Episode #70: Consumer-led Advocacy for Aphasia: In Conversation with Avi Golden and Angie Cauthorn

Ellen Bernstein-Ellis, co-director of the aphasia treatment program at Cal State East Bay in the department of Speech, Language and Hearing Sciences and the member of the aphasia access podcast Working Group aphasia access strives to provide members with information inspiration and ideas that support their aphasia care through a variety of educational materials and resources. I’m today's host for an episode with Angie Cauthorn and Avi Golden. In honor of National Aphasia Awareness month, we'll be featuring these two stroke survivors who are very engaged in aphasia advocacy.  Guest: Avi Golden   Avi Golden was a practicing EMT and former critical care and flight paramedic with Northwell EMS and New York Presbyterian EMS. Avi holds a Bachelor of Science in Biology and has extensive experience as a practicing paramedic, both in the US and with Magen David Adom in Israel. After experiencing a stroke in 2007 with resulting aphasia, Avi now is a volunteer EMS. He actively partners with speech pathologists to educate the medical and lay community and is an active advocate for aphasia awareness. Guest: Angie Cauthorn   Angelique Cauthorn, better known as “Angie,” is the proud wife of Charles Cauthorn. They live in Moorestown, NJ along with their cat Tigger. Prior to her stroke, her jobs included a national top selling manager of Radio Shack, a mortgage banker, and at the time of her stroke in 2017, the finance manager of one of the largest car dealers in the country. Pre-stroke, Angie was on the Board of the Eleone Dance Theatre for 15 years as well as a youth leader and basketball coach. Angie was a panelist at the Aphasia Access 2021 Leadership Summit. She is now an ardent aphasia advocate and is co-founder of the newly formed Aphasia Resource Collaboration Hub (ARCH). ARCH is working to become a clearing house for available aphasia resources and services in South Jersey, Philadelphia, and Delaware areas. Listener Take-aways In today’s episode you will: Learn why it’s important to provide aphasia education and communication partner training to EMS students and providers Learn the benefits of engaging in disability sports for individuals with aphasia as a means of strengthening social connections and creating opportunities for fun.  Understand the value of having updated flyers in your waiting room or on your office bulletin board Learn about the plans for the Aphasia Resource Collaboration Hub (ARCH) and how the organization hopes to connect stroke survivors, their families, and researchers. Edited show notes. This transcript reflects the guests’ original responses as a way to acknowledge and honor their ability to be highly effective and gifted communicators even when facing word finding challenges due to their aphasia. Interviewer: Ellen Bernstein-Ellis Avi, welcome to the podcast. We've had fun just trying to get everything to work today. And you've been laughing a lot already. I know it will be fun to interview you today.  Avi Golden: Thank you very much. And you too as well. So we'd like to start with an opening question. Is there an aphasia mentor that you want to give a shout out to? Avi Golden: So for me, again, for me, the speech, a speech pathologist works with me together every day and I love it. I work all the time. I laugh, but very good, but also, I speak with a speech pathologist together talking about aphasia with EMS or police or hospital around the world. And I want to say I forget the name, the guy, the girl, the girl the Karen. Not Karen. The one that we talked about earlier, Kaitlin Brooks? Is that right?  Avi Golden: Yes. She and I spoke many times, many times, with EMS or hospitals. And Kaitlin is amazing.  You just gave a hats off to speech pathologists in general because you're still working hard on your communication, but you also now have a different role where you're partnering and presenting together all the time, and that's part of what we're going to talk about today. So, thank you.  Avi, you had your stroke in 2007. And it was following surgery for mitral valve prolapse. Maybe we could start with what you were doing before your stroke. Would you like to provide our listeners with a little personal background?  Avi Golden: Sure. 4, 5, 6, 7, 8 years I was a nor-uh, paramedic in Columbia Presbyterian and North Shore and a lot of part time at EMS. And then later I was riding for critical care and flight paramedic as well. And I was going to go to medical school. But first, I had, my father, who is a radio- he was a radiologist and he, he has a, he is, he was going to surgery twice to have a mitral valve prolapse. So I have a hereditary, is hereditary. So I have prolapse. So I say l, you know what, before medical school, I want to go to surgery and then go to medical school. Okay? Unfortunately, in the surgery, I have a stroke resulting in aphasia. Okay, and Abi, what was your communication? Like right after your stroke?  Avi Golden: Sorry, sorry, I'm not laughing at all. I'm crying no--. It's funny, Is for basically one year, again, everybody is different. That's my number one. But for me, basically, one year, all I could say was “Michael” l, and I have no idea who Michael is. I mean, maybe my roommate, maybe my cousin? I don't know. But so everybody's like, who is Michael? I'd say, “Michael, Michael, Michael” So yeah but... You're laughing, maybe at the memory of how surprised people were? You're shaking your head. You would come out with “Michael, Michael, Michael” and people would try to make meaning out of that. And you didn't really have meaning for that.  I can already see the teacher in you. Because you're already starting off by saying, “Okay, I'm going to speak for me because everybody's different.” You recognize right away that there's not one rule or one description. Yes, you're shaking your head in agreement.  What was the adjustment process like for you? You said that for a long time, you wondered about going back to medical school, but then you told me when we talked last week, that you had three things that you thought about doing. You started to prioritize and adjust to what was going to be next for you. Do you want to share what that was?  Avi Golden: So in my head, swear, I swear, I want to go to medical school. So I am working with a speech pathologist together every day, working to try to speak, not, not normally but is getting better. And reading and writing, listening. And so (??) but also, I am teaching with a speech pathologist together, talking about aphasia with doctors, nurses, EMS, etc. And number three, for me, is disability sports. Before, sports, a lot of sports, like (??) well, I don't like it, but hiking or skydiving, and it's the same thing for disability. That’s gonna be our focus today is to talk a little bit about your EMS training and disability sports. And we'll start with your EMS and aphasia advocacy first. And as we've already figured out, I probably need a whole episode just for you. And I'm going to feel the same way about Angie when we talk.  