Alexis Read Story: The Importance of Self-Advocacy
At age 4 months, I received diagnoses of optic atrophy and nystagmus. My visual acuity is 20/400 with a visual field of 65 degrees. I utilize a white cane for independent and safe mobility.
Growing up, I received infrequent orientation and mobility (O&M) instruction as I lived in a rural state. I was taught how to safely cross streets depending on traffic cues. I’ve crossed many streets in my life using the skills I was taught by my childhood O&M instructor. Upon moving to Tempe, Arizona, the skills I learned weren’t enough to keep me safe.
I live near a very busy intersection. The traffic lights are actuated to the traffic flow, which has caused some safety issues in the time I’ve lived in the area.
On April 15, 2013, I prepared to cross the street on my way home from work. After assessing the traffic surge, I made a determination that it was safe to cross. Immediately upon stepping into the intersection, I was hit by a turning car. The vehicle was turning right into the crosswalk. I believed the intersection to be safe because cars were travelling parallel to me. I thought nothing more of this and continued to travel as I had been taught.
On May 29, I was returning home from work when I was hit again in the same intersection. Like before, I was not injured. This time, I realized that I needed to do something, and fast.
I contacted a local mobility instructor with whom I had worked upon my arrival to the community. I described what happened in both incidents. The instructor determined that it was unsafe for me to cross this street independently until I received approval from the instructor I was working with at the time. Not knowing how long it would be until I received this approval, I realized that I had to do more than wait passively.
I contacted a traffic engineer in order to request the installation of an audible pedestrian signal (APS) at the corner in which I had gotten hit. I was prepared to ask for a mobility teacher’s statement of need as this was the policy in another community in which I lived. The traffic engineer informed me this was unnecessary. She began making arrangements for the APS to be installed.
In the meantime, I was receiving rides home from a colleague as I had not received approval from the teacher. In mid-July, the APS was installed. I received approval to cross this intersection independently in early August.
I learned one important lesson from this incident. In order to remain safe on the streets of my community, I needed to advocate for the installation of APS where appropriate. Advocating for this need involved finding out who the right person to contact was as well as staying in regular touch with her until the job was done right.
I believed the installation of APS was the end of my O&M challenges near home. Little did I expect what awaited me on the morning of August 20th.
I left for work as I had done a thousand times before this. Thinking that this was a regular morning bus ride, I was walking to the bus stop enjoying the morning breeze. When I reached the large driveway exiting my apartment complex, I stopped as I always did in order to assess vehicular traffic.
I saw one vehicle idling on my left side waiting to merge into traffic. The vehicle was stopped as there were cars driving along the busy street next to the driveway. I waited a few moments and realized the vehicle was still idling. I determined it was safe for me to continue down the sidewalk.
As soon as I was in front of the vehicle, the driver drove forward. He hit me on the left side, which caused me to lose my balance and land on my hands. A moment later, the driver exited his vehicle and began spluttering that he didn’t see me. He asked if I was OK. At this point, I was still reeling from what had happened and most likely was beginning to go into shock. I informed him that I didn’t know if I was OK or not. He got back into his car and drove away from the scene of the collision.
I limped slowly to the bus stop and sank onto the bench in order to wait for the bus. Once I arrived at the campus bus stop, I called the transportation service the Disability Resource Center (DRC) provides. Upon arriving at work, I went to a trusted colleague’s office rather than my own. I needed to be with someone immediately. The colleague took one look at me and realized something had happened. When I told her I had gotten hit, she made arrangements to take me to a hospital.
The first lesson to learn from this incident was to call 9-1-1 from the scene of the collision. The police will take a statement from all parties, collect any physical evidence, and take any necessary measurements. A determination will be made whether to prosecute the driver. Since I did not call 9-1-1 from the scene of the collision; the police couldn’t charge the driver with any crimes.
My colleague took me to a hospital close to campus. Unfortunately, this was a hospital that doesn’t have a good reputation in the area. I was diagnosed with a sprained ankle and given prescriptions for a walker and pain killers.
The second lesson I learned was to research hospitals in an area you live in or are moving to. Find out which hospitals are good and which to avoid.
My colleague drove me home and helped me get settled in for the afternoon. As I thought about the incident further, I realized I should seek a second opinion as quickly as possible. I located an orthopedic clinic that was across the street from my apartment complex. Luckily, I was able to make an appointment for the next morning.
The doctor took new X-rays and determined that I had fractured my navicular bone. This is a small bone located at the top of your foot. It’s an important bone for walking according to a friend who is a nurse. The doctor decided to put me in an air boot for 4 weeks, and I readily agreed with her plan of action.
