WINNING WAYS

Who knows where it will lead?

ASHA is the American Speech-Language-Hearing Association, the professional and credentialing body for speech-language pathologists, audiologists and speech, language and hearing scientists in the USA. Its Annual Convention attracts expert speakers and well-known names from around the globe. When UK speech and language therapists Claire Butler and Roger Newman were invited to present at ASHA 2009 they were taken by surprise - and not a little daunted! Here they recount how they overcame their terror, doubts and competing priorities, and prepared themselves for this chance of a lifetime.
for a short course, which people would be paying an additional $60 to attend. I was to be on a panel alongside big names from the world of swallowology names I knew from the books on my shelf and the papers Id been reading for the previous 15 years. I was originally slated for a 20 minute slot but, as the discussions went on, my time extended first to 30 and eventually 40 minutes. The pressure was building steadily. Preparation for ASHA made use of all the skills Id learnt during my MSc. I sourced all the recent papers and guidelines I could find in the area of dysphagia screening, and read and critiqued them as they arrived. With the help of colleagues I contacted speech and language therapists around the UK to ask about their current dysphagia screening practices, what guidelines they were following and whether they had particular issues or concerns. All this was done in my own time and had to be completed while balancing work and family life. One of the more surreal moments during the process was a conference call with the other speakers eminent names in swallowology in America and Canada - while simultaneously trying to get my little girl ready for bed. But as time went on I began to create the structure for the presentation and the whole project started to come together. A couple of things I hadnt anticipated almost threw me off course. One was discovering that ASHA would need the completed presentation much earlier than I expected. In fact, the finalised PowerPoint slides needed to be with them over two months before the convention date, so a CD of presentations could be provided for attendees. Around this time I also discovered I was pregnant with our second child which, although wonderful news, was an additional complication around my plans for ASHA.

New Orleans Morial Convention Center

Claires story
was approaching the end of maternity leave when I was first contacted about presenting at the ASHA convention in New Orleans. ASHA were looking for someone to present the UK Perspective on Dysphagia Screening. My name was put forward by Paula Leslie; we had become friends when she was my MSc tutor 5 years earlier. Having been away from work for over a year, immersed in nappies and bedtime routines, my initial reaction was no way! Although tempted from the very beginning, I felt out of touch with the world of dysphagia and quite frankly terrified. A quick response was needed and as I sat down over the next couple of hours I realised

that, with my knowledge and experience, maybe I did have something to offer. More importantly, other people clearly believed it was something I was capable of. When I discussed it with my husband he confirmed what Id started to appreciate already this was one opportunity not to be missed. With agreement that ASHA would pay at least some of the costs, saying no was getting harder. The exhilaration I felt on accepting confirmed Id made the right choice. I dont think I really believed I was presenting at ASHA until the official emails started to arrive a few weeks later. As the details of what Id let myself in for became apparent, the anxiety levels began to rise. What started as purely a presentation turned into presenting

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WINNING WAYS

Never a perfect time

For the last few weeks before the trip, every spare moment was spent reading through my presentation and gradually tweaking and fine-tuning what I wanted to say. If I thought doing an MSc while working full-time was hard, preparing an ASHA presentation while caring for a toddler and battling with morning sickness and pregnancy exhaustion was on another level! The trick was to remember what I was aiming for every time I really thought about my imminent trip to New Orleans, all the hard work became bearable. The truth is theres never a perfect time to do these things and I remember some wise words from Paul Carding in Newcastle: life always gets in the way. Opportunities like this dont come along every day and personally I now try to grab them every time. Attending ASHA was an experience Ill never forget. My taxi from the airport brought me right past the doors to the convention centre. Almost a mile later, when we reached the other end of the building, my jaw was nearly on the floor I could hardly believe I was going to be presenting in that huge building in just a few hours. I certainly felt fortunate that my short course was scheduled for first thing on the first day. It meant less time for the nerves to build up and I knew I could relax once the presentation was over. The logistics of presenting at such an immense convention, with more than 10,000 attendees and in such a massive building were interesting to say the least. I arrived a good 40 minutes before my short course was scheduled to begin, plenty of time - or so I thought. Five minutes of brisk walking and I was only as far into the building as the queues to register. As an overseas attendee, my registration pack hadnt been sent out to me in advance, requiring me to queue to collect my badge, convention schedule and goody bag. As we slowly edged forward, I had visions of still standing there when the presentation was due to begin. Luckily, on being told I was presenting that morning, everyone was more than happy to let me jump the queue. Amazingly it took another ten minutes of walking to reach the room where my short course was due to take place. Not for the first time my MSc training came in handy with 15 minutes to spare I discovered my memory stick couldnt be recognised, but luckily I had a backup on DVD. During the presentation itself, I was probably the most nervous Ive ever been in my life. Despite the long walk, almost 300 individuals turned up to hear us speak, the biggest group Ive ever presented to. Ive been told it came across really well, but from my perspective I noticed every little point where I stumbled on words or my voice began to struggle. Being told I only had 10 minutes left to speak, when in fact I had 20, really didnt help. I know from my MSc experience that the speaker is their own worst critic, so I had to rely on the feedback I received, which was all good. Most heartening was to be grabbed by

