May 11, 2018
By Greg Peters
When Bonnie McKee Crume heads to Massachusetts after graduation to start her residency at U.S. News & World Report's No.1-ranked children's hospital, she does so with a heart filled with confidence and the satisfaction of having proven her doubters wrong.
Born with bilateral severe to profound sensorineural hearing loss, Crume has overcome her physical disability, moments of self-doubt and the nagging words of naysayers to finish tied for the top spot in her class with a 4.0 GPA and then landing a prestigious pediatrics residency at Boston Children's Hospital.
"Reflecting back on my time in medical school, I always think to myself, 'what was I thinking, and how did I manage to get through that? I must be pretty crazy,'" she said. "I guess the benefit of being born with hearing loss is that I have had no choice but to adapt to it. I know my own limitations and would never put myself in a situation where I thought I would harm others."
Crume was born and raised in Abilene, Kansas, and is a proud Abilene High School Cowboy. She and her brother both have the same hearing loss condition, so they took part in several research studies while growing up to determine a cause. Unfortunately, each study lost its funding, so they were left with no answers. They have a sister who did not inherit the trait and has no hearing loss.
After high school, Crume earned a Bachelor of Science in biology from Washburn University. Then it was on to the KU School of Medicine. And while the rigors of four years of intense study in medical school can be daunting on their own, Crume had her own special set of challenges to get past, not the least of which was doubt.
"Trying to figure out where I belonged was absolutely the most difficult for me," she said. "Sure, the coursework can be tough and can get to you, but adding a personal obstacle that no one else around you can relate to was soul crushing. I distinctly remember a time between my first and second years of medical school where I spent every day in tears. I felt so all alone and isolated because there was no one who quite understood what I was going through.
"There was plenty of trial and error as we figured out accommodations, and although the faculty and staff at KU were supportive, I couldn't help but question if I really belonged here because I was trying so hard to fit in."
Perhaps the greatest challenges would come in rotations such as surgery and obstetrics, where Crume had to work in the operating room, a place where decisions are made quickly, being able to communicate imperative and masks cover everyone's face, making lip-reading impossible. To help accommodate Crume, the University of Kansas Medical Center and The University of Kansas Health System were able to cobble together a computer-based communication system based on a similar setup at another institution. Cyn Ukoko, senior coordinator for academic accommodations, spent the better part of a year working out the details. The system allowed what was being said in the operating room to be transcribed in real time onto a computer monitor so Crume could converse with her colleagues.
"We called it 'the rig,'" she said. "KU put together an awesome team to assemble this machine, and Dr. Peter DiPasco (director of the Surgery Medical Student Clerkship) let us test it out in his operating room before starting the actual rotation, so that things would flow smoothly when it was time to start. It wasn't perfect by any means, but it was incredibly cool."
Basically the rig required the surgeon, resident and scrub tech to wear wireless microphones under their surgical masks. The mics were connected via a sound mixer to a PC, and their voice data were sent to transcribers via a secured connection on Adobe Connect. The transcribers would type the speech into a network where it would be displayed on a desktop monitor in the operating room. Each speaker's voice was transcribed in a different color on the computer screen in the operating room, so Crume could tell who was talking.
"It was awesome, but any sort of technical disruption would throw a wrench into it," she said. "And there's a natural delay since things are happening in real time, so my answers would be off. Focusing on the surgical field in front of me and trying to read the captioning was challenging."
Crume notes that since her surgical clerkship, clear masks with lip-reading capabilities have returned to the marketplace. "It would have made my surgical and OB/GYN clerkships a million times easier. But it's the challenges that make you stronger. Plus, I wouldn't have gotten to know the team and masterminds behind the rig."
Crume says she would have laughed if someone had suggested before she started medical school that pediatrics would be her calling. But, as she explains, taking care of kids is a rewarding field that is filled with many of the challenges she is looking for in her career, including constant opportunities for education, plus working with pathology and physiology. As a pediatrician, she will be caring for patients from birth to early adulthood, so she'll be able to see everything from common illnesses to complex medical cases.
"One thing that really topped it off for me is that my personality fit best with the pediatricians I had the opportunity to work with," Crume said. "I look forward to going to work every day because of my colleagues."
In addition to the rig, Crume says simple awareness by faculty and peers was perhaps the most instrumental accommodation to her success in medical school. She believes courtesies such as having only one person talk at a time when working in groups, repeating questions from the audience during lectures, and engaging in eye contact among speakers and listeners, can be beneficial for everyone.
While accommodations might have played a role in her success, it was Crume's own grit and determination that got her through the challenges of medical school and landed her a residency in the field of her choice at an esteemed hospital.
"The most rewarding aspect is the results," Crume says of her time at KU Medical Center. "Hard work truly does pay off, and now I can continue my dream without limitations. I have the privilege of taking care of kids, and there is no better reward."