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Quadriplegic doctor aspires to walk again

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Dr. Dinesh Palipana Queensland’s Australian of the Year 2021

By Sajitha Prematunge

Dr. Dinesh Palipana does not have the full command of his fingers and his usual offer of a handshake took the form of an awkwardly extended fist. President Mahinda Rajapaksa, like a good sport, fist bumped the quadriplegic doctor, gangster-like, an act of empathy Palipana appreciates to this day. Such are the trials and tribulations Sri Lankan-born Australian doctor, lawyer and disability advocate, Dinesh Palipana is faced with, on a daily basis. But such technicalities didn’t prevent him from recently being named Queensland’s Australian of the Year 2021.

The quadriplegic doctor, the first of its kind in Queensland, and the second in Australia, is currently a lecturer at the School of Medicine, Griffith University; Adjunct Research Fellow at Menzies Health Institute Queensland and Senior House Officer (Emergency Department) at Gold Coast University Hospital. “Eleven years ago I was lying on an intensive care bed, I couldn’t move my arms and legs, I couldn’t eat or breathe. My life was falling apart all around me. But to be here after all that trauma seams surreal. But I am grateful for life, for my community, friends and family that supported me,” said Dr. Palipana.

He is a founding member of Doctors with Disabilities Australia, an advocacy group for physicians with disabilities and the ambassador for Physical Disability Australia. Palipana is a member of the scientific advisory committee of Perry Cross Spinal Research Foundation. In 2019 Palipana was awarded the Medal of the Order of Australia for his service to medicine; Junior Doctor of the Year at the Gold Coast University Hospital; Henry Viscardi Achievement Award, a global award in recognition for his work in disability advocacy; and ‘Change Making’ in National Awards for Disability Leadership. All these accolades and achievements would have been impossible without the love and support of his mother, Chithrani Palipana. “My mother taught me what love, strength, commitment and perseverance are.”

 

Tragedy

Born in 1984, Palipana and his family migrated to Australia in 1994, when he was 10. Not only physical disability, Palipana knows only too well how debilitating mental health disorders are as well. He battled with depression, anxiety and panic disorder while studying law. “It took some time. I had to readjust my life and thinking. Finding my purpose really helped.” He realized that law was not his calling. He commenced his Doctor of Medicine at the Griffith University in 2008. When he was 25 and half way through his medical degree, he lost control of his car while driving home on a wet night. The car aquaplaned and rolled. When it finally stopped, he realized that he could not move or feel his legs. Palipana was far enough in his medical education to self diagnose it as a spinal cord injury. It left him quadriplegic.

He lost all sensory and motor function below his chest due to the injury. “I can’t move my fingers,” said Palipana. He has had to make a lot of adjustments to life. “Initially, going from a normal life to being paralysed, was very challenging.” Palipana pointed out that even day-to-day activities can be difficult with impaired movement. Despite a life-changing disability, Palipana decided to go back to medical school. Against all odds he graduated in 2016, with quite a few awards, as the first quadriplegic medical graduate in the state of Queensland, the second in Australia. He also completed a medical clerkship at Harvard Medical School.

Prof Harry McConnell of Griffith University was instrumental in getting Dinesh back on his feet, no pun intended. “He is a passionate believer in inclusivity and has always fought for the rights of those with different abilities. He did a lot of work to facilitate me coming back to medical school. He also helped me a lot with getting my life back together.” Palipana was inspired by Dr Harry Eeman, Australia’s first doctor with tetraplegia, who sustained a severe form of Guillain-Barré syndrome (GBS), a rare neurological disorder that left him paralysed, halfway through medical school. “Dr. Eeman spent time with me to figure out solutions to some of the physical challenges. His experience really laid the foundation for my journey.”

 

Medical school

Palipana adapted new methods to train as a quadriplegic doctor, in partnership with Griffith University and the Gold Coast University Hospital. Quadriplegia can turn everyday activities into obstacles, but he learned his way around them. “Before coming back to medical school I spent a lot of time finding solutions to challenges. I had a great team helping me.” And with persistence, he learned how to hold a stethoscope making use of the natural grip of his fingers. He learned how to examine patients. “I even learned how to insert a cannula with some assistance.”

When asked how inclusive Australian professional culture is, in terms of employment opportunities for the differently-abled, as opposed to a country like Sri Lanka, Palipana admitted that it initially proved difficult to secure an internship in medicine in Australia. Despite two years in clinical training as a medical student at the Gold Coast University Hospital, Palipana had trouble securing an internship. In 2016, he was the only Queensland medical graduate without an employment offer. “I worked really hard in medical school and got good grades. It was very frustrating that non of those things mattered.”

Palipana admitted that medicine is not the most inclusive profession, but said it has improved much in the past five years. Although he explored the possibility of pursuing a medical degree in a Sri Lankan University, Palipana said that most university administrations were reluctant to accommodate him, “Except for Kelaniya University. Other universities have a long way to go in terms of inclusivity.” As a quadriplegic doctor working in Australian, Palipana said that shortcomings of accessibility are not restricted to Sri Lanka. “Accessibility needs a lot of work globally.”

