life are are also frail, andjust one of a million things
could go wrong and it couldchange our entire lives.
Dr. Samantha Stallkamp Tid (41:01):
Yeah , I think that that's such a
great point.
I think it's it's so.
I have such a differentperspective than my classmates,
right, like I've I've hadconversations with them, and
something that many of my peersfear is becoming disabled.
Oh, if I, if I became disabledlike, oh, I'm a surgeon, if I
lost a hand I'd be dead.
(41:21):
There's nothing, I can't goback.
My quality of life would benothing.
And as someone who you know hasbeen in this community, I'm like
I, you know, some of thehappiest people I've seen are
quadriplegics.
You know, I met, I met the.
I think he was, I think he wassecond in the world in adaptive
bocce.
(41:41):
What he does is he sets up aramp, he can angle it, he has
someone that helps him angle itand he wears a helmet and he can
use his neck muscles and hetips it in just right and plays
bocce and is phenomenal at it,and he had so much joy in his
life and most people would lookat him and say, oh, I would
(42:03):
never want to live like that.
Well, I don't.
I think that sometimes peoplehave these assumptions about the
quality of life of people withdisabilities.
That, as someone who lovessomeone with disabilities, is
scary.
I mean we saw during COVID Imean there's a I think it's a
New York Times article that wentthrough this that people with
(42:23):
disabilities were more likely tohave their care withdrawn
during COVID.
And you know that it reallyaffects me, you know, when I
read things like that and Ithink as doctors we have this
inflated.
A lot of doctors have thisinflated concept of what quality
(42:43):
of life means and it isdifferent for every person.
But I think that also comeswith experience of knowing oh, I
can actually adapt.
I remember having thisconversation with my classmates.
We were like I like it'sliterally I.
You know, ms is not genetic thatwe know of, you know, but it
also is environment.
It's like maybe, you know itdepends, it has factors for both
(43:06):
, but it's not.
It's not like, because my momhas MS, I'm going to have MS,
for sure, right, but I also grewup in the exact same area as my
mom.
So maybe those factors allalign and I get MS.
Maybe those factors all alignand I get MS.
I'm not really scared of thatbecause I know that I'll be able
to adapt.
I've seen my mom adapt.
I've seen my sister adapt.
(43:27):
I've seen people who becameamputees later in life,
quadriplegics later in life.
I've seen them adapt and behappy and I think a lot of this
can be really fixed by justhaving exposure to people with
disabilities outside of thehospital, because you see people
with disabilities as a doctorin some of their lowest points.
(43:49):
They don't want to be at thehospital.
You know they're not going tolook happy.
You don't see the joy that theyhave in their life.
That's actually why we I'mreally it's probably the thing
I'm most proud of my group doingis we developed this curriculum
that's in its pilot right now,called the Disability Buddy
Program, and it's five sessions,three of them.
(44:09):
All you're doing is hanging outwith a buddy with a disability
right.
So we had a luncheon where theyjust where there's a dinner
where they came.
We ate barrio tacos and playedboard games with med students,
two of them, two on one, it was.
It was a great time.
And then the next time it was apanel where they got to ask the
(44:31):
med students got to ask us anyquestions, both people with
disabilities, not their buddies,this was a separate thing and
people that cared for peoplewith disabilities.
And then, third session, theyhad it last week they went out
in public to an art museum withtheir buddies.
So they went to the ClevelandMuseum of Art.
They got to see what it waslike walking with someone
(44:52):
disabled in the space.
Them, you know, wrotereflections on the fact that
they never had to think aboutwhere the elevators were or the
ramps or things like that.
And they're going to thinkabout that next time.
They you know they have apatient that's running late for
an appointment.
Oh well, you know what?
Those?
That one elevator?
(45:13):
It's slow as heck.
There's no way that they wouldbe able to get up here in time.
I should have, like, warnedthem in advance before they came
to this appointment.
There's many things that cancome.
Then.
Our next session, which I'mreally excited about and
planning for it, is we're goingto go through different cases of
.
Here's a patient vignette whatcan you do to adapt a exam for
(45:36):
this patient?
