October 1, 2012
Veterinarians with disabilities: Practicing a full life
Adapting is possible
By: Phyllis DeGioia
For The VIN News Service
A veterinarian without a left arm examines and treats dogs, cats and other companion animals without difficulty. A severe congenital neuromuscular disorder doesn’t hamper a clinic owner’s daily work schedule. A student with spida bifida pursues her lifelong career dream by enrolling in veterinary school.
Photo courtesy of Diane Haithman
Dr. Erica Heim lost an arm to cancer as a veterinary student but went on to a successful career in medicine.
Disabled veterinarians may not be common, but more than a few have busy, productive practices. Dr. Roger Clemmons, an associate professor of neurology and neurosurgery at the University of Florida’s College of Veterinary Medicine, discovered this recently after one of his students had a stroke.
Searching for ways to encourage the young woman, Clemmons reached out to colleagues on the Veterinary Information Network (VIN), an online community for the profession.
“I am hoping that you can help me to find exemplary veterinarians who have overcome adversity and could be an inspiration to my student,” he wrote. “Then she would be able to be the next inspiration.”
Stories of just such exemplary veterinarians poured in.
One is Dr. Erica Heim. The doctor in Valley Village, Calif., was diagnosed with a rare form of bone cancer, Ewing's sarcoma, a month before graduating from veterinary school at the age of 30. Her left arm and shoulder had to be amputated. After a rough year of treatment, including chemotherapy and radiation, she returned to veterinary medicine. Heim is now a medical director and plans in the next several years to take ownership of the practice.
Some clients ask about the amputation, but that doesn’t bother Heim. She does most exams herself while technicians act as her left hand. She relies on other doctors for two-handed jobs. Heim has found that except for surgery, she’s able to do everything she would do if she had two hands.
“The thing about my amputation is that I have practiced this way since I started practicing," Heim said. "I had to learn to do this from the get-go. With bigger dogs, I'll often say (to clients), ‘You're going to be my left hand. You're going to hold this, and I'll do the exam.’ Clients never ask if I can take care of their pet. If anything, they are surprised that I am not doing their pet’s neuter or spay."
One of Heim’s clients, Diane Haithman, attests to the doctor’s skills and the matter-of-fact way she handles her condition. In an article published last year in Echo Park-Silver Lake Patch, Haithman wrote:
"She mentioned it once: ‘I don’t do surgery,’ she said, giving herself a careless whack with the other hand on the empty left sleeve of her lab coat by way of explanation. But beyond that, it was all about the dog ...
“Not sure whether questions would be politically correct, my husband and I didn’t ask about the arm situation. Besides, by the end of our session, we had pretty much forgotten about it (and Heidi [the dog] never noticed it at all). We only knew we wanted the petite vet who was willing to get down on the floor and go nose to nose with our big German shepherd to continue to be our dog’s doctor.”
Another story came from Dr. Melissa Nixon, who inherited a neuromuscular disorder called mitochondrial metabolic disease with myopathy. The disorder can cause an array of symptoms; most common for Nixon are spasticity, respiratory issues and fatigue.
Her condition wasn’t outwardly evident when she graduated in 1981, so it didn’t get in the way of finding a job. “I had much more trouble being a female interested in equine work,” she said.
Nixon landed her first position in a mixed rural practice. She found she had difficulty being on her feet for extended periods, walking or moving quickly and doing certain procedures with large animals. “There was not enough tech support available to work around that, even during the day shifts,” she recalled, and her employer wasn’t willing to hire extra support.
These were the days before the Americans with Disabilities Act of 1990, which prohibits discrimination based on disability and compels employers and institutions today to extend accommodations to people with disabilities.
Once Nixon realized she had a serious progressive condition, she decided to become self-employed. She went into partnership with a colleague in 1983.
“Being an owner allowed me more control,” Nixon said. “I could come in late — at 10 a.m. — and then work late (client visits until 7 p.m.), take a day off to rest midweek, use the tools I needed, hire appropriate assistants and avoid procedures that became problematic. My clients were mostly wonderful. Some goat owners moaned and begged when I did not feel up to dealing with obstetrics anymore.”
Nixon practiced for many years using crutches, a scooter or a manual wheelchair. She had an ergonomic chair for doing records and an ergonomic stool for surgery, but for exams, she sat on a metal covered garbage can because it was the perfect height. She always had one technician with her; sometimes two.
