0:00:01.000,0:00:05.733 Opening Music 0:00:12.113,0:00:16.121 Joanne: People who are disabled aren't broken 0:00:16.567,0:00:21.159 We're just challenged. 0:00:21.436,0:00:24.752 We have different abilities. 0:00:24.752,0:00:27.934 We're not all the same, and recognize 0:00:27.934,0:00:32.136 that we are different... 0:00:32.136,0:00:36.548 and recognize that we do have needs. 0:00:36.548,0:00:38.499 Everyone has needs. 0:01:02.717,0:01:04.853 My name is Joanne Daniels-Finegold [br]and I live in 0:01:04.853,0:01:08.898 Braintree Massachusetts. [br]I grew up in Orange, New Jersey 0:01:08.898,0:01:11.500 ah, having 0:01:11.500,0:01:17.567 just a normal childhood -- with asthma 0:01:17.567,0:01:21.525 and just going through school, doing well. 0:01:21.525,0:01:25.914 Graduating from Orange High School, [br]and going on to UNH. 0:01:25.914,0:01:30.333 Having a disabling condition made me [br]more determined to just 0:01:30.333,0:01:32.800 do things that needed to get done. [br]It just made things harder 0:01:32.800,0:01:36.943 to do, but it didn't make things impossible to do. 0:01:36.943,0:01:42.300 Being raised by a very strong [br]mother, grandparents and dad 0:01:42.300,0:01:46.881 there was no question as to 0:01:46.881,0:01:52.598 to keep on going. Not persevering [br]was not an option. 0:01:52.613,0:01:57.625 Oddly enough one of the most basic [br]challenges when you have 0:01:57.641,0:02:01.440 a disabling condition is dealing with [br]other people. People who... 0:02:01.440,0:02:05.917 don't listen. For example, there are 0:02:05.917,0:02:10.867 more things that I can do that I can't do. 0:02:10.867,0:02:14.514 If I drop something, I expect to pick it up... 0:02:14.514,0:02:18.375 Just what my mother taught me; [br]you drop it, pick it up. You dirty it... 0:02:18.390,0:02:22.729 you clean it. That doesn't stop [br]because I use a wheelchair to 0:02:22.729,0:02:26.623 get around. Having a person speak [br]and another person listen 0:02:26.623,0:02:33.067 doesn't cost money, it's not a cash outlay. 0:02:33.067,0:02:34.238 One of the things 0:02:34.238,0:02:38.400 hospital administrators need to do is [br]talk the people who are 0:02:38.400,0:02:42.240 experts in disabilities. Those are people [br]who are disabled themselves. 0:02:42.609,0:02:47.044 I am Lisa Iezzoni, I am a physician; [br]I do not practice. 0:02:47.044,0:02:50.481 I'm the director of the Mongan Institute for [br]Health Policy here at the Massachusetts 0:02:50.481,0:02:53.100 General Hospital and a professor at [br]Harvard Medical School. 0:02:53.100,0:02:58.190 I would not at all describe my story as inspiring, [br]I would describe myself 0:02:58.190,0:03:03.333 as a poster child for why we need [br]the Americans with Disabilities Act. 0:03:03.333,0:03:07.106 I started Harvard Medical School in [br]September of 0:03:07.106,0:03:11.518 1980, and was diagnosed 0:03:11.518,0:03:15.800 probably in January of '81 with [br]Multiple Sclerosis having 0:03:15.800,0:03:17.636 had symptoms of it for years. 0:03:17.652,0:03:22.408 Probably in the Spring of 1983, and [br]Harvard at that time 0:03:22.408,0:03:27.767 often hosted dinners for students where they would give you cheese cubes and sherry. 0:03:27.767,0:03:31.394 And you would kind of mingle with the administrators 0:03:31.394,0:03:35.100 and leading senior physicians at the local Harvard institutions 0:03:35.100,0:03:39.823 then you would all sit down to dinner afterwards, so that is what happened. 0:03:39.823,0:03:43.333 I had my cheese cubes and sherry and then [br]sat down for dinner, and sitting 0:03:43.333,0:03:47.718 to my right was the leader 0:03:47.718,0:03:50.867 of a very large Harvard teaching hospital, [br]and I decided 0:03:50.867,0:03:56.633 I was planning to do an internship [br]in medicine, and so 0:03:56.633,0:04:00.327 I said to him look, here is my story; I might 0:04:00.327,0:04:04.122 be able to do a half time position, maybe [br]share it with another student or 0:04:04.122,0:04:08.152 maybe do my residency for twice the [br]amount of time, what would your 0:04:08.152,0:04:12.635 hospital think about a person like that [br]joining your program? 