Can You Hear Me Now? Part II

Last quarter I wrote the article “Can You Hear Me Now?” which chronicled my journey through the ASCP Leadership Institute as I attempted to acquire the ever-elusive skill of being an effective listener. I now ask you the same question, this time somewhat rhetorically—as a student in an American Sign Language (ASL)-English interpreter training program. I come to you with a unique perspective, as both a medical laboratory professional and someone who seeks to bridge the linguistic and cultural gap between those who do not hear through perceived sound and those who do. In other words, I want to connect those who are d/Deaf and those that are hearing, particularly in the medical laboratory setting. Deaf can be “deaf” (lowercase d; those who do not rely on auditory perception), “Deaf” (uppercase D; those who are deaf and further identify as culturally Deaf), or “Hard-of-hearing” (those who partially rely on auditory perception and may or may not identify as culturally Deaf). Collectively, for the purposes of this article, I will abbreviate these as D/HH. Those that are “hearing” rely on auditory perception, the majority within the medical laboratory

“Can you hear me now?” may seem like an unusual question, so I’ll provide some context. I completed my undergraduate studies at the Rochester Institute of Technology (RIT), which, when I applied, I was not aware was also the National Technical Institute for the Deaf (RIT/NTID), one of only three deaf colleges in the United States. I had not expected that approximately 1,300 of the 17,000¹ students would be D/HH (this ratio is somewhat higher than the national 3.6 percent projection).² I had not been exposed to ASL, or seen a flashing doorbell or a TTY phone before. I never expected to see sign language interpreters (SLIs) in my human diseases or pathophysiology courses. My experiences at RIT/NTID forever transformed my perspective about the D/HH community.

This transformation resulted in my becoming aware of and understanding that deaf people are not disabled or broken. They don’t need (or want) to be “fixed.” However egalitarian the term “hearing impaired” may be intended to be, in the eyes of a D/HH individual, it can sometimes be offensive, as it implies weakness or damage.³ D/HH individuals are not “less than” you or I. In fact, I met some of the most intelligent engineers, scientists, and biochemists at RIT—all of whom were D/HH.

In the midst of a critical workforce shortage, it is imperative that we explore all resources and be aware of the diverse workforce that surrounds us. The D/HH population has historically been an overlooked segment in the general workforce, and I would like to invite you to reconsider your notions of working with, hiring, or accepting a D/HH applicant.

Until 1990, when the Americans with Disabilities Act (ADA) came into effect,⁴ many D/HH students were infrequently accepted into medical laboratory programs or medical schools, either due to discrimination or lack of accessibility. While students were allowed to study biochemistry, biology, or chemistry, careers in health care were off limits. Currently, a growing population of D/HH individuals are seeking careers in health care. The Association of Medical Professionals with Hearing Losses, a multidisciplinary team of D/HH individuals, had close to 300 attendees at its 2017 annual meeting.⁵ My point: the number of D/HH healthcare professionals is growing, and many of them are not working in the lab.

In an attempt to glean an honest opinion on this topic, I interviewed a variety of individuals, including D/HH medical laboratory professionals, their hearing coworkers, an SLI who has interpreted in a lab setting,⁶ and successful scientists who ultimately chose careers outside of the medical laboratory. One such interviewee was deaf pathologist and associate professor of pathology at Marian University Mary Jo Robinson, DO, FAOCP. My questions for Dr. Robinson included the following: How do you communicate with surgeons during frozen sections? How was your training at the microscope handled during your residency and undergraduate studies (she was a medical technologist in hematology before going to medical school)? How did you read the lips of physicians who had facemasks on? She was eager to share a myriad of creative and resourceful solutions for communication she has employed over the years, using flexibility, adaptability, and commitment to patient care.⁷

I interviewed Dr. Robinson via Indiana telecommunications relay. The US Federal Communications Commission (FCC) mandates that every individual with hearing or speech disabilities have access to telephone use, which includes video relay services, captioned telephones, and TTY. As these are federally mandated to be available 24/7, they are entirely federally funded—and mandated to be HIPAA compliant.⁸

Another interviewee was professor of chemistry at Gallaudet University Daniel J. Lundberg, PhD. Dr. Lundberg has an impressive CV, which includes a postbaccalaureate fellowship at the National Institutes of Health, as well as a doctorate in pharmacology.^9,10 My correspondence with Dr. Lundberg was compelling. When asked for insight, he spoke of the importance of ensuring equal—or near equal—access within the laboratory. His second point was regarding the importance of qualified SLIs, whom he believes were the “key to [his] success.”¹¹ If a D/HH candidate or employee relies on ASL to communicate through an SLI, the SLI must be qualified and certified, and have medical training. As medical laboratory professionas, we are required to understand medical terminology; so should SLIs.

With training programs closing their doors at astounding rates, some of the requirements for the remaining programs make it difficult, if not impossible for D/HH students to apply—let alone be accepted. The National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) requires that each program clearly state the “essential functions” required of each candidate. While NAACLS maintains that recruitment be nondiscriminatory and subject to federal law practices, a number of academic institutions list the ability to hear as an essential function.^12,13 My intent is not to criticize any program, but to encourage program directors to revisit their statements on essential function and determine whether they are compliant with either NAACLS or federal nondiscriminatory statements.

