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The Neurotransmitters: Clinical Neurology Education
Disability advocacy with Dr. Samantha Stallkamp Tidd
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 podcast decoding young brains and behavior in a digital world.
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Hello and welcome to the Neurotransmitters, your podcast for everything about clinical neurology. I'm your host, dr Michael Kentris, and I am very pleased as I always am on this recording to welcome another excellent guest. I have the future Dr Samantha Stallkamp-Tidd with us today from Cleveland, ohio. Thank you so much for joining the show.
Dr. Samantha Stallkamp Tidd:Thank you so much for having me. I'm excited to be on.
Dr. Michael Kentris:So you know, as so many of my guests do, I came across some of your work on Twitter slash X and listened to some other podcasts you'd actually done recently and you were talking a lot about kind of disability advocacy and disability in neurology advocacy specifically. So I thought we could start by just talking a little bit about kind of how you, because I should say you know you are just moments away from graduating medical school Congratulations.
Dr. Samantha Stallkamp Tidd:Thank you.
Dr. Michael Kentris:And you'll be heading to neurology residency up in Rochester and so again, they're very lucky to have you. But, thank you, tell me a little bit about the path that led you to this point and how you kind of navigated your way to this point in your medical training and slash career.
Dr. Samantha Stallkamp Tidd:Yeah, I mean that's a great question to start. So, um, I it's really family ties is kind of how I got into this space and I think if I was born into a different family I don't know if I would have found neurology I hope I would have. But you know, I grew up in Lima, Ohio, which is a small town in northwest Ohio. I have an older sister who's a NICU nurse not neuro ICU she does the baby one, which I guess is fine. But you know, I have a more ofU nurse not neuro ICU she does the baby one, which I guess is fine, but I have more of a soft spot for neuro. And my younger sister, kellyanne. She is a teacher's aid and also Paralympic athlete, but she has spina bifida and she was born when I was around three years old and so I grew up really in that disability mindset.
Dr. Samantha Stallkamp Tidd:It's all I knew. I mean, I knew that I'd have to make some adaptations for her. I knew that people looked at my sister differently when we were in public and you know, me and my older sister are always so protective of her and there were just things that, as are her sisters, we made sure happened so that she could exist in public, um, and go through her life the way she wanted to, and I saw, you know, my parents are just 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 her going and running sled hockey, my sister's sled hockey teams, and then seeing my sister get on the USA women's sled hockey team and winning the world championship, that's pretty cool, insane. She's very cool, much more cool than I am.
Dr. Samantha Stallkamp Tidd:I'm very proud of her, but my mom just made sure that there were spaces to where she could feel both included and also experience things that everyone else did is I want the world to be as good of a place that it is. That like my family has made for my sister everywhere. Right, cause not everyone has those people that are by them, their side, and you know we always talk to like how it is in our home Isn't always how it's going to be for you out outside of the home, kelly. Like she's going to face things. She's going to face discrimination and she has, um, but that's kind of what I've decided to fight for. She's going to face discrimination and she has, but that's kind of what I've decided to fight for. So I went to Ohio State third generation Buckeye, big, big OSU fan.
Dr. Michael Kentris:So you mean to say the Ohio State University?
Dr. Samantha Stallkamp Tidd:The Ohio State University. I didn't know how pretentious I wanted to be on this podcast.
Dr. Michael Kentris:I went to undergrad there as well, so we'll call it the Ohio State University and everyone else can just deal with it.
Dr. Samantha Stallkamp Tidd: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 State University, majored in neuroscience, because, again, I was going to these neurology appointments with my sister and unfortunately, my mom was diagnosed with MS while I was young as well, and so I was headed up to the Cleveland Clinic to, you know, go with her to her appointments and my sister's appointments at Nationwide, and traveling, because when you're a kid or you have a family member and you're in a more rural area without specialty care, you have to travel quite a lot and get pulled out of school because maybe the babysitter pulled out and things like that.
Dr. Samantha Stallkamp Tidd:But I thought it was the coolest thing ever what those doctors were doing, and so I was just obsessed with the nervous system. So I thought let's study it. So I went to undergrad, I was studying it and I was walking around the Oval it's the big for people that don't know, it's a big like green space at Ohio State and there was an activities fair and there was a group called Abilities. It was Abilities, an alliance of people with and without disabilities and I went yes, I walked up to it, found out there were two people in the club and one of them was graduating. But I said, okay, let's sign on. I immediately became the vice president. I drug my now husband onto it, several of my roommates and we just kind of went about growing this and I got a lot of inspiration from my mom and what she did in our hometown, which was like a Paralympic experience. So people from all over Northwest Ohio came and got to try out Paralympic sports so both people with disabilities and without disabilities to see what Paralympic sports were about. And every year she had one kid that would decide to do sports and then their world would open up and they would be really entrenched in a community of support. And that's why I think people don't understand that disability community is huge and warm and welcoming and it's just accessing it that can be hard. So I started throwing them at Ohio State and every year we had a kid who wanted to play sports in the local community. We did some other advocacy stuff, like we put signs on handicap bathroom stalls that said, unless this is your only choice, this shouldn't be your first choice, just saying, when you go in a bathroom and all the stalls are open, don't go in the accessible stall Because I think some people just immediately go there and we want to keep it open most of the time for people who need it. We did some other things with partitioning the bus system that wasn't doing well, but anyway I was so entrenched in that and it grew and by the time I left it was thriving and it's still around. But they renamed themselves Buckeyes for Accessibility, but I'm very proud of that.
