The feeling of making a difference...

(29 June 2017)

The feeling of making a difference…

Two years later and the inspiration hits me once more… I am currently a community service Speech-Language Pathologist at a public hospital in Pretoria, South Africa. Since I last wrote, I completed my honors degree, obtained my Masters degree, and have now been working for six months.

So I get to work on Monday feeling tired and demotivated after a busy weekend. I’m going through the motions for the day, running around like a mad thing with all the patients, because my colleague is on leave. After lunch I finally manage to go to the wards. So because the hospital that I work in is small, our wards are combined medical and psychiatric patients. Up I go to ward five (the male ward), and I have got two referrals, one of which is a TBI (traumatic brain injury). So I go to the patient, glance at him (he doesn’t look good) and start off by reading the file.

So Mr X’s name in the file is “Delta Unknown”, he was admitted to the hospital over the weekend – down-referred form a tertiary hospital’s neuro ward because they needed the bed. Mr X was assaulted and admitted to hospital on the 3^rd of March 2017, where he has been diagnosed with severe TBI and dehydration. They still do not know his name, and state that he cannot communicate. Every now and then Mr X would make this moaning noise, almost a cry, for a reason not apparent to me.

So I approach the patient with hopes not being too high, and a slight sinking feeling in my stomach because I expect the prognosis to be poor… The patient is lying on his back, in a position that is similar to a foetal position in an infant, in a nappy, and my goodness is he skinny. His thighs the size of my forearm. I approach him while putting my gloves on and try and wake him up. The patient is looking at the roof with an expression of non-recognition, suggesting visual difficulties. As I start talking, he makes that moaning noise again, and my hopes drop just a little bit more… This patient isn’t all that aware of what his circumstances are, or what has happened. Before I finish, I quickly had to do a basic swallow assessment on this patient. So I bring the glass of water closer to his mouth, and he purses his lips as though he knows that is going to happen (interesting). So I give him a sip of water, and feel a safe, strong swallow, when through clenched teeth and in a whisper, says to me “more please”. Just to confirm that I heard him correctly, I ask him “sir would you like some more water”, and he answers “yes please”. Through small sips of water, and very basic questions, I managed to find out Mr X’s name, his age, and where he is from before he became upset and distraught again.

I told the nurses how I managed to get this information out of him, so when I arrived at work the next day, during meal times one nurse had managed to obtain a contact number and get hold of his family. What an amazing development! And this because I managed to figure out that this patient is somewhat aware of his surroundings, and is able to communicate. I walked into Mr X’s hospital room the following day, to find his family crowded around him crying. His father, an elderly man, looked up at me and said “thank you”. I have never before been speechless in front of one of my patients, but that day I was unable to say a word, and had tears streaming down my face as I watched them reunite with their son (who they believed had been dead for the last 4 months).

Where we stand today (November 2017), almost 5 months later, I have just discharged Mr X from Speech Therapy. He has gained weight, he is feeding well, and has developed into a witty young man with a good sense of humour. Mr X now loves with his three lovely sisters, and although he is still wheelchair bound and completely reliant on others to get him from one place to the next, intends on studying mechanical engineering in 2018.

Being a Speech Therapist, especially in the public sector, it becomes somewhat of a necessity to develop a certain ‘hardness’ towards your patients. We see some very upsetting cases, people who have been brutally beaten, or who have some serious neurological deficits, and yet we still need to hold our heads up high and put a smile on our faces every day. We need to learn how to be stern to those patients who are refusing therapy, and we need to make the call on how a patient will be able to feed whether they are fully functional or not. There is a lot that falls on us as therapists, and a lot more than what the medical community believes. We are the invisible healers…

Watch this space for more stories and insight into the life of a new Speech Therapist…

Xoxo