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The moment this happened during an SLP session, I immediately pulled out my phone to jot it down and then gave Kaitlyn my “can I put you in a comic” spiel.
Assuming Kaitlyn sees this, I love you and you’re fantastic and I genuinely look forward to our sessions and I think you’re doing a great job.
…and for anyone wondering, yes, it certainly seems that the “smile” shape does in fact give my voice a more feminine quality. “You should smile more” traditional male comment towards women silliness aside, I kind of like the idea that my transition journey is giving me new reasons to smile… this one having a practical effect!
It’s not often that we have the opportunity to combine emotional and logistical positives, so I see this as a win.
Now if I can only get over my embarrassment and practice these techniques “in the wild” like at the office. I do try, but often times I find myself needed to just communicate “normally” and not have to devote any brain power to how I’m shaping my words… but in order to create that mental (and physical) muscle memory, I do actually have to practice…
…it’s a loop of “I don’t practice as much as I should, so I’m not great at the voice yet” to “my voice isn’t great yet so I don’t use it in the office so I can more effectively communicate” which means “I’m not practicing as much as I should” which leads to “still not great with the voice, I’m not practicing at the office…” and so on.
Womp womp…
…I need to practice… I’m sure Kaitlyn would support that.
You, a visitor of a patient, take up your grievances with hospital policy to Robby. Robby decides he could help you do something about it.
WC: 3.5k
Warnings: My blog is 18+, MDNI, female reader, language, car crash (off screen), arguing, pining, my poor attempt at writing a meet cute, no use of y/n, likely medical inaccuracy, reader is a pediatric speech language pathologist, reader is described as shorter than Robby but there is no other physical description of reader
^lmk if i missed anything
part ii.
For those who don't know:
Speech Language Pathologist (SLP)=speech pathologist=speech therapist
SLPs work birth-to-earth (infants and new borns, pediatrics, adults, geriatrics). Reader is a pediatric SLP.
There is a national speech and hearing association, you can look it up if you want. for the purposes of the fic, i will not be using the official name for it
whats the point of a specialized degree if i don't write niche fanfiction for it
Author’s Note: this has been in the works since may,,, im so sorry i didn't post over the summer,,,i became important at work and also got excruciatingly sick like five times,,,please be kind about the medical inaccuracies i dont work in the medical field, its not my speed,,,this is based off of a true event however, so, again, be kind and please enjoy!
Michael Robinavitch walked in through the sliding glass doors of the PTMC just before 7 a.m. Already, Robby knew he was in for a doozy. People flooded the waiting room, piling into the rickety chairs and lining the walls—waiting, hoping for their name to be called next. It was likely that most had been waiting for well over three hours.
It was fucked, frankly.
Robby knew it. His residents and nurses knew it. Hell, even his medical officer, Gloria, knew it deep down. Sighing, he proceeded further into the ED, looking to relieve Abbot for the shift change.
Instead of finding Jack at the nurses' station, Robby assumed he must be getting air on the roof—not an uncommon place for Jack to be at the end of a hard shift. Making his way to the elevator, Robby realized he needn't go much further, as he found his friend trapped near the stairs by none other than Gloria.
Jack caught Robby's eyes, a look of pleading glazing over. Most days, avoiding Gloria was Robby's number one priority, but helping someone else escape a conversation with her occasionally overrode said priority. Walking toward the pair, Robby braced himself for whatever bullshit he was about to hear.
"Ah, Robby, I'm glad you're here,” she offered him a smile that he immediately recognized as her seemingly permanent mask of condescension. “I was just telling Dr. Abbot that while our patient scores are still up from last quarter, we really need to prioritize the satisfaction of each and every patient that walks in through those doors."
Of course, Robby should have guessed, this would be her topic of concern today; it always was. Gloria seemed to be ever so worried about the business of the hospital rather than the true purpose of the hospital: helping people.
Pulling up all of the professionalism training videos he had been subjected to over the years, Robby breathed in and plastered a smile on his face.
"Well, I will certainly try my very hardest to do just that. However, it does seem to be a challenge when we don't have the staff to keep up with all of our patients, regardless of whether or not they are able to walk." Jack stifled a smirk at Gloria's eye roll and Robby's marginally distasteful quip.
"You know very well what I meant, Robby. And I can't hire more staff if there's no one to hire. Other hospitals are going through the same issues as we are. Now, please—figure something out."
"Ohoho, there are plenty of those who can be hired, we just both know that that costs money, so it's not your desired course of action. Now, I think that I should really be working on my patient satisfaction scores and figuring out how to run my ED. Why don't you excuse us, and you can work out our staffing issue?" Robby breathed out sarcastically, turning away from Gloria and Jack at his side.
