Monday, January 5, 2009

Eval Only

It's never a good sign when the Occupational Therapist who did an evaluation on a new patient just before my appointment time with the same patient says, "They really don't want to do the speech appointment -- they don't think they need it". It either means they really don't need it or they need it badly but don't understand that the SLP domain isn't just the sound of speech, but also all of the language and cognitive skills that drive what we talk about. Either way, these patients tend to give me crap, as if it's my fault that their doctor sent them in.

I was not excited when the OT grabbed me before my 4:00 eval and gave me this message. I introduced myself and when we got into the treatment room, I told him he could take his coat off if he'd like, to which he replied, "No, I won't be here that long. I don't need to be here, I talk fine". Super. I calmly explained that if he felt confident that all was the same after his stroke that I would just do a cursory eval so that I could tell his doctor I asked all the questions he was expecting me to ask, and he could be on his way. We started. He interrupted me at one point and said, "You seriously get paid for this?". I was not loving him.

In an effort to make this awkward situation slightly less awkward, while I was jotting a few notes to myself I asked him why he moved out of DC into the 'burbs, which he had mentioned earlier.

"Well, I'll tell you. I'm from the streets -- I grew up on the streets, selling drugs, the whole thing. One day 12 years ago, I was on the street and I saw this girl I'd sold crack to, and the wind blew a little and her shirt came up some. I could see she was pregnant -- I didn't know she had been 'cause she always wore big clothes. I told everyone on the street, 'Don't mess with her and DON'T sell her anything -- if you do, you'll have to answer to me'. Now on December 24th, I was on the street sellin' and she walked up to me, and said, 'Hey Three Feet' (my nickname is Three Feet). I said, 'I thought you were pregnant' and she said, all in one sentence, 'I had a miscarriage can I get a fifty?'. That day I told my boys I was out, I gave up the life and got the hell out of there. I moved in with a friend, got a real job, met a good woman... now I know what home means, I know what it is to have a remote control in your hand, a Twinkie in the other, and a Law & Order marathon on TV. "

I was blown away, and weeping. He didn't need speech therapy.