A Speech Evaluation as Experienced from the Other Side of My Desk

aphasia1

We wait in the lobby for about 10 minutes, my son, his wife and I. “David.” His name is “David.” I can’t consistently recall his name, but I always know who he is, that he is my son, and that I love him. Hopefully he knows that. His wife – I cannot for the life of me remember her name. Anyway, David, his wife and I wait in the lobby, and then a woman walks in. She has on a name badge, and I know, even before we make eye contact, that she is here for me.

“Mrs. Stewart?” she says in a voice that is too cheerful to be used in a hospital.

“Morning,” I answer.

The woman starts talking. Loudly. Quickly. Or maybe she isn’t so loud. Maybe it is the stroke – the way it has changed the way I perceive things. Everyone talks so fast now. That is how I hear it. And I can’t understand but every few words. I catch a phrase here and there, but I miss a lot. It is like a phone call when the reception is bad. I watch everyone’s face trying to determine what they expect me to say or do. It has been this way for two weeks. Ever since the stroke.

The woman says “Good morning.” She shakes hands with me and with David. Nods to David’s wife. She says her name is, “Ginger.” I think instantly of our old dog, Ginger; the pet we had when David and Susan were young. Ginger. A Yorkie, she was. Grateful for the association, I tell myself to think of that dog whenever I see this loud woman. Then I’ll know what to call her.

Ginger says something to me. Something about coffee. What is she saying about coffee? Her voice goes up in pitch at the end, “something something coffee?,” so I know it is a question. I’m sure of it. “something something coffee?” Do I like coffee? Is that what she wants to know? Have I been drinking coffee? Did I want a cup of coffee? That’s it. She is gesturing to the coffee pot. She is offering me coffee. I shake my head to answer.

David and his wife stay in the lobby. Ginger leads me down a hall and to a room. Ginger, I think to myself as we enter the room. Ginger, like our little Yorkie. Good ol’ Ginger. The room is an office. Her office. It is cold. There are books and papers everywhere. A computer. Photos of kids on the wall. Ginger’s kids, I’m sure.

Ginger says something about speech therapy. Her name badge says “Speech Therapist,” and then I remember why I am here. Why David insisted on bringing me back to this hospital.

I just got out of this very hospital a few days ago. I don’t want to be here now or ever. I hate it. David promises that I won’t have to stay the night. I don’t want to stay here one second! I just hate it here. And I mean no offense to Ginger. I’m sure she means well, and I’ll play along. I don’t have the words to protest, and even if I did, I don’t have the freedom to change it. Or drive. Or go back to my own home. Or even go to the bathroom in peace without David or his wife (what is her name?) hovering outside the door. “You okay, mama? You need any help? I’m right outside the door if you need a hand.”

Ginger starts talking. Her office door is closed, and it makes her voice even louder than it had been in the lobby. She says, “something something speech something something hospital something something stroke something something to help you something something whenever you need to…

I watch Ginger and try to listen. Try to understand. When she pauses, I nod. That is what I do. I nod or shake my head. Usually I nod. That seems to satisfy most people who talk to me. People like for me to agree with whatever it is they say.

Ginger gets a notebook and a pen. She tries to ask me a question about my speech.

“What is hard?” she asks. It is a short question, and I understand it. I struggle to answer, and my struggle is answer enough.

“Uh, um (sigh), well, well…okay. Well, whike, no, not whike. Whike. LIKE. Wow. It’s like, um, um, crock. No. Crock. Crock! Not crock. I can’t say crock.”

I can’t say it. Can’t tell her what is hard. I can think it, though. I think this: It is like when I talk, the words get stuck or come out wrong. I try to tell her, but like comes out as whike, and talk comes out as crock. I can hear the moment I say the word that it is wrong, but I cannot seem to figure out why or how to correct my mistake. It is so incredibly frustrating. I can’t go on or I will cry, and what will happen if I cry in front of this loud woman, this speech therapist with a dog’s name? If I cry, will I have to stay in the hospital longer?

The speech therapist begins speaking more slowly and in shorter sentences. It is both helpful and humiliating.

“What is my name? Do you remember?” she asks. She covers her name badge with her hand and smiles playfully.

“Dog, no. Dog! Not dog. Dah- no, d-… (sigh) Whike uh dog.” An obscenity escapes my lips, and I reflexively gasp and clasp my hands to my mouth.

“Oh, I am so sorry!”

“It’s okay.” She says.

“Wow. I’m sorry. Ginger. It’s Ginger. I am so sorry.”

“You got it! It’s ‘Ginger.’ Good job! Don’t be sorry, Mrs. Stewart, you’re fine.”

It is not fine. I have never used foul language in all my life. Now I use it everyday. Not on purpose. It just slips out, and I don’t know why. I am scared to go to church. What if I swear right there in the Lord’s house? What if everyone hears me?

And Ginger thinks I’m slow now for sure. Thinks I’m simple. Or crazy. I want to tell her how I had a Yorkie years ago. A dog with her name. I can’t explain it. I don’t try.

Ginger gets this book and has me tell her what the pictures are. It takes forever. The harder I try, the worse I seem to do.

What is that? I know what that is. Like a horse, but magic. Has that thing on it’s head. I want to say Capricorn, but that doesn’t seem right.

“Capricorn?”

“You’re on the right track,” Ginger says. “It starts with a U.”

