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This hits hard. Last week at my eval I was told that if I don't start putting on a better neurotypical performance for my colleagues and evaluators, I won't pass the clerkship. PASS, not honor. Let me break it down. 
https://twitter.com/appyjumpindaze/status/1292326364373229568
https://twitter.com/appyjumpindaze/status/1292326364373229568
"You accomplish excellent things but we have to tell you to do them first." This is literally part of #autism. If you don't tell me to do something, it probably won't occur to me that I should do it. Especially in brand new environment- I don't know what's normal/expected.
"You don't look at people enough when they are presenting on rounds" I'm concentrating. We're standing in a group outside a patient's room, and there's beeping, side conversations, people walking around, more beeping...my Autistic brain does not filter these sounds for me.
A lot of #ActuallyAutistic folks have auditory processing issues. I plan to make another thread talking about auditory processing disorder, as it's a huge difficulty of mine especially with losing my ability to lip-read (we need clear masks please).
But suffice it to say that focusing my eyeballs on a more neutral area (like the floor) helps me deal with the overwhelming auditory input I'm receiving. I promise I'm trying my hardest to listen, follow along, and ask appropriate questions.
This also shows why keeping a diagnosis, or the details of a disability, PRIVATE in a workplace is so difficult. I want to explain why I do the things that I do. I can't explain that without disclosing my diagnosis and opening myself up to a lot of discrimination.
Imagine: you're asked to act in a show and do most things in a way you're not personally comfortable with at all. Then imagine being asked to perform like that, not just for patients like you expected, but for all of your colleagues and evaluators. All day, every day.
Rarely a second of rest. I've taken to hiding in the bathroom and stimming aggressively until I feel ok enough to come back out and continue my performance. This past week I probably took at least 4 of these breaks each day.
(Which doesn't help because I also have #EDS, a connective tissue disorder. Having to stim so aggressively to cope with performance expectations has already led to a wrist injury)
"Remember, you are always being watched" was said to me as I walked out of my eval. This is not helpful advice for anyone, particularly an #Autistic student. I only feel comfortable in the privacy of a bathroom stall. Don't worry, I am very aware of the eyes on me.
I just want to make myself perfectly clear- I expected this. I entered medicine with the knowledge that few people are going to "get" me, and that I would probably have to spend a lot of energy just looking "normal" to others. At least to get through training.
But that doesn't mean I can't talk about it. That doesn't mean it's not an issue that needs to be addressed. Anticipation of this issue doesn't make it an OK one for neurodivergent folks in healthcare to struggle with.
It's one thing to mask, or perform, for patients. Personally, I am happy to do that. It's another to need to perform for colleagues and higher-ups, and to have your future and career hinge on how well you fit the neurotypical mold they require and expect.
THIS is the state of medical education for neurodivergent students. #medtwitter, THIS is what your ND colleagues are dealing with daily. This is why I've been unable to see my partner, or any other supports, for weeks. I just come home and sleep.
#medtwitter, please listen to your neurodivergent colleagues. Please be kind. Please know that we are doing our very best. I am so tired. This exhaustion is unsustainable.
