American Speech-Language-Hearing Association

Care and Inspiration:

Inspired by his SLP, recovered stroke patient Scott Janokowski now wants to do more good with his life

A Night that Changed Everything

College sophomore Scott Janokowski took great pride in his role on the varsity debate team. An accomplished football and baseball player, Scott also sailed through his academic requirements, maintaining a 3.8 average during his freshman and sophomore year.

At 19 years of age, his life was on a fast-track to success. Then, without warning, on one December night in 2004, everything changed.

During final exam time just before Christmas, while exercising in his parents' basement, Scott experienced an agonizing pain on one side of his body. "When I got up from doing pushups, my left shoulder felt a sharp pain, like a bear clawing it," Scott recalls. "The pain was intense. I tried to tell my parents I needed help but couldn't get any words out."

His right side was paralyzed, and when he tried to stand up, he found he could not. Scott's parents called 911, and the medics transported him to the local hospital. From there, he was transferred to University of Michigan Hospital by helicopter. Scott went into a coma for three days and was hospitalized for two weeks.

After his release from the hospital, he began rehabilitation therapy. His treatment took place at Wayne State University Speech and Language Center in Detroit, Michigan, and began just a few weeks after his stroke.

"My debate coach, George Zieglemueller, was friends with the pathologists at the University clinic," says Scott. "He is the one who set up my appointments there. My mother didn't realize there was such an excellent, affordable facility so close to us."

A New Patient Faces the Challenge

When Scott arrived at the Wayne State clinic in January, 2005, he was in desperate need of help.

Center Director Kristine Sbaschnig remembers that first encounter, which occurred about a month after Scott was stricken. "He was completely non-verbal. He could not speak, and it was not clear whether he could even understand or process words spoken to him. His body had been paralyzed on one side. To be honest, when I met him I had no idea if he could recover."

Injuries such as Scott's happen quickly. At any given moment, speech language pathologists and professionals must be ready to aggressively treat patients, in order to have the most impact on their lives.

Kristine managed the team of SLPs that would handle Scott's case at Wayne State over the coming months. As a teaching institution, the Speech and Language Center employs supervised graduate students to take a primary role in seeing and treating patients, as part of their clinical training. This arrangement helps ease the financial burden for patients, as services are offered at a more affordable rate.

In Scott's case, a different graduate student studying in the University's Audiology and Speech Language Pathology Department would take over his case at the beginning of each new semester. The workload and specific therapies would change according to where Scott was in his recovery.

Fifty-minute therapy sessions were held four times a week, with an extra group session held on Fridays. Scott's case was unusual in that his stroke was so severe, and because it happened when he was so young.

"He had a big challenge ahead of him," recalls Kristine. "Verbalization is so crucial. It's a big loss when that ability disappears. He could not understand other people, he had trouble processing what he was hearing, he really had to work extra hard on that. Plus he could no longer write. Our clinicians identified with his struggles and did all they could to help."

A Meaningful Encounter

One clinician, Amy Thompson, a third-year SLP graduate student, took over Scott's case about two years into his recovery, in January 2007. Just a few years older than her patient, Amy connected with Scott immediately, both professionally and psychologically.

"I saw this patient, Scott, who as a student had many of the same interests and concerns that I had," says Amy. "He was also willing to work incredibly hard on his recovery. I did my best to become his advocate."

When Amy began working with Scott, he had already come a long way, but was having difficulty reading, writing and speaking aloud in class. His therapy was centered on increasing function in a number of areas, including comprehending grammar, processing language, formulating coherent sentences and acquiring the skills he needed to speak in public.

"I tailored our activities to what was most important to him and his goals," Amy recalls. "I feel like I had an amazing opportunity to connect with him because it is so rare that our patients are fellow students."

Amy's path to becoming Scott's clinician was not an ordinary journey. Before beginning her speech and hearing studies, she had been a journalism student and already had three associate degrees under her belt: in applied sciences, liberal arts and massage therapy.

"I have always been interested in words and language," she says. "But medicine has also been a passion of mine." She got excited about the idea of pursuing a career as a Speech Language Pathologist when introduced to it in one of her classes.

She is thrilled with the prospect of becoming a certified Speech Language Pathologist. "This training has been intense and structured, but an amazing experience. This pursuit is the best decision I ever made," Amy says.

A Trying Recovery - and a New Life

Scott had to start at the very beginning-identifying pictures on flash cards, and mastering basic language processing-steps that took several months. "I would work toward certain benchmarks," he recalls. "For instance, learning to speak in a full sentence, which took about three months, or beginning to read, which also took about three months."

"Word recall and concept recall was unbelievably hard work. It was totally draining. My clinicians and my mother kept on me to practice, even when I didn't want to."

"It was inspiring and humbling to watch Scott push and push and push," Amy says. "He would tell me, 'No, I need more' when he wasn't there yet with a step we were taking. He felt so comfortable in our program at Wayne State. There was an endless amount of support. Really, this program was the best thing that could have happened to him."

The bonds that Amy and her fellow clinicians created with Scott, and the therapies they worked on together, proved strong enough to make a spectacular difference.

Less than three years after his debilitating stroke, Scott has re-enrolled in school full time and has even taken his old slot back on the debate team. He says writing is still hard, especially because of the paralysis on his right side, but he has adapted and become ambidextrous with most tasks.

"I can guarantee that if I didn't have my clinicians, I would not have made this progress," he says.

Inspired by those who cared for him during his illness, he is pursuing a career in nursing. Amy encouraged Scott in this pursuit, researched his options and helped him apply to the programs that interested him.

"The difference between who I am now and who I was before my stroke is enormous," says Scott. "There is no return to where I was before. I have a new appreciation for the disabled, for anyone in a sad situation. Before my stroke, I was far more egocentric and individualistic; my career path was about making money. There is so much more good I can do-that we can all do. I realize that now."

Like Scott, Amy Thompson's feelings about the work she does reflect strong personal values.

"This profession is such a great fit for me," she says. "I feel like we are contributing to humanity and to the recovery of people who have been through so much. I have found my purpose in life."

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