Author: Dr Rosanna Greaves, ST7, King's College London

Due to complex congenital hip dysplasia, I’ve been disabled since my second year of medical school, and I’ve used a manual wheelchair for the last 10 years. While I can stand for a few minutes and walk a few steps, I otherwise use a wheelchair full-time.

I currently work as an ST7 in anaesthetics in South London, and I was attracted to anaesthetics partly because of my own interactions with anaesthetists as a patient, and my understanding from the patient perspective of what a positive difference the anaesthetist can make to patients undergoing surgery.

As my special interest area, I chose to undertake training in pain medicine – management of chronic pain is close to my heart both as a clinician and as a patient with chronic pain.

Naturally, when I began my training, I was concerned about an endless number of things. Would I be able to intubate and perform procedures? Would I find accessible toilets and changing rooms? Would I constantly get in the way in theatre?

Most of my worries turned out to be unfounded or something I could work around. I can perform most procedures without needing to stand, and the architectural design of theatres varies between hospitals, but there’s always a solution if access is challenging.

In addition to the physical difficulties, relationships with co-workers and the assumptions they might make about what I could do were definite concerns. However, my colleagues in anaesthetics and pain have been incredibly supportive. Most people working with me for the first time haven’t previously had an anaesthetist in training who uses a wheelchair, and this can make them feel awkward or worried about my abilities and whether they can ask questions. I’m always happy to answer questions about my disability, provided they aren’t about if I’m going to get a speeding ticket!

Of course, there have been downsides. Inter-hospital transfers by ambulance are already cramped before adding an extra wheelchair. I’m lucky enough to have a spinal cord stimulator, which means MRI staff don’t want me anywhere near their scanner. I found obstetrics to be a particular challenge due to the high-volume workload and the manual handling required from the anaesthetist. Similarly, on calls, and nights in particular, can be arduous, but I’ve always felt strongly that these are an important part of my training and have pushed myself to work the same hours and workload as other anaesthetists in training. Using the team around me and being honest about why something is difficult has helped me find creative solutions to these challenges. Being fastidious about ergonomics has helped me with procedures, both maximising my chances of success and minimising pain and mobility difficulties. This is important for all of us!

Being disabled has helped me to become more confident and assertive. I’ve learned to ask for what I need to do my job, and I’m always pleasantly surprised by how much colleagues want to help. As a chronic ‘people-pleaser’, this has been a steep learning curve and, even years later, I still worry that others will think less of me because of my disability. As with any skill, advocating for myself gets easier with practice.

One benefit of being a disabled doctor, particularly when working in chronic pain, is that it allows me to truly empathise with my patients. While everyone is different, there are lots of experiences that my patients and I have in common. Patients often feel that doctors don’t understand what it’s really like to live with long-term pain and disability from day to day. This is often at the heart of how patients manage their conditions, for example, why they aren’t able to take medications consistently or engage with physiotherapy. The insights I have as a patient allow me to communicate better across these gaps in understanding and explain why these things are important, while validating patients’ experiences of how difficult managing their health can be. On a human level, I've had patients tell me how relieved they were to have a doctor who ‘looks like them’, and how they knew that I would ‘get’ some of their experience of living with persistent pain and disability.

Being a disabled anaesthetist has taught me to be adaptable and how to problem solve. Sometimes this is as simple (or not!) as solving the endless Tetris puzzle of how to fit myself, my chair and an ITU bed into a small theatre lift. At other times, it’s involved accepting that there are things painful or difficult for me to do, and that it’s okay to ask for help.

All of the trusts I have worked at have been welcoming, inclusive and keen to help disabled staff as much as possible. However, there are often small things I notice that could further improve things. Parking is an important consideration, and is often challenging for London trusts to manage due to space limitations, but it’s vital for disabled staff who are unable to access work in any other way. Every disabled person has different needs and challenges. Those with invisible disabilities may feel judged when using facilities for disabled people. Some trusts use strategies like the Sunflower Lanyard scheme to help staff and patients discreetly identify that they have a disability and may need extra help. Continuing open dialogue between leadership and disabled staff is vital to ensure trusts are as inclusive and accessible as possible.

As I approach the end of my training, I feel lucky to have had the unique experiences I’ve had because of my disability, and grateful for how these have shaped me as a person and a doctor. I hope medical students and doctors with disabilities see anaesthetics and pain as career options that are welcoming and adaptable, and that being a disabled doctor can come with advantages as well as challenges.