And just keep going through it?
Because it's really once you.
It's like anything when youstart in HPI.
When you learn the HPI the firsttime, I remember being so
terrified I was like, oh, how amI going to remember medication?
Like I came up with all thesemnemonics and I was terrified.
Then you just keep doing itbecause it becomes habit.
(45:57):
If you think, every time I walkinto a room I'm going to make
sure I adapt this exam as bestas I can and it's just a part of
your routine, that's when Ithink we change things for
people with disabilities.
And then the last session, we'regoing to do dinner in public.
I don't know, we haven'tdecided on the restaurant, maybe
(46:18):
Cheesecake Factory or somethinglike that.
I don't know.
But I think it's really justgetting to know people outside
of the hospital withdisabilities, because you get to
see, okay, there is a wonderfullife that you can have and we
can focus on their quality oflife.
And it's not, it's just itbothers me because we talk about
quality of life.
(46:38):
And it's not, it's just itbothers me because we talk about
quality of life.
So much in neurology, some ofthe things I've heard just as
someone who's exposed to so muchdisabled joy, if you have to
give it a name it reallydistresses me, but it's because
people aren't exposed, they justaren't.
Dr. Michael Kentris (46:58):
No, I think that's the exposure things it
brought to mind.
A, I would say, semi-relatedthing, a criticism of family
structure in America, as opposedto, say, european or other
countries, is themulti-generational household
when you as a child growing up,you are with your grandparents
(47:19):
and you see them as they arebecoming aged and developing
medical issues, and so youdevelop this closeness with
different infirmities or otherkind of things that they might
be having as they go through thelater stages of life, stages of
life and it is something that Ithink that we don't see as much
(47:40):
in the United States.
Obviously, there's people whohave immigrated and they still
kind of may maintain those closefamily ties.
I know, growing up, my family,my dad's side, is Greek, so we
lived in very stereotypicalfashion for many years right
next door to my grandparents,very stereotypical fashion for
(48:01):
many years right next door to mygrandparents, and so when I
would come home from schoolafter kindergarten, I would go
next door until my parents camehome from work, and so we would
spend all afternoon with ourgrandparents, day after day
after day, and it is one ofthose things where a lot of
people probably have somethingsimilar, but we see more and
(48:21):
more people like moving on toall corners of the country.
Families become fragmented andyou don't see that like.
You know why.
Why would a you know, a 10 yearold, a 14 year old, spend all
this time with someone in theirseventies, eighties, nineties,
you know, unless there was a youknow close family tie or
something of that nature?
And I think it really doeschange your perspective in those
(48:43):
very, very formative years.
You know, by the time we are inour early 20s, much of our
mindset is already kind of set.
And I think it goes back rightthat early exposure through life
with someone who hopefully youcare deeply about, exposure
(49:03):
through life with someone whohopefully you care deeply about,
really helps to mold thatempathy and the way you see your
fellow human.
Dr. Samantha Stallkamp Tid (49:07):
That is such a good point and it is,
I mean it's the same way with,I mean, one of my friends
growing up too.
Her younger brother has autism.
She's occupational therapybecause that's what she was
guided by her experiences andneurology.
(49:28):
We work with elderly quite alot and maybe that is kind of
some of what has led you to thispatient population.
I know for a fact the reason Ilove the patient population is
through my sister and my mom andseeing it and seeing, just like
the resilience of you know, thehuman spirit and how much you
can, the impact you can make onsomeone by helping their quality
(49:51):
of life, I think I'm very.
People are like, oh my gosh,you sound so PM&R.
I'm like, well, it's so similar.
I think that I think it's verysimilar.
There's a lot of there's a lotof crossover.
But yeah, I mean, I thinkgeriatrics is definitely another
you know area that I think itdoesn't get a lot of attention
at all.
Pediatricians that are tryingto be more involved, and that
(50:19):
population.
I mean I love my grandparents.
I call my grandparents everyweek, both sides.
I've been blessed to have allfour still with me and it really
has.