"Thanks, brother," Jack said once out of earshot of Gloria.
"Anytime. How was last night?"
"Could've been worse," Jack paused to think of the right phrasing that wouldn't jinx Robby. "There was a group of college kids with some minor alcohol poisoning that were brought in. They're hooked up to IVs and stable now. Should be released soon. Had an elderly woman in a car crash—pneumothorax. She was intubated just a few hours ago and is waiting for surgery. She should be awake soon. Family might get here around the same time."
Robby nodded, walking side by side with Abbot to the nurses' station while he continued to fill Robby in on all the cases he oversaw during the night shift. Robby looked around the floor. Nurses were moving from room to room, doctors were switching focus from charting to patients themselves, and in the midst of the chaos Robby's chest tightened as he breathed in.
Same as everyday.
"Well, I'm out, Robby. Have a good shift."
"Get out of here, brother, I'll see you tonight."
Abbot nodded, strapping his bag onto his shoulder, before walking out of the hospital doors. Taking in another deep breath, Robby went about his day.
Case after case, coffee after coffee, the day didn't slow down. It was a normal shift, well, as normal as it could be for an environment like the ED. Patients came in and out, med students and interns followed around his residents in herds, Dana asked her usual inquiries about his health and well being.
Robby found himself in a rhythm until—
"Hospital policy? There is absolutely no way. Where is your attending?" A loud, feminine, yet strong, voice broke through and caught Robby's attention.
"Ma'am," Langdon's voice cut through from the same room.
"Fucking Christ," Robby muttered under his breath as he gathered himself to deal with whatever it was that Langdon had presumably gotten himself into. He walked toward the room that was occupied by the intubated elderly woman. She was awake now, looking to her left, where he saw you. You were facing Langdon, one hand resting on the railing of the bed, and the other tightly gripping the strap of the bag that slung over your shoulder. You were dressed professionally: slacks and a vibrant blouse that accentuated your features. Your aura exuded the very same vibrancy and professionalism that you wore. Annoyance traced your eyes, your brows furrowed together, creasing the skin on the bridge of your nose.
Robby knew he had never seen you before—of that, he was certain. He would've remembered seeing someone like you. Someone not yet dragged down by the weight of the world, someone who carried themselves with confidence and pride.
Stepping into the curtain enclosed room, Robby pulled it shut behind him, closing the lot of you off from the rest of the ED to offer privacy—and to hopefully spare the rest of the department from a potentially very loud conversation. You turned your attention to Robby, sizing him up. Despite the fire that lit behind your eyes, he noticed a slight crack in your demeanor, which you quickly recovered.
Tearing his eyes away from you, Robby barked to the young doctor. "Dr. Langdon! What is going on here?"
"You'd better be the attending physician in this emergency department, because I don't want to speak to anyone else at the moment," your articulated voice cut through to him once more as you turned to Robby, completely ignoring that Frank was even in the room. Now that he was in your direct line of fire, he felt a shiver run down his spine and a warmth creep up his neck. He shrugged the feeling away.
"Yes, ma'am, I am the chief attending. My name is Dr. Michael Robinavitch, or Dr. Robby. How can I help?"
"Well, Dr. Robinavitch,"—he bristled at the use of his government name—"I would like to know as to why your speech therapist hasn't come to see my mother?" you asked pointedly, nodding to the woman in the bed—your mother—to emphasize your inquiry. She glanced between you and Robby before staring up at the ceiling, her eyes glassing over with tears. Robby knew that waking up after intubation was never pleasant, but it was better than not being able to breathe at all.
"Your mother has a collapsed lung," Robby said carefully. "She didn't suffer a stroke or a brain injury in the crash. Her brain is perfectly fine. There's no need to bring our speech pathologist down here."
You looked at him incredulously. "Dr. Robinavitch, I'm not worried about my mom's brain—she's intubated." You emphasized the word, but the point seemed to be lost on him. You rolled your eyes. Doctors, you thought. Communication across fields weren't exactly their strongest suit. "Where is your speech pathologist to assess and offer my mom alternate communication modalities while she's in your department?"
"Our speech pathologist is only called to assess and treat strokes and brain injuries, nothing else."
An emotion Robby couldn't quite describe—some combination of disbelief and suppressed fury—passed over your face as you attempted to process what he'd just said.