To those very program directors or employers, I would argue that deafness could be of benefit to a medical laboratory professional. Research supports this, citing that deaf individuals have increased light and motion sensitivity, peripheral vision, visual perception and discernment, and sensitivity in evaluating complex shapes and sizes.¹⁴ These traits are incredibly advantageous in the realm of "microscopic" medical laboratory diagnostics.

To those I interviewed who already work with D/HH individuals: thank you. Though a federal mandate disallows discrimination, one must still employ a level of open-mindedness and patience when working with someone who communicates differently from us. Whether you communicate with a D/HH individual by typing on an iPad, writing on a specimen container, using an SLI, or speaking clearly so he or she can read your lips, ultimately our communication is different with D/HH individuals. Different can sometimes be viewed as difficult or frustrating—especially when there are a thousand blocks to embed, a stat blood culture that needs to be called in, or a frozen section diagnosis to deliver.

With this in mind, I appeal to you who work in an underrecognized facet of healthcare: the medical laboratory. We who work in the lab strive for recognition within the healthcare community, as the “unsung heroes of health care.” Similarly, many D/HH individuals who are highly educated, unique, and resourceful have been underutilized and often overlooked by the healthcare community.¹⁵ Join me in looking for opportunities to further diversify our cadre of medical laboratory professionals by “listening” when a D/HH applicant “voices” interest in the medical laboratory. 

References

1. “Frequently Asked Questions.” Rochester Institute of Technology – National Technical Institute for the Deaf. http://www.ntid.rit.edu/node/1022. Accessed 24 October 2017.
2. “Collaboratory: Demographics.” Rochester Institute of Technology – National Technical Institute for the Deaf. http://www.ntid.rit.edu/collaboratory/demographics. Accessed 24 October 2017.
3. “Health Care Careers for the Deaf and Hard-of-Hearing Community: Terms and Abbreviations.” Rochester Institute of Technology. https://www.rit.edu/ntid/healthcare/terms-and-abbreviations. Accessed 29 October 2017.
4. Stiles, Holly. “Accommodating Deaf and Hard-of-Hearing Employees.” North Carolina Medical Journal. Vol. 78, no. 2 2017, pp. 101-103. http://www.ncmedicaljournal.com/content/78/2/101.full.pdf+html. Accessed 26 October 2017.
5. The Association of Medical Professionals With Hearing Losses. Conference History: A Snapshot, 2017, http://amphl.org/conference/. Accessed 23 October 2017.
6. Personal communication via FaceBook Messenger with anonymous ASL-English interpreter. 20 October 2017.
7. Robinson, Mary Jo D.O., FAOCP, FCAP. Associate Professor of Pathology, Marian University. Personal Interview (via Indiana Telecommunications Relay). 19 October 2017.
8. United States, Bureau of Consumer and Governmental Affairs, Federal Communications Commission. Public Notice: Clarification of the Use of Telecommunications relay services (TRS) and the health Insurance Portability and accountability act (HIPAA). Government Printing Office, June 2004. https://www.fcc.gov/document/clarification-use-telecommunications-relay-services-trs-and. Accessed 29 October 2017.
9. Kuo, Maggie. “Science in sign language: How deaf scientists navigate the hearing scientific community.” American Society for Biochemistry and Molecular Biology – ASBMB Today. February 2015. http://www.asbmb.org/asbmbtoday/201502/Features/SignLanguage/ Accessed 10 October 2017.
10. “Health Care Careers for the Deaf and Hard-of-Hearing Community: Profiles in Health Care.” Rochester Institute of Technology. http://www.rit.edu/ntid/healthcare/success. Accessed 26 October 2017.
11. Lundberg, Daniel J., Ph.D., Professor of Chemistry, Gallaudet University. “Re: Microscope solutions for deaf students/residents.” Received by Jesse McCoy, 21 October 2017.
12. NAACLS (National Accrediting Agency for Clinical Laboratory Sciences). NAACLS Guide to Accreditation and Approval. November 2016. https://naacls.org/getattachment/04b18332-efc2-444b-b7fa-10e5a7e478bd/NAACLS-Guide-to-Accreditation-and-Approval-Edited.aspx. Accessed 29 October 2017.
13. NAACLS (National Accrediting Agency for Clinical Laboratory Sciences). NAACLS Standards for Accredited and Approved Programs. November 2016.
14. https://naacls.org/getattachment/04b18332-efc2-444b-b7fa-10e5a7e478bd/NAACLS-Guide-to-Accreditation-and-Approval-Edited.aspx. Accessed 29 October 2017.  
15. Pavani, Francesco and Davide Bottari. “Visual Abilities in Individuals with Profound Deafness – A Critical Review.” The Neural Bases of Multisensory Processes, Edited by Muray MM and Wallace MT. CRC Press/Taylor & Francis, 2012, Chapter 22. https://www.ncbi.nlm.nih.gov/books/NBK92865/. Accessed 26 October 2017.
16. Luft, Pamela. “Communication barriers for deaf employees: Needs assessment and problem-solving strategies.” Work, vol. 14, 2000. https://www.researchgate.net/profile/Pamela_Luft/publication/11026132_Communication_barriers_for_deaf_employees_Needs_assessment_and_problem-solving_strategies/links/54fde6e50cf2741b69ef97fd/Communication-barriers-for-deaf-employees-Needs-assessment-and-problem-solving-strategies.pdf. Accessed 26 October 2017.