The Speechless Doctor: The Art of being a Doctor to a Speechless SLP

Episode 103 July 02, 2022 00:38:02
The Speechless Doctor: The Art of being a Doctor to a Speechless SLP
The Missing Link for SLPs
The Speechless Doctor: The Art of being a Doctor to a Speechless SLP

Jul 02 2022 | 00:38:02

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Show Notes

Patient-clinician relationships are crucial in any type of care. In this third episode of the Speechless SLP series, Vanessa Abraham, SLP, and her ICU doctor, Dr. Jared Rosen, share their thoughts on how important this relationship is, and how you can work with patients/clients, and their families.

 

Visit FreshSLP.com/podcast for this episode's show notes, a full audio transcript and more great resources at the intersection of grad school and a successful SLP career. Not a substitute for a formal SLP education or medical advice for patients/caregivers. Fresh SLP is in no way affiliated with or representing any university.

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Episode Transcript

The Missing Link for SLPs Podcast Full Transcript Dr Jared Rosen 00:01 So, I remember I walked in in the morning, and I was meeting Vanessa for the first time. We were all going on rounds with the whole big team. And I will never forget seeing her in the bed in the ICU, and there was this simultaneous sort of interest, both from a medical standpoint, because here was this medical mystery coming in, but here was this very young woman coming in with this seemingly out of the blue, crazy illness. And so, I was very much drawn from both the sort of interest in helping to try to figure out what was going on, but gosh, wow, this woman is not a whole heck of a lot older than I am. How can I be there, to be of comfort to her, as much as she's able to, and then especially Dale, her husband, and later on, her other family members. And I think over that time we had about two and a half, three weeks, of working together, part of that was sort of our longevity, I guess. And most people wouldn't think that three weeks is a long time, but I guess in the ICU or the hospital, that is sort of eons of time for us. We got to build that relationship. But, for me, what it was is when I would go into that room, it wouldn't be I'm going in there as your medical student or doctor. I'm going in there as an individual trying to help you, and in any way, shape, or form that I could. And I wasn't some world renowned neurologist who was going to crack the case on what was going on. I could do what I could as a medical student. But I gave what I had to offer, and that was largely my compassion and my care. Mattie Murrey 01:45 Hi, everyone, and welcome to the Missing Link for SLPs podcast. I’m Mattie, your host, speaker, and very passionate speech language pathology advocate. You are listening to The Speechless SLP series with Vanessa Abraham, and you get a unique perspective in each one of these episodes on her journey being the speechless SLP in the ICU bed, unable to talk. So, welcome to this series of the Missing Link for SLPs podcast. Glad you are here. Sit back, take a listen. So, our two guests of honor today are Dr Jared Rosen, and our Speechless SLP, Vanessa Abraham. And I want to tell you a little bit about them both before this conversation unravels too far because their credentials are important, and their story is even better. But let me tell you about Dr Rosen first. Dr Jared Rosen was born in Chicago and raised in the San Francisco Bay area, the oldest of three kids. He earned his undergraduate degree in molecular and cell biology from the University of California, Berkeley, and after graduating he conducted translational research in male fertility at the University of California, San Francisco. He went on to earn his medical degree from the University of California, San Diego, where he is currently completing his residency in Internal Medicine, and this is also where he met Vanessa. As a medical student and resident at UCSD, Jared’s interest in ICU medicine and pulmonology flourished in both the hospital and the lab. Now in the final weeks of residency, he is thrilled to be heading to his fourth UC this summer to complete a fellowship in Pulmonary and Critical Care Medicine at the University of California, Davis. In his free time, he loves cycling, and hopelessly trying to keep indoor succulents alive. And that is Dr Rosen. You just heard him speak. So, our second guest of honor today is Vanessa Abraham, our Speechless SLP. She is a wife, mother and school-based speech language pathologist. She learned firsthand what it's like to be on the receiving end of speech therapy services after experiencing a sudden onset critical illness that left her with limb and neck paralysis, as well as a PEG tube