Now retired from clinical practice, Nixon gets around using a power wheelchair and service dog.
Dr. Ken Harkewicz of Berkeley, Calif., has Charcot's neuropathy, a progressive degeneration of weight-bearing joints, as well as a congenital insensitivity to pain in his bones. His bones can break and he doesn’t feel it.
In fact, in high school and college when he played rugby and football and could bench press 325 pounds, Harkewicz kept developing fractures he didn't know about, which resulted in osteoarthritis and general deterioriation.
Photo courtesy of Dr. Ken Harkewicz
A progressive neurological condition makes it difficult for Dr. Ken Harkewicz to stand or walk for long but he nonetheless maintains a full-time practice and serves as president of the Association of Reptilian and Amphibian Veterinarians.
One thing led to another. The Charcot's neuropathy began to affect his feet and gait, leading to scoliosis. Then came severe sciatica, causing pain that required epidurals to control.
Three years ago, he underwent a laminectomy, a surgical procedure in which part of a vertebra is removed to relieve nerve pressure. For 19 months, he didn’t drive.
But throughout years of contending with an uncooperative body, Harkewicz pursued a passion with animals, particularly reptiles. Following graduation from veterinary school in 1981, he spent 20 months in a wildlife medicine externship in Queensland, Australia, working with small marsupials, reptiles and amphibians.
This year, Harkewicz is president of the Association of Reptilian and Amphibian Veterinarians. As an exotic animal veterinarian in Northern California, he works full time, seeing 12 to 15 cases a day, five days a week.
He’s developed go-arounds for his condition: He has a permit to park in spaces reserved for people with disabilities. To shorten his walk, his treatment room is near the clinic entrance. He sits while examining, treating or operating on patients. When animals need to be lifted, his technicians assist.
"Standing to do a longer procedure impairs me,” Harkewicz said. “If I had to work in a place with stairs or walk a long distance, that would impair me somewhat. My boss has been really accommodating. My techs are really good.”
The most visible manifestation of Harkewicz’s condition is a pair of custom orthotic shoes, size 15 EEEEE.
"These special shoes are heavy boots with a lot of support. They look like a Frankenstein shoe," Harkewicz said. "Most (adults) won't ask 'What's wrong with your feet?' but little kids will.”
He responds with humor. “I’m a mutant,” he tells the kids, “like the X-Men.”
A piquant sense of humor is what Dr. Meghan Ellis remembers about her favorite mentor, Dr. Charles Ward. During veterinary school, Ward broke his back, an injury that left him a paraplegic, though he maintained some use of his hands.
Ward had an accessible two-story clinic built. Ellis worked for him there as a veterinary assistant. In a VIN message board post, she recalled:
"During our annual safety drills … he would tell everyone that if he was stuck on the second floor and the elevator had already parked itself, just get a running start and toss him over the balcony, because what's the worse (that could) happen, fall and break his back?"
Eliis went on: “If something didn't really excite him, be it a slightly abnormal lab result or an over-dramatic owner, he'd tell the client, "It's nothing I'd jump up and down about."
Ellis said Ward liked treating exotics and was the only doctor in the hospital to do surgery on them. She would run the CO2 laser, pressing the foot pedal at his command. “Things only got interesting when he forgot to tell me to let up,” she recalled. “I loved my safety goggles!”
A few dogs didn’t like Ward’s wheelchair, Ellis said, but that wasn’t a huge issue. “Most dogs who didn’t like it ran away,” she said.
"Otherwise, I have to say it never seemed too difficult for him, but I know a lot of that was because he hid his chronic pain very well.”
Regardless of pain, he led an active life. Ward died in February at the age of 67 while scuba diving.
Like so many veterinarians, Katie Brueggen aspired to be an animal doctor from the time she was a kid. The fact that she has spina bifida and needs a wheelchair to get around didn’t strike her as an impediment.
Photo by Jordan Dieckman
Katie Brueggen is a second-year student at the University of Wisconsin-Madison School of Veterinary Medicine. Because Bruegger has spina bifida, the school provided an electric wheelchair to make getting around campus easier, and has made other accommodations.
And so far, it hasn’t been.