a stranger in the corridors of the convention centre some 24 hours later and told how much they had enjoyed my talk. Once my presentation was over, the rest of convention was mine to enjoy. Its an exhausting experience, a whirlwind of presentations and networking opportunities. For me, the most exciting aspect of the whole thing was the people I got to meet. In the three days of the convention I made friends and work contacts from around the world. These contacts are invaluable in so many ways helping me with evidence based practice, giving me a wider sounding board for ideas and making further personal challenges more likely to come my way in the future. I can honestly say that the entire experience has been well worth all the hard work involved. After finding out about my invitation to present, I had a variety of responses from friends and colleagues. Many were pleased that I had such a great opportunity and impressed with the achievement of being invited. But a significant number asked why these things just fall into my lap. Ill admit that a degree of this was down to luck the right person was in the right place at the right time to put my name into the frame. However, the underlying reasons why I came to be presenting at ASHA were hard work and dedication to a challenge. I put myself forward for my MSc, for presentations at events in the UK, for writing articles for publication and for becoming a Royal College of Speech & Language Therapists advisor. Although Ive had support from my employer wherever they can, most of the work for all these things has been done in my own time. Im still an ordinary, everyday speech and language therapist, but I do what I can to challenge myself. I feel proud of being invited to present at an international conference and of accepting and achieving that goal.

itself, but it soon got a great deal bigger. After the article was turned down by many peer reviewed journals, I was contacted out of the blue by Dr Jay Rosenbek from the University of Florida. My heart was in my mouth as I opened the email to find he was asking for the manuscript. He was editing a book on rare dysphagia and wondered if Id like to contribute. Although aim for the top and work your way down didnt seem to succeed at first, we got even higher than the top, and the journey continued.

The important stuff

Rogers story

y story began many years ago after being enticed into the world of academia when a patient was admitted to hospital after hanging himself in a suicide attempt. It may sound gruesome, but for him the end result was not what he had set out to do, and for me it was entirely different. The patient presented to me with acute dysphagia, but his CT brain scan was clear and he did not have any other noticeable damage, except what I spotted when I captured the image of the fracture upon videofluoroscopy. His swallowing function had been significantly affected something Id never come across before. After speaking to Maggie Lee Huckabee at a local course, she looked at me sternly and instructed me to write it up. My first thought was why?, and my immediate subsequent thought was ok, why not? The story began. I made contact with Dr Paula Leslie, formerly of the University of Newcastle, who helped me a great deal. Her philosophy is aim for the top and work your way down. We eventually agreed that the article could be a joint venture, something of a privilege in

After much hard work, deliberation and editing to turn the article into the chapter required, it was finally accepted for publication in an international textbook. I couldnt believe it. Having achieved what I thought was the ultimate, the books co-editor Dr Harrison Jones emailed and invited me to present the chapter at ASHA. Jaw dropping and heart stopping are the words that spring to mind. I quickly emailed back and accepted his invitation, without giving a thought to cost, flights, accommodation, material to present you know, the important stuff. I had about six months to prepare everything. Paula was the only person I knew who was definitely going but she was presenting in various other short-courses. She asked if Id mind doing this one alone as Id done all the hard work. There was a compliment in there somewhere, but I was feeling pretty dumbstruck at the thought of presenting as part of an international convention alone. The presentation had to be perfect. I was going to be talking to the worlds greatest researchers in swallowology, potentially being asked horrible questions I didnt know the answer to. I had to keep telling myself that the condition I was presenting is extremely rare; I was the one whod done the research into it; I knew what I was talking about. Trying to convince myself of all this was extremely difficult, nigh on impossible, but it was the only way I could do this. My wife must have heard the presentation a thousand times, and strangely enough she now knows all about the hyoid bone and its connections too. The presentation was finally complete. I made three copies of it, and emailed it to myself several times at various addresses. Paula was kind enough to take the presentation too. Like Claire, upon arriving in New Orleans I was horrified to see the size of the convention centre. I know the citizens of the USA like to do things on a bigger scale, but this building was immense, literally one mile long. I was constantly reminded of this as my hotel was directly opposite and full of ASHAs attendees in other words, potentially my audience. After exploring New Orleans itself on the first day I arrived, I collected my registration pack with all the things Claire mentioned, and retired to my hotel to practise the presentation one more time. My two hour time slot was also scheduled for the first day, something Ill always be thankful for, although I had no power over when it was going to be.

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WINNING WAYS

Jo Middlemiss comments...