0:04:12.635,0:04:17.207 He paused for a second, and he thought [br]and then he said 0:04:17.207,0:04:20.400 There are too many doctors in the country [br]right now for us to 0:04:20.400,0:04:24.684 worry about training a handicapped person. [br]If that means 0:04:24.684,0:04:27.715 that someone gets left by the wayside, so be it. 0:04:29.223,0:04:33.285 John Kelly: I have a spinal cord injury at the C4 level, [br]I've been 0:04:33.285,0:04:35.992 disabled for over 25 years, and 0:04:35.992,0:04:40.520 have used a power wheelchair that I drive [br]with a sip-puff tube 0:04:40.520,0:04:44.067 since then. I was born and raised in [br]Middletown, New Jersey 0:04:44.067,0:04:47.788 which is a central New Jersey suburb of 0:04:47.788,0:04:51.867 New York. It was a sledding accident and my 0:04:51.867,0:04:57.053 head hit a tree and my neck got broken. [br]Well the first thing I would say 0:04:57.053,0:05:00.722 is that if you look at the record of changes 0:05:00.722,0:05:04.400 supposedly on behalf of people with [br]disabilities, everything that 0:05:04.400,0:05:08.315 has been done, ostensibly for us, has been wildly 0:05:08.315,0:05:13.033 popular among the rest of the population. [br]All you have to do is look at 0:05:13.033,0:05:17.092 automatic doors, ramps, curb cuts 0:05:17.092,0:05:21.033 level sidewalks for example if we 0:05:21.033,0:05:25.300 can figure out how to get them. [br]Adjustable tables, 0:05:25.300,0:05:29.733 would certainly be great for medical professionals 0:05:29.733,0:05:34.033 of different height. And, I would ask... 0:05:34.033,0:05:37.267 medical professionals to listen to us and to 0:05:37.267,0:05:41.287 start thinking about addressing the [br]needs of the whole human 0:05:41.287,0:05:45.967 population rather than some 0:05:45.967,0:05:50.033 non-existent typical person, so 0:05:50.033,0:05:54.900 hospital beds should go high [br]enough for a 6 foot 4 nurse 0:05:54.900,0:05:57.592 to work with us. They should go [br]low enough for a 5 foot nurse 0:05:57.592,0:06:01.947 to work with us so that they are not injured. [br]We should be able to 0:06:01.947,0:06:05.267 go to a hospital in a wheelchair get 0:06:05.267,0:06:08.867 onto a gurney and get x-rayed without 0:06:08.867,0:06:12.967 feeling like the best way for us [br]to do that is to take a $2000 0:06:12.967,0:06:16.906 ambulance trip back and forth to the [br]hospital because the medical 0:06:16.906,0:06:21.782 professional can't handle our body, [br]don't want to deal with it. 0:06:22.674,0:06:25.384 I view the health care system as 0:06:25.384,0:06:28.622 one of the slower industries to kind of 0:06:28.622,0:06:33.733 look themselves in the eye and say,[br]what do we need to do 0:06:33.733,0:06:37.600 to care for our clients, our [br]customers, our people 0:06:37.600,0:06:41.667 who have disabilities? Movie theaters [br]have had to do it, 0:06:41.667,0:06:45.996 cruise ships have had to do it. [br]The Supreme Court 0:06:45.996,0:06:50.500 made sure of that, but it's been [br]frankly really interesting 0:06:50.500,0:06:53.467 that the health care system hasn't. [br]The health care system 0:06:53.467,0:06:58.284 I've tried to figure out why that is... 0:06:58.284,0:07:02.719 why I think the health care system [br]has really not been at the forefront 0:07:02.719,0:07:07.294 of making sure that their facilities 0:07:07.294,0:07:10.167 and their communications and every aspect 0:07:10.167,0:07:12.425 of their policies, etc. are accessible. The only 0:07:12.425,0:07:17.333 explanation that I can come up [br]with is because 0:07:17.333,0:07:23.083 the underlying mission of healthcare is beneficence 0:07:23.083,0:07:26.606 of doing good, doing humanistic, [br]good work for people. 