Ten days from now you will have a diploma to frame and a caseload to manage. I know it feels as though you’re finally crossing the finish line, but in actuality you are just getting into position at the starting blocks. A few words of advice before you take off:
1) Remember this: just because your patient cannot speak does not mean he has nothing to say. You will work with many nonverbal patients. Talk to them as though they hear and understand everything you say. Many probably can but have no way of demonstrating their comprehension. Give them the benefit of the doubt.
2) Consider what is important to the patient and her family. I remember early in my career assessing a child, determining that I should start by teaching her the “k” sound, and then drilling that velar pressure consonant with great fervour. When the child’s mother came in for a conference, I had the child recite a list of “k” words: key, kite, kiss. The mother said, ‘Oh, that sounds wonderful! Do you think you could help her say her name?” It had escaped my attention that this child couldn’t say her own name. I don’t know about you, but I say my own name much more often than I say kite.
3) Write every report assuming that the patient or his family will read it at some point. Imagine how your report would sound if an attorney were to read it aloud in a courtroom.
4) Cut yourself some slack. None of your coworkers or patients expect for you to have all the answers on the first day, and you shouldn’t expect yourself to have them, either. Demonstrate that you have the inclination to find the answers, then go look for them. Your initiative is enough.
5) Don’t say or do anything in a closed-door session that you wouldn’t say or do if the patient’s family members were in the room. When I was doing outpatient pediatric work, the mothers of the children sat in on the session about 25% of the time. Sometimes I would notice a mother tense up if I used a stern voice or was especially firm with the child. I would stop and say, “This is just how I talk, and I know you don’t want me to change the way I work just because you’re here,” and then I’d go back to treating. After that brief explanation the mother always seemed to relax, and I can honestly say that it was never an issue.
6) Be kind to the office staff.
7) Be on time. If you’re working in the school, get to the classroom on time. If you’re working with outpatients, be in the lobby on time.
8) Listen first. When you pick up your patient, be it from a teacher if you’re in a school or a nurse if you’re in the hospital, give that teacher/nurse/whomever a moment to tell you her concerns before you start in on your plans or the results of your assessment. Her concern probably generated the referral in the first place. She has a heart for the patient and a good idea about what needs to be done.
9) Take on the patient that your colleagues don’t want. My friend Rachel and I call this patient “the cyclops mermaid.” This is the patient who is so rare and unique that no one wants to take her on for fear of looking incompetent. Take her on and do your best. Pretty soon the cyclops mermaid will be your favorite patient.
10) Put manners on hold. This is a tough sell in the south, but a speech impaired child does not need to worry about saying “please” and “yes ma’am” if he cannot even tell you when he is hungry. Start with words that will motivate the child, like “cookie.” His family can teach him “yes ma’am” later.
11) Don’t use pediatric materials with adults, even if the content is the same.
12) Don’t lose sight of the fact that taking care of your patient is your job. When paperwork is out of hand and there are lots of meetings to attend, it is easy to see the speech therapy session as an inconvenience. Remember that the therapy session is not a hurdle to slow you down when you’re trying to complete your job, it is the job.
KaLeigh and Katie: You have both been delightful and are going to be terrific speech therapists. Happy graduation!
My nine-year-old daughter recently started fixing dinner for the family one night each week. It is an activity I have nicknamed the Dirty-Every-Dish-in-the-Kitchen challenge, and it is fraught with danger. The tips of her hair fall to the exact height of the burners, she needs constant reminders to wash her hands after handling meat, and she holds a knife like the heroine of a Lifetime movie who is seconds from stabbing her abusive husband in self-defense.
The inconveniences and annoyances of having a pediatric chef prepare your dinner are somehow just as foreboding as the health and safety risks. She constantly loses her place in the recipe. She pours/measures/stirs/scoops too vigorously. Her hands are too small to use the can opener properly, her arms too short to reach the timer on the microwave. Everything is slow. Everything is messy. Learning something significant always is.
Knowing how to cook a meal independently is an important life skill. It fosters problem-solving skills, organizational skills, and even a bit of math. Planning a meal with your child is a good way to teach them about the building blocks of nutrition, and in my experience, kids are more adventurous about trying new fruits and vegetables if they had a hand in preparing them. Yes, it is kind of a dangerous and gross activity. Such is life.
I conclude the Dirty-Every-Dish-in-the-Kitchen challenge in much the same way each week. I sit down to supper and I watch my daughter. The soles of my feet are caked with spices and my kitchen looks like a Jackson Pollock painting. I have a meal before me that I probably would not have chosen, a meal I could have prepared in half the time had I not been relegated to sous chef, and I watch my daughter.
She nervously surveys each plate. Each diner. She sheepishly offers little disclaimers, reveals some of her secrets, and makes suggestions on how we can best-enjoy our meal.
“I used some of the Greek seasoning in the salad dressing.”
“If you have a bite of tomato mixed in with the noodles you wont have to taste it so much.”
