EDI Spotlight: Madhav Swaminathan, MD


The human brain works in different ways for each of us. But Madhav Swaminathan, MD, professor of anesthesiology, says that shouldn’t be a reason for anyone to feel excluded. Witnessing his autistic adult son thrive as an office assistant at the Duke Center for Autism and Brain Development has been the motivation behind Swaminathan’s push to create welcoming, inclusive spaces for neurodiverse individuals at Duke.

In this month’s EDI Spotlight, Swaminathan shares how he became involved with a group focused on increasing inclusion of neurodiversity, a disability that he says is often hidden yet deserves more attention in EDI work. He also tells us about a group he founded for fathers with autistic children and shares his joy of baking and painting.

You currently are part of a group called the Duke Neurodiversity Initiative Working Group that collaborates to develop initiatives and practices to increase inclusion of neurodiversity at Duke University and beyond. What exactly does neurodiversity mean? How did this group come about?

Neurodiversity to me means acknowledging that the human brain works in different ways, which can be seen in the diverse ways in which we all interpret or process information and communicate with each other. It is about being respectful and accommodating of these differences.

The group was formed out of a shared interest in promoting inclusivity of neurodiverse individuals in the Duke community. I have an autistic adult son and have seen how he has thrived in an inclusive environment as an office assistant at the Duke Center for Autism. A couple of years ago, Dr. Geraldine Dawson, then director of the center, and I discussed increasing the awareness of neurodiversity in the health system, acknowledging that there was a lack of awareness within the EDI sphere of activities. Dr. Dawson informed me that Dr. Tara Chandrasekhar was already working on Neurodiversity Connections at the student level and would be a perfect ally in this initiative. We then gathered a small group of interested individuals across the university, including human resources, faculty advancement, the Office for Institutional Equity (OIE), and ADA office to brainstorm ways in which we could make all of Duke an inclusive space for neurodiverse individuals.

What are some of the major Duke Health neurodiversity initiatives that you all have worked on as a group?

We conducted neurodiversity training for the EDI team at Duke Raleigh Hospital and are currently engaging in dialogue regarding future trainings. We updated the Duke Center for Autism on-boarding manual to include information about the center’s core values related to neurodiversity. We have also liaised with the Continuing Professional Development office to develop training modules for nurses to recognize the unique ways in which autistic patients may communicate their health care needs.

Why is neurodiversity a key aspect of equity, diversity, and inclusion (EDI) work?

Neurodiversity is a less recognized aspect of EDI work, given that it is often a hidden disability. Most EDI work focuses on the readily visible forms of diversity such as sex, age, race, etc. The hidden disabilities are then at risk of lagging behind in the attention they deserve. Neurodiverse individuals often feel excluded from their communities, and are at high risk of anxiety, depression, and suicide. They are also underemployed despite having skills that may be valuable to an organization. We need to recognize the inherent value of neurodiverse individuals and make our community inclusive.

How did you first become interested in doing work related to inclusion and neurodiversity?

I became first interested in this work when my son started part-time work in college. He worked at a grocery store and at a pharmacy helping stock shelves. He loved the work and the people who he worked with. He also had a job that he did not like where people were not inclusive. When he worked at the Duke Center for Autism, my wife and I realized what a blessing it was for him to be surrounded by people who were inclusive of neurodiversity. He thrived in his work and became more self-confident and happier. It made me realize that the Duke Center for Autism was a model of a workplace that was neurodiverse inclusive and that should be extended to all of Duke, given the high prevalence of neurodiversity.

I now run the Duke Autism Dads (DADs) group. I started it in 2017 in response to requests for help from fathers across the university whose lives have been impacted by autism. We gather each month as a group.

How does this work connect to your current position within the Department of Anesthesiology?

As vice chair for faculty in Duke Anesthesiology, I work with the EDI leaders in the department to raise awareness of neurodiversity initiatives in the institution. The work of the neurodiversity initiative group is in its early stages and as the activities grow, it will include more areas of the health system and School of Medicine.

Recently you were appointed by the North Carolina Governor to the North Carolina Council on Developmental Disabilities. What do you hope to accomplish as a member of the council?

I hope to engage with the other council members to influence policy that impacts services for individuals with developmental disabilities, especially autism. I also plan to advocate for greater state and federal funding for services that help neurodiverse individuals integrate with their communities. As the number of adults with intellectual disabilities increases in our state, there is a great need to support them throughout their lifespan. This will require commitment from not just individuals within communities, but also policy makers and funding agencies. I would like to advocate for increased education and training of employers on the value of employing neurodiverse individuals.

What passions or hobbies do you have outside of work?

I am an avid baker and I enjoy painting. I dabble in oil on canvas and mixed media art.