Dr. Samantha Stallkamp Tidd:So then I got into my dream medical school, the Cleveland Clinic, lerner College of Medicine. Again, it's like this weird thread in my life I mean my mom's doctors which I credit for you know she has done so very well and that's because of the care that she received at the Cleveland Clinic To then get into that medical school was kind of surreal for me. I think it's also just because, from where I come from, I'm from a smaller town, you know I went to a state school and then it's like wait, I want, I'm gonna go to the Cleveland Clinic. And I did. And when I started there I knew I wanted.
Dr. Samantha Stallkamp Tidd:I was already interested in neurology. Right, I did neuroscience, I was, I was so interested, but the advocacy stuff I kind of you know, I was like I'm going to put this on a back burner a little bit, just because I got to focus on medical school. Medical school is hard, you know, sammy, you gotta, you gotta focus, and that lasted for only a few months. Really, one of my classmates, really good friend of mine we're going to her bachelorette party this weekend. Actually, she fell and twisted her ankle while rock climbing and she was on crutches for a little bit. We're in this brand new building. State of the art. You might have seen it in the worst presidential debate of all time. That was my med school. They just put it in.
Dr. Michael Kentris:There's so many contenders.
Dr. Samantha Stallkamp Tidd:It was. Yeah, it was terrible. And then the president got COVID and it was a whole debacle. I probably shouldn't be talking about it they don't want me talking about that probably, but anyway, it's beautiful, brand spanking new building.
Dr. Samantha Stallkamp Tidd:And the doors to the bathroom were so heavy and I noticed it right away, but I didn't realize how heavy they were until I saw my classmate struggling to open the door to the bathroom. So anytime she had to go to the bathroom we had to take her because the doors were too heavy. And so of course I just emailed and 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 and they just said no, they're all, they're all compliant.
Dr. Samantha Stallkamp Tidd:That didn't sit right with me, so I bought my own pressure gauge because I don't know when to give up, but they were five times the legal limit of pounds per. You know force to open these doors. When they showed them that, they changed it. And now the doors are, you know, they open fine, which is great, and it was a big win for me. But I told this story to my now one of my greatest mentors and friends Dr Natavich Marvin, I call him and he just said let's make this group. And so we started a group on campus and, yeah, it's really been kind of up since then been kind of up since then.
Dr. Michael Kentris:Now is the. Is the focus of this group for specific, like local initiatives, or is it for education of other students with respect to, like the needs of people with disabilities, or how would you characterize its mission?
Dr. Samantha Stallkamp Tidd:Yeah, I mean I. So it's called the disability action group, we we. So we started, I guess it. We ended up formally starting my second year, but we have been crafting it for a little bit and the original mission was to address the gaps in the curriculum when it came to disability related content. That has grown a lot to the disability related gaps in med ed as a whole and also accessibility things like the technical standards at our school. It's kind of grown to where we have a ton of different projects going all at once and lots of student involvement, lots of community involvement.
Dr. Samantha Stallkamp Tidd:I think it's kind of rare for medical school groups to have people that are not affiliated with the school at all. I mean, these people are not affiliated with the Cleveland Clinic and they're just community members parents of people with disabilities, people with disabilities themselves that work in social work or health care and some doctors from different institutions that just heard about it and wanted to help. So our mission is really just improving the lives of people with disability. I think that's the easiest, I think, definition that we could make and I think that it's just incredibly important. This is a stat that I wrote down because I wanted to make sure I read it just so people know how big of a scale this is, and I want to ask you what you think this number is. So they did a. Lisa Iazzoni, wonderful researcher at Harvard, did a survey a couple of years ago of 714 physicians. What percent of them do you think, said that they were confident in their ability to provide the same quality of care to patients with disability?
Dr. Michael Kentris:How many? You mean like self-evaluation? They thought they could do it.
Dr. Samantha Stallkamp Tidd:Self-evaluation. They thought that they could give the same quality.
Dr. Michael Kentris:It's probably some ridiculously high number like 100%.
Dr. Samantha Stallkamp Tidd:No 40. 40.7.
Dr. Michael Kentris:I was just expecting our profession to overestimate their abilities.
Dr. Samantha Stallkamp Tidd:I don't not with this and I think it's it's because it's not addressed. Um in medical school, like when were you taught how to um adapt an examination for someone who's using a wheelchair or for someone with sensory sensitivities because they have autism? You just kind of weren't. 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 mean there's more statistics. You don't.
