September 18, 2009

What’s in a Score?

Posted in Uncategorized at 11:11 am by blakecharlton

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.



  1. Jess said,

    “But in some cases, like mine, denying accommodations is the right thing to do.”

    I’m not sure about your logic here. Just because you did well without accommodations doesn’t mean that you don’t merit them. Who knows what your score would have been with accommodations — it could have been better, or it could have been worse. What if you’d had the accommodations but also a head cold? Or swine flu? Or gotten yourself in a funk before the exam over needing accommodations? I think there are many more variables here than your disability, which I know all too well and for which I will always, always vouch. :)

  2. Jeff Weitzel said,

    I have written a novel. I have never taken a medical licensing exam. And I am not dyslexic. However, all along, I have had a very strong intuition that if you can write a book, the reading and writing involved in taking a difficult exam are not going to be an issue. What a pleasure to be vindicated.

    Congratulations, on several levels. Your world just got simpler. Breathe into a paper bag a few times to clear your head, and get on with it. It’s a good thing, and you deserve to enjoy it.

    A final thought: if you are more keenly aware of your failings than anyone else, thank your lucky stars it isn’t the other way around.

  3. Kei said,

    ” I am left with a profound feeling not being entirely sure who I am.” You are Blake Charlton, an author, a man who will one day be called ‘Dr. Charlton’, friend, son, etc etc… and you just happen to also have dyslexia. Congratulations on your score. You faced a major anxiety trigger and not only survived but surpassed the challenge.

    As for the possibility of abusing the system had you gotten the accommodations, puh-leez! How could you have known? Since you were in the second grade you’ve been told you needed accommodations until it was ingrained in you. How could you have known you could successfully test with them until you had to?

    The prize here is not just your score, but the knowledge that the angst you went through preparing yourself for the test has revealed the preparations you needed to successfully pass the test.

    Again, congratulations, now… go…..Celebrate!!!!

  4. Jack Kincaid said,

    There’s nothing wrong with always expecting the worst. As you know, all that leaves is the potential for pleasant surprises. Congrats on your score. I am not sure I follow you on the matter of “accommodations”, but as for being disabled–which I can relate to … in a sense–and identity, who you are, well, too often we silly humans dwell on those things which we can not do and define ourselves by our shortcomings.

    Ultimately, however, what truly defines us is what we *can* do, not what we can’t.

  5. Kate Elliott said,

    Blake, you are awesome. Congrats on passing. It’s even okay that you did better than you expected. ;>

    I understand about the phenomenon of working oneself up before a difficult event, trial or effort of some sort, sure that it will or could be a disaster, and then – after all – it is fine. I mean, maybe not quite on that level, but I know the base emotional cycle really really well (as my spouse will tell you, since he has to suffer through it with me and has learned the refrain “it will be fine it will be fine” (repeat 100 times).

    One of my sons had several years of speech therapy in elementary and early middle school, mandated by the district in PA with an IEP (I think that’s the right acronym). Then we moved to HI, and had to have a meeting with the teachers and etc because the IEP transferred with him, of course, and when they met with us they kind of looked at each other, looked at him, looked at us, and without saying this exactly basically said, “we don’t understand why he needs this compared to the children who are really struggling” and we decided to let go of the IEP because we were kind of embarrassed, us being so middle class and well educated and knowing how many children in the schools here have such severe problems that there often isn’t enough $$ to deal with. It was fine for our son (he was happy to stop the therapy) and his speech is fine.

  6. Mary Victoria said,

    Hey Blake,

    I only know you from your blog, but I’m amazed at your courage and perseverance. Hear hear to all of the above. As your friends say, quit bellyaching and go celebrate! You obviously deserve it.

    Hearing you worry about success is like talking to a couple of my female friends who have reached the top of their still overwhelmingly male-dominated profession (animation.) I’ve heard them react to their own achievements with disbelief. Or else they might confess to thinking they aren’t good mothers, wives, etc etc. Believe me this happens!

    Enjoy the sense of well-earned success, Dr Charlton…

  7. thank you all for the wonderful comments. you’re all a blessing to me. i’ve been on the road for the past couple days and had to let the blog languish. my attack massive things-to-do but will get back to you all.

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