Redefining Resilience as a Medical Student

Hi all, exams are over and it has been so nice to not have the pressure of work looming over me. I can finally rest! But what does this mean…

It has been really hard figuring out what rest looks like for me. Over the last decade, mental health has become more widely spoken about and of course, with the pandemic, there seemed to be a shared understanding of struggling with a lack of purpose. We all sipped our Dalgona coffees with our banana bread, after a grueling run that our Couch to 5k app guilted us into (hey, don’t bash it until you try it!) I am so grateful that these lockdown trends are a distant memory that I can joke about, but at the time, it was really hard to be living with this constant unshakeable uncertainty.

chocolate chip banana bread made by me (and yes, it is zoomed in so you don’t see the burnt bits)

As lockdowns passed by, and Trump came and went, our lives may be feeling slightly more normal, but the importance of looking after our mental health is still as great as ever. I am not afraid to say I struggle with my mental health (though much easier to say behind a screen), but the stigma and silence around it is pervasive. This is especially true in Medicine where the traditional definition of success often looks like long working hours, relentless competition, and constant pressure, all while maintaining a smile for the patient. We are told to be resilient, and this is what makes us good doctors.

Here are some ways I hope to redefine resilience. I want to allow myself to feel all the difficult feelings. It is okay to have bad days and to need help. I want to learn to be more compassionate towards myself, to be curious about what looking after myself means, and to not feel guilty for resting. I hope to lean into my community and not isolate myself when I struggle. I want to be an open vessel and still know when to close myself before I am full to the brim. I hope to continue to speak up for adjustments I may need (without feeling guilty for taking up space). Resilience doesn’t have to mean pushing on when times are tough. It can mean stopping, taking a break, calling a friend (or a therapist), and practising self-compassion before you carry on.

So yes, exams are over… And still, I have been feeling a bit anxious and struggling to fully relax (and feeling frustrated for not being able to when I have been waiting for this for so long!) But, I am going to try and just let it be, and trying to be kind to myself. I am where I am, and there is nowhere I have to be. Apart from maybe the clinic I said I would join later this afternoon…

NDCS Families magazine front cover!

Hi! It has been a very long time, and I promise to start writing again as soon as my finals are over! I have so much to talk about, but have had a busy few months with ups and downs, and have been trying to not feel guilty about taking rest when I need to.

So, as you may know, my work with ITV started (read my last post!) because I reached out to the National Deaf Children’s Society. And I have since been invited to be interviewed for their Summer 2023 Families magazine!!

It was such an amazing opportunity and such a big platform to talk about my experiences that of course, I said yes! I was interviewed and shortly after, photographed at Gonville & Caius College with a few friends. Yes, it was a bit awkward pretending to talk to them about what they had for lunch with a camera glaring at me. Yes, I was very aware of all the students staying in college who did not(!) choose the scenic garden-facing windows to see me floundering about. But, wow, it was such a great opportunity and I am so grateful!

So here is the article: https://www.ndcs.org.uk/information-and-support/parenting-and-family-life/families-magazine/your-stories/stories-of-deaf-young-people/making-it-in-medicine/.

Please read through and share with anyone who may be thinking of applying to medicine or anyone who thinks deaf people can’t be doctors! Okay, there is a chance I may not be a doctor if I don’t get back to studying for tomorrow’s exam, but it sure as hell won’t be because I am deaf!

Ashna x

Upcoming TV star?

Hi everyone! I know it has been a while since my last post, I think I have been in a slight writing slump and have been telling myself that there is no pressure to write regularly. But I am back again because I wanted to share an amazing opportunity I had this week!

Since starting this blog, a close friend of mine suggested I reach out to deaf charities to let them know about my writing. I reached out to the National Deaf Children’s Society (NDCS) and they really liked the blog. Coincidentally at the same time, they were working on the Deaf Works Everywhere Campaign to raise awareness on all the different kinds of jobs and careers that deaf people go on to do! This is especially after a recent YouGov poll of 2176 people commissioned by NDCS found 47% of the public do not think deaf people can be doctors. For this, they collaborated with ITV to do a press release and ITV contacted me to be their main person!

I, of course, said yes! I brushed up a bit on my acting skills, last pulled out when I was a Lost Boy in my Year 6 Peter Pan production. Oh no, but that wasn’t a speaking role…

So, ITV said they wanted to film me in my work environment interacting with colleagues and then do an interview on my experiences as a deaf medical student. I was at Chesterton Medical Centre, as part of the CAMEO team. CAMEO (Cambridgeshire and Peterborough Assessing, Managing and Enhancing Outcomes) is a mental health service for people who are struggling with distressing experiences like hallucinations or paranoia. The service supports people that may be at high risk of developing a mental health problem such as psychosis and those that may be experiencing their first episode of psychosis.

