Wednesday, July 23, 2008


As Jehmaine says in my favorite gangsta rap battle (see the link to the right), "Sometimes when I freestyle, I lose confidence." He says this right after starting his freestyle, off the top of his dome, by looking behind him, seeing a mural of a cityscape, and saying "There's a picture of New York, there's a picture of New York, there's a big fat crazy picture of New York".

I freestyled today. I lost confidence. I would have loved to have a big fat crazy picture of New York to inspire me.

Our research department was hosting 3 lovely Israeli visitors today from Sheba Medical Center in Tel Aviv. They connected with us via my colleague (and neighbor both at work and in real life) D. when he traveled to Israel several months ago as an invited speaker at a conference for telerehabilitation, which is a way of providing traditional therapeutic interventions remotely via computer. Its a very exciting area -- the technology is improving daily and the options for implementation are enumerable.

D. and my speech colleague A. have worked on several teleSLP projects over the past 10 years, and have developed a platform to interact with a patient over the computer so that the clinician can see the patient, the patient can see the clinician, and you can both share a document that serves as a treatment material. The visitors came, all this way, to see this in action yesterday and today. They have research dollars to spend and want to throw some our way to help them develop their own protocols using the same technology (but with Hebrew materials, of course).

I was brought in on this project because A. isn't going to be able to travel this fall, and the plan is for D. to bring a clinician with him to Israel when he goes in a few months to help get them set up and running. I think I was tagged because, as I mentioned, I live just across the hall from D., I have some research in my past, and I like computers. Easy enough.

The project meeting started yesterday and was to be 2 days of meetings, slide presentations for overviews of where telerehab has come from and is going, time for brain storming the Israeli projects, and most importantly patient demonstrations using this paradigm. Two different patients, both whom I've seen for a long time and know well, were already scheduled with me so I figured I could just do a tele-session for demonstration vs. trying to reschedule them to another day. Both patients were willing, particularly as the session was not going to be billed to their insurance (telerehab isn't a covered service in most states or by Medicare, though we're working on changing that). I'd never used the computer platform before, which was supposed to be a good example to our visitors to get a feel for the intuitive, user-friendliness of the interface. D. gave me a few articles to read to get me up to speed, but 10 years of research is not easily digestible.

I couldn't attend yesterday's meetings and missed dinner out with them as I was at another building outside of DC until after dinnertime, so by the time I got met them this morning, D. and A. and the three visitors were old and dear friends, and knew all about each other's institutions and practices. I barely know what day it is.

My first patient session goes okay -- I sort of figure out how things work, as it is pretty intuitive, though I found myself saying really dumb things like, "are you ready?" before almost every task, and a very cheery "okay!" in response. Oh, did I mention the visitors are sitting about 6 inches from me so they can see and hear what I'm doing? Taking notes?

The second patient session goes, as you might imagine, horribly. The patient is a wonderful guy who makes phonemic errors in his speech, meaning that his brain sends him the sounds out of sequence. It's difficult to understand if you are face to face but not impossible by any means, but today I just couldn't do it. I tried to talk him through a writing exercise and he tanked. I tried to work on his listening by using a website with audio files, but didn't realize it couldn't be done in a way that both he and I could hear the material. I couldn't even type correctly. It was good evidence that maybe this method of service delivery isn't for everyone, but as the visitors were talking with each other in Hebrew, I was fairly certain they were saying this method was not for me.

I would love to be one of those people who is comfortable in any and all social situations, always has the right level of energy, and always seems like they meant to do that. If I didn't know before that I was not one of those people, today underlined it. And put it in bold print. And italics, all of which is more than I was able to do today.

I definitely take comfort in the memory of a picture A. brought into work one year. She is my daily model of all things pragmatically smooth and comfortable, but this picture was from the year she moved from out of state and no one at her new school liked her -- she is gorgeous now but this picture was of a girl with braces and short curly red hair wearing a pop-a-bead necklace. It was just a few weeks before this picture was taken and just a few days into life at her new school with all new kids when she tried to stop herself from sneezing and, well, you know.

My freestyling today was not so great, but at least I maintained bodily functions. There's something to be said for that.
This big fat crazy picture of New York is from

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