0:07:26.606,0:07:30.633 And there's an assumption that [br]if you need to be moved, 0:07:30.633,0:07:35.320 we will move you. [br]You should not have to move 0:07:35.320,0:07:39.748 yourself you disabled person. [br]We are here to help you move. 0:07:39.748,0:07:42.819 So, the person with a disability, [br]if they can't get up onto the table 0:07:42.819,0:07:46.977 because it doesn't automatically adjust to wheelchair height, the assumption is 0:07:46.992,0:07:51.551 that the practice assistants or nurses will do that. Of course there's a consequence 0:07:51.551,0:07:54.882 to that. Not only does that mean that 0:07:54.882,0:07:58.900 the person with a disability who might [br]have the capability of 0:07:58.900,0:08:02.814 transferring if the table height is correct 0:08:02.814,0:08:06.700 can't do that independently, it also means [br]that nurses and practice 0:08:06.700,0:08:10.833 assistants are much greater risk [br]of occupational injury. 0:08:10.833,0:08:15.100 My name is Frances Deolatch. I've spent 0:08:15.100,0:08:21.690 I would say most of my life in a hospital. 0:08:21.690,0:08:24.616 For a couple reasons. One... 0:08:24.616,0:08:27.658 It was hard for my family to 0:08:27.658,0:08:31.667 care for me. I have two brothers and so 0:08:31.667,0:08:36.333 as my parents had to care for them 0:08:36.333,0:08:39.523 as well, and with me breaking bones 0:08:39.523,0:08:43.726 all the time it was really 0:08:43.726,0:08:47.627 hard to have to keep me home. 0:08:47.627,0:08:52.233 One time I was going into the hospital 0:08:52.233,0:08:55.382 and they put me in a room where 0:08:55.382,0:08:59.900 I couldn't use the bathroom because [br]the doorway was 0:08:59.900,0:09:04.856 too narrow and I said to the nurse, 0:09:04.856,0:09:09.700 you know if you put me in room 0:09:09.700,0:09:13.098 with a bathroom that's more accessible 0:09:13.113,0:09:16.257 I can take myself to the bathroom. 0:09:16.257,0:09:20.833 That nurse's reaction was: Oh, that's okay [br]we can just help you. 0:09:20.833,0:09:24.533 Don't worry about it, [br]you can use a bed pan. 0:09:24.533,0:09:28.900 We'll take you to the bathroom. [br]I said yeah, that's a simple solution 0:09:28.900,0:09:32.720 but I don't want it that way. [br]I'd rather be in a room where I can 0:09:32.720,0:09:36.800 use the bathroom myself. [br]They really need to listen 0:09:36.800,0:09:41.079 to their patients. They need [br]to think to themselves... 0:09:41.079,0:09:44.353 Oh yeah, well she's [br]had this disability, she 0:09:44.353,0:09:49.740 knows what's she's talking about. [br]Let's take our cues from her. 0:09:51.248,0:09:52.300 Doctors 0:09:52.300,0:09:57.200 physicians and nurses are like other people. They've grown up in a society 0:09:57.200,0:10:00.491 where disability has been [br]historically stigmatized, and 0:10:00.491,0:10:04.600 even though they are members of a caring 0:10:04.600,0:10:08.633 profession, very much so, and very much [br]have that humanistic mission at 0:10:08.633,0:10:12.767 heart, they may not fully [br]appreciate the fact that 0:10:12.767,0:10:17.133 people with disabilities have lives in the [br]outside world. You know 0:10:17.133,0:10:21.389 doctors typically see people with [br]disabilities when they are sick 0:10:21.389,0:10:26.133 therefore they're lying in their bed, they're inert, they're not moving, they don't look 0:10:26.133,0:10:29.433 like they are necessarily out there and active [br]in their community and so people 0:10:29.433,0:10:33.067 tend to forget that when the go home from [br]the hosptial or when they home 0:10:33.067,0:10:37.433 from the office, that the [br]person is resuming their life 0:10:37.433,0:10:41.867 in the community as a parent, [br]as a worker, as a partner 0:10:41.867,0:10:46.327 I go out quite a bit actually, I go to restaurants. 