How would you describe your field of medicine to someone who’s not familiar with it?
When a person has an impairment, there’s an organ system or body malfunction. You’re left with a certain physical functional challenge, and that’s called a physical disability. In rehabilitation medicine, we work to improve function by utilizing medical treatments, physical or occupational therapy, and acupuncture. Our goal is always to maximize a person’s function—not just their physical function, but also their vocational capacities and emotional quality of life.
Given your vision loss, how do you conduct a typical physical examination?
Technology is an invaluable tool for me. I have a patient’s demographic information, medical record, background on when I last saw them, and all of my notes; my screen-reading software dictates that back to me.
I also rely on sound and touch. If I’m doing a physical diagnosis, there’s palpation; auscultation, which is listening with a stethoscope; and percussion, which is using a finger to tap for different kinds of sounds. If I have a patient who has an underactive thyroid gland, I can still feel if the thyroid is enlarged (that’s palpation) or hear if the person has a very hoarse voice or a low voice. I can ask them if they’re losing hair or have an intolerance to cold. With other fine-tuned senses, I leverage these substitute ways of making a diagnosis.
I find that, having been a patient myself, I can relate to my patients’ experiences and share my vulnerabilities. I think my patients are, in turn, more willing to show me their own.
— Dr. Stanley Wainapel
Are there ways in which having a physical disability has changed how you approach your relationship with patients?
Early on, I didn’t realize that patients within my field of physical medicine and rehabilitation could, in a way, see themselves in me. I find that, having been a patient myself, I can relate to my patients’ experiences and share my vulnerabilities. I think my patients are, in turn, more willing to show me their own.
Your presence in the field has helped break down barriers for people with disabilities who wish to enter the medical field. Do you have any advice for medical students with disabilities?
There will be barriers; some of them are physical and more are attitudinal. Many people don’t think about what a person with a disability can do but instead focus on what the person can’t do. For instance, when people see someone with a severe hearing impairment, it may not occur to them that the person might be able to lip-read. A person’s limitations are not flaws of character; they’re aspects of character.
You’ve worked in Boston and other places. What drew you back to the Bronx?
In the early 1990s, my visual acuity had begun decreasing quickly and exponentially. Within a couple of years, it was less than half the level it was before, and I began needing my cane more. I had lost a lot of self-confidence in being able to continue on my professional path. Through the National Federation of the Blind—and on the advice of a friend who has been blind since birth—I began using a computer with screen-reading software and started to gradually gain back my confidence.
At that point, a former resident of mine and long-standing friend, Avital Fast [M.D.], had just taken a leadership role in Montefiore and Einstein’s combined clinical and academic program in physical medicine and rehabilitation, and he asked me to join him. Since I’ve been back in the Bronx, my colleagues have been supportive by providing me with the equipment, software, and tools I need—and have continuously trusted that I could be productive in a high-powered clinical and academic atmosphere. Here I am, more than a quarter century later, still working full time in clinical care (I have 70 or more patients every week), writing articles and book chapters, and teaching.
Outside of medicine, you are a classical pianist. Do you still play?
It’s one of the great joys of my life. I play complex pieces, and my virtual piano teacher has to teach them to me gradually. I know the sounds, but I can’t read the page. He’ll say, “Here’s this chord. Here’s what you’re doing in your right hand. Here’s what you’re doing in your left.”
I think of it as brain work. I find that there is a lot that I can do in my head—whether it’s traveling by daydream, listening to music, or taking piano lessons. I smile from the fact that I am still growing through the wonderful challenges of life.