and a tracheostomy. She was thrown into the rehabilitation world after being an independent and healthy and vibrant young mother. She went through swallowing studies, voice therapy, occupational therapy, physical therapy, the whole gamut. She had to learn to eat, talk and move again. And her goal now is to help critically ill patients cope with a grief experience after critical illness, to speaking up about the topic of post intensive care syndrome, depression, and anxiety and post ICU. In addition, she strives to educate families and patients about the various rehab modalities that were successful for her. Welcome to this episode of the Missing Link for SLPs podcast. We continue on with our Speechless series with Vanessa Abraham, and our special guest today is Dr Jared Rosen. Welcome, welcome. Dr Jared Rosen 04:49 Thank you so much for having me. Vanessa Abraham 04:50 Thank you, Maddie. And thank you to Dr Rosen for being with me today. I might cry, but you were there by my side during a very scary period of my life, and here you are three years later, still by my side and supporting my recovery in other ways. I remember in ICU telling you I would write a book, and I never imagined we'd be doing podcasts together. But in a weird and twisted way, this is now a dream come true for me to have you here, and I can't thank you enough for this. This shows what an incredible caring and dedicated doctor you are. So, thank you. Thank you both. Dr Jared Rosen 05:25 It's truly an honor and a pleasure to be here, and to be able to talk to you these years later, and to see the amazing progress that you've made both spiritually, emotionally, and physically. Vanessa Abraham 05:40 Thank you. Mattie Murrey 05:41 We're going to talk a little bit today on your role about that. And when I first jumped on, I said, “Dr Rosen”, and you were like, ”Ah, call me, Jared”. And I love it when you pull it down at the very beginning to this basic, basic level. Can you give us a brief introduction of why you became a doctor, and why you want to do what you want to do? Dr Jared Rosen 06:03 Sure. Yeah. It's funny, because I remember many years ago when I was first applying to medical school, and you have to write your personal statement, and everyone has this sort of same trite, sort of general idea of I want to help people, and it's everyone tells you that you can't write about that, you have to write about something else because everyone writes about that. But, for me, it was very challenging, because that was truly at the core of why I wanted to go into medicine, is I really – I wanted to help people, and loved sort of puzzles and mysteries. And so, getting to combine that with the humanistic side of this, is I can actually try to help somebody by solving some puzzle, or helping to figure things out. And then help guide people through just as a human – not as a doctor, but just as another human with them. That combination together really got me excited and interested in pursuing medicine. Mattie Murrey 06:59 I can see that. It's one of my favorite things about working in the medical field as well, the challenges. And I love how you bring in the extra layer of working with the human side of things. Dr Jared Rosen 07:11 Mhm. Mattie Murrey -7:13 Vanessa, when we were prepping for this podcast, mentioned how she was – well, I can let you talk about it, Vanessa, how you were laying in the bed, and how when Jared walked in, how he was immediately able to build that trust. Tell me about that. Vanessa Abraham 07:27 Gosh, from the minute I met him, and I've told him this – I had this love-hate relationship with him. His body language, his demeanor towards me, he was always so kind. I think one of the things that really stood out for me, and I said this in a previous podcast, is that he treated my family too, and that gave me a sense of relief. I knew that he wasn't only there for me, but he was there for my husband. He was taking my husband to rounds. He was explaining things to him. My husband doesn't come from a medical background. And the fact that he was there for my husband, talking to him, making sure that he was sleeping at night, making sure he was going home at the end of the day. That just gave me a lot of reassurance in his care. He would go above and beyond. There were times he would come into my room with – I'll never forget too, with printouts, and I still have the printout of different meditations for me to listen to with my earbuds in. He was just treating me as a whole person. He was very aware that, wow, in order to treat her, we need to treat her anxiety. She's very anxious. We need to look at these other areas. We need to talk about her daughter, and her daughter’s needs, and making sure that that's taken care of. Because if all these other