When she sees everyone eating, everyone enjoying the dinner, even her little brother (who is too young and inconsiderate to feign pleasure with a meal for the sake of being polite), she smiles. I smile. And I dust the cumin off my feet, pull the band-aid out of my casserole, and hope there are lots more dinners in the future just like this one.
photo credit: coverlaydown.com
“It was only after years of playing the banjo and searching for the ‘pure’ roots of old time music that I finally figured out that, like everything else American, it’s utter lack of purity was the source of it’s vitality and mysterious beauty.”
– Rhiannon Giddens of Carolina Chocolate Drops
The Atlanta Botanical Gardens is a lush oasis in the center of downtown and is diametrically opposed to the usual Atlanta concert venue. I had the pleasure of seeing the Carolina Chocolate Drops there last night alongside my faithful show-goin’ buddies, Todd and Michele. The weather was perfect, and the Drops performed with a level of musicianship I have not seen since I-don’t-know-when. There was lots of banjo and fiddle, of course. They also played the bones, the quills, the stand-up base, and even a kazoo. Rhiannon Giddens sang in English, Creole and Scottish Gaelic. She passionately shared with the audience her knowledge of the history of American Music.
The banjo has it’s roots in Africa. The first banjos were made with skins and gourds. African-American musicians taught the banjo to white musicians, and eventually it became a staple in country and blue grass music. Unfortunately, the white musicians who took up traditional banjo were largely minstrels, and they played the instrument in black-face as part of shows that entertained by portraying black people as happy-go-lucky (if musically inclined) fools. At some point in time, we as a country came to see Minstrel’s portrayal of black people as shameful, so we swept this uncomfortable part of our history under the rug, sweeping with it the roots of the banjo and the role of the African-American musician as a pioneer in American music. Giddens concludes, ‘The music should not have been swept under the rug.”
So there I am on this perfect night, accompanied by my two favorite people, listening to this amazing music, and where do my thoughts wander? They wander to Paula Deen. And I’m like, crap, because I don’t want to think about this mess with Deen’s court testimony, the hot “news story” that it is.
I am not passionate about Paula Deen or her job loss one way or the other. Do I think it is gross that she wanted to have an all-black wait staff at a plantation-themed wedding reception as though American slavery had been quaint? I do. Do I think it has anything to do with her ability to get ratings by making a pound cake on television? Probably not. Does it surprise me, a native Georgian, that a person born in the south in the 1940s has used the “N” word at some point as recently as 1987? It doesn’t surprise me in the slightest. As I have said, I have no strong urge to punish her or fight on her behalf, but here is what I think: I think the Food Network hired this woman to be a cartoonish, overly-southern old mama, and then they fired her for being that very character in real life.
Trent Lott also comes to mind as I develop my thesis. Lott, you may recall, was Senate Majority leader about 10 years ago but had to resign after making some controversial remarks. He was speaking at Senator Strom Thurman’s 100th birthday party about how much better our country might have been if only Thurman had won the presidential election back in 1948. (Thurman was a big-time segregationist and fought tooth-and-nail against the Civil Rights Act of 1957. Oh, and when he was 22 years old he had a biracial baby with a black girlfriend.)
The true history of our country is not unlike the history of the banjo. It is not unlike the personal history of Paula Deen, of Trent Lott, of you, of me, or even of ol’ Strom Thurman. There is good and bad, heroism and cowardice, knowledge and ignorance, and they are woven together: an “utter lack of purity,” as Giddens put it. It is the responsibility for each of us (and for us collectively as a country) to do better once we know better, but we sacrifice something significant when our shame leads us to throw the banjo out with the minstrel.
I still have a slide phone. A “dumb” phone. I bought it when I was pregnant with my kindergartener. It is red, has a full QWERTY keyboard, and smells permanently of maple syrup due to an aggressively eaten Waffle House breakfast last Christmas that I wish not to discuss. I hope this description helps to paint a clear picture in your mind. I cannot post an actual picture because, like I said, I still have a slide phone.
My initial resistance to getting a smartphone was born out of laziness. I had just replaced a flip phone with this syrupy little guy when smartphones became popular. I had just learned to text, and I couldn’t be bothered to switch again so soon. Once friends started saying, “Oh, you have to get an iPhone, you just have to get one!” I decided to dig in my heels. It became a sociology experiment of sorts. Watching people’s reactions to my crappy phone is more entertaining than anything up for sale in the App Store. Children say things like, “Hey, my meemaw has that phone!” Friends complain that the text messages I send arrive broken and out of order. When strangers see me texting, when they hear the “beep—beepbeep—beep” that my phone makes as I work the maple-flavored buttons of the keyboard, they smile. It is a subtle smile, the same smile that overtakes you when you see an elderly man use a cloth handkerchief instead of a disposable tissue. The smile that, here in the south, precedes the phrase, “Bless her heart.”
I an getting an iPhone. I ordered it today from a handsome young Verizon salesman who told me that the slide phone I am using is, “the last one still in existence,” and that it is “the same phone that Jesus used.” Just to make up for lost time, I am getting the 64 gigabyte version. The whole room got quiet when I asked for it. Everyone turned and looked at me like on movies when the record scratches and the music stops.
Handsome salesman: “64?! We don’t have that in stock.”