Dr. Michael Kentris:It is one of those things where I definitely didn't learn that specifically in medical school.
Dr. Michael Kentris:And it was something that, again, not formally instructed during residency. But it's one of those things where you keep getting presented with different situations and you have to think to yourself, how can I adapt this? And at least in neurology, doing like our child neurology months and I will definitely tip the cap to the child neurologists out there they're masters of adapting the exam to different scenarios through the entire, from neonatal up to young adulthood, and so those months that I spent on my child neurology thing probably provided the most robust experience in terms of, like I need to check their leg strength. Well, have them hop on one leg or do all these different things Very much enhances your observational skills and things like that. But I would agree with you, it is not a formally trained skill in most definitely not in most specialties, but even in neurology I wouldn't say it's necessarily integrated into the curriculum most places.
Dr. Samantha Stallkamp Tidd:Yeah, and I think the thing I mean I'm so glad that you've had that experience and I think that just the experience of seeing someone think through how they would adapt something I think makes it easier for you in the future, because you can't teach every single adaptation you could ever do, because people are so different. I mean people have multiple disabilities, people have multiple things going on, so the adaptations are going to be individualized, but the fact that we're not even told to do that or how to do that, it leads to a worse quality of care. I mean this is a very sad example, but one of my sister's friends he passed away from a pressure ulcer that he went into sepsis and passed away. That ulcer was not discovered during his primary care visits. No one checked, no one took him out of his chair and full physicals are often not done.
Dr. Samantha Stallkamp Tidd:You can talk to many people I mean, it's an adonal. I don't know if there has been a formal study, but at least those I know in the disability community they do feel like they're not given a full exam because I think people get nervous about it or they think they don't have time oh, I don't have time to take them out of their chair to do a full abdominal exam. Well, you could miss masses. There's so many things that you can miss that you would do on an able-bodied person but you're not doing in the specific situation. So I think that just that fact, as someone who loves someone with a disability, when I've kind of thought about how many people are uncomfortable like seeing that stat and then thinking about what tools I was given in medical school, it scares me. It scares me because you hear all of these stories from people with disabilities that they've had these experiences and I think people can do something about it. I really do.
Dr. Michael Kentris:And I think I remember hearing you talk at one point about kind of a video encyclopedia that you were working on. Is that, is that still ongoing, or could you tell us a little bit more?
Dr. Samantha Stallkamp Tidd:Yeah, so the original idea is called the adaptionary. So this is. This is just a a wild dream of mine that you know it might happen. There's a lot of people that have offered to help. You know it might happen. There's a lot of people that have offered to help. You know, zach London at Michigan has been great and given me some tips and essentially what it would be is either an application or a website where it would show adaptive techniques like in video format.
Dr. Samantha Stallkamp Tidd:We don't read. My generation does not read Like I am sorry for all of the people that are in curriculums and doing this. We don't read medical textbooks anymore, we watch videos and I think that having ideas of, oh, okay, if I need to do a strength exam on an amputee, what are some 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 and being able to just quickly Google abdominal exam seated, because you can't, you physically can't, and a lot of these things are structural as well. If you only have 15 minutes and you don't have nursing staff to help you get someone on an examination table, you have to work with what you've got, but I think some people you don't have nursing staff to help you get someone on an examination table. You have to work with what you've got, but I think some people just don't.
Dr. Samantha Stallkamp Tidd:And so, showing examination techniques, showing adaptations, you can't obviously do all of them, but I think you could do quite a bit.
Dr. Samantha Stallkamp Tidd:And hearing people talk about it and you know, pm&r, child neurology all of these people have a lot of really great um techniques that they can offer, and also those that work with people on the autism spectrum disorder, I think, also can offer a lot. So it'd be almost like an encyclopedia Um. We also, you know, we had to try to find see if these videos existed already. There's not a lot of good quality on how to go through the exam in video format, and so we are trying to develop a very basic guide that's almost like an introduction ourselves via video, but the app might be more of a reading pictures demonstration, but it's something that I think over time we can develop and if anyone wants to, I don't care if anyone takes it from me and does it, I just want it to exist. I want it to be easy to figure out how to adapt examinations for different disabilities, limitations, all of those things. So yeah, that's one of the projects that we're doing right now, for sure.
Dr. Michael Kentris:No, it's very cool and it does remind me like in my own medical school time. So, confession I initially was and did apply to physical medicine and rehab and so during that I did a couple of sub-Is in PM&R and during some of those rotations I spent a couple of weeks with the physical and occupational therapists. And you do learn some really useful things, things that I still use to this day, like as a practicing neurologist, like how do I transfer a patient from the bed to the chair? Yes, or just these very, very simple things from the bed to the chair. Or you know, just these very, very simple things. And it's because, you know, obviously we need very often to walk our patients and see how are they moving. And so it becomes one of those things like how can I walk a patient, walk with a patient, kind of like as their walker or you know with or without a gait belt and all those kinds of things, depending on the situation and relative body sizes and all that kind of stuff.
