November 1, 2011 People

First Person on the Last Page: Today I Saved a Life

Speech-language pathologists - Tronda Moss, Lauren Wick, and Megan Urban

Speech-language pathologists (from left) Tronda Moss, Lauren Wick, and Megan Urban recommended a speaking valve for a paralyzed patient and corrected a critical miscommunication.

There are many moments when I know that speech-language pathologists make a difference in someone's life, such as providing conversational support so that a newly aphasic patient can communicate effectively for the first time after a stroke or at other communication milestones. But it's not often that SLPs can say, "I saved a life," which is how Lauren Wick, Tronda Moss, and I felt today. 

We had a young adult patient who sustained a spinal cord injury resulting in quadriplegia, respiratory failure, and ventilator dependence. As the patient mouthed words, the ICU team and family interpreted that the patient was mouthing, "Kill me." His team and family began to discuss the patient's plan of care, and even discussed taking the patient off of the ventilator if that was the patient's wish. 

During trach rounds, Lauren recommended obtaining an in-line speaking valve consult so that the patient could better participate in medical decision-making. Once the patient was able to communicate verbally, it was immediately clear that the patient was really saying, "My shoulder is killing me." His shoulder was also injured during the accident and was the one extremity that was partially regaining movement.

During this initial session with the speaking valve, Tronda and I called the attending physician into the patient's room to facilitate communication between the patient, family, and medical team. Everyone was shocked that they had so misinterpreted the patient's initial message.

Clearly it is essential to maximize communication with all patients. Ensuring that patients have the tools they need to communicate and that team members use conversational support strategies, such as response verification with yes/no questions, is paramount to excellent patient care. In this case, it was a matter of life or death.  

Megan Urban, MA, CCC-SLP, is clinical coordinator for adult inpatient speech pathology at Duke University Medical Center. Contact her at

cite as: Urban, M. (2011, November 01). First Person on the Last Page: Today I Saved a Life. The ASHA Leader.


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