This is the second of a series of spotlight articles that will be posted on the blog every month until the conference in June. This spotlight series will highlight a deaf or hard of hearing healthcare professional and AMPHL member who has found success in their field and continues to break down barriers. Ian DeAndrea-Lazarus is AMPHL’s current Vice President. Read below to learn about his background and vision for success.
Ian DeAndrea-Lazarus, MPH
Tell us about your aspirations and field of study. What are you doing now?
I am currently a fifth-year MD/PhD candidate at the University of Rochester School of Medicine & Dentistry. At this time, I am working on my PhD thesis exploring the effects of deafness and delayed sign language acquisition on visuospatial attention and white matter microstructure in the brain. My project involves the use of electroencephalography (EEG) to observe the presence of alpha-band oscillations in the parieto-occipital region of the brain in anticipation of the appearance of a cued visual stimulus in the periphery. The presence of this specific type of electrophysiological activity represents the endogenous suppression of irrelevant visual space and contributes to the ability to selectively attend to relevant stimuli in the periphery. I am also using diffusion tensor imaging (DTI) to identify microstructural changes to the white matter tracts that play a role in visuospatial processing resulting from delayed sign language acquisition as well as deafness. After completing medical school I am interested in specializing in either neurosurgery, neurology, or psychiatry and continuing to research innovative ways to assess and improve cognitive and language outcomes in the deaf population.
What kind of hearing loss do you have and what is your preferred and primary communication method (e.g., signed communication, voiced/lip-reading)?
I have congenital, bilateral sensorineural hearing loss. American Sign Language is my native language and is my preferred mode of communication. I do have some speech ability but I prefer communicating in my native language.
In your application for graduate school, did you reveal your hearing loss?
Yes, however, I framed it in a positive light. I am of the belief that we should not be trying to hide our deafness and instead demonstrate how our deafness enhances us and benefits our patients -- see the concept of deaf gain. For example, there is evidence of enhanced peripheral attention in deaf people to compensate for our hearing loss. Also, sign language experience may lead to enhanced manual dexterity, which is a great skill to have when performing medical procedures.
What resources and accommodations did you use while receiving your training?
I have a dedicated team of world-class ASL interpreters with years of experience in the medical field who interpret all of my classes and shadow me during my clinical and lab rotations. I was also fortunate to be able to work with amazing captioners from White Coat Captioning who captioned all of my lectures in real-time. The medical school has also been very accommodating and made sure that everything was completely accessible, including making sure that any videos shown during lectures were captioned in advance. During my clinical rotations, I use my ThinkLabs One stethoscope that is either directly connected to my hearing aid or to over-the-ear headphones. I also received accommodations during my USMLE Step 1 licensing exam, which included using my own over-the-ear headphones and accessing visual representations of heart sounds shown on-screen (make sure you request accommodations from the NBME in advance!). I’ve also used wearable headsets (Google Glass and Microsoft HoloLens) to access real-time captioning in my visual space in the operating room.
Do you have any advice regarding resources and accommodations used during your training?
The most important skill you should have as a deaf or hard-of-hearing person is to be able to advocate for yourself. Be aware of any gaps in accessibility and offer practical solutions. Connect with other professionals and students in your field and find out what resources they use. Accommodations are not a one-size-fits-all solution -- some things that work for others may not be for you. Find out what works for you and advocate for yourself.
Did you set up your office/clinic/practice with any particular accommodations?
I am currently working in a research lab and I have a videophone set up at my desk. I also have my interpreter set up at their own desk within arm’s reach.
Any funny or inspirational stories?
During a Comprehensive Assessment exam in my second year of medical school, I was to give “bad news” to a standardized patient (SP). After the encounter, the SP sent the course director the following letter which was shared with me:
“The encounter that I had today with Ian was phenomenal. I regretted that I didn't keep him longer in feedback to tell him every single positive thing he had done, but truthfully I was so impressed by everything about the encounter and how thoughtful he was in feedback, I had difficulty keeping all of those positives straight. While I managed to fit one into the computerized BET form after oral feedback ended (which I hope he'll take note of, because it was a very moving choice of words on his part that I'd like to draw attention to), I wanted to relate a few more that I had missed because I can't say enough good things about how he approached the entire situation.
He was cognizant of the time and explained partway through the session that, while we were limited to only 20 minutes today, that didn't mean our conversation had to end; I could make another appointment and talk to him more if I wanted to, and he would make himself available for such a conversation. Throughout, he reiterated that he would be there to support me.
His presence was incredibly calming. I believe his thoughtful questions and acknowledgment of my concerns was a factor in that, but I can also say that he possesses a sense of presence that, while not impossible to teach someone, would certainly be difficult. You know that I had another session this week in which I felt vulnerable enough to cry hysterically. I felt a similar depth of emotion here, and I did cry, but that urge to cry was also tempered by a deep sense of peace. I can't recall any other student who brought me to this point, whereas terrible as everything was, I felt prepared by the end of the encounter to face it. That was so special to me.
I know that Ian's successes, like all of our successes, don't exist in a vacuum. I would be remiss if I didn't also compliment the amazing working relationship that he and his interpreter had. I wondered at the start of our encounter if hearing Ian express himself through his interpreter’s voice would affect how he would be able to console me. The short answer: it didn't affect things at all. The longer answer has more to do with what excellent communicators both of them are, and that was a pleasure to witness.
I have my suspicions that this kind of praise won't exactly be news to Ian if you choose to share it with him, because he strikes me as an exemplary student who thinks carefully about his work and also comes naturally by his skill in the bedside manner element of his studies (and if he doesn't come by it naturally, it would be useful for all of us to learn his secret to success!). I mostly wanted him to know how moving our encounter was for me, and how much I appreciated that experience. I have no doubt in my mind that he will excel as a physician, because he already has.”
This encounter is probably the best moment of my medical school education so far. Not only did I handle a very difficult situation well, I felt validated in my belief that I could do just as well as my hearing classmates and that my deafness, in addition to working with a great interpreter, made me a better communicator.
Any last words of wisdom or advice?
The only obstacle between you and your dreams is yourself. You can do anything you set your mind to, but you must be willing to put in the hard work and come up with solutions that work for you. I strongly believe that self-advocacy is the most important skill to have as a deaf or hard-of-hearing healthcare student or professional.