pieces aren't put together, how is this person in an ICU bed going to fully heal? And he was so aware of that. Mattie Murrey 09:02 Is this something you learned in medical school? [crosstalk] Dr Jared Rosen 09:06 Yeah. I mean, I think one of the great things in sort of recent years, and maybe the last decade or so, is that there has been certainly a shift in medical education that we've focused a lot more on the humanistic side of what we're doing. Obviously, there’s still the scientific aspect of it, but there's definitely a renewed, or I guess, a new sort of focus on the humanistic side. But I think the people who actually showed up to those lectures, or didn't show up, I think it really comes from within the individual is what I'm trying to get at. It’s you can have as much training as you want, but it's really what is within here, and what is within your heart and soul that is going to motivate whether you would take that training in and run with it, or just kind of say, “Okay, well, I sat through that lecture, and onto the next thing”. And so, I think we certainly get the training, and for those of us who are willing and open to that, it can be really helpful. And I think that that, in my case, was very much something that I was thinking about when I was in school. Vanessa Abraham 10:10 One of the things that I remember, and I don't even know if you remember this, but after I got out of rehab, I went online and I tried to find out your email address. I just typed in Dr Jared Rosen, and UCSD and sure enough, some email address popped up, and it was you, and I thought, well, I’m going to email this person and hopefully it’s him, maybe it's not, but I’m going to email him anyway because I had things that I wanted to say to you, and express my gratitude. But in my email, and I was pulling up those emails because I still have them. I collected everything because I knew I was going to write a book. But one of the things that you said in it, in that email, was that much of your recovery is tied to your emotional wellbeing. Dr Jared Rosen 10:45 Mhm. Vanessa Abraham 10:46 And here, three years later, that stands out in my mind, and it just – it reminds me of how aware you were of not only my emotional wellbeing, but my entire family. Dr Jared Rosen 10:58 Mhm. Vanessa Abraham 10:59 He was on the phone with my parents. He was there helping put these pictures up on my wall, with my husband, making sure that I was looking at the pictures on my wall. They had somewhat of a vision board, Mattie, in my ICU room, and he would point to those pictures to remind me of my goal of where I was heading. And just all those little pieces just gave me such reassurance in his care. I knew that when my husband was gone, that he was there, I was safe. Mattie Murrey 11:30 Mhm. Vanessa Abraham 11:32 If something were to happen, that he was somewhere on property, and he would be there, and then he would notify my husband. It was just such a comforting feeling when my anxiety was at a level 10 all the time. He would come into my room, and there were times that I just wanted to kick him, and tell him to leave because he wanted me to do certain tasks with my body that I physically couldn't. So, I wanted to tell him like, “Please, just get lost”, or other words. But I was so grateful at the same time that he would come in. He was kind and compassionate. I knew the reason why he wanted me to do these tasks, to see if there was movement in various places of my body. So, again, it was just that love-hate. Like, “Okay. Good. He's here. Thank God he is here. I'm safe. Somebody is really looking out for me”. But then, like, “Oh, he wants me to do these things, and I can't do them, and I don't want to let him down”. That's another thing. Mattie Murrey 12:33 Mhm. Vanessa Abraham 12:34 And when he would come into my room, and he’d want me to do something, I’m like, “I'm sorry, it’s just…“. I couldn't say this because at this time, I was speechless. But I just couldn't do these, and there was just this sense of heartache for not only my husband, of letting him down, like, “Oh, I didn't make any progress overnight. I still can't do this task”. And then for him too, because he was dedicating so much of his time to me and my care, and I would feel like, “Oh, I just let him down. He made this trip all the way into my room to see me, to see if I could do XYZ, and I can't”. And that, ooh, I just felt like such a burden to all of them. Mattie Murrey 13:15 But Jared, I don't think you felt that way. Dr Jared Rosen 13:16 No. I mean, you’ve given – this was the last few weeks of medical school getting to work with Vanessa, and I had the luxury of extra time. Mattie Murrey 13:25 Mhm. Dr Jared Rosen 13:26 I didn't have as many responsibilities, or as many patients, as I do