I was feeling quite nervous on the day, but the CAMEO team were really lovely and reassured me, especially Dr Lili Galindo Guarin! The CPFT communications team were also there to support me, and they eased my worries too!

So! I will be on ITV1 news today (27th Jan) from 6-6:30pm raising awareness of the different types of jobs deaf people can have. I spoke about my experiences as a deaf medical student, some of the challenges and the support I receive. I think an online version with subtitles will be released this weekend (and will upload this as soon as I have access!)

I loved this opportunity and hopefully it will inspire more deaf people to apply to Medicine. It is so important to have medical professionals who look like the community they serve.

(note to myself for next time: be less nervous! you are doing well, and try to ignore the camera inches away from your face!)

Thank you for reading 😊

Ashna x

You don’t look deaf

What do you mean? What does deaf look like? Is it because I can talk? How about with my hair up? Do I look deaf enough now?

I have been told this many times in my life, and every single time, I wish I had said something back. Grrr…

Telling me that I don’t look deaf suggests deafness is bad, something I should be thankful I don’t look like! It suggests that I have done well to look ‘normal’, like everyone else, like you.

It insinuates there is a way to be deaf. All my life, I have felt in the middle of two worlds: the hearing and the deaf. My hearing aids allow me to move through life appearing normal, yet all it takes is a dead hearing aid battery or a lost ear mould to feel deaf again. The term ‘hearing impaired’ felt wrong, it felt like I needed fixing. ‘Hard of hearing’ felt like I was falling short of the norm again. Yet, I also know I didn’t fully fit into the Deaf world. I don’t use sign language, my parents and friends are hearing, and I didn’t grow up immersed in the vibrant Deaf culture.

It also reminds me of years of my life when I consciously and unconsciously tried to not look deaf. Throughout school, I have had different Teachers of the Deaf who would support me, my parents, and my teachers to help provide an accessible home and learning environment. I remember feeling embarrassed to be taken out of class to see them, and to have to explain to my friends where I went. I was given various assistive listening devices (or radio aids) to help transmit a teacher’s voice directly into my hearing aids, and would have to hand this over at the start of every lesson. However, I stopped using these as I struggled with calling attention to myself and then having to explain to teachers and peers why I needed them. I remember early in secondary school, I was asked by my Teacher of the Deaf why I don’t wear my hair up, and if this was to hide my hearing aids. I was annoyed she would even suggest that, but in hindsight, I think she was right.

Growing up, deaf looked like old white men on TV commercials, who struggled to hear their grandkids – this didn’t look like me! It is only recently with social media that I have started seeing more diverse deaf representation, and I met my first deaf friend at uni only this year (hi, if you are reading!) I am working towards feeling proud to be deaf, and there is still so much I have yet to learn. But I know there is no one way to look deaf.

So here is to a whole day of wearing my hair up!

Ashna x

“It doesn’t matter”

Hello! Happy New Year 😊 I hope you had a good break, regardless of whether you celebrate Christmas!

We have just had a much-needed fortnight off before starting our new term today! Though two weeks is very short, I had a good time and really enjoyed it. I went to India for a week and it was so nice to see my family again after 3 years, and to reconnect with cousins who are also now much older! Yes, very little work was done, but I still have time for that, right?

I wanted to write a short post about how the holiday season may not be all fun and games for deaf people. The holiday was a much-needed break away from the hustle and bustle of work, but I came across several challenges. I struggled with the big family gatherings, the new voices and sounds, and family members who did not know about my hearing loss. Suddenly, my deafness affected me much more than it had before, though nothing about me had changed.

So here are some tips, for deaf people and their loved ones, to help make holidays and family gatherings more deaf-friendly:

