Located in a private office wing of the University of Miami Hospital, the practice of Jane Asprinio O'Brien, AuD, CCC-A, FAAA, draws a cultural mix. The local area of Miami-Dade, Broward and Monroe counties offers a rich social, educational and religious diversity, and the hospital regularly draws patients seeking quality care from the Caribbean, Latin America and Europe.

Dr. O'Brien shares office space with a cardiologist as well as a bilingual support staff of four, with roots in Cuba, Nicaragua and Colombia. The staff regularly helps with Spanish translation. And when the occasional need for Creole interpretation arises, fluent speakers from nearby offices pitch in to help.

The audiologist appreciates the mixed medley in her waiting room and the opportunity to help them all with their individual hearing and balance needs.

"The cultural diversity of these patients extends to their idea of what promotes well-being. Some cultures are more concerned with aesthetic appearance, while others are concerned with price," says Dr. O'Brien.

"However, along the way I learned that a smile and an expression of genuine interest in the person are sought after by all people, regardless of what part of the globe they reside in."

Another sought-after quality Dr. O'Brien offers is understanding. When she was just 3 years old, she and two of her brothers experienced severe hearing loss and vestibular dysfunction after taking an antibiotic that was later pulled from the market. Dr. O'Brien has worn hearing aids ever since.

Life Isn't Fair

The audiologist considers her mother and father heroes.

"Due to the nonstop efforts of my parents to seek advice from a multitude of people regarding the best ways to help us, what should have been a mountain to climb became speed bumps along life's journey," she explains. "We obtained hearing aids quickly and were enrolled in speech therapy and speech reading classes. Additionally, we took ice skating, ballet and played baseball to work on improving our balance function."

Eventually, vis­ual impairment was discovered in two younger siblings, and Dr. O'Brien's mother gave up her career as a nurse to

take her five children to various appointments, which the family referred to as "activities."

"It was not until first grade that I realized other families didn't have multiple people with hearing aids," says Dr. O'Brien. "My parents never let us think that we were disabled, and they made sure that we always knew that there were others worse off than us in life."

Still, the struggles of living with hearing impairment in a verbal world took a toll. A regular game of whisper-down-the-lane at school often resulted in the young girl misinterpreting the line and passing an incorrect phrase to the child next to her. Humiliation and embarrassment followed.

At a camp for children with hearing impairments, Dr. O'Brien recalls sharing her tender pain with staff audiologist Enid Lofchie. In return, the youngster received comfort, guidance and inspiration.

"She gave me a huge hug and told me she learned long ago that life was not meant to be fair. Different struggles for different people. The secret was to use the tools God gave you to become the best "you" possible-forget what you can't do and concentrate on what you can do," remembers Dr. O'Brien. "She even told me that many years before, her superiors had told her that she wouldn't be successful at her job as she was too hearing impaired."

Dr. O'Brien later decided to become an audiologist herself.

"My experiences as a woman who is hearing impaired shape my view of the world," she says. "There is no denying that, so what I decided to do is put those experiences to good use."

Irresistible Opportunity

In high school and college, the future audiologist worked as a medical assistant for her physician father who owned a private practice. The opportunity afforded her a close-up view of the necessary balance of clinical, business and managerial skills required for success. Understanding insurance, budget and personnel issues would be as essential as quality clinical care.

Good bedside manner, however, was just as important and demonstrated repeatedly in her father's interactions with patients.

"Dad always reached out to his patients, inquiring first about their lives, their loved ones, getting to know the world they lived in," says Dr. O'Brien, who adopted his greeting-first, malady-second mannerism. "Everyone counts in life."

Dr. O'Brien graduated from the University of Rhode Island with a master's degree in audiology in 1985. A position working in a local private practice owned by an ENT captured her professional interest with its exposure to a multitude of diseases and syndromes, but the rapid pace of the office failed to measure up to her patient-first philosophy. She next took a job as a hearing conservation audiologist at a nuclear submarine manufacturing plant, also in Rhode Island. Although the work was enjoyable and rewarding, a year later at an audiology convention she found herself presented with an opportunity she couldn't resist.