now at the end of residency. So, I certainly had that luxury, but it was – I didn't view it as much of a burden. I viewed it as an opportunity to work with Vanessa. Mattie Murrey 13:38 Mhm. Dr Jared Rosen 13:39 And Vanessa, to your point about you feeling trapped because you were speechless and couldn't communicate a lot of these things, I promise you that your facial expressions, and the dirty looks on your face when I would come in and ask you to move your arm when you were not able to, it told all of – everything in the world I would need to know! Mattie Murrey 13:58 What's it like communicating with a patient who is speechless and you have these major medical events going on, and you need to communicate with them? What's that like? Dr Jared Rosen 14:10 Well, I would say that this was a very unique experience, because Vanessa is – up until that point, and still since then, the only speech language pathologist that I’ve had the pleasure of working with. I will never forget when they – when she was awake enough to point at one of the letter boards. And she's lightning fast. Like, I'm there with Dale, and we're looking over her shoulder, and we're looking at each other like, “Why did she just say? Or what did she just try to spell out?” Because she was way better, and way faster than either of us were. It was almost very frustrating, because I'd be like, “Hey, I'm sorry. Can you repeat that whole long sentence that you've just spelled out, or that you just like… “ it was like a paragraph, and we're like –. So, I got ‘cat’, and that was about all I got! And so, I think that was sometimes challenging for us, and I'm sure very frustrating for her. And I remember, Vanessa, at some point, you got some app where you could text out the words, and it would read it aloud. So, just Stephen Hawking's style. And that was – it was a little bit easier for all of us. I think that eased a lot of the burden. But it was still really challenging because the moments where things were calm, and there wasn't a lot going on, that was easy, she could spell that out. And there were moments like when we attempted to extubate her, or other really challenging moments where she was not able to sit there and calmly point out words or text on her phone. And that was extremely challenging because it was only one way communication and we could say whatever we wanted, but she couldn't say what she wanted back. And I think that only amplified – from my perspective, at least, it seemed to only amplify, and rightfully so, just the fear and the terror and the anxiety. Mattie Murrey 15:50 Mhm. That's where the trust, and the time you had put in at the beginning of establishing a relationship with her, where the trust and the security came in just big time, big time. But in the medical setting, people come to us at their worst, and we have to develop these relationships very quickly, and very deeply. Dr Jared Rosen 16:12 Mhm. Yeah. Mattie Murrey 16:13 Any thoughts on that? Dr Jared Rosen 16:14 It's something I've thought about a lot over the years, and I think especially having worked a lot during the pandemic it's become particularly important, and particularly salient. And I think you just learn how to do it. Mattie Murrey 16:29 Mhm. Dr Jared Rosen 16:30 I'm not really sure. It's sort of an organic process that you just learn to do. If you're – as most of us are in medicine, empathic caring people, you just – you learn to do it. You learn to go and walk into a room and say, “Hey, I'm Dr so and so. I met your grandma two days ago. We need to talk about end of life for her”. And you just – you learn these skills. And I think a lot of it is really just – it's channeling you as a person. It's not about channeling – and we talked earlier about sort of what training we got on this in medical school. Sure, we did these simulations with actors as patients, and learning how to have hard conversations. But what it really comes down to is how much are you able to channel yourself as an individual and your humanism. I think that, with some training, will carry you as far as you need to go. Mattie Murrey 17:21 How do people do that, though? For people who aren't there, and who want to walk in, whether they're a medical SLP and they really want to connect, or school SLP and they have these students that they really want to connect? How do they reach down into that core? It comes naturally for you. Dr Jared Rosen 17:39 Mhm. I think when I've had to explain this to interns, or to medical students, I say, “What I want you to do is I want you to imagine this is your family member or a close friend. I want you to think about how would you want them to be treated? What would you want them to be told?” Or “Let's say you are the one in that bed over there? How would you want this to