Dr. Michael Kentris:But it definitely gives you a sense of how to do some of these things that we don't necessarily learn during routine training and they are very, very useful skills that will stay with you the rest of your career.
Dr. Samantha Stallkamp Tidd:Yeah, I think that's such an important point and I think that's some of the pushback when people try to put disability curriculum in, like when you talk about, I mean even like the social work aspect of it, knowing the resources that are out there. I think as a physician, we should yeah, we can't replace social workers but they'll push back and be like we can't be social workers, we can't be occupational therapists, we can't be physical therapists and I'm just like, okay, but we should probably know what those jobs do and where the overlaps are so we can help our colleagues. Right, social work is so they're so overworked and that profession is so phenomenal. I mean they do such great work. But literally, just being a physician who takes care of patients with certain disorders, I've made this suggestion to a lot of physicians. So if you work with patients with cerebral palsy type in cerebral palsy national organization or national association or something on Google organization or national association or something on Google, you'll find a billion organizations that have tons of resources for your patients that if you just hand over some of that information, it can make such a difference in someone's lives just to get connected.
Dr. Samantha Stallkamp Tidd:And there's so many things going on in these people's lives that they don't even think about doing that half the time. They don't have time, you know, they have to make all of these appointments. Even making some of those information available can really help both the social work yourself and the patient. But yeah, ot, pt, I mean even spending a day with them.
Dr. Samantha Stallkamp Tidd:I think I'm such a big proponent of you know some of these interprofessional education activities that schools are doing, like just students working with students, I think that's you know it's good to get to know other people, but I want to know what it's like to actually be in their job. I want to shadow a nurse and see everything that she does or he and same with PT and OT and actually learn from them. Because, again, there's it's not a like, it's a Venn diagram of things that we can learn from each other and I think it's really important that I mean you mentioned that that it's it is interdisciplinary and it's something everyone just assumes that the other person is going to do, but that doesn't always happen due to time constraints and such.
Dr. Michael Kentris:I know One of my and again, this is something that's very innate to PIMA and ours you have these multidisciplinary rounds where the whole therapy team sits and they talk about every patient, and I had a similar experience when I was a fellow working in neuromuscular clinics, in the ALS clinic, and we would have the exact same thing right. There would be neurology, pulmonology, hospice and palliative, ptot, assistive technologists, like all like literally like 15, 20 people. We would spend an entire like 10 hour day seeing all these ALS patients from the region and then everyone would go. We'd go down patient by patient and everyone would have their input on that person's care, and it's really logistically challenging but it is so fruitful for these people with with these complex medical situations.
Dr. Samantha Stallkamp Tidd:Yeah, I mean I I'm smiling over here because those types of clinics I mean, yeah, it's so hard to schedule those things. I mean I am sure it's a logistical nightmare, but as someone who has family members you know my younger sister I'd go to the Milo Clinic with her. It was at Nationwide and she'd see all of her doctors at once and she'd only have to get pulled out of school one day, maybe two, and me myself I would go with them to. You know, help dependent on you know what was going on. And I don't think people understand how big of a deal that is. Um, just because, oh, you have other, it's not the caregivers of people with disability. They have other things to do, and people with disabilities have other things to do and they have lives and jobs and school and all of these things.
Dr. Samantha Stallkamp Tidd:And I think we don't often think about how disruptive medical care can be to their lives. When you have so many different appointments, I think it's hard for people to kind of scope it out when they're like, oh, I see my PCP once or twice a year, but if you have eight different specialist appointments and you have to leave your work, your job, I mean people lose income people lose. It's so hard to be a student and then get yanked out in all the different directions. It was hard for my sister We'd be doing the homework on the way there and back from Columbus and it's even more exacerbated by people being in rural areas.
Dr. Samantha Stallkamp Tidd:So, that clinic. Those clinics are just so amazing and I hope more institutions make it for more and more disorder, like more disease groups, more, more of them, because I think it's so and the collaboration is so fruitful. I mean it really is.
Dr. Michael Kentris:So I'm curious on your perspective to shift gears very, very slightly. You know we've talked a lot about people who need, like, assistive devices for mobility or have other like readily physically apparent disability. But how do you think folks who have maybe the quote unquote, you know invisible disabilities, whether that's, you know, like multiple sclerosis or epilepsy or a lot of things that you know us in the neurology field deal with, have you done a lot of work with those populations in your advocacy and, if so, how does that differ?
Dr. Samantha Stallkamp Tidd:Yeah, I mean I think that it's it's a really good question and our group, I mean I'm I'm so proud of the students that are coming up after me. You know, when I started the group I was like, oh, maybe it'll survive after I'm gone. Now I know definitely it's going to survive and continue to keep going and I'll get to come back for meetings which is really cool and cheer them on. But one of our first year medical students, Swetha she is very passionate about people with chronic illnesses or disabilities come that are in health care, come and talk and share their stories. So so far we've had someone with long COVID in health care, having to deal with that and being temporarily disabled and also having, you know, they have a lot of like, worst days, good days, and a lot of stigma is thrown their way. And then we also had a doctor, pm&r actually who has Marfan syndrome, not feeling supported but then at times feeling like he had to be better, like even better than anyone who was able-bodied and wasn't dealing with chronic illnesses. And I think it is a lot harder when your disability is not readily apparent. I think the judgment is there, especially because I mean, you don't you hear, people with chronic illnesses will tell you this all the time, like they've been told to their face well, you don't look sick and that doesn't doesn't do I mean anything for for them and I I've actually a lot of my research and my that part of my work.
