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Gold, incentives and meh

A disability does not have to be a handicap

Dr Stewart Mercer explains

how losing a leg positively influenced the way

he practises

It's difficult to say how having one leg has affected my life as a doctor. I lost my leg when I was five (because of an osteogenic sarcoma) and now, more than 40 years later, it seems to me that I have pretty much always had one leg.

For me, it's normal. It's no big deal. I know very well what my limits are and nowadays I neither overestimate nor underestimate them. What I can't do, I don't dwell on, and therefore I don't miss. What I can do, I do as well as I can and enjoy to the full.

And as life progresses, then of course these activities change; as a kid I loved riding my bike (two-wheeler of course ­ a monocycle would have been a step too far), playing football (on crutches or in goal on one leg), boxing (I joined a local boxing club at the age of 11, though ­ despite some nifty footwork ­ fairly quickly discovered I didn't much enjoy hitting my club-mates ­ and I definitely didn't enjoy being hit back), and swimming (my major sport throughout my teens and early university years).

Nowadays, I prefer rather more sedentary activities, such as meditation, writing poetry and reading good books; the occasional bit of painting and decorating, with the odd walk in the country thrown in to appease my guilt about not doing enough exercise.

I do these things now because they are what I enjoy, not because they are 'all I can do'. Having a disability is largely a mind-set. Your thoughts can be your biggest enemy or your best friend.

In a way I was very fortunate to lose my leg at a young age, because kids respond to 'what is' rather than 'how it should be' and I never really saw my 'one-leggedness' as a problem.

And other kids, once they saw my ability to join in, also accepted me just as I was. This pattern has continued throughout my life. I do what I know I can do and my friends and family support me and simply see me for who I am.

Since becoming a doctor I can't say my disability has limited me at all. Of course, I haven't signed up for mountain rescue although I worked in the foothills of the Himalayas as a volunteer doctor with Tibetan refugees in Dharamsala, North India.

My main problem was getting to medical school. Advisers at school insisted that medicine was 'far too physically demanding' for someone with an artificial leg. I applied against their advice but was turned down. Instead, I headed off into a career in science and medical research....but I still yearned to be a doctor. And 12 years after leaving school, armed with a PhD, a post-doc, and a barrel-load of life experiences, I was accepted by the University of Bristol.

I am often asked if having a disability has any positive aspects in terms of being a doctor, and the answer is a definite yes.

I've been a user of the NHS for more than twice the length of time I've been a doctor, and I think that is a very useful qualification. I've experienced first hand the good and the bad of medicine. I know how it feels to be patronised and I know how it feels to be treated with respect and dignity. And I know the difference it makes.

Do my experiences of being a patient, and of having a disability, make me a better doctor? It's a hard one to answer.

All doctors of course need to be up to date with medical knowledge and technical skills, but I feel there is much more to good medicine than that. The ability to listen, empathise and communicate well are for me the core skills and values of medicine. What better way to learn such skills than to have experienced them as a patient?

It saddens and worries me that the medical profession still seems unwilling or unable to grasp this. In December last year I spent two days counselling colleagues with a range of disabilities and chronic illnesses at the BMJ Careers Fair. I was shocked to hear how unfairly many had been treated.

In April I attended a conference (led by Professor Ruth Chambers) entitled 'Enabling doctors with disabilities to remain in the NHS'. Again, the stories told were heart-breaking with highly qualified and highly able people being undervalued ­ and at times actively discriminated against ­ by a system that can ill-afford to lose such a valuable resource.

Why is it, as a caring profession, we seem unable to help each other?

My advice for others with disabilities who would like to be doctors, or who develop a disability as a doctor, is to think positively. Don't underestimate your abilities.

Don't undervalue yourself. And please don't give up. Medicine needs you.

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