be explained to you? Or how would you want someone to behave towards you?” And, you're right, I mean, I think there's a certain degree that, for certain people, this comes a little bit more naturally than others. But I think even for people who it's not as natural, if you really try to put yourself in the mindset of a loved one, or yourself in that bed, you can start to really understand what would it be that you would want to be told to you. Mattie Murrey 18:23 Thanks for giving me that pushback. I know a lot of listeners on the podcast, they see skilled people, skilled SLPs, skilled guests who come on, and they're like, “I want to be like that”, and they don't know how to be like that. So, that perspective taking, that role playing is so important so we can make those connections, they can make those connections. Dr Jared Rosen 18:47 Yeah. And I would say, just as part of training when I was in school or in residency, and things that I have done to practice with the students or the interns who have worked with me, is we have done these sort of role play activities in a structured setting to kind of get a feel for it because it is awkward at first. It feels very strange. The first time you walk into a room and you say, “Hi, I'm your new doctor. Grandma's not doing so well in the ICU. Nice to meet you. We need to talk about possibly transitioning to a comfort focused form of care”. You've never met me before. I remember the first times I was doing this early in my training, I'm like, “Wow, this is really strange. This is really unnatural”, because it is Mattie Murrey 19:34 Mhm. Dr Jared Rosen 19:35 In one other sense, do we build such deep trust with an individual within minutes, or hours, or maybe a couple of days of meeting them? But you have to out of necessity. And so, you kind of have to just do it. You have to dive in. And so, I've certainly done role playing in practice, and I think that certainly can help make those situations less awkward. But, I mean, I remember my first times doing that where it was real time, and it's not easy. It's not. It's not perfectly natural. Vanessa Abraham 20:09 I think one of the things that comes to my mind when we're talking about this topic is something that we talk heavily about in the school setting, and that's some of your nonverbal language. Your eyes – how are you communicating with your eyes? COVID, right now, makes things challenging with mask usage in the hospital setting. But I remember, and I'm so fortunate that I was in the ICU pre COVID times, but I could see your smile. To me, that was comforting. Okay, he would come in, and he would crack jokes with me and help alleviate some of that tension in the room, but some of those facial expressions and being able to approach the family member, and shake hands with them. Just the mere fact of Dale being able to go to rounds and stand next to you, and lean on you – not so much in a physical way, but just having that connection. And again, those nonverbal body language. What you're doing with your hands, I think that sends a signal too. That's one of the things that I – with you too, that it was like all right, your eyes, he's focused on me, he's looking at me, and he would give me a smile. And when I was crying, you could see in his face that he was feeling it with me. And trust me, there were a lot of tears shed during that month. Mattie Murrey 21:32 Mhm. So, she was your patient in your setting for a month? Dr Jared Rosen 21:36 Yeah. I think it was about three weeks that whole time, Vanessa. And it's interesting, you bring up the point about cracking jokes, and it's something that I don't even really think about because that's just kind of my personality in the hospital, and outside the hospital. But I think that's another thing that it really gets to that point of I – when I walk into a room, yes, I'm your medical practitioner, and I'm here to explain what's going on, and try to figure out what's going on, and treat you. But again, like I try to think of myself as a person. I try not to put this wall between myself and my patients. I try to eliminate that wall. It's like, again, I am another person here. Yes, I have a lot of training and experience, but I'm another person and how can we just sit here and connect as people. And when you're in the ICU, or part of my residency we do work doing primary care at the VA, and I sit there and crack jokes with my patients in clinic, and I try to connect with them because that's how you get people to work with you. Mattie Murrey 22:42 Mhm. Dr Jared Rosen 22:43 And that’s how people feel comfortable telling you really tough challenging things. This is trying to break down that barrier. And I've never had anybody say, “Oh, well, you feel much more like a friend than my doctor”. They still