You Are the Most Important Person

I started mentoring young professionals in the profession of communication sciences and disorders (CSD), in the late 1980's. I had been in a hospital job for a few years, with acute rehab, acute med, SNF, outpatient, home health and hospice among our services. Needless to say for many readers of this blog, we had a steady demand from master's students in the nearby CSD training program. It's been my good fortune since then to mentor more than a score of women and men, entering the field of CSD: whether a shadow during undergraduate years, a participant in ASHA's STEP program, or an intern prior to receiving the master's degree - they have all taught me a lot.

* the mentor does not have to be infallible - In these days, all the digital interconnections in our world allow persons with Internet savvy the ability to answer content questions. So, if the mentee needs to know  the efficacy of melodic intonation therapy, there may be little need for the mentor to actually provide the answer. Where the mentor will lend expertise is in framing the search terms for the answer: "efficacy of MIT w/ global aphasia"; "MIT short form"; "MIT and return to work for persons w/ nonfluent aphasia ";  - only one example of how the mentor may help hone the mentee's thinking on her/ his feet.

* a thinking mentee is a fearless mentee - the workplaces for CSD professionals  are constantly changing,  as the economic forces supporting their operation convulse and change.One day procedures in the worksite will require response "A" from the clinician, and the next day they are clamoring for your response to be "D". The mentor can be of assistance through contacts with the American Speech-Language-Hearing Association (ASHA), the credentialing and advocacy organization for professionals in CSD. When ASHA staff are able to give the working clinician advance word of  changes in reimbursement policy, or in development of regulations affecting practice, the mentee may adapt to the changes with more confidence. In numerous instances the mentor can help the mentee learn proactive,  evidence-based abd easily-expressed  action in the daily grind. which reminds us that -

* the relationship comes first - when a mentorship begins, how the dyad communicates sets the tone for how the mentee achieves her/his goals. The trust,
The clarity, feedback, and the focus and planning for the duration -they all begin with the formation of the mentor - mentee relationship. What the mentor seeks to give the mentee is not so different from what happens, at the first meeting of clinician and client in the CSD treatment setting -

* you are the most important person to me now -  at this moment, I am solely focused on you, and what you need is my top priority. I will be ethical and open throughout. I am committed to your great future.

My Swallowing Is My Business

Here's an illustration of one component of what I have called "organic SLP": teach, teach, teach. An actual teaching handout given to an actual patient - with the aim of the consumer of clinical service, taking action to prevent disability when possible. One way to do that, is to understand normal function. Feedback as always is VERY welcome!

I don’t have to think about swallowing most of the time. I started swallowing before I was born.

Scientists have found that the human fetus swallows at age 15-16 weeks. I developed my first taste preferences in the womb. After I was born, I was fed and then learned to feed myself, by learning all the skills to get food in my mouth.

Sitting up in a chair, or standing, seemed to be the positions where swallowing was done most often. When I was a kid, I also ate in every other position because – I could!  I ate upside down; lying flat while watching TV; - I even ate while spinning in a carnival ride!

But, as I got older, my swallowing seemed to work more easily when I was upright.

My swallowing happens because I use some muscles voluntarily, and because of other muscles that work without my thoughts. The voluntary muscles are controlled in this

  part of my brain.

 The muscles that work automatically   are controlled by this part of my brain.  So, even though I can control some parts of my swallowing and change part of the swallowing act, all the swallows I have done over my lifetime have made the way I swallow a strong pattern of habits.

Here is how I do it. Here are my habits:

I pick up the food with my fingers or a utensil. When I take a drink, I use a teaspoon, a cup or a straw to put it past my lips.

I hold the food or liquid on my tongue, and form it into a shape that can be squeezed back or chewed, until it forms a more slippery and sticky shape (left illustration).  The squeezing gets the material to the back of the tongue, where my control over swallowing changes. The swallow “triggers” there (right illustration) and pushes food or liquid into my throat. When the material goes DOWN, the voice box lifts UP. What I swallowed moves down past the voice box and pushes open a valve into the esophagus.  My swallowing is totally automatic at this point. Before the material goes into the esophagus, I can use my tongue to affect what happens to the food or liquid. In the esophagus material travels in waves of squeezing, down to the stomach.

There. That is my swallowing. It is my business to swallow well, because I eat to live. I eat to feel satisfied. I eat to be with others. My body, my business.