"That's unethical. Incredibly unethical, actually. My mom is intubated, Dr. Robinavitch. She's conscious and has a tube down her airway. She cannot speak and you're telling me that your speech pathologist—your communication specialist—doesn't get called down here unless there's a stroke or a TBI? That's only a percentage of your patients who need one. What if she is in pain? What if she needs help? What-"
"Well, that's what the call button is for," Langdon interrupted your tirade. You turned your attention from Robby to him. Your mother shifted her gaze from the ceiling to Langdon, then to you, a knowing look in her eyes. A look that said Langdon didn't have the slightest clue what he just walked himself into.
"And then what, Dr. Langdon? A game of charades?" You asked sarcastically. To you or any other person who didn't know him, it would have appeared that Dr. Langdon took your comments in rough stride; to Robby, shame and embarrassment flushed his face.
"Look, Dr. Robinavitch," you turned away from Langdon, "I'm sure it's not within your power to determine what is or isn't hospital policy, but either you bring down a speech pathologist, or I will go to your management to fight for her and all the other communicatively impaired patients care that you have neglected. Your policy is inhumane."
Objectively, you knew you were being too forward with the poor man. Stress was stitched into and around his presence—a, granted, very attractive, thread-work of wrinkles and salt'n'pepper hair. If this had happened at your work place, your ability to remain level headed would've been astronomically easier. But you didn't work with these doctors, and your mother was their patient. A level head was out of the window.
Despite your forceful, and admittedly emotional, outburst, Robby knew you were right. As he processed your words, he mulled over his options: he could continue to refuse you at the risk of causing a scene, he could ignore policy and bring someone down anyway, or he could put you through—
Before he finished the thought, he said, "Again, ma'am, I cannot bring down a speech pathologist. However," your eyes lit up at the hope of getting what you wanted from him, "I can get you Mrs. Gloria Underwood, our hospital's Chief Medical Officer. She will be better help to you than Dr. Langdon or myself."
Langdon shot Robby a look. Everyone in the ED knew of Robby's typical avoidance of Gloria. For him to voluntarily seek her out was wildly out of character. But with the way that this conversation was currently going, Robby was keenly aware that you were not going to back down—rightfully so, in his opinion.
Plus, an opportunity to see Gloria squirm while being ripped a new one? To that, Robby thought: Front row tickets, please.
"Thank you," you say, mildly surprising Robby at your swiftness to sit down and divert your attention back to your mother, whose eyes were trained on you with gentle gratitude. Robby looked to Langdon and motioned for him to follow out. He shut the curtain, taking in a deep, calming breath before paging Gloria down.
"There's no way she's gonna get Gloria to change hospital policy," Langdon said, clutching the stethoscope draped around his neck. Robby fought the urge to roll his eyes. Frank was a great doctor, wonderful even, but his ability to read social cues, coupled with his bedside manner, needed improvement. Especially for a senior resident.
"Maybe," Robby muttered, "but she'll make an exception if it means patient satisfaction scores go up."
"She's one patient. She's not gonna change our scores alone."
"No, but did you see her badge on her bag? She's a committee member of the national speech and hearing association, and likely a highly respected speech pathologist. Gloria will most definitely care about that.”
It didn't take Gloria very long to reach the ED and find Robby, which was to be expected, since paging Gloria wasn't within his norm in any capacity.
"What's wrong? You said you needed to see me," she asked, approaching him briskly.
Robby simply pointed the room where you sat with your mom. You were at her bedside in a chair, papers scattered across her legs, and a laptop open on your thighs, presumably pulled from your bag.
"You wanted higher patient scores? Here's your chance," Robby remarked as Gloria walked away from him. He followed her into the room, having taken over the case from Frank now that he had involved Gloria.
"Gloria, this—"
You cut him off, standing up and extending your hand to her.
"Gloria Underwood," Gloria said, accepting your handshake.
Robby, used to being the one in control of the conversation, took a step back as you assumed his role. If anyone were paying attention to him, they would've noticed the slight shift of his eyebrows and the perplexity that painted his face. It was rare anyone other than him—or maybe Dana on occasion—to truly challenge Gloria so directly. Something shifted in his chest, rising to the hollow of his throat.
"What seems to be the issue?" Gloria asked, breaking Robby from the trance that had fixated itself on you. He watched as you breathed in deeply, seemingly in a way to soothe yourself before speaking.
"My mother is intubated and hasn't been seen by the hospital's speech pathologist. I asked Dr. Robinavitch why that is, he simply says 'hospital policy' and that I should speak to you. Now, Dr. Underwood, why does your hospital policy state that speech pathologists are only consulted proceeding a stroke or TBI?"
"Ma'am, as your mother is awaiting surgery and a place in the OR, there is no need for one to come down and evaluate her. Hospital policy states—"
"Yes, I understand that," you interrupt, fingers pinching the bridge of your nose in frustration. What little composure you had beginning to falter. Robby noticed the way that Gloria tensed, and the way your body seemed to be hum with simmering anger.