view me as their doctor but they view me as somebody they want to talk to, and they want to share things with. And I think that, like I said, Vanessa brings that up, it's something I don't even think of a lot of the time because it's just kind of my jokes or personality, but I think it's a really key thing. Vanessa Abraham 23:12 I think some of the jokes in the ICU setting, and I don't even know if you remember this, but I remember typing out on my keyboard, or whatever I was using at that point, like “Your jokes are horrible!” Dr Jared Rosen 23:23 I'm sorry! Dale laughed at plenty of my dad jokes, thank you very much. Vanessa Abraham 23:29 I know. He was laughing. I was like, “This is not funny”. But again, it goes back to that love-hate relationship. Mattie Murrey 23:37 Yeah. Vanessa Abraham 23:37 Like I hated his jokes, they were so bad. But I loved the fact that he was trying. He was trying to lighten the mood. He was trying to make me smile. And it just broke down, like he was saying, it broke down that wall of ‘I'm up here and you're down there. I'm a doctor and you're just a patient’. It brought us to equal levels. Mattie Murrey 23:56 Mhm. Vanessa Abraham 23:56 To the point that, yeah, you are a trusted individual. Yes, you are my doctor, but I view you as an equal to my husband now. You care about me and you care about my family. You're not just my doctor. You're somebody that I truly value and support. Mattie Murrey 24:15 Mhm, because of the relationship. Vanessa Abraham 24:18 And I'll be honest, the first time he came into my room, I thought, “Oh boy. He looks like he's 12. He can’t be my doctor!” You know. His skin is perfect. He reminds me of like a Doogie Howser of the 80s or so, and I thought this guy can't be my doctor, no way. And then just instantaneously it was like “Yes, that's my doctor, and I want him by my side until the minute I leave here, and then when I leave here I want him back”. That’s why when I got home, I got on my computer, and I typed in his name, and I thought I've got to find this guy, I got to thank him for everything he did for all of us. Mattie Murrey 24:57 So, personality, competence, connection, communication, trust. Dr Jared Rosen 25:05 Yeah. Absolutely. Mattie Murrey 25:08 Those are some of the top things that made everything work for you. Vanessa, I've been in a hospital bed waiting for an unknown to walk in through the door. I've not been speechless like you, but I know when I am laying there I'm wondering, “Are they going to be good? Are they going to care? Are they going to connect?” What was that like laying in the bed waiting for your physician to come in? Because he doesn't have a name or a face yet. What’s that like? Vanessa Abraham 25:45 Well, the first couple days, I don't really remember anything. I remember being relieved when speech finally came in the door because I knew I couldn't talk. Mattie Murrey 26:00 Mhm. Vanessa Abraham 26:01 I remember thinking, “Okay, good. Finally, they're here”. And then once weaning the medications, and I started becoming more and more aware, that's when dozens of people started entering my room. So many different medical professionals. I don't know what they were taking samples for, or what they wanted from me. They were all incredible, no doubt. Very knowledgeable, very patient, very understanding. Trying to work with a patient with an unknown diagnosis. They were all just as perplexed as I was. But having them come into my room and at least answer questions that my husband had, or be there for them, it was very reassuring. I knew I was at a teaching facility. So, I knew I was getting the best care. I knew I was at the right place. There was no doubt in my mind that being at UCSD was the place that would be able to figure this out, that would give me the right care. So, in some respects, it was very, very reassuring in a very scary time. My anxiety was at a level 10 the whole time. It was a very scary period. But again, I know when Dr Rosen walked in the room my anxiety was still high, but I know it had come down a little bit because I knew that he would – he may not have answers as to what's going on, but he was at least somebody for us to lean on, and that's just incredible. Mattie Murrey 27:32 You’ve called him your second husband at times. Vanessa Abraham 27:35 I have. Yes, no doubt. It was like when my husband was gone, they would kick them out and say you need to go home and sleep and eat and take care of yourself. I knew that – or if my husband had to step out and make phone calls, that – you know, I was afraid that there would be a code blue on me, or who knows what. Mattie Murrey 27:49 Mhm. Vanessa Abraham 27:50 Because my anxiety was going. It was – my thoughts, and I was thinking, I don’t know, this is it for me. I would