On the Trail of Evil with DICK DARING, Speech Therapist

On that fateful day, he facepalmed to gather his wits and calm himself, stopping the walk down this long hallway in the building he knew intimately, to scrape the slightly clammy flesh down his face and reset his thoughts for the afternoon. A toddler who had come to the clinic some weeks ago, to play games – so he thought – was on the floor, so Dick Daring was on the floor, too! In the process of living his best life with the Fisher – Price doll house, - the wellworn plastic device giving off a slight chemical odor - the toddler noticed that Dick had his back to the window letting in morning sunlight. Brilliant beams cast an outline around the speech therapist’s ear, bearing the signs of middle – aged hirsutism: hair sprigs no more than a ¼ inch from top to bottom of Dick’s outer ear, and the child couldn’t repress his need walk over to the therapist, and play in it with a finger. The mother was tickled – or was she mortified?? DICK WAS MORTIFIED. Make it stop, please! The therapist took a deep breath after resetting and then moved down the hall to his next case.

The walk down this hall seemed to take forever, though. Daring had worked here so long; used all the rooms to see all kinds of people, young and old; talked to his colleagues and managers in their offices over all kinds of cases; - that he tended to get lost in thought. The room on his right he was just passing had the barest remnants of a drywall patch on the far side. Dick had even been a student therapist here, and after a rather contentious meeting with a case supervisor about a report – put his then powerful fist through the clinic room wall, to be followed by a shriek of pain that would have awakened the dead! As Dick paused at that room’s door, he felt the offending hand throb a bit – and he then heard the clinic director calmly speaking with him, a few hours after the incident. Dick had been quickly escorted to the Student Health Center; his hand X-rayed, cleaned and wrapped with an Ace bandage, before he had been plopped in an office chair to learn his fate. “I looked over that report”, she said. “You were right with your calculations. Don’t ever do that again”, she said in a businesslike voice that belied her skill at managing people. Dick felt himself smiling as he moved on. One victory there.

Yes, Daring had been doing what he’s doing for what seemed like forever. He looked on the field of communication sciences and disorders – what the “man in the street” called speech therapy - so much differently than most of his fellow therapists, that he scarcely felt he could talk with them. He actually could talk with them! He could recite data recently published on a journal website, that explained informed consent for an “at – risk” swallowing therapy approach. He could demonstrate to a family member, or to the consumer with family in the treatment room, how blowing bubbles through straws of differing diameters was very similar to using the EMST (expiratory muscle strength training) technology, so popular now. Cost of a package of straws? As little as $3 USD for 100 straws. Cost of an EMST 75 or 150 training kit? $55 USD. Daring moved on down the hall and entered the next room, the case file in a clear plastic bin mounted next to the door.

This 25-year-old woman had initially “presented”, like she was an unlucky invertebrate pinned to a display board with those colored pins, as a case of severe hoarseness – conversational speech marred by sudden “pitch breaks” where her voice just cut out; she was often breathless, and she was increasingly frustrated at work – an educational co-operative – because persons calling her office had trouble understanding her. Today, she reported that her primary care physician had prescribed a proton pump inhibitor, a drug that stifles stomach acid production that seems to be refluxing up into her throat. She went on to say that she had promised to cut down on her beer consumption. After she demonstrated how much clearer her voice was becoming, reading 25 10 – word sentences without a pitch break, Daring scheduled her for a final visit next week, then left to move on to the next case.

“Dick,” a woman passed him by as he moved on. “Hello, Mary”, Darling replied without pausing in his brisk walk to the next case. Mary had been a fellow graduate student with him, but had moved on to becoming a staff supervisor, occasionally managing a case with Dick. There had been that time, he remembered, when he and Mary might have had something – until they had met one day at the materials center on the third floor. You had to check out a toy, or a test, or some specialized equipment to use It during a therapy session. Mary had just procured her toys for use with a child with cleft palate and turned to progress down the hall to the child’s therapy room. KAPOW! Daring, in his style, is barreling down the same hallway but in the opposite direction, lost in thought and carrying his FIFTH cup of strong black coffee without a lid! STUPID. They called it, when people gossiped about the event, the “eruption of Mount Mary”. She publicly forgave Daring for the incident, but on another level, their interactions were that brusque. Hello, move on. Daring opened the door to the next case he had been assigned today, a bit weary for the late afternoon.

Name: _____; Age: 55; Diagnosis: Severe aphasia after left hemisphere stroke, right hemiplegia. The patient held his right arm crooked against his chest, waiting seated behind the table and smiling at Daring, the case file in hand. “One time”, he greeted the veteran therapist with a smile. “Hi, Mr. ____”, Daring replied, resting his well – worn Fedora at the corner of the table. “How is your day today?”, the therapist asked. “One time!”, the client answered with a woeful sound to his voice. “Did you see the game last night?", Daring inquired, knowing that the client’s favorite team had won – and BAM! The patient SLAMMED his strong left hand on the table and exclaimed “ONE! TIME!!”, smiling broadly and then – showed that he could sing a bit of the team’s fight song when Daring started the song. He could actually sing the actual lyrics - !! “Applause!”, Daring cried out with a broad smile and clapped to celebrate the client’s performance. Laughter came from the client’s side of the table: “ONEEEEEEEEEEEE TIMEEEEEEEEEEE!”. Daring wrote down the client’s next scheduled date and time for another singing lesson, what was called in the literature “Melodic Intonation Therapy”.

Fedora back on his head with a slight tug to get the brim just right, Daring gently closed the door of the treatment room. On to the next case – Boy, this corridor seems extra long today.