"Why is that your policy? Because you have at least one patient who is cognitively present and communicatively impaired. Your hospital has not offered any sort of comm—"
Gloria cut you off. Your patience, Robby could tell, was wearing thin.
"Ma'am, I assure you, we can find ways to communicate with her—"
"And yet, you haven't."
A beat, and Robby stepped in.
"You're right, we haven't."
You break your intense gaze from Gloria and turned it on Robby. And perhaps he was imagining it, but the little line between your brows seemed to soften as your eyes met his.
"Dr. Underwood, my mother needs to be able to communicate with Dr. Robinavitch," you said, gesturing toward him. "I want her to be able be on the same field as we are—communicatively. She doesn't want me speaking or understanding for her when it comes to her health. Now, please."
Gloria looked between yourself and Robby, clearly weighing her options. After a moment, she sighed and looked at your mother.
"I'll call down Sam Kurtane for you, Robby," she said finally.
She looked back at you, rolled her shoulders and straightened her neck.
"Ma'am, I will meet with the hospital board about updating our policies to ensure our patient's are receiving the best care they can receive in our hospital."
She promptly turned on her heel and left Robby and you alone in the room. The soft clicks from her shoes getting further and further lost in the voices and machines of the emergency room.
You slumped down in your chair, letting out a heavy breath. Your head dropped into your palms as you quietly murmured, "Thank you."
Robby stepped toward you and your mother, "Of course."
You smiled at him, and—he swore—the air in the room shifted. It felt thinner somehow, leaving him feeling lightheaded.
Just need to get some food, he thought, too much coffee on an empty stomach.
He cleared his throat and reached up to scratch the hair at the nape of his neck. "Yeah, it, uh…it really was no problem."
He was beginning to lose his composure. What had started as a simple attempt to draw some entertainment out of his boss had become something else—something different. There you were, in his ED, taking charge the same way he would.
You angled your head slightly, picking up on his sudden fidgeting.
"I take it you're a speech pathologist?" Robby asked, redirecting his attention to your mother's chart and moving around the bed to face the monitors.
"Yeah, uh, pedes, mostly. But I have friends and colleagues who work with adults."
"Hospital?"
"Uh, kind of—yes? It's attached to a hospital, but it's also part of a university." You waved off the specifics, feeling heat rise to your cheeks and goosebumps prickle at the back of your neck. "I used to work in a clinic that's part of a teaching hospital and a university. I'm a professor now—same place. Less clinic, more lectures."
"We're a teaching hospital too," Robby offered casually.
You looked back up at him and smiled. "Would you ever become a professor? Teach med students?"
"I've never thought about it before. Probably not. I already teach them plenty here," he shrugged. "It's probably for the best that I don't end up in a lecture hall."
You chuckled and nodded. "I imagine it's a lot more dynamic here than a lecture hall ever could be."
"I'm sure you're a wonderfully dynamic professor. Any student would be lucky to have you."
A rush of warmth flooded your face once again. "Thank you, again, Dr. Robby," you whispered.
Hearing his name—his nickname at that— from your voice stirred something in his stomach. Admiration? Nerves? He couldn't quite tell.
"I know I can come off a bit…" You trailed off, searching for the right word before settling on, "…aggressive."
The broad man looked back up at you. You couldn't quite read the expression on his face, but whatever it was, it slowed the frantic pounding of your heart in your ears.
"You're a good doctor. I can tell."
He rubbed the back of his neck again, and it struck you that compliments likely weren't something he was used to receiving.
"Thank—"
As Robby began to thank you, a young, frazzled-looking doctor pulled back the curtain—likely preventing Robby from making a move or saying something he might regret later that night.
"Robby, Trauma One's coding. We need you over there." His voice was confident, but the slight tremor in it told you he was still very young in the field.
"Thank you, Whitaker, I'll be right there," Robby sighed, then turned to you with a nod of apology. "Your mother's waiting for the OR, but if you need anything else, find me."
You glance up at him with gratitude, then looked back to your mom, who weakly signed a quick 'thank you' in Robby's direction. She refocused on you, taking your hand in hers and closing her eyes in relief.
Robby smiled to himself, giving another quick nod, and turned out of the space to hurry to Trauma One. He made a mental note for himself to try to find you before your mother was transferred out of the ED, though he knew it was doubtful it would happen.
As he tried to shake the thought of you from his mind, he felt sudden grab of his arm—polite, but firm. He turned and saw you standing behind him, staring up with wide eyes.