“Unicorn!”

We do this for what seems like hours. I don’t know if I will call it an escalator or an elevator, an excavator. I say “eskavesker,” which is nonsense.

Ginger asks me something about weak. “Days something weak?

Do I feel weak? Is that what she is asking? How many days have I felt weak? I have been weak since the stroke, which was two weeks ago. Two weeks equals fourteen days. I decide to tell her I have been weak for fourteen days. But when I try to tell her fourteen, it comes out as porking.

“Porking,” I answer. “No. No. Not porking. PORKing. Poor KING! No. No. I’m sorry.”

Days something weak,” Ginger repeats. She says, “Sunday, Monday…” and she circles her hand. Days of the WEEK! And I try to say them, but they are a jumble. Ginger and I say them in unison. That helps. I wish I could tell Ginger about my background. That I taught Kindergarten for thirty years. That I taught the days of the week, the months of the year, every Fall for three decades. I can see my old classroom, I can see the over-sized teaching calender, snowmen and valentines, but I can’t say the days of the week without help.

“It’s okay,” Ginger says. And each time she says fine, good, okay, I know it isn’t. The tears finally come. Ginger gives me a tissue. She takes my hand and squeezes it, and she looks into my eyes and says something. “something something everyday. A little better everyday.”

It’s over. Ginger finally gets up and motions toward the door. I walk to the lobby. I see David, his wife, and then her name comes to me! It’s “Gail.” It is the first time in two weeks I have remembered it. Gail, who came to the hospital everyday. Gail, who took me into her home after I was discharged from the hospital. Gail, who is the mother of my grandchildren. I love her, and I remember her name, and I say it aloud when I see her. I say, “Ready, Gail?”

Gail walks over to me and rubs my back a couple of times while David sets up a follow up appointment so that I can come back and work with Ginger, my Yorkie speech therapist, three times next week. He takes me by the arm, and together we walk to the car. We go home. Their home, not mine. But I am out of the hospital. And I will get a little better everyday.

aphasia2

Tips for Talking to People with Aphasia

Written for: Weekly Writing Challenge: Leave Your Shoes at the Door

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35 Comments on “A Speech Evaluation as Experienced from the Other Side of My Desk

      • I read this post yesterday and I was left blank, I had no words to say. It’s beautifully written and very heart warming. I saw Laura’s video too and she is awesome and funny and… well awesome! I got some plumbing issues after reading the post πŸ™‚
        This was amazing! πŸ™‚

      • Aw, thank you! I love that it gave you plumbing issues – is that wrong of me? πŸ™‚ People really do amaze you with how they improve. The human brain is remarkably good at healing. And Laura…just hilarious. Her video (which was put on Upworthy!) will do so much to educate others about aphasia.

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  2. This post reminded me of a friend who had a stroke in his early twenties. His speech was muddled, and I remember the frustration on his face. He was dismissed and judged by many. Thanks for highlighting what aphasia must be like. More people needs to know that it doesn’t have anything to do with intelligence.
    PS. I think the work you do must be very hard and draining. It was an interesting glimpse into speech therapy.

    • Thanks for the comment. Your 20s must be a rough time to have a stroke, but young people recover better. I hope your friend is doing well. Not everyone is as severe as the patient I invented for this story. Some are quite mild. Anyway, it is a neat job. I’m blessed to do it.

    • Please, I want you to link related pieces. Feel free to do that anytime we have brain-shared. And thank you for supporting my assertion that “Ginger” is a name for a pet. Or a stripper.

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  4. This post makes me miss my mom who died three years ago. She had a stroke when she was 49 and suffered from aphasia (and right side paralysis) for the rest of her life. It often wasn’t too bad except when she was really tired. She shared with me her reminiscences of her experience of having had a stroke…it was really powerful. She always said that the words were in her brain but somehow got lost on the way to her mouth. How frustrating it was for her. Thanks for this post.

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  8. When I was really little, I fell into a coma and woke up with a very temporary bout of aphasia. This post hit home, as I still remember how harrowing an experience it was. I felt like you gave the memory and sounds in my head a voice, and for that… I am thankful. Thank you also for participating in this week’s challenge! πŸ™‚

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  10. Wow, I really enjoyed this post! I’m a first year SLP student, and getting this perspective was really interesting. Sure, we can learn all about aphasia on paper, but seeing and considering the person with it, is something else entirely. I hope that I’ll be able to put myself in my future clients’ shoes as you have, some day. Thanks for this!

  11. Beautifully written. Since I was an audiologist in a previous life, I really get this. Years ago I had a patient who had had a stroke and when I asked him to say the word “baseball”, all he could say was “stands.” Each time he repeated that word, his wife would smile and nod. “He really loves baseball!” she said. Since he was so consistent with that, I gave him credit in my evaluation because I assumed that he meant that you watched baseball from the stands. Imagine my surprise to learn that his son played professional ball…and was named “Stan”!! Sometimes the “confusion” isn’t all on their side of the desk!

  12. One of the best articles about aphasia I have read in a long time. As a CF SLP, it is a great reminder to not just consider the plan of treatment and the activities related to that plan, but more importantly, to consider the patient’s perspective currently and in comparison to their prior functioning (as you so clearly and beautifully wrote). Thank you for reminding me and guiding my thinking to such a wonderful thought process!

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