Dr. Samantha Stallkamp Tidd:I worked with the people with POTS and long COVID and it's a population that is constantly maligned, constantly told that they're making it up, that they're anxious. It's so wild to me because I'm like this is someone who was running marathons three months ago and now she can't walk across the room. You're telling me that it's all in her head, some of these chronic illness stories. When you hear them and they talk about their lives, they feel like they shouldn't be sick. They should be able to do some of these things and it's really society's expectations that are put on them that they should be able to do this in the state that their body is in. But a lot of times they might need adaptations and it's harder for them to get those. It's the same with mental health. It's so much harder for people to even be open about it.
Dr. Michael Kentris:Medical students aren't open about their mental health.
Dr. Samantha Stallkamp Tidd:I can tell you most of-.
Dr. Michael Kentris:Physicians as a population? Right, it's like I know you haven't had to do this yet, but when you check the boxes, do you have any physical or mental disabilities that could impair your, your ability to practice medicine? Right, I mean, it's essentially a form of discrimination, right?
Dr. Samantha Stallkamp Tidd:Well, I mean, that's actually it. It's exactly what technical standards are. I mentioned that earlier. So, basically, every medical school has this document that you have to sign almost every year. I don't know if you remember signing it, but it it. You have to be able to fulfill these very specific things, and some of them. It's like you have to not get distracted and you have to be able to focus on one thing. And I'm like I have ADHD. Am I lying to this document because I'm signing saying I'm good, I'm fine, I've never needed accommodations. I'm a little hyperactive, maybe. I'm fine, I've never needed accommodations. I'm a little hyperactive, maybe I get distracted.
Dr. Michael Kentris:I would never have guessed.
Dr. Samantha Stallkamp Tidd:Am I lying? I was in the generation where no girls were diagnosed and they diagnosed me in kindergarten because they were like girl. There's something wrong with you kindergarten, because they were like girl. There's something wrong with you. But really it feels like you're lying to this document and some of them are very specific and they target people with low vision. One of my best friends in medical school has low vision and he had to sign this document saying that he had perfect vision, basically, or that he had adaptations to get perfect visions. He didn't, but that he had adaptations to get perfect visions. He didn't, but they made adaptations for him throughout his career. But the problem is, this is a contract that people can use to kick these students out of school and so if they became, you know, let's say that their chronic illness got worse and they couldn't fulfill one of those things. If the school didn't want to deal with them, they could say look, you lied, you signed this. Bye.
Dr. Michael Kentris:Yeah.
Dr. Samantha Stallkamp Tidd: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 fact that that's hanging over your head, I think, is very destructive. So there's a lot of people that are trying to update their technical standards to make it okay. We just expect you to be able to fulfill these criteria with adaptations, or you have to be able to have a path in medicine that you're going to be able to do right. So someone who is blind, visually impaired, might not be the best pathologist, but they might be a brilliant internist, a brilliant, you know, psychiatrist, right, and so those paths are open to them. They can be wonderful physicians, but some of the other ones are closed.
Dr. Michael Kentris:I do remember reading an article not too long ago about a P1R doctor who had about a P1R doctor who had, like he was legally blind but he was still performing his function, like by hearing people walk and physically examining them, and like he had adapted his practice to such an extent that he was still providing care for these people, and I thought that was just wild.
Dr. Samantha Stallkamp Tidd:I mean that's I think I think it's when those people were given the tools that they needed. And I mean, if you think about how many patients would be losing out on having such a fantastic physician if he was told no or if he was kicked out because of some health thing that came on, and it's just so scary with some of these documents and it makes it so unwelcoming. And we're trying to rewrite ours. We get our accreditation through Case Western, so it's like this whole. We have to help them change theirs. But Michigan has I mean it pains me to say this as a Buckeye, to be honest but Michigan has some of the best technical standards in the country and they really are the benchmark for how to be inclusive without and actually show what do you need to be able to do in medical school, without being blatantly discriminatory and opening students up for getting kicked out of school.
Dr. Michael Kentris:Excellent, and we kind of skirted around this a little bit. But a thought that occurred to me as we're talking is, if I can loop a few of our points that we've hit along the way together, that a lot of physicians think that they're unable to appropriately take care of people with disability, that we have this system structurally in place that limits people with disability from entering medicine. And then we talked a little bit about this before we were starting recording, about how medicine as a profession is perhaps one of the more discriminatory professions out there against our own people. If you had to tie those threads together, what are your thoughts about this? Because this is a kind of perennial online debate that we see, where the older generation criticizes the younger generation for not being as tough, for working as hard, or X, y, z or the other thing. But where do you see medicine with the inclusion of people with various disabilities and what are the things that you've seen that are going well or not, as the case may be?
