For the third-year medical students attending the Boston University School of Medicine, there’s a guest lecturer in today’s class. By way of introduction, he tells the students a little about himself. He enjoys riding his bike and playing piano. On weekends, he likes to go to the skate park with his mom.
Braeden Yee, the guest lecturer, is 11 years old.
For these students — some wearing lab coats, others in scrubs, a few wearing stethoscopes — Braeden is the first “co-teacher” of their pediatric rotation. His visit is part of Operation House Call, a partnership between the school and the Arc of Massachusetts, an advocacy organization for children and adults with intellectual and developmental disabilities. Braeden has autism.
Medical schools typically expect students to make home visits, which provide opportunities to learn about the nuances of the profession outside the classroom and the clinic. But the Operation House Call program provides a twist: It brings in young self-advocates with developmental challenges, such as autism or cerebral palsy, into the classroom. There, they becomeeducators for a day.
Braeden is accompanied by his mother, who works to keep him focused. He pulls slips of paper, one by one, out of a brown bag and reads the name of a student. Each asks Braeden gentle questions: How does it feel to go to the doctor? How do you get along with the kids in your class? What do you want to be when you grow up? (“A doctor! And a police officer, a firefighter — a lot of jobs,” Braeden answers.)
In exchange for answering their questions, Braeden gets to ask each student one of his own. It’s the same every time: “What kind of car do you drive?”
“Ooh, brand-y new!” he crows when one student says he drives a dark blue 2017 Toyota Corolla.
After Braeden has exhausted the students’ queries, he takes a seat in the back row, puts on headphones and watches videos on a tablet. His raucous laughter fills the room as his mother, Kimberley Walsh, offers a few insights from a parent’s perspective.
OHC began at BU in 1991 with input from a pediatric neurologist whose brother was born with autism. Under the guidance of program director Maura Sullivan, who has taught the class for seven years, the program has expanded recently to Tufts Medical School, Simmons College, and the University of Massachusetts. In 2015, the Yale School of Nursing adopted it.
In her role at the Arc of Massachusetts, Sullivan doubles as director of government affairs, lobbying for legislation for improved disability services. Walsh, who met Sullivan as fellow parents at their sons’ school, now works as the OHC family coordinator, pairing families of children with disabilities with medical students for home visits.
Isaiah, a 22-year-old with Down syndrome, was a co-teacher for eight years at BU.
“It was his favorite thing in the world,” says his mother, Angela Lombardo, who took a job as a program coordinator at Boston Children’s Hospital a few years after Isaiah’s birth.
There’s a world of difference between reading about Isaiah’s diagnoses and meeting him in person, says Lombardo. She volunteered her family for home visits for Brandeis students before learning about the co-teaching opportunity at BU.
“I think he surprises people,” she says of her son.
‘In our first two years, we learn about all these diseases, but unless we meet the patient, we don’t have a good idea of what the people themselves are going through.’
Before Braeden addressed the class, Sullivan told her new students about her experience: She’s the mother of two sons with autism. When Tyler, her youngest child, was born, she volunteered him to take part in a study on siblings with the disorder.
“He became the hardest-working baby in the autism business,” she joked.
She recalled an incident in an emergency room, when Neil, her older son, now 16, had a meltdown. Another patient in the crowded waiting room angrily told Sullivan to “get a muzzle” for her child.
It was not the stranger’s cruelty but a doctor’s simple act of kindness that has stayed with her all these years. The doctor knelt in front of Neil, apologized for the long wait, and quietly told him the staff was going to get him all the help he needed.
“That changed me,” Sullivan said. She had never felt stronger, never more prepared to care for her challenging children.
“And you guys are in that position,” she told her students. “It’s like a chain. You affect someone, and they can affect someone.”
After class, third-year student Alan Hsieh, a 24-year-old from Toronto, said he found the co-teacher visit to be invaluable.
“In our first two years, we learn about all these diseases, but unless we meet the patient, we don’t have a good idea of what the people themselves are going through,” he said. The program boils down to one imperative, he said: “How can we make their lives easier?”
Isaiah Lombardo is working with the Department of Developmental Services to plan for his future, when he will live independently. His current goals include learning to prepare meals for himself and navigating the subway system.
His experience as a co-teacher for Operation House Call, his mother says, helped him develop a strong sense of self-awareness.
“It’s what you want for our kids,” she says. “To be able to speak up for themselves.”James Sullivan can be reached at firstname.lastname@example.org. Follow him on Twitter @sullivanjames.