Thursday, July 23, 2009

10 things -- but really, only one

Among the various tasks I have to do at work is triaging new orders that come in for outpatient evaluations and then deciding which of our speech pathologists should see each patient.  Every chart I get has a patient history form that has been completed by mom, dad, caregiver, foster parent -- whoever cares for the child.

Most are run-of-the-mill.  Some are hilarious.  Some, worthless.  One was even insulting. 

And, of course, some are sad.  One mom, who obviously had very basic reading and writing skills, had clearly spent a long time working on her son's history: she had been exceptionally thorough, proof-read it (changing correct grammar & spellings into errors on several occasions), and written a lengthly note sharing her guilt that her child's delays were her own fault.  

But the ones that always get to me come from the parents whose children are unable to speak at all.  Usually these parents are some of the strongest we meet:  their children are so medically involved, fragile in so many ways -- unable to walk, talk, eat, dress themselves, clean themselves -- that by the time we are working with them on communication they have developed a pretty tough exterior.  While I'm sure they have private moments where they grieve for their kids, wonder why, feel guilty, and indulge in the anger they rightly hold, these parents can't dwell on those emotions every day.  They wouldn't survive.  They have therapies, and medications, and tube feedings, and real patient care duties to attend to every single day.  

The history we gather on these kids is a little different.  We try to figure out who's in there, what gestures, expressions, even grunts they might already be using to reach out to the people around them.  It's amazing to me how resilient these kids are and how intimately their families know them that they can understand what, to an outsider, is just a meaningless noise or an almost imperceptible glance.  We try to figure out what kinds of motor, social, and cognitive skills they have.  We ask what kinds of communication approaches have been tried before, what has worked, and what didn't.  

The last thing we ask is for parents to list ten things they would like their child to be able to say.  And I'm sure you already know their first response -- it would be yours and mine as well.  All of them, every last one, answers the same.

"I love you."

Can you imagine?  (I can't.)

And this is one reason, among oh so many, that I tell my daughter a hundred times a day that I love her - and why I truly do know how blessed I am to hear her tell me the same.

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