Dr. Samantha Stallkamp Tidd:Yeah, I mean, oh, that's such a good question. I mean I think, as we see physicians with disabilities all the time, I mean Stanford does a lot of work and they have a group that and they have this docs with disabilities and we see more like more are being successful and I think that is just because we've made medicine a little bit more humane. I think that we've been able to see more people with disabilities enter the field and I think it'll only increase because I think people will feel inspired, like other people with disabilities will feel inspired to go and become doctors themselves. You know there's a famous neurosurgeon again at Michigan who has spina bifida. My sister was so inspired by her but then she realized she hated science so she threw that out the window. But it really opens up possibilities. When you see someone who has gone through the same health struggles that you did and now they're helping patients with the same thing, I mean it's so. I think it's so overwhelmingly good for that population who they're constantly told you can't do this, you can't do this, and that's why I think I love.
Dr. Samantha Stallkamp Tidd:I'm very passionate about Paralympic sports. I'm terrible at all things athletics, but my sister is obviously quite good. She's a Paralympic athlete, but it really can change someone's mindset when they look at the possibilities. You know my mom actually wrote a book about my sister. It's called Sports Set Me Free. And they're doing like this book tour where they're talking to kids with disabilities about all of these different um sports that my sister was able to do. And when you see the possibilities, um that when you make good at adaptations right, we took off the bottom of her crutch and put a golf club in it so she could golf with us you know you can see.
Dr. Samantha Stallkamp Tidd:See, I mean you can there's so many different ways you can adapt and you can overcome these things Um that when you see doctors doing that and performing at the highest level, I think it can only increase. But I do think there is. You're talking about pushback to a lot of these things I mean from the other generation. Oh, it's soft. You know 24 hour calls you learn better. I mean we talked about that. You know there's soft. You know 24 hour calls you learn better. I mean we talked about that. You know there's science, that I mean you don't, you can't.
Dr. Samantha Stallkamp Tidd:Basically, after 15 minutes in a lecture, you're not really learning that much anymore, right? I mean, it's so true and I think that, as I think this generation is reshaping medicine to remind all of us that we're people first, and I think only good things can come of it. You know, like I never want to be a doctor that is so obsessed with working and my job and so dedicated to it that I forget what it's like to be a human being, Because I also think that's dangerous. If you can't put yourself in a patient's shoes because you haven't lived your life at all, I think that's a little dangerous.
Dr. Samantha Stallkamp Tidd:I really do, and I think having these people that have been through chronic health conditions, that have been through these things, they have an understanding. No one else does that have been through these things. They have an understanding. No one else does. I mean I only know so much because I, you know, am a sibling of someone with a disability, which we're in a we're very specific group. We have very specific quirks about us. It's really interesting when you talk to siblings with people with disabilities. We have very similar like issues, all these things. But I think that it's that diversity of experience and I think that is only common recent years, when we're celebrating that and I just hope that we continue to include and talk about this, this set of diversity, people with diversity of experiences in healthcare and disability and those things because I think that they make such fantastic physicians. I really do.
Dr. Michael Kentris:No, I think that's an excellent point and it's something that I think it's important for us to remember. If we look at the majority of medical students, they're young, relatively healthy people who haven't been in the healthcare system, and it's very likely that at some point in all of our lives we will be patients hopefully for just a brief time, but some of us for longer.
Dr. Michael Kentris:And, if I may wax philosophical for a moment, I think this concept of human frailty and the you know, the memento mori of it all is very important. You know that I always think of I forget what hospital it is but those who are online too much like myself. There's a picture of some muscle bound guy holding a, a caduceus holding back the grim reaper with one outstretched arm in front of him, like he's going to stop death oh yeah, you know what I'm talking about yeah, I think yeah and I think.
Dr. Michael Kentris:I think that is just like the peak of hubris. Uh, that's that medicine. You know you cannot stave off death. Um, you can help people and hopefully correct problems, but eventually it's very much that all of us will pass away at some point. I'm not so much of a futurist, transhumanist type person to believe that immortality is just around the corner, but I think it's very important for us to remember that we are all human, as you said, and we are all susceptible 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've been dealt the hand that they have. It could just as easily be any one of us, or you could be walking across the street and it could be.
Dr. Michael Kentris:So I think it's one of those things where it's very easy for us it's the easier thing not to think about. You know, these, these bodies that we all have during this life are are also frail, and just one of a million things could go wrong and it could change our entire lives.
Dr. Samantha Stallkamp Tidd:Yeah, I think that that's such a great point. I think it's it's so. I have such a different perspective than my classmates, right, like I've I've had conversations with them, and something that many of my peers fear is becoming disabled. Oh, if I, if I became disabled like, oh, I'm a surgeon, if I lost a hand I'd be dead. There's nothing, I can't go back. My quality of life would be nothing.