Me: “Can you order it?”
Handsome salesman: “Nobody ever gets that.” (subtext: What is a nice little lady like you going to do with all that storage?)
Me: (after calling Michele to make sure I was making the right decision) “I kind of have a lot of music, close to 30 gigs already. I want room to grow. I will be keeping this phone for a long time.”
Handsome salesman: (looking down at ol’ syrupy) “You’ll be using this phone until 2050. That is probably true. You want it in black or white?”
So there you have it. I am getting an iPhone. I am getting it in black, and I am getting it Thursday. The slide phone will be spending the next 48 hours doing all of his favorite things: draining his battery in three hours, getting recharged, going on long walks down the street in search of a signal, and smelling like breakfast.
Imagine with me the sound of a voice as it cries out for help. The voice is coming from the inside of a bathroom. It belongs to some poor soul who finds himself in the very unfortunate position of being seated upon a commode with need for but no access to toilet paper. Now imagine that that voice belongs to the country of Venezuela.
This is no joke. This is an honest-to-goodness problem I discovered while reading the Business section of “The Week.” Venezuela has a critical shortage of toilet paper. I am ten IQ points and one Economics degree short of understanding the reasons why; something about the late Hugo Chavez and “price controls” he put in place in an effort to make goods accessible to the poor. Venezuela’s scarcity index is presently 21%, which means that one out of every five of the most basic items needed by consumers is missing from stores’ shelves. A world without TP: tell me this would not put an end to political apathy in the US.
When my husband, a forester by trade, is put in the position of justifying his industry’s existence to someone categorically opposed to the cutting down of trees, toilet paper is his go-to for establishing some common ground. Toilet paper is a staple. I think we can all agree on this one. What I find remarkable is the speed at which it became such.
My mother is not even old enough to meet eligibility for Social Security and wont be for 6 more months, and she remembers life before toilet paper. Home without running water. Her family had an outhouse until she was 6 or 7 years old. They were wiping with pages from a Sears catalog back when “Reduce, reuse, recycle” was a way of life, not a bumper sticker.
I didn’t give toilet paper a second thought as a child unless Mr. Wipple was chastising a costumer (that hypocrite), unless I visited a home that used toilet paper that was colored, scented, or covered with a crocheted southern belle cozy, or unless my mother got to talking about her outhouse-using childhood. It sounded so antiquated, but now I have my own children, and they think that running out of the flushable wet wipes constitutes a run-to-the-store-at-midnight type of emergency. “We didn’t even have those wipes when I was a kid,” I explain. They ask me what we used, and when I say, “Regular-old dry toilet paper,” they look at me with pity and bewilderment, like it is the most pedestrian form of personal hygiene they’ve ever contemplated. Like I said, “pages from a catalog.”
I celebrate the 4th of July with the hope that my children will always know such opulence, but there is a kernel of fear that they may not, that we are ill-prepared for a Venezuelan style economic downturn. It has been an intense few months at the Anderson house. We have so much. So much to lose. What do we do? I suggest that we take more time to learn from our past, from our neighboring countries’ mistakes, that we choose our leaders wisely, and just to hedge our bets, maybe pick up a few rolls on the way home.
I hate the pool. I make this confession with the full knowledge that the 4th of July is upon us, that Summer has only begun, that you may end up striking my name from the invitation list to your next poolside cookout, but I really want to get this off my chest.
My children are insatiable when it comes to spending time in the water, and I was the same way as a kid. Marco/polo. Sharks and minnows. Underwater tea parties. I am not sure what happened, but over the course of the last 20 years or so, the idea of painstakingly shaving from toe to hip, encasing my matronly torso with a hand towel’s-worth of Lycra, stepping out into the harsh light of day with pale flesh and spider veins on display, immersing myself in cold, communal water, allowing my hair to become slick and flattened to my scalp, and exposing the dark circles beneath my eyes as tributaries of mascara, concealer and sunscreen join together and form dark rivers that course down my cheeks (think Brandon Lee in “The Crow”) while listening to kids say, “Look at me. Watch this. Watch me. Watch ME! WATCH ME!!!” simply lost it’s appeal.
If raising young children has taught me anything, it is how very different I have become since the time when I was, myself, a young child. It isn’t just the pool. I have done an about-face on many childhood favorites. On staying up late. On cats. Tom Cruise. Bologna. It strikes me at the most unexpected times. I will be walking around Six Flags and find myself admiring the impatiens growing in the hanging baskets, my taste for funnel cake gone, my interest in paying a stranger $5 to guess my weight for a chance to win a plush, Rastafarian banana now nonexistent.
I have decided to start blogging. If you had given me this as an assignment when I was in high school I would have said, “How many words does it have to be?” I would have worked diligently to keep the composition as spare as possible, but the thing about it is, I am not in high school. Not even close. The person I have become really enjoys writing, and a blog seems like a good outlet for this interest. Maybe it will help me connect with a few old friends. I hope what I write will occasionally make someone smile, even if that someone is only my mother. And if nothing else, maybe it will be a good excuse for me to stay home while Todd takes the kids to the pool.