start planning my funeral. But I knew that when my husband was gone, and my “second husband”, Dr Rosen, was going to be somewhere around there. That I would be okay. That the machines wouldn't stop working. That if something were to go down, that I would be okay and I had to keep telling myself that over and over again. Mattie Murrey 28:23 So, Jared, this is clearly a very impactful connection she has with you. Dr Jared Rosen 28:33 Mhm. Mattie Murrey 28: 34 How has working with her changed your outlook and your practice as a medical doctor? Dr Jared Rosen 28:40 Yeah. No, I mean, and as I think I was kind of alluding to earlier, this was this very kind of formative time – Mattie Murrey 28:47 Mhm. Dr. Jared Rosen 28:48 – and near the last few weeks of medical school, right before I was about to start my residency. And so, it was an opportunity for me to kind of work and explore what was the right style for me? What was important to me? What were the kind of values and important things, the values that I had, and what was I going to place importance on? And having those really solid, very positive, experiences working with Vanessa, it gave me an opportunity to see “Wow, this is what the true power of being this way can – what can I do for my patients”. Being able to just show my true compassion, and not have to hide it. To just entirely be myself in terms of from a personal standpoint, as well as a professional standpoint, and to really let that shine through and to see the impact that had. And I think had Vanessa not contacted me after, I think I still would have known, but I think particularly because she tracked me down some months later, and we've now been able to talk many times since, it has sort of further reinforced that who I was able to explore being back then is the kind of doctor that I wanted to become going forward. It has definitely influenced my practice. Particularly – Vanessa brought up earlier the challenges now due to COVID and you can’t see people's faces, or people can't be in the hospital. One of the probably more profound moments that sticks out in my mind during the pandemic is I worked in the ICU probably about 15 weeks in the second half of 2021. And I remember one of those weeks, we had a very sick patient. It was a US citizen who was vacationing down in Mexico, and was airlifted back on a ventilator to UCSD in the middle of the night. And he – we were taking care of him in the ICU. I get a call from the nurse saying, “Hey, his wife and mother were airlifted with him. They're not sick, but they're not allowed to come into the hospital. They’re outside the hospital”. And it's like 1:00 o'clock in the morning right now, and I'm like, “Okay, all right. Well, let me kind of get their loved one settled in, and get the ventilator set up with the rest of the team”. They want – because she said she wanted an update. So, “Okay, give me a little bit of time”, and I go. We finish up. It's 1:00 o'clock in the morning. “I told them, try to get them a hotel, but I'm going to come down and talk to them”. And it was this eeriest thing where I put on all my PPE, the N-95, the face shield, the gown and everything, and I walked outside the front of the hospital in the middle of the night because that's where his family was. Mattie Murrey 31:31 Mhm. Dr Jared Rosen 31:32 And I'm sitting there kind of yelling to them from 6-10 feet away, just trying to tell them what was going on with their family member, what was the situation, and providing updates. And it was just this weird, really eerie kind of situation of wow, have we really gotten to this point where I'm standing outside and all geared up in the middle of the night talking to this family member. But it was really important to me to actually go out in person. I could have – we could have picked up the phone and called them on their cell phone. But I'm like, “No, they're here. Let us – let me show them the respect and compassion that they deserve. I'm taking care of their family member here”. And it was just that moment, out of many of the moments from COVID, really has stuck with me. And I've reflected on that as I've talked to Vanessa a bunch that it is those small little things that can make a huge difference for that family. And I certainly hope that that little extra step meant something extra to them, and showed them in some small way the degree of compassion and care that their loved one was going to receive in the hospital. Mattie Murrey 32:42 You said something interesting. You said I was able to be me. Dr Jared Rosen 32:45 Mhm. Mattie Murrey 32:46 And that, I think, is one of the keys of connecting on a genuine, authentic level with those we work with, whatever setting it is. Be you. Dr Jared Rosen 32:58 Yeah, absolutely. Mattie Murrey 33:00 Final question