There's not enough room

A local healthcare system, the flagship of which is a tertiary care hospital that trains physicians, ancillary healthcare clinicians and biomedical basic scientists, is running a television commercial. Of course, the patient featured in the commercial has had a terrific outcome. She's training to be a trapeeze artist; can you believe it!? And it's her surviving a massive brain tumor that makes the TV promotion memorable. Brain tumors are so scary. I got my first exposure to the mystery and the horror of brain tumors when I watched as a kid, the series "Ben Casey". It was a sterile portrayal of hospital life - no disinfect stink, not much of the clamor of carts, and doc's, of course, don't show the pressure of time on their faces. Miracles, of course, were achieved, in less than 60 minutes each week. That's productivity.

The pressure of time is always there, once you find out there is a brain tumor in your head. The tumor victim might be heard saying: I wasn't born with it, was I? I didn't know it was there until my eyesight started to glitch up, or I found myself losing my train of thought, or - that I vomited all over my prom tuxedo, when I was picking up my date! Why couldn't I have known about this earlier? My head hurts almost all the time now. Is it growing? I'm afraid! I'm afraid it will get so big that I won't know, I won't know what is happening. Please get it out. Take it out, please. PLEASE!!

When there's something found inside you, something that threatens to take over your control of your body, mind and your spirit. panicking is natural. It's natural to want autonomy over ourselves. Pro athletes asserted autonomy, thereby declining vaccines during the COVID pandemic. Everyone who advocates for reproductive health, including the right to abortion services, feel they need to be in control of their bodies as well. Vegans, members of religious sects, owners of semiautomatic weapons, proud owners of old Samsung Galaxy phones and brave Cybertruck owners - they all want to survive and be left alone. Can't the person who finds out there is an invading mass inside her head - isn't she deserving of that same kind of control? Doesn't she deserve to be free of the threats to her identity?

I hope everyone everywhere, who is living or even just discovering that there is a rogue element inside their heads, can find calm and hope that we in the CSD community want their identities to be kept whole. Given that all our identities evolve with development and experience, we'd still want amy person living with a brain tumor to draw on their powers for self - care, the resources of the medical community that are available to them, and the nurturing and uplifting support circles who help every tumor victim tap their deep history, for growing a post - tumor future.

I just couldn't resist. I've been fuming for decades that with all the promotions, all the campaigns and all the zeal of our mentors and leaders in the fields of communicative sciences and disorders (CSD), we're still a poorly understood group. Even with our getting a foot in the door with our National Speech - Language - Hearing Month: where is the speech - language pathologist (SLP) on "America's Got Talent"? Do an audiologist and an SLP capture the Kiss Cam at Yankee Stadium? And if you get caught spreading a rope of ketchup on a Vienna Beef hot dog, are you punished for your Chicago meat heresy, or because you're an SLP making a diet recommendation?

I thought there had to be a more concise, powerful and memorable method to "sell" our fields to celebrated men and women on the street. i found these public relations tools I had craved, in actual slogans and posters from wartime propaganda. You notice that some posters ask you to do your part in the fight.

For those who felt they had to do something for the war effort, but didn't have the constitution to go into battle, there were posters and slogans to motivate those at the homefront.

Then there's the allure of what you look forward to again, after the fighting is over.

Are there lessons for my peers in CSD, from the punchy presentation of wartime propaganda? Let's see if an SLP or an audiologist can be captured.

For example, the Sherlock poster might read beneath: "Have you lost your voice? Call SPEECH THERAPY, so people in your world can hear you again!" What other messages do you hear, seeing this gumshoe? Here's another idea for a CSD hard sell - "You talkin' to me? Yes, I hear you now. Let me take you where you wanna go!" Are there any better slogans for this one?

A third persona for the CSD professional; not cabbie, and not private eye, but - a COACH. What does a coach do? "You've almost got it. Let's try again - take a deep breath and shoot for the goal!" Is there still another great slogan to give the coach?

Let's have a caption contest! What do the SLP or Audiologist do as a coach, taxi driver or detective??

I miss my wife.

I miss my wife terribly. When the cancer and all the contiguous complications finally took her - 10 months ago now - I had to and have to think about the emotions that have pulled at me. I can only say what I felt, and describe what I saw, and recollect what I heard. The Pope died today. I guess the mood of his passing 'triggered' the mood that grew from my wife's escaping pain. As a rehab professional, it's been a very profound lesson, processing what has happened.

