Life of a speechie

Although I sometimes complain about the travel/time/distance/living situation, it's difficult for me to give up my job in Adelaide completely because I really just love it.  In the last couple of months, day rehab has been full, which means I see people twice a week (Tues/Thurs) for 45-60 minute sessions per patient between 9am - 1pm.  You tend to develop a relationship with these people, since you're seeing them fairly regularly.  We often laugh, and there sometimes might be tears (usually not mine!)  Sometimes you get repeat customers (e.g. they've come in for a block of therapy, had some time off, and then returned when their private health insurance says it's okay).  This time around, I've had a couple of patients who were completely new to me, one who I knew from day rehab previously, and one who I had met as an in-patient before Christmas.

One of the new (to me) patients had a stroke a couple of years ago.  He is only in his early 50s and has the best attitude of anyone I have ever met.  He has had pretty steady therapy, and although he hasn't been able to go back to work, he can drive, he volunteers, he has a supportive family and does a lot in the community.  He has aphasia and I think he has probably progressed a fair amount, where his understanding is quite good, he can write short e-mails, and get his point across verbally with pauses and some word finding issues.  We have been working on fairly high level stuff - conversation with background noise, narratives, giving opinions, etc.  A couple of weeks ago we were talking about a new article (about Donald Trump, hahaha) and we went through the content and then I asked him what he thought.  He paused, and his facial expression changed, and he got teary and said "In two years, no one has asked me that".  Kind of a profound moment.  Anyway, this man is just a delight to work with, always smiling and we often have a good laugh.  Recently he has expressed irritation with one of the organizations he volunteers with.  He has shown me e-mail communication where the person writing to him is sending long and rambling e-mails (which are difficult to follow even when you DON'T have aphasia) and he gets kind of lost and frustrated.  Together, we came up with a statement for him to send to the people he is in regular e-mail communication with.  Today I received an e-mail, showing me that he had sent the statement to a list of people in his organization and he had decided on the following:

Dear Fellow Board Members

I had a stroke, which has left me with a condition called Aphasia.

Aphasia affects communication, which can include speaking. I can read, understand, and respond to e-mail.

However, it is best when e-mail communication is short and direct.  Please don't waffle.

Thank you for understanding.

He added in the "please don't waffle" and also bolded and underlined key elements.  I loved it.  I will be sad when we finish up because he is so pleasant!!

Then we have another patient who was also new to me.  This was quite a challenge.  Lack of oxygen to the brain due to a medical even had caused some issues, but they were very very high level.  So, he could have a conversation, scored well in a high level cognitive communication assessment, but was adamant that he needed therapy/help because he wasn't functioning at his previous level.  The occupational therapist and I decided to take him on...and it was a lot of work.  Luckily he has a supportive and very caring partner.  Most of our sessions were spent...almost arguing about what the point of therapy was.  He definitely kept me on my toes, and would often change his mind about what he wanted to target.  There was a lot of...well, waffling!  He would say to the OT "You need to be more direct" and then come to my session right after and say "The OT is very direct"...these sort of contradictory statements were a normal occurrence.  We tried our best, but didn't really feel like we were getting anywhere.  At our last session, we had a very intriguing conversation which ended with me laughing hysterically, and his partner laughing so hard she was crying.  I ended up recommending that they read the book "The Rosie Project" - highly related to our conversation.  Yesterday at work, I found that they had come in and dropped off a letter for me with an invitation to their celebration of life party.  He wrote the letter, and part of it said "You were able to apply your professional training into the bigger picture of my needs.  This puts you into a small group who have actually helped me enormously".  It then went on to talk about the book, and how it had actually answered a lot of questions for him.  Unfortunately, I will not be able to attend their party, but it was beautiful and flattering to get the letter and invitation.

So, two very different patients - personalities/conditions/approaches/situations...but a constantly rewarding career.  So...despite the debt and the living situation and the driving...how can I let that go? 

Also - confirmation was successful, although the actual meeting was a story in itself! :)