2022 Scott A. Gunder, MD, DCMS Presidential Scholarship Essay

By LYDIA R. SMELTZ

“Last week, we went to the Ellen DeGeneres Show and . . .” These words floated out of “Lex’s” mouth, and she didn’t skip a beat of her story as I slipped into the spina bifida clinic room. “What music did Ellen play?” the physician asked, directing the question to Lex’s mom and not Lex. Next, Lex was physically lifted from her wheelchair onto the fixed height examination table and her animated story-telling faltered. Her identity was reduced to her disability and subsequently, she felt her autonomy vanished. I found myself blinking quickly, trying to hold back tears.

Feeling compelled to advocate for Lex’s needs, I connected the clinic with Team Impact, a non-profit that “drafts” kids with chronic conditions onto collegiate athletic teams to support social and emotional development. While helping Lex find her voice, I witnessed her confidence increase, empowering her to advocate for her own health and well-being. I realized that clinical medicine’s power stems from using observations to effectively detect one’s holistic health needs. As Lex acquired the tools to manage the social, emotional, and mental health implications of her spina bifida, in conjunction with the physical implications, she regained her autonomy. Contributing to her multifaceted growth fueled me.

I desired to further explore my observations of the unique needs of persons with disabilities and their differential health care experiences. I secured funding to design an original research project at the intersection of social determinants of health and disability. This initial project grew into multiple poster presentations and manuscripts. Research taught me the value of translating my observations into communicable scientific knowledge as an avenue to promote disability justice. Realizing the power of words led me to seek additional avenues for advocacy.

I began critically examining the spheres I occupied. When I returned to Pennsylvania for medical school, I immediately joined an adult recreational field hockey team. However, I realized no opportunities existed for disabled people to play. My desire to serve the community led me to start PA Revs All Starz Field Hockey, the second adaptive, disability-inclusive field hockey program in the entire country. In our inaugural Spring 2022 season, I facilitated growth, learning, and relationship development amongst the 24 adaptive athletes, 24 local high school athlete “buddies,” and 6 adult community volunteers. When planning for the fall season, I proactively identified barriers to adaptive sports participation in order to increase participation. One barrier is the lack of physician knowledge of disability health and adaptive fitness opportunities. Further, reflecting upon my experience with Lex and her patient-provider interaction, I recognized that medical education is a key opportunity to improve health equity for people with disabilities.

To improve future physician knowledge, I developed a threepart Disability Curriculum elective and started an Introduction to American Sign Language program for medical students at Penn State College of Medicine (PSCOM). To further expand my reach, I have partnered with the Penn State Health Office of Diversity, Equity, and Inclusion to create opportunities for staff members to partake in our curriculum. Importantly, The Americans with Disabilities Act mantra, “Nothing about us without us,” reminds me of the need to align my efforts with the voiced needs of the disabled community. Forming equitable partnerships with disabled people who have provided feedback on the curriculum and All Starz program development has been instrumental in helping me reach a significant impact.

At PSCOM, I plan to pursue dual Doctorate of Medicine and Master’s in Education degrees through the Clinical Educator Pathway. After medical school, I plan to complete a physical medicine and rehabilitation (PM&R) residency and employ a patient-centric approach to restore function and promote quality of life for patients living with temporary or permanent disabilities. Long-term, I envision myself at an academic institution in a medical education leadership role. By leveraging my curriculum development experience, dual degree, and leadership role, I will expand my reach by educating the next generation of physician advocates. Clinical medicine provides an intimate glimpse into people’s lives, leaving physicians uniquely positioned to uplift others in their communities. My observations with Lex showed me the need for improved health equity. My multi-faceted approaches, using research to disseminate knowledge, creating opportunities for physical activity through All Starz, and enhancing knowledge through curriculum development, have given me the confidence to know that I am already a leader in disability health. While I am proud of the impact I have had thus far, together we can go further. The synergism of my efforts will result in remarkable change.