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The Other Side of the Stethoscope

planned to move to Maine, they stayed on in Hanover for a while to help Lee get established on his own. "He made it possible for me to endure all the hardships," Lee says.

Today, Lee is a celebrity as one of only a handful of quadriplegics practicing medicine in the U.S. His story has been featured in Reader's Digest and on national television.

His full-time job is in the Department of Physical Medicine and Rehabilitation at Johns Hopkins. He does clinical research, managing the medical needs of patients with spinal-cord injuries and evaluating them for eligibility in clinical trials.

After 24 years in a wheelchair, Lee is now able to use his arms and hands well enough to examine patients. If necessary, he can raise the seat of his hydraulic wheelchair so he's at eye-level with a standing person. He finds it easy to use the speakerphone in his office but has "a little trouble" flipping open his cell phone. And although he has built up the muscles in his arms and back, his fingers and hands remain weak. Still, he can draw blood and manipulate a cotton swab—but admits that he does a dreadful rectal exam.

Most of the techniques he uses to get by are ones he devised himself. "You learn the basics, and then it's up to the individual," he says. "The rehab process never ends."

At Hopkins, Lee leads a support group for patients with spinal-cord injuries. He says they ask all kinds of personal questions: How can I use an airplane toilet? What about sex? "No one was able to answer these questions for me," he says, "but now I have the privilege of providing information to these people and saving them from grief."

Lee prides himself on his ability to build

strong ties with his patients; he says strong communication skills are as much a part of good medicine as strong technical knowledge. The "advantage" of his own experience with spinal cord injury, and the self-assurance he has gained from meeting challenges since then, have made him a better physician and a better person, he believes.

He recently married a Korean teacher whom he met during one of his trips to Korea, where he volunteers as the medical coordinator for the nation's Olympic teams.

Looking back at the many challenges he's overcome to get where he is, he says, with the hint of a smile, "Now I can reflect and see only the positive."

The Americans with Disabilities Act (ADA) was passed in 1990, but it took a while for the academic community to determine how the law could and should be implemented on campuses. "S.B. Lee and others like him were pioneers in teaching [DMS] what [disabled students] needed" in order to succeed, explains Dr. Joseph

O'Donnell. The senior advising dean for DMS, he says that Dartmouth has recently expanded its programs for students with disabilities. O'Donnell hopes, if he ever finds himself in a situation similar to Lee's, that he will "have as much grace as S.B." It's a daunting thought, though. "How could I live," O'Donnell wonders, "without being able to tie my shoes?"

Lee may not be able to tie his shoes, but before he left DMS he developed an elective to give faculty and fellow students a chance to step into his shoes, by spending a day in a wheelchair. Those who participated—including O'Donnell and Bell—still talk about what they learned. It was quite a sight, they say, as the

"class" maneuvered through doorways, figured out how to get in and out of restroom stalls, and balanced a cafeteria tray while wheeling through a lunchtime crowd.

The psychic lessons were even more powerful. Lee educated—and humbled—those who volunteered to experience firsthand the effort it takes just to get through a day when key abilities are compromised. "It's amazing what people do to overcome what's thrown in their way," says O'Donnell.

From those who have succeeded in spite of great challenges, DMS students and faculty have learned that everyone has differing abilities, not disabilities, notes O'Donnell. "In a world not built for them," he says, students like S.B. Lee and Wendy Osterling "had to learn how to adapt, and they did."

O'Donnell has seen many improvements in recent years in the climate in the classroom, on campus, and even in town for students with disabilities. For one, learning specialist and professional counselor Kalindi Trietley was named director of learning and disability services for the Medical School in 2004. She reports directly to Dr. David Nierenberg, senior associate dean for medical education.

Of course, all students must meet certain essential requirements to be granted an M.D. But the creation of an office focused on disability issues is a testament to DMS's commitment to helping all admitted students succeed in medical school, Trietley says. "Dartmouth is not a place that just tolerates disabilities, or just works to meet the letter of the law, but has a genuine, heart-felt desire to support possibilities." For a list of DMS's policies related to disabilities and the services available to disabled students, visit the DMS Office for Learning and Disability Services.

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Paula Hartman Cohend, now a Massachusetts-based freelancer, spent almost 20 years writing for Newsday on Long Island. She has also worked as the science news editor for the University of Massachusetts at Amherst and as the director of communications for the Hospice Care Network of Westbury, N.Y. The photoillustrations accompanying this feature are the work of Jennifer Durgin, based on photographs by Ernie Branson, Flying Squirrel Graphics, Jon Gilbert Fox, Mark Washburn, and Keith Weller.

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