In retrospect, I should have insisted on having her cast the foot. Articles I read later state if this bone is fractured, the patient should be in a no weight bearing cast for 6 weeks. The doctor thought that because of my “seeing impairment,” her words, I wouldn’t be able to handle a cast. Had I had more presence of mind or had another person with me at the appointment, I would have advocated for conventional treatment immediately. Being alone at the appointment and being in a tremendous amount of pain clouded my judgment to the point in which I let the doctor’s lack of education about visual impairment dictate the treatment protocol.
About 4 weeks later, I was back at the doctor’s office because of an increased amount of pain at the injury site. By this point, I had spoken to my nurse friend and discovered the proper treatment protocol. The doctor took X-rays but saw no healing. She couldn’t figure out why I had more pain. All she could determine was I was perhaps walking too much on it too soon.
At this time, we had a long discussion about the pros and cons of casting. I was in a better frame of mind so I could advocate more effectively for myself. The doctor confirmed what my nurse friend had told me by proposing a cast for 4 weeks. I tried to think quickly through the logistics, but it was still difficult with the doctor there waiting for my decision. Again, had I had someone with me, I could have brainstormed with that person. Instead, I had to make a decision myself and in a short period of time.
I decided to have the cast as the doctor advised. I still had the walker at home but didn’t think to bring it to this appointment. We discussed how I would navigate my environment, but I had no good ideas. It had been 28 years since I had leg casts, but my mother carried me everywhere back then. I told the doctor that I thought I could use crutches like my peers who broke or sprained a bone. I didn’t think about how difficult it would be with my mild cerebral palsy. I wanted to fit in with my peers, and this clouded my judgment.
I was given a pair of crutches and shown how to use them. The staff member who trained me pronounced it safe for me to use them. The training was a quick 5 minute lesson in how to use the crutches. I requested a consultation with a physical therapist (PT) to receive more extensive training and evaluation; however, I was told there were no PT’s working at the facility I was seen at. Not knowing whether this was true or not, I allowed the doctor to bring in the durable medical equipment service provider. I should have advocated for a PT consult because I felt a PT would be able to more accurately evaluate my ability to use crutches safely.
The next week, I was experiencing difficulty with the cast shoe so I called the doctor’s office in order to get some advice. I spoke with someone who informed me that I was supposed to not bear any weight on the foot. After this conversation, I opted to use the walker full time. Although the walker had more support than crutches, I still was unable to move without bearing weight on the injured foot. My balance is such that walking on one foot is dangerous for me.
When the cast was dry and I was on my way out of the office, it began to hit me what I had done to myself for the next 4 weeks. I had no facilities for bathing with a cast, nor did I have a way to independently do laundry. I live in an inaccessible apartment complex. In the interim, I had a friend who assisted me with laundry, but this friend was going to be out of the country for several weeks during the time I was in the cast. I had to figure something out.
This is the benefit of working in the disability field. Prior to the accident, I met someone who is a nurse at a local home healthcare agency. The nurse had provided information for other students on my caseload. Now with the situation I found myself in, I contacted her asking for help. It took a few weeks to get someone in place, but I had laundry assistance by the end of October.
The day after the accident, I was able to think a little more clearly. I knew that since I had been hit, I needed to consult with a personal injury attorney. Having read The Rain Maker by John Grisham, I was familiar with this type of lawyer. I did a google search for personal injury lawyers in the community where I lived. I found one law firm that seemed to be a good firm so opted to call their office. Not even knowing whether I had a case, I was somewhat nervous making this initial call.
I described what happened to the receptionist. She scheduled an appointment with an attorney for later that afternoon. I told her that I was unable to drive, and she was more than happy to have the attorney come to my home. When the attorney and I discussed the case, he felt confident that I had a good case since the injuries were clearly the fault of the driver.
In discussing the events of August 20, I was very detailed and provided specific times and locations. I had also gotten the police report number as the driver called several hours later to report the incident. Having done considerable reading in the forensic sciences, I learned that providing a detailed description is important when discussing an incident such as this with a police officer or attorney. The lawyer was able to get enough information from me in order to determine that we did have a case.
In the months of treatment, I was advised to save everything related to treatment for submission to the attorney. I file documents anyway so this was nothing new. If this ever happens to you, it is critical to save all receipts and related documents for submission to your attorney at the appropriate time.
On October 30, I saw the doctor for follow up. She removed the cast and took another set of X-rays. She determined there was 95% healing and wrote a prescription for PT. Having had orthopedic surgeries in the past, I knew the importance of utilizing PT services to their fullest. The PT I worked with was very knowledgeable and comfortable with individuals with disabilities. If the professional with whom you are working shows discomfort with your visual impairment or you feel he or she isn’t comfortable, it’s perfectly appropriate to request a change in service providers. The therapist I worked with learned quickly that he had to verbalize all instructions and directions in the therapy room.
This incident taught me many lessons that will stick with me for a lifetime. Calling 9-1-1 immediately after an incident occurs is the first critical step in starting the wheels of justice. Other lessons were related to self-advocacy and living with a temporary disability in combination with a visual impairment.