Dr. Samantha Stallkamp Tidd:And as someone who you know has been in this community, I'm like I, you know, some of the happiest people I've seen are quadriplegics. You know, I met, I met the. I think he was, I think he was second in the world in adaptive bocce. What he does is he sets up a ramp, he can angle it, he has someone that helps him angle it and he wears a helmet and he can use his neck muscles and he tips 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 look at him and say, oh, I would never want to live like that. Well, I don't.
Dr. Samantha Stallkamp Tidd:I think that sometimes people have these assumptions about the quality of life of people with disabilities. That, as someone who loves someone with disabilities, is scary. I mean we saw during COVID I mean there's a I think it's a New York Times article that went through this that people with disabilities were more likely to have their care withdrawn during COVID. And you know that it really affects me, you know, when I read things like that and I think as doctors we have this inflated. A lot of doctors have this inflated concept of what quality of life means and it is different for every person. But I think that also comes with experience of knowing oh, I can actually adapt. I remember having this conversation with my classmates. We were like I like it's literally I.
Dr. Samantha Stallkamp Tidd:You know, ms is not genetic that we know of, you know, but it also is environment. It's like maybe, you know it depends, it has factors for both, but it's not. It's not like, because my mom has MS, I'm going to have MS, for sure, right, but I also grew up in the exact same area as my mom. So maybe those factors all align and I get MS. Maybe those factors all align and I get MS. I'm not really scared of that because I know that I'll be able to adapt.
Dr. Samantha Stallkamp Tidd:I've seen my mom adapt. I've seen my sister adapt. I've seen people who became amputees later in life, quadriplegics later in life. I've seen them adapt and be happy and I think a lot of this can be really fixed by just having exposure to people with disabilities outside of the hospital, because you see people with disabilities as a doctor in some of their lowest points. They don't want to be at the hospital. You know they're not going to look happy. You don't see the joy that they have in their life. That's actually why we I'm really it's probably the thing I'm most proud of my group doing is we developed this curriculum that's in its pilot right now, called the Disability Buddy Program, and it's five sessions, three of them.
Dr. Samantha Stallkamp Tidd:All you're doing is hanging out with a buddy with a disability right. So we had a luncheon where they just where there's a dinner where they came. We ate barrio tacos and played board games with med students, two of them, two on one, it was. It was a great time. And then the next time it was a panel where they got to ask the med students got to ask us any questions, both people with disabilities, not their buddies, this was a separate thing and people that cared for people with disabilities. And then, third session, they had it last week they went out in public to an art museum with their buddies. So they went to the Cleveland Museum of Art. They got to see what it was like walking with someone disabled in the space. Them, you know, wrote reflections on the fact that they never had to think about where the elevators were or the ramps or things like that. And they're going to think about that next time. They you know they have a patient that's running late for an appointment. Oh well, you know what? Those? That one elevator? It's slow as heck. There's no way that they would be able to get up here in time. I should have, like, warned them in advance before they came to this appointment. There's many things that can come. Then.
Dr. Samantha Stallkamp Tidd:Our next session, which I'm really excited about and planning for it, is we're going to go through different cases of. Here's a patient vignette what can you do to adapt a exam for this patient? And just keep going through it? Because it's really once you. It's like anything when you start in HPI.
Dr. Samantha Stallkamp Tidd:When you learn the HPI the first time, I remember being so terrified I was like, oh, how am I going to remember medication? Like I came up with all these mnemonics and I was terrified. Then you just keep doing it because it becomes habit. If you think, every time I walk into a room I'm going to make sure I adapt this exam as best as I can and it's just a part of your routine, that's when I think we change things for people with disabilities.
Dr. Samantha Stallkamp Tidd:And then the last session, we're going to do dinner in public. I don't know, we haven't decided on the restaurant, maybe Cheesecake Factory or something like that. I don't know. But I think it's really just getting to know people outside of the hospital with disabilities, because you get to see, okay, there is a wonderful life that you can have and we can focus on their quality of life. And it's not, it's just it bothers me because we talk about quality of life. And it's not, it's just it bothers me because we talk about quality of life. So much in neurology, some of the things I've heard just as someone who's exposed to so much disabled joy, if you have to give it a name it really distresses me, but it's because people aren't exposed, they just aren't.
Dr. Michael Kentris:No, I think that's the exposure things it brought to mind. A, I would say, semi-related thing, a criticism of family structure in America, as opposed to, say, european or other countries, is the multi-generational household when you as a child growing up, you are with your grandparents and you see them as they are becoming aged and developing medical issues, and so you develop this closeness with different infirmities or other kind of things that they might be having as they go through the later stages of life, stages of life and it is something that I think that we don't see as much in the United States. Obviously, there's people who have immigrated and they still kind of may maintain those close family ties. I know, growing up, my family, my dad's side, is Greek, so we lived in very stereotypical fashion for many years right next door to my grandparents, very stereotypical fashion for many years right next door to my grandparents, and so when I would come home from school after kindergarten, I would go next door until my parents came home from work, and so we would spend all afternoon with our grandparents, day after day after day, and it is one of those things where a lot of people probably have something similar, but we see more and more people like moving on to all corners of the country.