She had worked for a hospice agency, and so when we found that the chemotherapy was yielding utterly diminished returns, her family and I agreed that she deserved compassionate support for her transition. Still, the frantic voices in my head - the 'squadron of simpletons' making up my brain - kept saying, CAN'T WE DO SOMETHING?!?! Hospice's philosophy helps us see, that death is unmistakably part of life. I became the kid on the news report who told the correspondent interviewing me after my home was destroyed, that I can't make this about me. I sat with her on her last Earthly night, and told her - do what feels right for you. She had speculated when her mother lived with us, and a hospice nurse was on duty....that my wife's Dad, gone a few years prior, had appeared and beckoned to his wife, "Come on! The coast is clear!". Ah, the circle of life. Two dissonant notes in a jazz chord, that mirror the bittersweetness of our life here.

Phlegm, ahem?

I had an ice cream treat today, but when I finished the fantastic cone of cool; - My spring exulting for the warmer clime Became a gaggy cry: some phlegm, ahem??... The hemming hawing hocking brought no Respite, fulla gooey bubbles was my windpipe, So do I damn that chocolate bit of heaven Because its lava now plugs up this hole?.... You know: there's not a spot, a spit, of data Showing that milky foods do clog you up, Such sticky sludge is what you feel, but really - It's being coated, not a blockage, nay! So if your Rocky Road makes a mudslide A sip of hot will help make debris glide!

N'awlins rhapsody

O when the gun Is in your face O when the gun is in your face Do you think, Does this guy have a good job? Help your neighbor pull that gun from your face!

O when the school Sounds like a war O when the school sounds like a war Do you wonder, Why'd this woman feel so lonely? Help your sister walk away from the school!

O when that truck Flies toward your group O when that truck flies toward your group Did that driver feel secure, loved and nurtured? Reach out - you are best as your brother's keeper!

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Normalcy

I am attempting in these short little publications to show how human communication, thinking and swallowing should be your everyday concern - because you need them everyday. That means, eternal vigilance? Nothing that martial, white - hot or confrontational an approach is necessary. It's more an application of wide - angle mindfulness, allowing you a feel for getting up and doing what needs to be done (obscure public radio variety show reference).

Today, let's think about our swallowing, and how the outside world might impact your access to good nutrition. We should also think about the ease with which most of us can live placid everyday lives - because of what happens behind the scenes. I learned to appreciate this duality of existence while a hospital speech- language pathologist. Our new hospital featured a public corridor for patients and visitors, while an additional corridor was solely for staff. We were told at orientation, "It's like what they do at Disneyland".

Refer to my blog entry "Swallowing at the Crossroads", originally posted on the site "Pretty Wonderful, Communication", January 3, 2021: https://www.blogger.com/blog/post/edit/preview/326362698481900690/5502036516408368858 for more details on a wide - angle mindfulness for swallowing. On this day in 1997, Hong Kong chose to euthanize a large percentage of the poultry in its markets, after the microorganism found in an ill child's bloodstream had signs of bird flu. It was the initial sign that avian flu, termed H5N1 flu, has "jumped" from birds to humans without an intermediate use of a pig as a host. Destroying the potential hosts of the virus was the alternative to putting diseased fowl into the food system.

If you haven't any idea about what is needed to euthanize a large number of chickens, take a look inside a confinement building for chickens: feathers, feces, urine, ammonia, dust, rotting feed, and all the additional pathogens that might breed in this dirty environment, making your future chicken tenders not so appetizing. Having a wide-angle mindful attitude about such an operation, should bring to your lips the thought: I'm very glad I don't have to do that. And you don't. Farmers have access to support from their State Agriculture Departments, as well as Cooperative Extension offices, to control any outbreak of disease. Normalcy bias = our tendency to underestimate the impact of a powerful event....see the December 28, 2024 piece on the subject in Forbes (Bryce Hoffman). We just want our normal life! You've no doubt heard bird flu mentioned again and again over the past year. The state of California has even recently declared a state of emergency, to facilitate management of a potential H5N1 catastrophe. You have to do nothing. Thank you, state of California Ag workers, for keeping bird flu out of my gelato.

Through the work of these unseen people, laboring largely out of sight of your everyday best life, these ag and health workers make your mealtime experience safer and tastier. As government efficiency self-styled experts take aim at trimming institutional budgets, can we afford to make your protection against the next outbreak, invisible?