"While I was attending the conference, my husband Ed was scrutinizing the job listings in the career center and told me he found the perfect job for me: an audiologist was needed to develop a hearing center in Florida," says Dr. O'Brien. "I told my husband that I didn't know I was looking for a job, much less looking in Florida. But when he told me he had signed me up for an interview slot the following morning, I had no choice but to show up."

Dr. O'Brien learned that Cedars Medical Center, Miami, was looking for an audiologist to structure a new practice being built as a tribute to a pioneer ENT physician who had died from cancer. Thrilled with the opportunity, she conveyed her interest and, after an onsite interview several months later, was offered the job.

"Twenty-two years later and Ed and I are still here in Miami," she says. "Sure, some things have changed along the way. The position became one of medical staff member instead of hospital employee, the office space moved to the private office wing, and I obtained my doctorate degree."

Medical Staff Status

A little more than a year ago, Cedars Medical Center was purchased by the University of Miami Hospital and underwent a name change. Dr. O'Brien's status as a medical staff member means that, in addition to her private practice, she is now on-call for consults whenever the hospitalneeds her services.

"Response for in-patient consultations is done in a timely manner as per hospital rules and regulations. I respond to the page and assess the situation as to what testing will be performed, although all conscientious folks usually go and see the patient the same day, unless it is late at night," she says.

Dr. O'Brien either transports her practice's equipment to the hospital, or the patient, if ambulatory and not contagious, comes to her office. After testing is complete, she collaborates with other medical staff on the case as to appropriate treatment. Rather than receive compensation from the hospital, as she did while an employee, she bills the patient's insurance directly. In cases where patients have no insurance (not uncommon in an inner-city hospital), she usually receives no pay but is able to deduct a portion from corporate taxes for "indigent care."

As a member of the medical staff, Dr. O'Brien is evaluated by the medical credentialing committee and approved by the medical executive committee every other year to determine continued eligibility for medical staff status. Dr. O'Brien also participates on the bioethics board of the hospital.

She also has the opportunity to make a difference when the consequences are dire.

"Several times I have been called to ICU to help a dying person with their hearing aid-not someone I know or sold the aid to, but someone who is gravely ill and wants to hear the doctor or their family. This I consider a necessary thing," she says. "If I was lying in a bed and my hearing aids were not functioning, I would be panicked. If I can bring a bit of comfort to these patients and their families, I am honored to do so."

Humanitarian Heart

Eight years ago, Dr. O'Brien accepted an invitation from an otolaryngologist to participate in a humanitarian medical mission at a physician-established clinic on the Dominican Republic-Haiti border. Patients often walked days to receive treatment. However, services for residents with hearing impairment were nonexistent, save a local woman who daily hosted deaf children and young adults on an outside patio and attempted to teach them sign language without the use of visual aids or printed materials.

It was then that Dr. O'Brien made it her mission to help the clinic. Monetary donations received from family, friends, patients, fellow colleagues and anonymous donors are used to supplement the assistance received from the Starkey Hearing Foundation, Westone Labs and Godisa USA. Dr. O'Brien now travels to the Dominican Republic several times a year to provide audiologic care. When electricity is available, she conducts formal testing using a portable audiometer and tympanometer.

An audiologist who read about Dr. O'Brien's work there recently donated a diagnostic audiometer to the cause. "Her goodness has led to an immense improvement in the quality of the testing," says Dr. O'Brien. In addition to the audiologic care, monthly care packages are sent to the region containing clothes, hygienic supplies, toys, and other items in an attempt to ease their impoverished lives as much as possible.

"I want to let others know that no matter the conditions they live in, other more fortunate folks still care about them," she says.

Today, there is little doubt in Dr. O'Brien's mind that she is indeed one of the fortunate. Able to mold life's challenges into personal strengths, she and her siblings (an orthopedic trauma surgeon, a mechanical engineer and two attorneys) have successfully overcome potential limitations.

"As Ms. Lofchie would have said," muses Dr. O'Brien, "I am using the tools God gave me to become the best possible me: an audiologist on a quest to assist mankind."

Jolynn Tumolo is a freelance writer in Morgantown, PA.