September 18, 2009
What’s in a Score?
For those who consistently read this blog, both of you might remember my post about how the exam brought me to my knees. Preparing for the test and confronting my fears about my disability created one of the most painful events of my life—only having my heart shattered by a reckless lover and watching my father deal with metastatic cancer were more agonizing. I was a mess and relied heavily on support from friends and family. When I got the email reporting that my scores were available online, I thought I was going to vomit. “Somehow I’ve fooled everyone into thinking they should let me become a doctor,” I thought. “But now that they took my accommodations away, the truth is going to come out. They’re going to know I was a fake.”
Finally, I checked it.
And here’s the thing: I did fine. Better than I had hoped. I didn’t believe the score report. I downloaded it three times. In fact, just after I wrote that last sentence, I downloaded it again. Some part of me still believes there must have been a mistake. The score has elicited the strangest storm of emotions. There is the obligatory joy, euphoria, and content. But below that there is a powerful fear and confusion. Considering the number of breakdowns I put my friends through, I’m more than a little embarrassed. When sheepishly reporting my score to those who I leaned on the most, I received a well-deserved salvo of eyerolls and I-told-you-so comments. The score has transformed me from a sympathetic disabled fellow, struggling to overcome a frightening obstacle into an just another unsympathetic med student who’s inappropriate fear of failure is made more annoying by perfectly acceptable performance.
I have always been contemptuous of those who abuse special accommodations, contemptuous of those who take an accommodation who do not need it. And yet, here I sit, having received a score without accommodation that is well away from remedial. Clearly, the NBME was right. I did not need the accommodation, and yet I was so very close to fighting for that accommodation. Had I gotten it, I would have been one of those who abused the system. I would have been the very type of person I despise.
I wonder how it was that I was so phenomenally wrong. How could I have felt so certain of failure when failure was not certain? Why the panic and the dissolution of character? I need to do more thinking and research about the subject. But I suspect it has something to do with identity. Disability has been part of me since they pulled me out of second grade and shipped me to special ed. I’ve spent most of my adult life trying to either fight or embrace my dyslexia. That struggle has always been part of who I am. Not that my dyslexia will ever fully go away. You can look forward to smiling at misspellings on this blog for a long long time yet to come. But, suddenly, official recognition and the need for accommodation for my dyslexia is gone. I am left with a profound feeling not being entirely sure who I am.
I have to write two more books about characters coping with disability. This is going to change them. I’m just not sure how.
I’m becoming obsessed with the phenomenon of withdrawing accommodations. I’ve heard more than one horror stories from disabled friends about accommodations that have been inappropriately withdrawn. But in some cases, like mine, denying accommodations is the right thing to do. I wonder if there’s a better way to do it. I wonder if there are more sensitive ways of detecting whose accommodations should be withdrawn. If you or anyone you know has struggled with such an issue, or if you’ve run across an article about it, please let me know. I’m hoping to get my head straight about it, and maybe write about it one day.
Meantime, I’m going to be on the road for the weekend and then early next week attending the “First Stanford Symposium on Bedside Medicine,” which I’m very excited about. I’ll post more about that later. But the posting will be light for the next week or so.