Brueggen is a second-year student at the University of Wisconsin-Madison School of Veterinary Medicine. As soon as she was accepted by the school, the director of administration called to discuss accommodations.
“They told me I'm the first wheelchair-bound person to go through the program at Madison ...” Brueggen said. “However, they talked to other schools that have had wheelchair-bound students to get some tips and ideas for accommodations. And they have been great in brainstorming ideas with me to figure out what works best for me.”
Brueggen can get around slowly with crutches or a manual wheelchair, but the veterinary school, pooling funds with the McBurney Disability Resource Center on campus, bought an electric wheelchair for her to use.
When the class began hands-on large animal work last year, Brueggen carved out special time for the training so the animals could be placed first in a chute for her safety.
"Otherwise, the horses were just in a stall and students had to catch them...” Brueggen said. “This way, I couldn't get kicked. I was able to work one-on-one with an instructor.”
That’s not to say that every day’s a breeze. “There have been some frustrating days in school, and definitely days where I question whether or not I'll physically be able to do certain things,” Brueggen said, “but one of my professors recently told me that in grad school she worked with a veterinarian who was in a wheelchair and he did just fine. That made me feel a lot better and gave me the confidence to keep pushing forward.”
Not every disability is visible.
Deana Baker, a certified veterinary technician in Cody, Wyo., was diagnosed with epilepsy as a child. That was before the advent of modern anti-seizure medications. She would have two or more seizures a week, which left her struggling to walk and talk.
At the time, epilepsy was something kept hidden as something shameful. In some ways, that had its benefits. “I was not treated differently than anyone else,” Baker said.
As a young adult, she pursued a degree in range management, but because jobs in the field were scarce at the time, she wound up working as a pet groomer at a small animal hospital. When grooming work was slow, she’d help clean kennels and pitch in on other veterinary-assistant duties. That sparked an interest in veterinary medicine that became a passion. In spring 1990, Baker returned to school to become a veterinary technician.
Today, with the help of modern medication, Baker is down to one or two seizures a year, if that.
At the clinic where she’s worked for 21 years, Baker said, the accommodations she requires are minimal. For example, she needs to work the same shift each day, and to be alerted to look away if a fluorescent light or other type of flashing light is coming on.
Noting that the accommodations she needs are less than those of a pregnant woman, Baker said that a person’s abilities and skills should be “put in front of the stuff that they cannot do.”
Another invisible disability is mental illness, a condition that has not shed its social stigma. Because of that stigma, one veterinarian with bipolar disease who offered to share her story with the VIN News Service asked that her name be changed to protect her identity.
In a new city with a new job, Dr. Stella Finn became at once euphoric and depressed. She knew she was acting strangely and annoying people, but she didn't know why. It came to a head one day when she constantly repeated herself.
"Instead of calling an ambulance like they would if I had a heart attack, they called my partner," Finn said. "If I had a heart attack, people would have taken me to the hospital and taken care of me but because I was acting crazy they didn't."
Finn had been seeing a therapist for what the therapist thought was a severe midlife crisis. After the episode at work, Finn ended up seeing a psychiatric nurse practitioner, who within a few minutes of the first exam diagnosed her as having bipolar disease.
At one point, Finn sunk frighteningly low.
"I went out to my car and looked for a knife to kill myself," she said. "I was lucky I couldn't find a knife.”
Finn spent six months on disability. With proper treatment and medications, her condition stabilized. She found a new job. After the interview but before her start date, she revealed her condition in case the employer wanted to back out, but that didn’t happen.
As it turns out, the job didn’t work out for reasons unrelated to Finn’s diagnosis. Finn found another job at an emergency hospital, where she remains today. She said the only accommodation she needs is to work no more than three overnights in a row because insufficient sleep can start a manic phase.
She said as long as she takes her medication and sleeps enough, she remains stable. Finn exercises by biking, walking and doing yoga. She has learned to recognize when she is becoming too stressed, and at that point relaxes by reading a book, listening to music or spending time with her family. If those approaches don't help, she sees her therapist.
Heim, who lost her left arm to bone cancer as a student, captured the emotions of many colleagues like her when she said:
"When this first happened, I thought my life had ended," she said. "Now, in addition to a great job, I have a wonderful husband and a very happy life. I am not a Pollyanna, but I am living proof that you can have it all: life, love, a fulfilling career, and a disability."
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