His perseverance paid off. He was eventually employed by the Gold Coast University Hospital as Queensland’s first quadriplegic intern. His disability makes him no less capable as a doctor compared to an able-bodies person. Gold Coast Health, Emergency Medicine Director, Associate Professor David Green, speaking to the Today Show Australia, vouched for Palipana’s ability to pull his weight, albeit on a wheelchair. “In a big, busy emergency with a lot of staff, his value is enormous…After a while you just forget about his disability,” said Green on the Today Show. Dinesh said that the team spirit gets him through. “Besides, there are plenty of patients, I can examine, who do not require me to perform any procedure.”

When asked whether his disability has made him more empathetic towards his patients and whether the accident and subsequent hospitalization made him more able to relate to his patients, Palipana said he remembers what it felt like to be a patient. “It can be disempowering and terrifying. Anchoring myself in my own experiences helps me to remember what it’s like being a patient.” On the other hand Dinesh said that he has never had a patient react negatively to him. “Every single patient has been amazing. I am privileged to be a part of their journey towards recovery.”

Cutting-edge rehabilitation techniques for spinal cord injuries has a major research appeal for Palipana, who is determined to walk again. As Griffith University’s Biospine Project co-lead, Palipana explained that thought-controlled rehabilitation involves translating thought patterns into movement. “For example, if someone’s thinking of walking, we can translate that thought to movement by electrically stimulating the leg.” Promising results suggest that it can re-programme the spinal cord to restore some function in people with paralysis. “Therapies such as thought-controlled rehabilitation, drug therapy and digital twins have separately shown to restore some function in people with chronic paralysis. It is our hope that people like me will be able to stand on their own power again.” His ultimate goal is to come up with a therapy for spinal cord injury.

 

Advocacy

After recuperating at hospital for eight months, Palipana came back to Sri Lanka, where he spent another year, recovering in the company of family and friends. While in Sri Lanka he raised awareness and funds for spinal cord injury victims. In fact, his disability was a catalyst to his advocacy for training medical students with disabilities in Australia. “I’m lucky to be in a position to advocate for people with different abilities,” said Palipana.

Palipana obtained his law degree from the Queensland University of Technology in 2007 and was admitted as a lawyer in 2020. His background in law gave new impetus for his advocacy work on inclusivity in medical profession and education in Australia. “Law is a great tool that can be used to do a lot of good. It allows us to navigate legal and social structures.” His advocacy work with the Australian Medical Association has paved the way for national policies on inclusivity in medical education and employment. He used his story to demonstrate how the community can work with disability, to overturn a set of guidelines issued by the Medical Deans of Australia and New Zealand in 2015, vesting Australian medical schools with the power to exclude students with a range of disabilities. “Another major obstacle faced by students with disabilities was the attitudes of education establishments such as universities and academics.” Palipana said that Griffith University was an exception.

Palipana is also vocal about disability rights in the times of COVID-19. “The COVID-19 pandemic highlighted some of the inequities that differently-abled people face. Everything from healthcare access to employment has been an issue,” said Palipana. When health resources are scarce, some would argue that they are better utilized on those with a higher chance of survival. When governments of the developed world are forced to consider how to ration ventilators between people with disabilities and those without, how has COVID-19 affected those with disabilities?

If one with lungs as compromised as those of Palipana’s, were to contract COVID-19, the prognosis would indeed be bleak. Palipana explained that people with disabilities, depending on the disability, can be at high risk of increased complications due to COVID-19. “Many disabilities affect lung function. My lungs for example, don’t function as well, because of the spinal cord injury. It’s 30 percent of what it should be. If I were to get COVID-19 or even the flu, the chances of an adverse outcome is relatively high. Similarly, people with multiple sclerosis and stroke victims are susceptible,” pointed out Palipana. That should not justify sidelining people with disabilities. Palipana maintained that it is all the more reason to safeguard such vulnerable groups. “Through different forums and organisations, I am fortunate to be able to make a contribution in this important area.”

His message to people with debilitating disabilities and illnesses, who may be contemplating giving up on life is, “As a good friend once said, life is about ups and downs. Whenever there is an up, just know that there will be a down. Things can get challenging, but anyone can overcome them and live their dream, if they have the will. If I can become a doctor and lawyer others can too. Just find your passion and chase it.”

Going from being unable to breathe without the aid of a respirator, to advocating for disabled people and developing medical aid, real life success stories such as that of Robin Cavendish, never cease to inspire. Dinesh Palipana who proved his mettle by doggedly pursuing a career in medicine, while advocating for disability rights is, without a doubt, of that same calibre and hopefully will inspire multitudes more to achieve similarly extraordinary aspirations.

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