Wide World of Speech

It's time now for a broad - spectrum, quick but clear look at the world of communication sciences and disorders (CSD), in a post I wili call (obscure sports television reference) "PWC Wide World of Speech". It's both the thrill of a good therapy outcome, and the agony of forgetting to pack that new tool you were counting on for today!

Here are some recent clinical and research notes on events in the field, that many CSD professionals may have seen and noted.

COGNITION: Retired actor Bruce Willis appears "stable" to his ex - wife Demi Moore, as she commented recently about Willis' life with frontotemporal dementia for entertainment media. Moore stressed that not only does Willis enjoy moments of attention with family and friends, but he also benefits from all his supports living mindfully, or being in the moment when they're with him. Want to know more about frontotemporal dementia? See https://www.alzheimers.gov/alzheimers-dementias/frontotemporal-dementia, or Rene Utianski's PRIMARY PROGRESSIVE APHASIA AND OTHER FRONTOTEMPORAL DEMENTIAS (Plural, 2020).

FLUENCY: A July 2022 edition of the podcast "ASHA Voices" featured a discussion on how stuttering treatment might not focus upon achieving the highest level of fluency, but instead how the stuttering individual can learn to function in a chaotic world. To learn how stuttering might connect with neurodiversity, click https://leader.pubs.asha.org/do/10.1044/2022-0707-podcast-constantino-stuttering-neurodiversity/full/.

HEARING: Apple has received FDA approval for its software package that, when loaded onto their Air Pods Pro 2 listening devices will allow the wearer with diagnosed mild to moderate hearing loss to use them as hearing aids. It's been hinted at, that the vibrant market of "hearable" wearers might make wearing a visible device in your ears, free of stigma. If your consumer, family member, friend or neighbor has a mild degree of difficulty understanding speech, recommend they get tested and their doctor rule out a medical problem. For more information, see https://www.apple.com/airpods-pro/hearing-health/

LANGUAGE: What is the R.A.I.S.E. framework? An acronym for principles recommended in the evaluation of consumers with primary progressive aphasia: read it as client-clinician Relationship, Assessment choices, Including the client and care partners, providing Support, and Evolving procedures. These components should exist for any clinical assessment, right? Read about it in the paper by Jean Gallee' and colleagues, at https://pubs.asha.org/doi/10.1044/2024_AJSLP-24-00085

SPEECH: Virginia Member of Congress Jennifer Wexton is not on the ballot this November, choosing to soon spend time with her family as she lives with Progressive Supranuclear Palsy, called by some clinicians a "Parkinson Plus" impairment. She is closing out her term in the House, meeting her responsibilities, through use of AI - mediated synthetic speech she composes on a handheld computer. Her resilience can be seen at: https://youtu.be/UDwamEdbZk8?si=-AlANYcrpNP54aTX

SWALLOWING: Joanne Yee and colleagues report in the September 2024 issue of the AMERICAN JOURNAL OF SPEECH - LANGUAGE PATHOLOGY, on how standardizing exercise - based swallowing treatment might improve the swallowing therapist's ability to achieve the best outcomes. The paper is one of a series titled "Forum: Proposed Considerations for Fostering Rigor and Transparency in Dysphagia Research" in this journal issue. For more information, look at https://pubs.asha.org/doi/10.1044/2024_AJSLP-22-00179

VOICE: Harper Steele commiserated with another trans woman about her voice, in the recent Netflix film "Will and Harper". Harper's acquaintance commented on her own thoughts following a trial of voice therapy, by saying - but this is my voice. See the forum "exploring Culturally Responsive Voice Care", prefaced at https://pubs.asha.org/doi/10.1044/2024_PERSP-23-00126, for more information.

OTHER: Speech - language pathology (SLP) is challenged to assume responsibilities for a level of professional practice, above that for a individually - oriented, impairment - based discipline. "Communication Public Health", by Sarah Warren and colleagues, offers a road map for how the field might grow into a population - level science. In the tutorial, SLP clinicians are given directions to add prevention modalities and to labor for increased equity for serving the entire population. Remarkable in this paper, were citations of earlier papers which advocated a similar approach for their professions: "Occupational Therapy in the Promotion of Health and Well - Being" (AJOT, 2020), and "Promoting Health and Wellness: Implications for Physical Therapy Practice" (Physical Therapy, 2015). The Warren et al. paper can be found at https://pubs.asha.org/doi/10.1044/2024_JSLHR-23-00491.

Come explore the Wide World of Speech again sometime!