"Wait, take my card," you said, holding out a thick paper card with black lettering and red accents. "You can use it to get in touch with me. About the…" you paused, "hospital policy. I'll be sticking around for my mom, so just email or call."
"Of course," he said with a smile, taking the card from your hand. His fingers brushed lightly against yours. As your skin touched, goosebumps rose on his arms and neck, the flutter in his stomach returned—stronger than before.
You glanced down at the space where your hands connected before pulling back to leave the card with him.
"Well, go save lives, doctor," you quipped, turning quickly to rush back to your mother's side.
He watched you walk away for just a moment before remembering he needed to go do exactly what you had just told him to do.
As he walked, card in hand, he noticed a peculiarity: there was not one card, but two. The one he saw in your hand, with the red accents, had a university number and your email address. But the other, tucked just behind it, was an expired Sonic gift card with a different number scrawled in black sharpie.
His breathing quickened, heartbeat thrumming through his veins. A slow smirk spread on his face at your slight of hand.
Maybe he hadn't embarrassed himself as much as he thought.
I'm working on making the homepages of different AAC apps for the Animal Crossing tablet item! You can edit the tablet with customization kits to have a custom design, so you can put your AAC device in your home or around the island.
So far I have LAMP, Proloquo2Go, TD Snap Core First, and TouchChat done. I'll be adding more soon.
Hey I'm a University AAC User: Involve Me In Your Conversation
One thing I'm noticing with back to school is how hard conversations are, especially with people who aren't familiar with my way of communicating, so I wanted to share a bit how you can support your AAC-using peers.
Acknowledge My Needs
You might think it's best practice not to mention I'm communicating differently, but for most of my classmates I find the opposite is true. Classmates don't know how to talk to me, or make assumptions that I won't need modifications in a conversation made, and then I get talked over and left out. Something you can do is politely ask about best practices. Phrases like "Hey, can I do anything to support your communication?" and "Do you need anything from me?" go a long way. Remember that these questions are not to sate your curiosity, but to provide me with an equitable space to communicate.
Give Me Time
In the fast-paced setting of university this is huge. The most common way I get left out of conversations is my peers talking too fast and moving on from subjects and topics before I can participate. Actively involve me! Ask me if I have anything to add. If you see me typing/selecting symbols, take your moment to wrap up your thought, and then glance over at me and wait for me to add on or shake my head to allow you to move on. If I don't have something to say once, don't assume that goes for every time. Regularly pause in conversations and create space for my input. I find I worry about slowing people down in conversations and the more you continuously make space the more I know I'm allowed to participate as an equal.
Involve My Contributions
Sometimes when I share something, it just gets ignored or not acknowledged. I have things to add to a conversation. Acknowledge what I share and build off of it. Have a conversation with me instead of letting me just say dead sentences that go nowhere. In return, I'll do my best to respond in turn and keep the conversation going.
Don't Interact With My Screen
Don't look at it, don't touch, don't move it. If it's in the way, ask if it's really in the way or if you can work around it. If it's in the way still, politely tell me. Unless I invite you to look at or interact with my screen, it should be for me only. Think of it as a brain and my thinking process.
Ask How I Want to Share
Sometimes when sharing with the class I prefer to write, sometimes I prefer to use AAC. If we are sharing back as a class, don't just say you will be the one to share back. Offer and include me in the discussion for options to share back. Understand when I say I don't want to, and if you're someone who's comfortable sharing feel free to volunteer to share for me if I want. Most importantly, respect what I say and listen to if I do or do not want to share back.
Let Me Have the Big Desk
If there's a larger desk in the classroom, let me use it. I need to have my AAC and my notebook and depending on the class sometimes a computer as well. I take up space and if there's extra room you don't need in a class, let me use it.
Go With the Flow
Sometimes I will vocally talk. Go with it. Don't question my ability or inability to talk sometimes. I am not here to sate your curiosity. Communicate with me at my level, how I choose to.
These are just a few things you can do to make me more comfortable and included in class. Please note that this follows my experience as a part time AAC user and does not represent every users experience.
What’s super exciting to me is not only is she a doll on regular Target shelves with a communication device, it’s also shows an actual, realistic, robust pageset!
I’m more or less aware of all AAC related toys out there, and most are sold by small Etsy shops or specialty companies catering to people like child life specialists, and even then they pretty much only show a handful of nouns rather than the full range of words AAC users need. Autistic Barbie’s communication device looks similar to a Proloquo pageset, mirroring what children are likely to see on their own devices
Hopefully there will be more AAC using dolls (and multiply disabled dolls!) in the future 🤞🏻