Good morning all and a huge HAPPY BIRTHDAY to the Americans with Disabilities Act. Today you turn 30. I'll be writing a love letter to you throughout tomorrow, but for now, I'll just remind all my abled followers to use this day for learning. #ADA30
It took a long time for me to think of myself as disabled. Certainly not throughout childhood. I was a sick kid, constantly having surgeries, but I was happy. I loved my family, my friends, reading, and schoolwork (yes, I've always been a nerd).
I really only related to "disability" when it came to school accommodations. I had to fight tooth and nail for the smallest things. As I grew older and schools started getting sick of my requests, the animosity grew.
Have you thought about what it means to beg for a step stool? For a copy of class notes? As a 9 year old?
It wasn't easy. And I was TREMENDOUSLY helped by being white, male, and having a mom who knew the ins and outs of IEP meetings.

But I owe it all the ADA. This glorious, flawed law is the only thing in our toolbox. We need more. But I for one am very happy we have it.
I have a lot more things to say throughout the course of the day. I’ll also quote my favorite under appreciated #DisabilityVisibility thinkers. For now, sleep.

It’s a party, y’all!
Good morning for real now!

Our first topic is my personal relationship with advocacy. Shoulda shared this with y’all a while ago.

I can’t wait to stop tweeting. Let me explain....
I don’t ‘enjoy’ talking about ableism, per se. I didn’t during high school or the beginning of college. I certainly didn’t plan on it becoming this big a part of my life.

I’m in med school — I want to spend my time studying and learning from @rabihmgeha how I fixate too early.
I’m here in this space because I saw a gap. There are beautiful conversations for equity in medicine and for disabuse rights overall, but the overlap is far too underrepresented.

Superstar Exceptions: @MeeksLisa @BonnieSwenorPhD @Okanlami @brookevitti
So please understand. I can’t wait for my threads to be completely unnecessary. But the constant parade of misunderstandings and injustices keep me here.
OK NOW Don’t make me regret this. But if you are well meaning and kind, I’ll let this tweet serve as question time.

What confuses you about disability? What do you want to know about this activism or the ADA?
While that's simmering, another 🎉 celebration 🎉 for inclusion within inclusion...

I talk a lot about #DisabilityTooWhite and how disabled people can't ignore other forms of oppression.

But I'd be lying to say that "We need to dismantle racism and sexism!" doesn't make me 🤔
It is so, so, SO easy to include ableism in your all expansive lists of systems of oppression. And is SO important since those MOST harmed by ableism are BIPOC or LGBTQ+ (aka not me).

Disabilities are often erased. It doesn't feel good for this movement to be erased too.
But I know I said this was a celebration a few tweets ago, and you're probably wondering how...

Bc y'all - it's changing. Not in our lecture slides or mass media pieces. But on twitter. I've seen peers, friends, and strangers over the last few days with #MedBikini INCLUDE US.
So this tweet is dedicated to you all. I will always try to be here to be a better white cishet male ally. Thank you for being an abled ally and including us in your lists. We can do this together.
While you're all here, please read this fantastic piece by @Keah_Maria, an icon. https://twitter.com/Keah_Maria/status/1287381534371196928?s=20
I speak about physical disabilities, some on mental health & intellectual disabilities. But I am VERY cognizant of the fact that my learning on sensory disabilities is severely lacking. For this, esp. within HC, I listen to my friend @coreyaxelrod https://twitter.com/2axend/status/1287374675253878784?s=20
Our next topic for discussion on this fine Sunday afternoon is about why I always say "disabled medical student."

Why not engage in disability work outside of medicine, where there is so much to be done?

Why not focus on learning medicine rather than advocating for change?
Let's be real for a second. I'm not any kind of leader in disability. Most of what I know is from personal experience and then self-taught. There are people who have written more, studied more, and overall know more than I do about disability rights in America.
Medicine is so intimately tied to disability. As trainees or clinicians, we're faced with it every day, but rarely name or discuss it.

Disabled patients have faced generations of harm by the medical model of disability - again, people have explained this much better than I can.
In the beginning of the year, I really only spoke about disabilities to my peers.

"Why did you use that word?"
"What do you think her experience is like?"
"Please don't say that."
As we've gotten closer and closer to #ADA30, I've realized this is an issue that HAS to be in the public eye. And is why I'm working on 4 (somebody stop me please) op-eds right now.

The ENTIRE ROOT of the issue is the segregation between medicine and disabilities.
If we as disabled docs don't talk and write about how we're trying to change medicine to be more welcoming, how will we build trust between our two communities?
If I just spoke about disabilities on here without anyone knowing I was in medicine - what would be the point? I add nothing to that conversation.

It's my experience as a medical student - being taught day in and day out the hidden ableist curriculum - that I try to share.
A very important clinical pearl I learned today from the incredible @BurgartBioethix

Most (all?) ED patients are given a tox screen. If we don't test for intoxication, it will be the disabled patients & the BIPOC patients, who receive worse care b/c of suspicion of intoxication.
I'm glad that clinical protocol exists. It helps prevent prejudice from affecting outcomes.

What's the corollary in other clinical settings? What's the corollary for other disabilities? There is none. That's why I always try to center my thoughts on disability AND medicine.
@traependergrast is a medical student who tweeted today about #ADA30. Be like Tricia. https://twitter.com/traependergrast/status/1287460620225347584?s=20
How's everybody doing? Y'all reading? Y'all learning? Y'all evaluating your own biases?

Let's check in.
I don't know, y'all.

It's nice that this thread got a lot of retweets but I've been waiting all day long for the "big names" in #MedTwitter to give even 15 seconds to tweet about #ADA30.

I'm not gonna call them out. But I want to.
Where does it come from? Are the "big names" in #MedTwitter not following ANYBODY talking about #ADA30? Is it that disabilities aren't seen as a part of being woke? Is it entrenched ableism within the previous generation of physicians who don't view us as equal?

Idk, y'all.
But let's take some time to appreciate the good ones, who don't make feel like I'm in a sandpit.

FIRST UP. @brookevitti is a dear friend, soon-to-be disabled medical student, and phenomenal writer. https://twitter.com/brookevitti/status/1287516559414501376?s=20
Next is the ever-brilliant @soupvector. In January I was awed by his ability to teach immunology and one of the best Clinical Correlations I've ever been to. Since then, he impresses me with his advocacy, support of equity, and amplification of others. https://twitter.com/soupvector/status/1287516102289846272?s=20
All right. That's it fam. #ADA30 is in the books.

I received a heck of a lot of hate today. Was told to quiet down, that I wasn't going about this the right way. I deleted my twitter, then came back to tell you all that I'm proud to know you.

You inspire me each and every day.
You can follow @_HarryPaul_.
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