‘We need to show leadership’: Doctors with disability

Dinesh Palipana had been through a lot.
 
After experiencing anxiety and depression while completing a law degree, he decided to follow his heart and pursue a career in medicine.
 
Then, on 31 January 2010, he was driving back to Brisbane after visiting his parents on the Gold Coast.
 
It had been a rainy day, and it was late.
 
The next thing he knew, his car was aquaplaning.
 
‘I lost control and the car rolled,’ Dr Palipana told newsGP.
 
As soon as he attempted to move after the crash, the then-third-year medical student knew what had happened.
 
‘I tried to get out the car and realised I couldn’t move or feel my legs, or move my fingers. [I knew] the accident had caused a cervical spinal cord injury,’ he said.
 
‘It was probably the most horrifying feeling that I’d ever, ever had, realising what had happened.’
 
But in the eight months Dr Palipana spent in hospital after the crash, and the four years of rehabilitation that followed, he never once questioned his desire to return to medicine.
 
‘From the moment of the accident – the second I had it – that was still one of the things I was really worried about: how am I going to get back to medicine?’ he said.
 
While Dr Palipana’s own determination to pursue a career in medicine never faltered, he was met with challenges from the medical community.
 
‘I had some close friends, who were doctors, telling me that it wasn’t possible,’ Dr Palipana said.
 
‘I remember an emergency physician saying, “You’re not going to be able to do your clinical rotations. You won’t be able to do this. You should go back to law or do something else. Your medical career is essentially over”.
 
‘Some of my friends said the same.
 
‘It was difficult stuff to hear. Those kinds of things really sting.’
 
He took the criticism on board, but Dr Palipana came to the conclusion that, if he left medicine, he would regret it.
 
‘I thought, “The decision I make is something I’ve got to live with for the rest of my life … I need to make the best decision that I can live with”,’ he said.
 
‘And that’s essentially what I did.’
 
Dr Palipana threw himself into his studies and graduated from medicine in 2015.
 
But with no motor function below his chest and no movement in his fingers, there were challenges. In order to be at hospital for a 7.00 am start, for instance, he had to wake at around 3.30 am to prepare for the day.
 
On rotations, he faced difficulties examining patients, taking notes and manoeuvring his wheelchair.
 
‘But then really it all fell into place,’ Dr Palipana said.
 
‘I found out really quick ways to do things and a few months later I was finding that I was keeping up with my colleagues.’
 
Graduating from medical school felt like a triumph. But what Dr Palipana describes as the ‘biggest’ hurdle still lay ahead.
 
While he watched his peers accept offers of internship, Dr Palipana was devastated to receive a letter telling him his application for internship had been removed due to his spinal cord injury.
 
‘That was a huge challenge,’ he said. ‘It took a lot of time to finally get a job.
 
‘I actually didn’t get the internship until two days before everyone started work.’
 
Not only was Dr Palipana rejected from internship, he was appalled to learn of a policy being written that would exclude other medical students with disability from becoming doctors in the first place.
 
‘Around that time, too, the medical deans across Australia and New Zealand wrote a policy, or a guideline, which was very prescriptive about physical qualities that a medical student needs to have,’ he said.
 
‘And it described certain levels of motor function, visual acuity, all these kinds of things that would have easily excluded me from medical school.
 
‘When that policy came out I was infuriated, but also hurt.
 
‘I thought, “Wow, I’ve been getting through medical school and now suddenly someone’s saying, because of the way you are physically, you can’t [be a doctor]”.’
 
While these policies were being formulated, the doctors closest to Dr Palipana rallied to keep him at work.
 
‘Fortunately, my medical school was very supportive,’ he said.
 
‘When I was having trouble getting the internship, the consultants there offered to give up part of their salary to fund my internship. They’ve been amazing.’
 
Dr Palipana is now a senior resident at the emergency department at Gold Coast University Hospital, and has deferred a training position in radiology.
 
He currently spends 75% of his time working at the hospital, and 25% working in research on spinal cord injuries.
 
‘The dream is to make a change in what spinal cord injury means to people,’ he said.
 
Dr Palipana’s other dream is to change the way the medical community views doctors with disability, which he does through his work with Doctors with Disabilities Australia.
 
Patients have ‘never raised an eyebrow’ over Dr Palipana’s disability, and nurses have been equally supportive.
 
But it is the attitude of doctors that concerns him.
 
Dr Palipana believes it is time for doctors to shed any preconceptions they have of doctors with a disability, ‘and to give everyone a chance’.
 
‘In the medical profession, historically, we’ve acted as thought leaders on a lot of issues and I think we’re at a time where inclusivity is really important,’ he said.
 
‘We need to show leadership in this area. It will have an effect on the rest of the community and professions as well.
 
‘It’s important that we have a progressive attitude and demonstrate that it can be done.’
 
Dr Palipana is thrilled to report he is now making an active change to the policy that would have excluded him from working as a doctor because of his disability.  
‘Funnily enough, I’m on the committee now that’s rewriting that policy,’ he said.
 
‘So it’s nice that it’s come full circle.’

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