Exercise puts medical students in deaf patients' shoes

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India Johnson went from a primary care physician to a psychiatrist to an emergency room to a social worker and a pharmacy, all as part of a lesson in empathy.

The 22-year-old from Hinesville, Ga., was among about 100 first-year medical students Friday at Deaf Strong Hospital, a role-reversal exercise at the University of Rochester School of Medicine and Dentistry.

The event, the only one of its type in the country, has students consult "health providers" who are actually members of the local deaf community. It was started by med students in 1998.

Johnson couldn't communicate clearly, so she wasn't sure she had a diagnosis of meningitis. Now she knows what it's like for people who can't make themselves understood.

"It's very frustrating."

The students were given a card with symptoms and where to start. They couldn't talk, not even to each other. The "health providers" were given scripts, and only some had interpreters.

Johnson had to present fever, headache, blurry vision, loss of appetite, difficulty concentrating and a stiff neck. "It's confusing. At each step, you don't know what's going on. You can't relate to them what you want to relate."

Exactly.

"This is normal for us," organizer Matthew Starr, a senior instructor in the Department of Community and Preventive Medicine, signed to interpreter Chris Kelley. "To realize that just because someone doesn't speak English, it isn't a reflection of their intelligence level at all."

Even the providers found it difficult. "I tried to come up with different gestures," Vicki Hurwitz, a former outreach worker at Rochester School for the Deaf, signed through Kelley. "They really were not getting it."

Hurwitz, playing a psychiatrist, asked Johnson to repeat three signs. It took her several tries. Hurwitz then gave her a diagnosis of brain infection, which Johnson took to mean meningitis, and sent her to the ER.

The conversation there was fuzzy. "I think she asked me if I'm taking any medication," Johnson said. "But maybe she was giving me some. I think there was medication in there somewhere."

Social worker Audrey Schell, to Johnson's relief, used the notepad at her table when she saw that the student could only stare and smile in response to her signs. Too much study? she wrote. Yes! Johnson wrote back.

Johnson, who's considering neurology, said the exercise underscored the importance of patience and empathy.

"I can't imagine what it's really like for someone who's really sick."