Front (l-r) Roger Newman, Justin Roe (SLT, Royal Marsden), Claire Butler Back Dr Jim Coyle and Dr Paula Leslie, both University of Pittsburgh I met up with Paula who introduced me to Claire. Wed never met before and both looked as pale as each other. Seeing another novice helped us relax a little into the concept of being in a huge convention centre in an unfamiliar city in the United States, about to present to some of the worlds leading figures. Despite having conversed via cyberspace with my editors, I had never met or spoken to them before. The first time I met Harrison was when I went onto the stage in the giant ballroom I was about to present in. He reassured me everything would be OK, then I was called to give my talk. I turned round to see the other presenters on the front table. I appreciated how big this was when I saw who they were, and Im certainly glad I hadnt realised before. Dry mouth syndrome as Claire and I nicknamed it set in. The glasses of water in front of me were my comfort as I tried desperately to see the people at the back of the room, but they were too far away. This thing I was doing was out of my league, but it cant have been, I was there, Id been invited, I knew what I was talking about, I was giving my presentation. These thoughts raced through my head but I finally became more comfortable with the concept of speaking at an international convention - five minutes into my presentation. The dry mouth syndrome cleared up; the images were very well appreciated by the audience; the topic was understood; I had made my point clear; the questions were answered coherently; the applause commenced Id done it, presentation successfully achieved. I could enjoy the rest of the convention with the proud feeling of accomplishment that had been waiting to explode for the previous six months. This opportunity has not only provided me with a huge amount of experience in both writing and presenting but, with friends and international work contacts made, other prospects have since arisen. Frightening as it may be, I can say I would look now at the situation with very different eyes. Claire and I are no longer the novice speakers, as we have the experience of presenting at ASHA 2009 to our names.

Always with us

This is something which will always be with us it will always be on our CVs and our continuing professional development profiles, and the friends and work contacts that weve made can never be taken away. If that email ever arrives in your inbox offering you the chance of a lifetime, we urge you to take it. It will be hard work, and it will take over your life for a time, but believe us both when we say it is worth it. SLTP Who knows where it will lead Claire Butler is the clinical lead speech and language therapist for adult dysphagia at East Surrey Hospital in Redhill, email pingucb@ googlemail.com. Roger Newman is senior specialist speech and language therapist at Royal Preston Hospital, email Roger.Newman@lthtr.nhs. uk. Information on the ASHA 2010 Convention in Philadelphia, 18th-20th November, is at www. asha.org/events/convention/.

Singer-songwriter Beth Nielsen Chapman is one of these characters who has grown through adversity. Her husband died when her child was young, she developed breast cancer a few years later, and only last year needed an operation to remove a benign tumour from her brain. The first symptom was a blanking out of the words she was searching for. As she was wheeled in for her operation she had no idea whether her language would be returned to her but, within hours, the lyrics which had been stacking up were unblocked. The result is a beautiful album Back to Love. Beth wrote one of the songs Happiness the day all her hair fell out during treatment. One line stands out for me: All those fears I held as truth. It reminds me that so often we convince ourselves of our own weakness rather than our strengths. Claire and Roger do not allow their fears to make the decisions. They remind themselves of strengths rather than weaknesses. They listen to and seek help from those who believe in and encourage them, and prepare incredibly well for their presentations and any predictable eventuality. I enjoy the honesty of their nerves, their surprise at having been chosen, their ability to say Why not? rather than Why me? and their complete refusal to give in to good excuses to dodge the challenge. We see that the benefits and opportunities for learning and growth far outweigh the energy they spent in preparation and planning. Sometimes when attending huge events we might be tempted to think these things are easy for some but not for others. This is a mistake. If Claire and Roger had not been prepared to put their heads above the parapet and take the risk of stretching themselves beyond their comfort zones, they would have lost far, far more than they gained - and never have known it. This poem by Arthur William Ward says it all:
To Risk To laugh is to risk appearing a fool, To weep is to risk appearing sentimental. To reach out to another is to risk involvement, To expose feelings is to explore your true self. To place your ideas and dreams before a crowd is to risk their loss. To love is to risk not being loved in return, To live is to risk dying, To hope is to risk despair, To try is to risk failure. But risks must be taken because the biggest hazard in life is to risk nothing. The person who risks nothing, does nothing, has nothing, is nothing. He may avoid suffering and sorrow, But he cannot learn, feel, change, grow or live. Chained by his servitude he is a slave who has forfeited all freedom. Only the person who risks is free. The pessimist complains about the wind; The optimist expects it to change; And the realist adjusts his sails.

REFLECTIONS DO I FIRST WEIGH UP THE IMPORTANCE OF AN IDEA AND THEN TAKE CARE OF THE LOGISTICS? DO I USE PREVIOUS EXPERIENCES TO HELP ME COPE WITH NEW ONES? DO I REALISE THAT LUCK IS OFTEN ASSOCIATED WITH HARD WORK, AN ELEMENT OF RISK TAKING AND DOGGED DETERMINATION?
Do you wish to comment on the difference this article has made to you? See the information about Speech & Language Therapy in Practices Critical Friends at www.speechmag.com/About/Friends.

Qualified Life Coach Jo Middlemiss offers readers a complimentary half hour coaching session (for the cost only of your call), tel. 07803589959.

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