0:10:46.327,0:10:50.414 I go to concerts. My favorite kind of 0:10:50.414,0:10:54.333 groups are from Motown. And, 0:10:54.333,0:10:57.967 my favorite group is the Temptations. (music) 0:10:57.967,0:11:01.583 I would just like people to know that [br]I've met the Temptations... 0:11:01.583,0:11:05.623 many times. 0:11:05.623,0:11:09.338 That was really a thrill to me, and 0:11:09.338,0:11:14.424 when I told a nurse once that [br]I went to concerts 0:11:14.424,0:11:17.953 she was like; You go out? 0:11:17.953,0:11:22.388 Music: My Girl 0:11:22.388,0:11:24.687 Music: My Girl 0:11:24.687,0:11:30.445 Music: My Girl 0:11:33.900,0:11:37.527 Stacy Berloff: I grew up in Framingham, Massachusetts 0:11:37.527,0:11:41.933 They told me I had Juvenile [br]Rheumatoid Arthritis, and 0:11:41.933,0:11:45.724 at that point that's all that they knew. 0:11:45.724,0:11:49.867 0:11:49.867,0:11:58.007 So I started with my first bout [br]of CRPS at 8 years old 0:11:58.007,0:11:59.470 and I had had 0:11:59.470,0:12:04.857 the RSD for several years before that, [br]just undiagnosed 0:12:04.857,0:12:07.267 probably since like 6 years old 0:12:07.267,0:12:12.133 and I was dealing with it without [br]medication, but it was pretty bad 0:12:12.133,0:12:18.200 My biggest frustration is [br]that people don't listen. 0:12:18.200,0:12:19.967 It has taken me 0:12:19.967,0:12:22.333 a very long time to get the physicians that 0:12:22.333,0:12:27.385 care for me in the way [br]I feel like I need to be 0:12:27.385,0:12:31.782 cared for. I've search high and low 0:12:31.782,0:12:36.500 to find doctors that have [br]been appropriate for me. 0:12:36.500,0:12:40.192 When you have a patient come [br]to you and has been 0:12:40.192,0:12:43.325 through a lot, listen to your [br]patient. They often 0:12:43.325,0:12:47.077 know better than what the textbook says. 0:12:47.077,0:12:51.300 They may not all the symptoms, [br]but your patients know what they're 0:12:51.300,0:12:56.933 going through. And that's a [br]big thing I've learned over and over 0:12:56.933,0:13:00.014 going through all my issues. 0:13:00.014,0:13:03.433 I've been told so many times that I'm 0:13:03.433,0:13:07.933 a psych case, because [br]it doesn't fit the book 0:13:07.933,0:13:11.667 and then eventually, years down 0:13:11.667,0:13:17.861 the road they figure out what it is 0:13:17.861,0:13:20.333 and I finally have had 0:13:20.333,0:13:23.333 doctors say, well patients [br]like you, you don't 0:13:23.333,0:13:27.638 fit the book, you write the book. [br]But that doesn't help me at 0:13:27.638,0:13:32.347 time, when I'm going through [br]the issues and they are 0:13:32.347,0:13:36.777 telling me that it's just impossible. 0:13:36.777,0:13:41.280 People with disabilities are people, [br]they are not just numbers 0:13:41.280,0:13:46.122 They're not just statistics, they're not just 0:13:46.122,0:13:48.229 people that they are going to have to 0:13:48.229,0:13:51.714 deal with and they going [br]to have to do things for 0:13:51.714,0:13:57.256 but we are actually people, and that we have feelings and that we have emotions 0:13:57.256,0:14:00.644 and that we are going to be [br]coming through their hospital 0:14:00.644,0:14:04.833 doors, looking for care, equal care 0:14:04.833,0:14:08.867 equal access to care, and that's what 0:14:08.867,0:14:12.933 they say the give; equal care to all [br]patients that come through 0:14:12.933,0:14:16.726 their doors, but they're not [br]giving equal access to care 0:14:16.726,0:14:19.138 to people with disabilities. 