  • Lighting – Try and have bright lighting as much as possible so that it is easier to lip-read or sign. Think about positioning, can the deaf person see everyone’s faces or hands? If eating at a restaurant, ask for a well-lit table.
  • Background noise – Turn music off, or keep it to a low. Allow anyone to leave for a quieter space if they need time away from the noise (listening fatigue is real, kids!)
  • Conversations – Speak one at a time, and try not to mumble or cover your mouth when speaking. Actively involve them in the conversation, do not just speak to their partner or parent instead. Actively involve them in the conversation, and be prepared to repeat anything. Don’t let the deaf person feel they are burdening you – do not say “it doesn’t matter”, never mind” or “I will tell you later”. I promise you, it does matter, and if you say otherwise one more time, then I just might cry!
  • Subtitles – Watching a film? Going to the cinema? Make sure the subtitles are set up on the TV beforehand, and try and find captioned screenings. From personal experience, it can feel very isolating watching a 2-hour movie without understanding anything (or you can just make up your own plot!)
  • Awareness – If possible, speak up. If your loved one is struggling to hear or follow the conversation, ask if they may need help advocating for themselves. Talk about how things could be changed to make it easier. If needed, with consent, even speak to family members before any gatherings so they are aware of what they could do to help. Raising awareness and advocating for oneself can be hard, especially in different social/cultural contexts where disability and asking for help is more taboo. Understand this and offer to help.

There are many more adjustments that could be made, but most importantly, ask if anything else could be done. Don’t shy away from the conversation. The holidays can be an overwhelming time for anyone, and if these tips could help make it a little less isolating, then why not try them out?

Ashna x

Disabled Brown Woman

Hi everyone! I hope you are doing well, and that the sub-zero temperatures haven’t dampened your spirits. Recently, I have been thinking about how my disability intersects with my race and sex, and how this shapes both my experiences in the world and how other people perceive me. I thought I might write up my musings, and do some research at the same time.

In sociology, intersectionality theory refers to the existence of multiple sociopolitical identities that contribute to a person’s experiences of discrimination and privilege (Crenshaw, 1989). I am a deaf woman of colour, and these identities alter the lens through which I navigate the world.

As a member of multiple communities, it can make it harder to fight for your voice. In particular, disability is hardly recognised in South Asian communities. There is a real need to uphold our reputation such that it is so common to not speak out about physical disabilities, let alone mental illnesses. A research study conducted by the University of Surrey found that South Asian people are 4x more likely to develop a physical disability compared to our white counterparts (Williams, Cox and Cooper, 2020). This is worrying for multiple reasons. If we are stigmatised for not fitting the mould and for speaking out, then who do we go to when we need support?

I am lucky to have parents who have always stood up for me, building up my confidence and encouraging me to ask for help. Still, there are moments with extended family where I have felt it might be better to wear my hair down so they don’t remember that I wear hearing aids. Still, I find myself not talking to my grandparents about the difficult parts of my day, the sadness I felt when I couldn’t hear my friends, the mental health struggles. Still, I try and minimise the pain I might cause by talking about my struggles.

Much of the world lives in a natural state of ignorance. The ‘normal’ person is not taught to be curious about disability and racism. Most people are able to move through the world every day, without needing to understand how much harder it is to move through when the world is set up against us. My white counterparts can watch news reports of the high rates of morbidity and mortality in BIPOC communities during the pandemic, without having to live through the impact of this.

I think about the dangers I face as a deaf brown woman. Often, I walk outside without my hearing aids so I can listen to music. I try to be as aware of my surroundings as I can without my hearing to rely on. Yet, as hard as I try, this has its limits. I feel much more vulnerable to the darkness, knowing that I am perceived as a woman of colour. Why must I keep my hearing aids on for my safety when I deserve to listen to music and walk outside as much as anyone else? I find myself wearing baggier clothes and taking on a more assertive stance. I keep my hearing aids in, and try not to speak another language on the phone. I try and minimise all the parts of my identity that make me vulnerable, and yet, why should I do this? After the murders of Sarah Everard, Sabina Nessa and Zara Aleena, how can I afford not to do this?

So where do we go from here?

I think it’s so important that we listen to people and understand how systems of oppression affect us differently, learn from this, and advocate for others when we can. The disability community is large, and yet, accessibility is largely centred around cis white people. I have barely scratched the surface of how race and disability intersect, and even then, my experience is one small part of a multitude of experiences. We must centre the voices of disabled people of colour. We must be curious about other people’s experiences. We must listen.


Here is some reading if you would like to find out more about the intersection of disability and race:

To hear or not to hear!

Stethoscopes! They were the bane of my life in Year 4. In Cambridge, the first three years of our course are pre-clinical, with very little clinical exposure and many, many essays… Come Year 4, we are thrown in at the deep end and suddenly I needed to know where the heart and lungs were! Towards the end of my third year, I knew I had to start looking into amplified stethoscopes when I tried a friend’s normal stethoscope and I realised I couldn’t hear their heart (or mine!)

Looking for answers, I emailed many people in the Clinical School, my university’s Disability Resource Centre (DRC), my current audiologist at Cambridge and even my paediatric audiologists from Guy’s and St Thomas’ Hospital, London. Everyone was really lovely and tried their best to help, but I was surprised at how little information there was on amplified stethoscopes, and how confusing it all was. I wanted to write a blog post to compile all the research I did.