Dr. Michael Kentris:Families become fragmented and you don't see that like. You know why. Why would a you know, a 10 year old, a 14 year old, spend all this time with someone in their seventies, eighties, nineties, you know, unless there was a you know close family tie or something of that nature? And I think it really does change your perspective in those very, very formative years. You know, by the time we are in our early 20s, much of our mindset is already kind of set.
Dr. Michael Kentris:And I think it goes back right that early exposure through life with someone who hopefully you care deeply about, exposure through life with someone who hopefully you care deeply about, really helps to mold that empathy and the way you see your fellow human.
Dr. Samantha Stallkamp Tidd: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 therapy because that's what she was guided by her experiences and neurology. We work with elderly quite a lot and maybe that is kind of some of what has led you to this patient population. I know for a fact the reason I love the patient population is through my sister and my mom and seeing it and seeing, just like the resilience of you know, the human spirit and how much you can, the impact you can make on someone by helping their quality 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 very similar.
Dr. Samantha Stallkamp Tidd:There's a lot of there's a lot of crossover. But yeah, I mean, I think geriatrics is definitely another you know area that I think it doesn't get a lot of attention at all. Pediatricians that are trying to be more involved, and that population. I mean I love my grandparents. I call my grandparents every week, both sides. I've been blessed to have all four still with me and it really has.
Dr. Samantha Stallkamp Tidd:I think, both my exposure to multiple generations of individuals in my family and then also through my sister, all of her friends, that I think it has shaped me in a certain way to practice medicine a certain way. And I mean it's so right that now, with how separate everyone has become and even that we spend less time together, you know with, I mean not to sound all you know crotchety with the oh, you know, these days we only talk over the phone. I mean we're recording this over the phone, right, I mean. But technology, I think there's something about human connection that we do miss with technology and I'm a big proponent of telehealth because it really helps rural communities. But I think something needs to be said about some of these in-person experiences and actually getting to know people, not just 2D but 3D, I don't know, maybe holograms will help, but I don't know I'm not ready to go full metaverse with my I don't think.
Dr. Samantha Stallkamp Tidd:I am either. I just imagine people popping up at times that I do not want them in my head. You see it in the movies. It doesn't seem like you can answer the phone calls, so I really hope that they work out that bug when they make it in real life, you know.
Dr. Michael Kentris:Awesome. So I know we've been talking a lot about various subjects. It's been very enlightening for me as well. For folks who want to learn more, where would you direct them? What are some good resources? I are folks who want to learn more. Where would you direct them? What are some good resources? I know you mentioned looking like X syndrome association. I know that's been super helpful for me in the past as well. But any more broadly sweeping groups that you would recommend people look to?
Dr. Samantha Stallkamp Tidd:Oh, yes, so Stanford. So they have a great group. Docs with Disability is a great podcast that highlights doctors with disabilities Is it just in the name? The University of Michigan, their family medicine department, has a page with a lot of resources on education materials, and disability has a page with a lot of resources on education materials and disability, largely focused in primary care, but they really do spread out a lot and they've come up with a lot of work. University of UPenn has a disability group that have been putting out some good stuff. And Harvard as well Dr Tolkien, dr Iazzoni there's a lot, of, a lot of interest over there. And then the Cleveland Clinic we're trying to.
Dr. Samantha Stallkamp Tidd:We might get social media eventually, but you know we were really, we wanted to. You know, have a product first and we're getting through this pilot. But they can also reach out to me on, you know, twitter, or yeah, twitter's probably the best to reach out to me, just because my emails are. I have like eight emails now and I don't know how to and I'm about to get another one, so I'm not 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 on it, but I honestly I have learned about so many groups just by being on there and just searching disability, med, ed or disability, and there's a bunch of people doing really great work. But yeah, I mean it's there. It's just people have to find it and I think we're getting louder and louder as time goes on, which is really wonderful.
Dr. Michael Kentris:Awesome. Thank you so much for coming on. I really appreciate you taking the time to come and talk with me and talk with everyone listening, and hopefully we'll get some more medical students interested in engaging with some disability advocacy.
Dr. Samantha Stallkamp Tidd:Well, thank you again and thank you for all you do for MedEd. You really are an inspiration for everyone who wants to go into it. So thank you again and thank you for all you do for med ed.
Dr. Michael Kentris:you really are an inspiration for everyone who wants to go into it, so thank you.
Dr. Samantha Stallkamp Tidd:Well, I mean, I'm blushing over here too it was a great conversation and, um yeah, I hope to talk again soon awesome.
Dr. Michael Kentris:thank you, uh, and thank you for listening. If you've made it to the end of the podcast, congratulations. Thank you for taking the time to 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 can also check out our website, theneurotransmitterscom. Thanks again for listening and we will see you next time.