I think, both my exposure tomultiple generations of
individuals in my family andthen also through my sister, all
(50:46):
of her friends, that I think ithas shaped me in a certain way
to practice medicine a certainway.
And I mean it's so right thatnow, with how separate everyone
has become and even that wespend less time together, you
know with, I mean not to soundall you know crotchety with the
oh, you know, these days we onlytalk over the phone.
I mean we're recording thisover the phone, right, I mean.
But technology, I think there'ssomething about human
(51:06):
connection that we do miss withtechnology and I'm a big
proponent of telehealth becauseit really helps rural
communities.
But I think something needs tobe said about some of these
in-person experiences andactually getting to know people,
not just 2D but 3D, I don'tknow, maybe holograms will help,
but I don't know I'm not readyto go full metaverse with my I
(51:30):
don't think.
I am either.
I just imagine people poppingup at times that I do not want
them in my head.
You see it in the movies.
It doesn't seem like you cananswer the phone calls, so I
really hope that they work outthat bug when they make it in
real life, you know.
Dr. Michael Kentris (51:45):
Awesome.
So I know we've been talking alot about various subjects.
It's been very enlightening forme as well.
For folks who want to learnmore, where would you direct
them?
What are some good resources?
I are folks who want to learnmore.
Where would you direct them?
What are some good resources?
I know you mentioned lookinglike X syndrome association.
I know that's been superhelpful for me in the past as
(52:07):
well.
But any more broadly sweepinggroups that you would recommend
people look to?
Dr. Samantha Stallkamp Tidd (52:14):
Oh, yes, so Stanford.
So they have a great group.
Docs with Disability is a greatpodcast that highlights doctors
with disabilities Is it just inthe name?
The University of Michigan,their family medicine department
(52:35):
, has a page with a lot ofresources on education materials
, and disability has a page witha lot of resources on education
materials and disability,largely focused in primary care,
but they really do spread out alot and they've come up with a
lot of work.
University of UPenn has adisability group that have been
putting out some good stuff.
And Harvard as well Dr Tolkien,dr Iazzoni there's a lot, of, a
(52:58):
lot of interest over there.
And then the Cleveland Clinicwe're trying to.
We might get social mediaeventually, but you know we were
really, we wanted to.
You know, have a product firstand we're getting through this
pilot.
But they can also reach out tome on, you know, twitter, or
yeah, twitter's probably thebest to reach out to me, just
(53:19):
because my emails are.
I have like eight emails nowand I don't know how to and I'm
about to get another one, so I'mnot sure how to handle that,
but I can always.
It's connected, honestly,twitter has.
So I know X Twitter.
I know people have opinions onit, but I honestly I have
(53:40):
learned about so many groupsjust by being on there and just
searching disability, med, ed ordisability, and there's a bunch
of people doing really greatwork.
But yeah, I mean it's there.
It's just people have to findit and I think we're getting
louder and louder as time goeson, which is really wonderful.
Dr. Michael Kentris (54:00):
Awesome.
Thank you so much for coming on.
I really appreciate you takingthe time to come and talk with
me and talk with everyonelistening, and hopefully we'll
get some more medical studentsinterested in engaging with some
disability advocacy.
Dr. Samantha Stallkamp Tid (54:16):
Well , thank you again and thank you
for all you do for MedEd.
You really are an inspirationfor everyone who wants to go
into it.
So thank you again and thankyou for all you do for med ed.
Dr. Michael Kentris (54:20):
you really are an inspiration for everyone
who wants to go into it, sothank you.
Dr. Samantha Stallkamp Tid (54:24):
Well , I mean, I'm blushing over here
too it was a great conversationand, um yeah, I hope to talk
again soon awesome.
Dr. Michael Kentris (54:31):
thank you, uh, and thank you for listening.
If you've made it to the end ofthe podcast, congratulations.
Thank you for taking the timeto spend your precious, precious
time with us.
You can find me on Twitter,slash X, at Dr Kentris,
d-r-k-e-n-t-r-i-s, and you canalso check out our website,
theneurotransmitterscom.
Thanks again for listening andwe will see you next time.
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