I had several factors to consider, which you may too:

  • How severe is your hearing loss – what level of amplification might you need? – I could not hear with a normal stethoscope.
  • What brand of hearing aids do you have? – I had Oticon Engage hearing aids, but halfway through this process, I switched to Oticon Sensei Pro hearing aids (causing some further confusion!)
  • Wireless connection (Bluetooth) or wired to your hearing device? – I use a wired option.
  • If wired, do you want earphones, headphones, or hearing aid shoes? – I use shoes.
  • What is your budget? Are you able to apply for funding from your university or place of work? – I was able to apply for funding from my university Disability Resource Centre and my college (Gonville & Caius College)

Stethoscope

I did some research, and I found out about the Thinklabs One Digital Stethoscope, which I had seen other health professionals recommending on Facebook groups and online. Their stethoscope claims to exceed the amplification of a regular stethoscope by 100x, addressing the needs of health professionals with hearing loss.

Thinklabs One Digital Stethoscope (https://www.thinklabs.com/)

Their website has a page specifically for people with hearing aids. They explain how their stethoscope can be used with a table summarising how it can be used with different types of hearing devices (click here).

Wired options

Wired options give a more robust connection, and potentially a better sound quality than wireless Bluetooth options. This would potentially give the user more security in knowing they have not missed any important heart or lung sounds. I have BTE (behind-the-ear) hearing aids, so from the above table, I could use either on-ear or over-ear headphones. Thinklabs recommend Beats Executive headphones, but these are quite expensive. However, for me, I knew I did not want headphones over my hearing aids. I have always found them to be very clunky and uncomfortable over my hearing aids, and the sound quality was never that good anyway.

Alternatively, I could have used earphones connected to my stethoscope. With my level of hearing loss, earphones usually transmit enough sound for me to take most phone calls and listen to music. However, I thought earphones would not be a good option for me as I would have had to remove my hearing aids to use them and this would mean I would miss any other sounds happening in the room, including anything the patient may say.


Wireless option

Apart from wired options, I also had the option to use streamer devices to deliver sound directly to my hearing aids, such as the Roger Pen. This is a portable microphone that can wirelessly transmit sound in noise and over distance. This would however require me to wear my hearing aids, Oticon shoes, and Roger receivers, allowing me to wirelessly connect to the stethoscope. With this option, I would not have to connect anything at the time of use, as it would all be automatic. The Roger Pen could also be useful in other situations such as lectures or conferences.

At the time, I had Oticon Sensei Pro hearing aids. This brand requires FM9 shoes to be put attached to the bottom. At the time of research, the pricing for all of the equipment was as follows on Connevans (after VAT relief for disabled customers):

  1. Thinklabs one digital amplified medical stethoscope = £444.00
  2. Phonak Roger pen Ruby microphone transmitter = £510.00
  3. Two Oticon shoes FM9 for ear level receiver = £21.84 x 2 = £43.68
  4. Two Phonak Roger X receivers (type 02) for Oticon hearing aids = £510 x 2 = £1020.00

This would come up to a total of £2017.68, and I found this to be too expensive for me, especially as my college (Gonville & Caius) and the Disability Resource Centre at Cambridge were both helping me fund my stethoscope.


My first purchase – Oticon Sensei Pro hearing aids

Alternatively, the cheaper option was to have direct input leads that connect my hearing aids (and shoes) to the stethoscope. This is, admittedly, more clunky to carry around in hospitals compared to a wireless option, like the Roger Pen. I would also need to attach the direct leads to my stethoscope each time I need to use it, requiring me to take my hearing aids out very briefly. At this time, I still had Oticon Sensei Pro hearing aids, but I would need another type of shoe (Oticon AP900 shoes) for the direct input leads. At the time of research, the pricing for this was as follows on Connevans (after VAT relief):

  1. Thinklabs One Digital Amplified Stethoscope = £444
  2. 800mm binaural V direct input lead = £21.50
  3. Two Oticon audio input shoes AP900 = £22.75 x 2 = £45.50 

This came up to a total of £518.95 with delivery, and this is the option I went with!


My updated (and last!) purchase – Oticon Engage 105 hearing aids

A few months later, however, my hearing aids had been upgraded to Oticon Engage 105, which has Bluetooth function. This was amazing as I could now stream music directly to my hearing aids! However, with regard to my stethoscope, the equipment I had would no longer work with my new hearing aids. I wanted a new option that would require me to buy the least amount of equipment.

