Fear.

“Good Morning! This is God,
I will be handling all of your problems today. I will not need your help. So, relax and have a great day!”

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I received this saying on a business card from one of my elderly patients on the day I discharged her from speech therapy. It was so sweet, and just what I needed that day. Things have been overwhelming to say the least with work lately. I guess it is a good thing, in this economy, having so much work there aren’t enough hours in the day, but it is a struggle to balance and try not to let anyone down. I work full time as a speech language pathologist at an early learning center, aka. preschool, in Tucson. I love love LOVE it. I currently have 69 kids on my caseload, but by the end of the year it rises to well over 100 children. My days are crazy, but full of love, laughter, hugs, and daily miracles. Yesterday, after a year of trying, a little red head that looks so much like myself at that age, finally was able to say her own name. Imagine not being able to tell people your name!! Days like those make everything worth it. Most days at the preschool make everything worth it. I am so happy to wake up every day and enjoy coming to my job.

After work and on summer vacations, I do private speech therapy for various ages and all types of issues. Most of my days are filled with the geriatric population. I help remediate swallowing problems and aphasia post stroke or any other illness or catastrophic event. I will give the patients and their families swallowing precautions and alternative diets so that they are safe and don’t choke on or allow their food/liquids to escape into their lungs and cause aspiration pneumonia, or even death. Talk about pressure. With aphasia, I work on helping the patients improve their functional communication and improve their word retrieval abilities, or develop some form of alternative communication so that they can express their wants and needs. Truly, speech therapy with a preschooler and an adult post stroke is not so different: encouraging voice, flashcards, over-celebrating every small success.

Every day is different, every day I learn something new. I have met some amazing people in my travels as a roaming SLP. Judges, Vice-Presidents of Universities with whole libraries named after them, the first woman professor at MIT. I have learned such wonderful things about my city, and know my way around all of the nooks and neighborhoods here. It can be devastating when a patient you have been making so much progress with goes back to the hospital from another stroke, a blood clot, or pneumonia. It is so hard when a little baby you have fallen in love with moves away or is taken by CPS because of poor living conditions. However, the biggest fear I have is this: the people I work for or the patients I see will realize, I have no idea what I am doing.

Now, don’t get me wrong. I am absolutely qualified, and entirely trained and educated in my field. I completed my Bachelor’s and Master’s degree in 6 years without difficulty and high grades. I have a passion for my work and am constantly reading and attending conferences on various topics that are completely relevant to what I do every day. I just have this constant nagging fear every time I go in to a new home, with a new patient, that one day I will be working with a patient and someone will call me out. Point at me and say, you are the worst SLP I have ever met and you are not helping my family member out at all!

Why is this? Why do I feel so inadequate and frightened like it is my first day of undergrad and I will ultimately not retain any information or warrant this “higher education” my parents have so lovingly and generously given me? Why do I wonder when I leave if I did the right thing or if I even made a difference? Part of it is the amazingly high amount per hour that these families are being charged for my services. It is completely insane. I do not receive all of it, mind you, but even what I receive myself sometimes feels a little ridiculous for one hour of my time. And if they don’t have insurance, ugh, that is just an awful feeling to take a check from the family. So, I am constantly having to tell myself, I am doing the right thing, I am making a difference, what they pay is worth it. But man, some of those days I admit I hold my breath and slightly wince as I am leaving, waiting for that moment when I am figured out.

I am excited for the day when I can go in to a new home, head held high, and know with my heart of hearts I am the best person to help this person, and help them I will.