Voices: Use What You Have
11/15/2002 | | Dr. John Schmidt (M.D. ’85) with Patrick, 12, who suffered a spinal cord injury in a car accident. Photo copyright Martin Czamanske |
As told to Vicki Stavig
It was father’s day 1979. I was a junior at Colorado State University, a pre-med student on an ROTC scholarship, hoping to become a surgeon. I had sent out my medical school applications three days earlier and was completing an ROTC physical fitness test at Fort Lewis, Washington. The final part of the test was a 2.5-mile run, which was easy because I had been running six to nine miles a day for several years.
About a half-mile from the finish, I began to feel a numbness on the right side of my body. Twenty yards later I began to limp. Ten yards later I fell to the ground with a bad headache on the left side of my head. It was like a thermonuclear accident in my head. I was 21 years old and was having a stroke.
I immediately lost my ability to speak. My right side was flaccid, totally weak. I couldn’t read or write and spent four and a half weeks in an Army hospital. Stroke is not an old people’s disease, per se. Ten percent of stroke patients in the United States are under 45 years old and about half of them have no [identifiable] reason for the stroke. I am one of those people.
Today I’m a neurologist at Rochester General Hospital [Rochester, New York]. I’m also an associate professor of neurology and rehabilitation at the University of Rochester, New York. My specialty is working with stroke patients, but I work with other patients as well.
I had grown up in Wyoming, but my parents were living in the Twin Cities when I had my stroke, so I had my therapy at the Sister Kenny Institute. I was in formal physical therapy for four months, occupational therapy for eight or nine months, and speech therapy for 13 months.
Forty to 50 percent of all stroke patients fall into depression. I didn’t. My family and I joke that I had a healthy denial. I’m very goal-oriented and wanted to go back to school. I didn’t care how. If I were on a stretcher, I was going to go back. I had to learn to write with my left hand. It was very difficult, but if you have to do it you do it. I was proficient in about eight or nine months. I also read aloud for three or four hours a day to practice reading and speaking. Fortunately, I could walk.
The University of Minnesota was one of the medical schools I had applied to before my stroke and I went back to college there, taking one class that following winter quarter. I did pretty well, so I took two classes during spring quarter. I went back to Colorado the next fall and completed my degree in 1980, a bachelor of science degree in physical sciences.
I had withdrawn from the medical school application process when I had my stroke, and I took the MCAT over. I could have let my score stand from before, but I thought it would be unfair to the medical schools. Because of my difficulty with language and reading, I asked the board to give me extra time to read and I actually got a better score the second time.
This time I applied to only three medical schools: the University of Minnesota, the University of Minnesota–Duluth, and Mayo Clinic. I had applied to the University of Minnesota before my stroke, and, interestingly, the associate dean of academic affairs there, Albert Sullivan, was the only person at all the schools I had applied to who had responded to me when I had written to withdraw my first applications. He wrote to me saying he was very distressed and disappointed about my withdrawal and the reason for it. His was the only personal response I got. He had a real personal interest and relationship with me for the five years I was at the University and was instrumental in my being there.
I entered the University of Minnesota Medical School in 1981. The admissions committee allowed me to take the first-year curriculum in two years because of my reading disability, which was very progressive of them and very beneficial to me. They view students individually and make allowances if a student has a special circumstance. One of my colleagues in medical school said it was unfair that I could identify with my patients so well and he could not. My response was that you use what you have. If I could be walking and talking and having the use of my right arm, I would do that, but I need to do what I can with what I have. That’s what God has given me. If I can use this as an advantage to treat patients, that’s what I do.
When I graduated from Medical School in 1985, it was a great day for me and for everyone in my family. I did my residency in Milwaukee. I met Lynn there and we married in 1987. We now have three children, ages 14, 12, and 10. Before my stroke, I had planned to become a surgeon, and I did pretty well in my surgery rotation, but I also liked family practice, rehabilitation, and neurology. I logically chose to specialize in neurology.
People are surprised when they ask me what was the toughest thing I did. They expect it to be the first year coming back, but it was my internship in my residency program because I really had to produce. I feel lucky to do the things I do, so getting up at 2 a.m. to see a patient was a privilege for me. There were some long, tiring days, but there are not very many people out there who can practice medicine and few people who have disabilities but can still live their dreams. It was frustrating and tiring, but I feel I’m very fortunate to do this.
When I finished my residency, I had a fellowship at Cornell University Medical College in neurorehabilitation. Then I went to St. Louis University as director of the Neurorehabilitation Program. I came to Rochester, New York, in 1993, and was most recently at Unity Health System, formerly St. Mary’s Brain Injury Unit.
I rarely talk about my experiences unless pressed. Everyone has his or her own situation. For people who have had a stroke, it is a very new situation, a catastrophic situation, and they really don’t want to hear from me all the things they can do. They want some support and to find out for themselves what works and what doesn’t.
I go to some of the local elementary schools to speak about my specialty and disability. I’ll ask, “Can you tie your shoes with one hand? No? Well, I can.” I was right-handed and now write with my left hand. I tie my shoes with one hand. With some equipment adjustments, I also cross-country and downhill ski. I don’t ski as well as before, but the point is I can ski.
I give a lecture I call “The Seven A’s.” The first is “acceptance.” I have accepted what I have. I have a lame arm and leg and problems with language. I can give up, or I can use what I have to do what I have to do as a neurologist, a teacher, a father, and a husband. Second is “attitude.” You can have a poor attitude or a good attitude about what’s going on. For me, in the beginning even speaking a few words was a great day. Learning how to tie my shoes and how to read were great days. Those accomplishments are very small, but they are very real. “Adaptation” is the third. If I can adapt to the world, I can be successful.
Then there is “activity.” Anything I can do to learn to do new things makes the activity much sweeter. Another is “assistance.” I can’t do my work personally or professionally without assistance. The nurses, other doctors, and therapists all help me with my work. My family does too. Another is “anticipate.” I have to anticipate the weather, for example. Will I have to carry my cane because it’s going to rain and be slippery? The seventh A is the “Almighty.” I can’t do anything I do without my Lord’s help.
Stroke is the third largest killer in this nation today, behind cancer and heart disease. We have about 750,000 stroke patients a year in this country and more than four million survivors. About 85 percent of strokes are caused by a blood clot in the brain. There are modifiable risk factors, such as hypertension, weight control, diabetes, and exercise. Non-modifiable factors include family history of heart disease or strokes; you can’t pick your parents.
There is no substitute for treatment in the first three hours after a stroke, but most of the time strokes are not painful, so many people don’t know they’re having one. Small strokes include a feeling of weakness or numbness on one side. Sometimes a person has language problems or becomes real drowsy or lethargic or has difficulty with walking or with sight or coordination or has transient blindness or vomiting. But it’s very sudden. These people should have acute medical treatment right away. It’s the sudden onset that one has to be careful about.
We have some research projects going on now that I’m real excited about. One deals with depression after a stroke. We’re enrolling patients in a study now that will test medication that we think will not only improve the mood of patients but their rehabilitation efforts too. I expected those studies to be completed in about a year.
Did having a stroke make me a better doctor? Probably. I think I can understand my patients better—their pain and their disabilities—because I’ve been living with this for almost 25 years. If I hadn’t had a stroke, I would probably be a surgeon, but I’m not questioning God’s wisdom. He knows what He’s doing. Is life good? Oh, yes. There isn’t much that I want to do that I can’t do.
Vicki Stavig is a writer living in Bloomington, Minnesota.
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