A Pediatrician with CP

Dr. John Melville stumbles through life with unsteady, plodding steps. His speech is slow and slightly garbled. His hands are shaky and unsteady. When he was a baby, his parents were told not to expect much from him. His IQ, a doctor warned, probably wouldn't exceed 50, placing him among the moderately retarded. But today, other parents entrust their children's health to him, and patients routinely count on him when their lives are on the line.

Melville, a 27-year-old with cerebral palsy, is a first-year medical resident at Children's Hospital Medical Center of Akron and at Akron General Medical Center. With a wicked sense of humor and sheer determination, he is on his way to beating the odds and joining the estimated 2 percent of physicians nationwide with a disability.

"Don't worry,'' he often says with a chuckle, "it's only brain damage.'' An oversimplification, perhaps, but technically he's right. Cerebral palsy is a condition characterized by poor muscle control, stiffness, paralysis and other neurological problems caused by brain injury during pregnancy, during childbirth or before the age of 5. It is not degenerative, meaning Melville's condition won't get worse. About 60 percent of people with cerebral palsy also have below-normal intelligence.

"Meeting new patients is the hardest because I constantly have to prove I'm a real doctor,'' he said. ``How do you prove you're not drunk when you constantly look like it?'' It doesn't take long, however, for anyone to see there's nothing wrong with Melville's mental skills. Respect and trust, despite his unsteady gait and unusual speech, Melville quickly earns the respect and trust of his patients.

"What brought you to the hospital today?'' Melville asked an anxious parent one recent afternoon while making the rounds of Children's infant-toddler floor. As the mother told him about her 5-month-old son's red, puffy eye, Melville sat in a chair and took notes. He held the pen steady against his knuckles, his middle finger wrapped over it for support. “I aced the bad-writing class in medical school,'' Melville said, laughing.

To conserve energy, he pulls up a chair and sits while he asks patients or their parents questions. Besides, he said, ``evidence says patients like that better. ''When he was in medical school at the University of California at San Diego, Melville figured out grips and different ways to hold his stethoscope and other instruments steady. With practice, he's been able to use the same techniques as other doctors.

"I've found as I've gotten better at physical examinations, I've needed fewer adaptive devices,'' he said. ``It was real difficult at first, but it's getting better. Repetition helps. Being an intern, you get lots of repetition.

During his recent head-to-toe exam of 5-month-old Trent Yarger, Melville made high-pitched siren sounds to get the baby's rapid attention. When Trent's mother, Raejean Yarger of Medina, warned that he often kicks, Melville dismissed her concerns with a joke: "That's where you learn the first rule of pediatricians: Take the shoes off. ''Before leaving the room to check on X-ray results, Melville reassured Trent's mother that the boy probably had an eye infection that would clear up easily with antibiotics. Yarger said she immediately felt confident with Melville, despite his obvious physical impairments. "Trent was comfortable with him, and he's the best judge of character,'' Yarger said. "It was surprising the first time he came in. But he was fun. He seemed very thorough.

Melville, a Southern California native, decided he wanted to be a doctor during elementary school -- after he abandoned his dream of becoming an astronaut. His parents had doubts, but they kept their concerns to themselves. "He always had an amazing confidence,'' said his mother, Candy Melville. "I don't think we ever believed him, and yet we never stopped him from doing it. We encouraged him.

From a young age, it became obvious that Melville wanted to find a career that would allow him to help others. When he was 11, for example, he used his family's computer to write a program for a blind friend whose parents couldn't leave her messages because they didn't have a Braille machine.

The thing I'm most impressed with is he never gives up, said his father, John G. Melville II. "He had tremendous expectations for himself. When you fall down all the time and talk a little funny, some people would want to retreat from that. But he never retreats.

When Melville was growing up, his parents tried not to treat him differently. "There was really nothing special for him, his father said. He has five brothers and sisters and took a lot of grief from them. We certainly didn't baby him in any way.

That non-preferential treatment continued through medical school and his residency. And that's just the way Melville wants it. ``We hold him to the same standards, and he's done a marvelous job rising to the challenge,'' said Dr. Paul J. Lecat, director of the internal medicine and pediatrics residency program at Akron General. ``He's held to the same standards, and he's able to perform the way everyone else does. He's a fabulous resident, whether he's handicapped or not. Whatever the standards, he's a darn good doctor.

Dr. Lynn Drab, a fourth-year internal medicine-pediatrics resident at Akron General who has supervised Melville, said he's inspiring to his fellow residents. "He doesn't want to be treated differently and doesn't allow people to make accommodations for the things he has difficulty with,'' she said. Residency is hard, and people tend to get pretty tired and burned out and feel sorry for themselves. I think John provides kind of a fresh look for people when they're feeling bad about their own life situation. He's very uplifting and energizing.

Future plans

When Melville is done with his residency in three and a half years, he wants to work as a pediatrician and internal medicine physician, most likely in rural Alaska. "For me", he said, "it's an opportunity to make a difference. If you weren't there, there wouldn't be a doctor there."

Part of Melville's success is setting high goals but honestly realizing his limitations. Neurosurgery is out of the question, given his impaired fine-motor skills. And since sticking himself with a needle several times during medical school, he has avoided doing any procedures with sharp objects.

"I believe for every person there is something out there,'' he said. "Something that is a passion. Something that is so invigorating. Something that you can spend your whole life doing it."

"We all have strengths. We all have weaknesses. I think it is essential to find a career you can be excellent at. I believe I could be an excellent med-ped doctor. And I love it.''

--This article was published in the March 7th issue of the Beacon Journal, a newspaper serving Akron and Cleveland.

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