0:14:19.800,0:14:24.920 Jean McGuire: You know, one of the little known 0:14:24.920,0:14:29.300 features of what's going on in our [br]population right nows is the expanding 0:14:29.300,0:14:33.511 number of people living with disabilities. [br]So we focus a lot 0:14:33.511,0:14:37.250 on more people that are [br]getting older, and as 0:14:37.250,0:14:39.525 you age you more likely to have a disability, [br]but the truth is more people 0:14:39.525,0:14:45.656 with disabilities are living longer. [br]People live after car accidents, they 0:14:45.656,0:14:49.185 live after Iraq, they live after serious ski 0:14:49.185,0:14:53.300 accidents, they live after developmental 0:14:53.300,0:14:56.900 disorders that used to take them ealy in their lives. So the truth is the 0:14:56.900,0:15:01.492 prevalence of people living with disabilities [br]is larger than it's ever been, and it's 0:15:01.492,0:15:05.833 going to continue to grow. So it's [br]any one of us, at any particular 0:15:05.833,0:15:09.711 moment. And, any family member of ours 0:15:09.711,0:15:13.287 so figuring out how we make sure that 0:15:13.287,0:15:17.420 accessible health care is there [br]for all people, including 0:15:17.420,0:15:21.767 those of us who either now are, [br]or will become disabled is an incredibly 0:15:21.767,0:15:24.753 important public health [br]and public policy issue. 0:15:24.830,0:15:30.633 The Americans with Disabilities Act, [br]is still a work in progress. 0:15:30.633,0:15:34.000 So twenty years later we're [br]still appreciating the 0:15:34.000,0:15:38.434 advances we've made and understanding [br]where the challenges still are. And, so 0:15:38.434,0:15:41.966 there are many adjustments that hospitals 0:15:41.966,0:15:44.286 and other health care settings and other [br]public buildings have made, in 0:15:44.286,0:15:50.021 that time. Wider doors, ramps [br]in and out, handles 0:15:50.021,0:15:54.692 that people can operate. [br]But, true compliance with the ADA 0:15:54.692,0:15:58.176 and true compliance with the vision of [br]health care for all requires 0:15:58.176,0:16:02.125 more than that. And actually [br]that's become a very vital 0:16:02.125,0:16:07.590 public policy debate. Throughout [br]health care reform you see many indications 0:16:07.590,0:16:10.648 about how disability [br]and access for health care 0:16:10.648,0:16:14.658 for people with disabilities is [br]going to continue to be an important focus. 0:16:15.735,0:16:19.487 John Kelly: The situation is really urgent, because... 0:16:19.487,0:16:23.200 this happens to me and it happens to other people with severe disabilities 0:16:23.200,0:16:27.893 I'm in a crisis, I think I really [br]should go to the hospital... 0:16:27.893,0:16:31.067 and I have this moment where [br]I think, you know... 0:16:31.067,0:16:35.110 maybe dying would be a little bit better[br]after all. Because going to the 0:16:35.110,0:16:39.018 hospital is so unbelievably traumatic. 0:16:39.033,0:16:43.200 People don't introduce themselves, it's very 0:16:43.200,0:16:47.333 disorienting. People will not answer questions 0:16:47.333,0:16:52.233 People are harsh and in a hurry, 0:16:52.233,0:16:56.200 and people are incredibly disrespectful. 0:16:56.200,0:17:00.067 I had a case where I had bleeding... 0:17:00.067,0:17:03.393 from my testicles, and 0:17:03.393,0:17:08.233 finally they had to have someone [br]come down and cauterize it 0:17:08.233,0:17:11.848 because it kept bleeding, and a nurse 0:17:11.848,0:17:15.494 said to the young intern, who had never introduced himself to me.. 0:17:15.494,0:17:20.333 isn't that painful? And he said; Oh, it doesn't matter he can feel it anyway. 0:17:20.333,0:17:23.233 He didn't even know I was there. [br]I was just a 0:17:23.233,0:17:27.102 thing to him. You know, 0:17:27.118,0:17:32.585 people value -- we value our dignity 0:17:32.585,0:17:34.964 sometimes more than our health. 0:17:39.867,0:17:43.333 Closing Music