After lots of research and help from my audiologists, I found out that I would need the Oticon AP1000 shoes. These would however require me to replace the battery drawers of my hearing aids using the Oticon Corda Hearing Aid Service Tool. This replacement drawer has it own specific shape and size to allow the AP1000 shoe to connect to the Engage 105 hearing aids. Luckily, my audiologist was able to send me a service tool that I could use, but otherwise, I could have bought it here. Therefore, finally, at the time of research, the pricing for the new equipment was as follows on Connevans (after VAT relief):

  1. Two Oticon audio input shoes AP1000 = £22.75 x 2 = £45.50
  2. Two battery drawer shoe adaptor = £10 x 2 = £20

This came up to an additional £73.40 with delivery, so that I could use my stethoscope with my new Oticon Engage 105 hearing aids. I then just had to replace the battery drawers using the service tool, where I found instructions online (click here!)

Finally, I had everything!


I hope this helps you in finding the right stethoscope for you. I would recommend reaching out to as many sources of support as you can, your audiologist, your university/work, Occupational Health, your supervisors, and even me! All of this research took a long time for me, and I could not have done it alone. All information was accurate at the time of purchase, around a year ago, so please make sure you double-check any of the details before you buy a stethoscope for your own hearing device. Be especially careful with buying the correct shoes, and finding out whether your hearing aid battery drawer needs replacing (but your audiologist should be able to help you)! Finally, do try and apply for funding as you should not have to pay for needing reasonable adjustments for your work.

Well done for getting this far! Thank you for reading, and I hope it has been of some help!

Ashna x

Clamouring towards me

Hi, I hope you are doing well, and defrosting by a warm heater somewhere. It was International Day of Persons with Disabilities on 3rd December, first coined by the United Nations in 1992. I am not sure I did anything in particular to mark the occasion… other than letting myself relax in bed and rest without guilt.

I had a spare 10 minutes today so I wrote this short poem, and maybe the feeling of being lost in (mis)communication might resonate with you.

I saw her across the room, and instantly it began
Her eyes lit up, and words spewed out of her mouth
The letters stumbled upon one another, all jumbled up
Clamouring towards me as fast as they could
This, and that, and everything in between
Colours, emotions and the mundane in-between
Alas, as the words inched closer, they bounced off me
Falling to the ground and disappearing
She did not notice though, her mind was still unloading
And it did not take me long to piece together why I could not switch on
Of course, my hearing aids were not switched on!
She did not notice though, her mind was still unloading
And surely, it would be unkind to stop her now!

Just an untidy ramble of thoughts, no Rumi here!

Ashna x

Leading the way

I was interviewed by Caius! Have a read through for me rattling on about deafness and medicine…

I wanted to write about my experiences as a deaf medical student, and I wanted to build up something that I would have wanted when I was younger. This was one way I could give back.

Source: Leading the way

The Perks

Hi everyone! I hope you are doing okay, and looking after yourself as the days get shorter and the festive mood creeps in.

Recently, as I cycle home from the hospital and unwind from the day, I have been spending more and more time alone with myself. And I realised, I really love being able to take my hearing aids out at the end of the day! I have been thinking about this a lot recently, and thought I would do some research on any perceived benefits for deaf people. So here is a short post on some of the perks of being deaf for me!

  • I can sleep in silence! No clocks ticking away, no wind crashing against the panes, no greasy ear buds falling out of my ears
  • I can work in silence, and concentrate better on work (or Netflix…)
  • Someone annoying me? No problem, just turn the volume down!
  • I am more sensitive to body language and facial reactions, and this makes me a more empathetic person (apparently)
  • I am motivated. I want to know what I missed, and I know I can work hard to do what others may find easy (but will I do this, is another matter…)
  • Discounts, discounts, discounts (though this does come with a side serving of having to prove your disability)
  • I can hear music through my earphones with no background noise. My ears come with in-built noise-cancellation!
  • I know how hard it can be to access support when you are faced with extra barriers, and I have used this to find opportunities to help other people (which in turn, has helped me)
  • Apparently, improved mental rotation skills – a better ability to imagine how an object would look if rotated in space and viewed from another perspective. (How does this help me? Hmm, maybe if I need to imagine how much icing is on the other side of my cinnamon bun)

To sum this all up, I would say my favourite perk is silence whenever I want it – the ability to switch off from the world around me at any given moment, and to slip back into my body. Ahh, now time to take a short Netflix break in the Clinical School Library, but hurrah to not being able to hear the people furiously clacking away at their keyboards around me!

Ashna x

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