for each of you. What words of advice do you have for the speech pathologist who is listening to this regarding physician-patient relationships? How do you make that – I know we've talked a lot about that connection, that trust, that security. Final words of advice for making that connection, especially for someone who's speechless? Dr Jared Rosen 33:23 Well, I can speak from my own experience of watching through the window one of the first times that Vanessa had the opportunity to meet with the speech pathologists. And I remember watching through the window of the ICU, and the speech pathologist is holding Vanessa's hand, and I remember looking through and they were just both crying. Mattie Murrey 33:43 Mhm. Dr Jared Rosen 33:44 There was this connection. You have two speech pathologists. Sort of this mirror image. One standing there in her scrubs, and the other one in a hospital gown. And I think that very easily those roles could have been reversed. I think it's important for all of us, whether you're a speech pathologist, or a doctor, or nurse to remember that that could easily be swapped. Mattie Murrey 34:06 Right. Dr Jared Rosen 34:07 You could very easily be in that bed, and how would you want that person to behave towards you? How would you want to be treated? I know this kind of sounds trite, the old golden treat rule, “treat others how you would want to be treated”, sort of thing, but I think that that really rings true. And it's hard for us at times. I think particularly in the hospital setting it can be a really – it can be a tough grind. There's a lot of burnout. There's a lot that's going on, especially during the pandemic. But it's important to sort of circle back to that core tenet of you could very easily be in that bed instead. And Vanessa's story, I think, is a perfect reflection of we're not talking that she's some 85 year old grandma in the bed. She was a young person who was fine one day, and not the next. Mattie Murrey 34:54 Vibrant, [crosstalk]. Dr Jared Rosen 34:56 It's important for us to remember that. Mattie Murrey 34:57 Yeah. Vanessa Abraham 34:59 I think for me, it's to treat that person as if that was your wife, your mom, your dad, your brother. Before I went into various procedures, I remember asking at all levels of care that I was at, “Would you recommend the same treatment to your wife? If I was your wife, would you tell me to do the same thing?” Whether it was being intubated, or whatever it was. “If I was your wife, would you want me to do this?” And a lot of the professionals would look at me, and they would freeze for a minute, think about it, and then they would come back. And every time they came back, they said, “Yes. I would tell my wife – if you were my wife, I would tell you to do XYZ procedure”. And then, I thought, “Okay, I'm going to do it” because I had more faith in their recommendation because if they would recommend this to their own mother, or their own wife, then this is probably what I need, and that gave me a lot of respect for them. So, I think just treating that person and that family as if it was your own family that you're delivering bad news to, or good news to. If you have to talk to them about a brain scan, or an upcoming medical procedure that's very scary, talk to them like you're sitting down with your wife, and hold their hand through it and resonate with them, and try to understand that this is terribly scary. This family's life has just been flipped upside down. For me, I was just this working mom, busy as can be, and within a week's time, everything was flipped upside down. So, try as best as you can to put yourself in their shoes. Mattie Murrey 36:54 Excellent. Well, as we wrap up this episode, I want to say thanks to each of you. Dr Rosen, particularly for setting such a good example for all of us on how to be human, and connect, and show care and compassion. And Vanessa, you just – each time you come on, you open up as the Speechless SLP, and you share, and you make the world a better place. So, thank you, both of you, and for your service as well. Thank you very much for coming on the Missing Link for SLPs podcast. Vanessa Abraham 37:23 Thank you. Dr Jared Morgan 37:24 Thank you. Mattie Murrey 37:30 So, hey, SLPs, that concludes this episode of the Missing Link for SLPs podcast. Please visit my website at fresh slp.com. Follow me on Instagram, or jump on Facebook to connect in our safe and friendly Fresh SLP community where we are empowering new and transitioning SLPs. If you found value in this episode, or in any way had an aha moment, or I gave you a fresh perspective, please show me some SLP love, and support me on iTunes or the Apple podcast app. or subscribe to me on YouTube. You got this!

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