How did you start as a public speaker and teacher about aphasia? You shared with me that you walked into the National Aphasia Association office (NAA) in New York. Can you tell me about that first encounter? Avi Golden: So NAA was in New York City. Now it's, unfortunately, Virginia. But I, I was, like, six months after the stroke. So I walk in the office, and I say, “Michael, Mike, Michael.”  And the guy, the girl, is like, “Thank you. Thank you. I understand, but who are you?” And I say, “I’m Avi Golden, Michael.” And then I will walk out because I'm, I'm, is like, angry. But later on, so Elaine Ganzfried, who, who was a President. Yes, the  Executive Director, that's right. Avi Golden: Yeah. So she come back. like, one or two months later, and she said, “You know, I speak, I am speaking with people with aphasia, about aphasia, with doctors or nurses or PA or EMS. Do you like to come and speak about your story? And I say, “Awesome. Michael, Michael. Yes. Awesome.” And that's the first time.   Wow, Avi, you're so comfortable. I've been joking that you've been as cool as a cucumber and I'm nervous. I'm more nervous than you about this interview. And you look just so calm. And you've been patient.  I've dropped the microphone a few times, and you’ve been great.  Avi Golden: But it's twice, not three or four times. So that's good.  Thanks, Avi, you're keeping count. So hopefully, we’ll have a fun interview because you are picking up on all the humor. But I was going to ask you if you were a public speaker before your stroke?  Avi Golden: No, not at all. Well, I mean, before the stroke, I was a paramedic. So you weren't going around giving speeches. Okay, thinking back on that first time you walked into the National Aphasia Association office and said, “Michael, Michael, Michael” as you told me, to now, how many speeches have you given over the past 10 years?  Avi Golden: I will say, I don't know. It's a lot. So I, I speak with EMS, police, firemen, hospital, around the world, because it's Zoom now, but also people with a disability, kids, etc.  So, would you estimate more than 50 speeches in the last 10 years?   Avi Golden: Yeah,  More than 100 maybe? Avi Golden: I don't know, maybe one week or two weeks, every day, every month, every week, one to-- One to two speeches a week?   Avi Golden: All the time.  That's a lot of speeches over the 10 years. We’ll put your contact information in the show notes. And we'll keep you busy. Avi, you’ve built a beautiful PowerPoint with lots of photos to help share your story. How do you typically prepare for a presentation?  Avi Golden: So before? I mean, after the stroke? So three years, I don't have a PowerPoint, so I speak for like two or three days, uh three or four, two or three minutes. And that's it.  And then, in my head, it says, “You know what? I have a PowerPoint.” So, I can have a PowerPoint. And then, number one, you, they have, see, what's going on? And also, I understand. I know that it's more before in my head. I know, but then, I also don't know, later, until later on, and, but the EMS are shut down. Do you understand?  No, I lost that last part.   Avi Golden: I speak with three, three or four minutes, but I don’t, I... rarely, I don't know, is, after with the PowerPoint, I have a list of stuff. And I look at the list. And I say, “Oh yeah, I forgot.” But then, I remember because, I, yeah... So it's like not having to have notes or a script because the PowerPoint is leading you through the story. And that serves as a way to help guide you.  Avi Golden: Correct And also illustrate things if you do have a moment where it's hard for you to come up with that word. Yeah? Avi Golden: (Laughter) Okay, I know that too. Thank you. So, you and I talked about wanting to use that PowerPoint for our interview. But since this is a podcast, we don't have visual support. And I really want to thank you for still being willing to have this discussion even though we can't provide that to our audience. But that's how you typically go through your presentations is by using the visual support as a visual script. That's become a really good tool for you. Do you have advice for anyone who wants to start being an aphasia ambassador and public speaker like you? What would you advise? Avi Golden: So, number one, I, um, a lot of people who has aphasia, speak with me together with EMT um Speech pathology students or OT students, etc. So, they speak about their stories. So that's number one. They have a PowerPoint. So, it's number two. And number three, please, please come either talk with about one or don't talk, but speak about their, your story. So, number one, please work with a speech pathology because it's amazing. So nice. So brilliant. People, people with speech pathology work with me, Work with them, and it's wonderful. Laughing hysterically but working all the time. But also, people who have a disability please come and speak about their, uh my, uh your story. You were hoping that I would invite more people onto this panel. I said that we will never be able to tell everybody's story (in 30 minutes). But you so firmly believe in collaborating and the strength in having multiple voices. That seems to be a really impactful approach for you.  Avi Golden: Yeah. Yeah. Absolutely. And that you like to collaborate with the speech language pathologist.  Avi Golden: People with aphasia as well.  Yes, absolutely. Speech pathologists, people with aphasia, and you form a team, a partnership. And you said you like living in New York because there's so many resources, right?  You were listing all the wonderful places you go-- Adler, Teachers College... Avi Golden: NYU, Mona Greenville is speech pathology, so she, I go twice a week, I go twice a week, but other people is three times a week. So it's Mona and the students. So, it's one, one versus one for one hour, working, and then three or four hours, a group together, and have a good time speaking, reading, listening to jazz, you know, stuff like that. So it's very, very cool. I noticed that you have quite a presence on social media. And that's part of how I got to meet you and see that you were just all over, going to different places and participating in a lot of different activities.  Given your connection to EMS as a paramedic, let's focus on that for a moment. What do you want to make sure that a new EMS responder understands about aphasia? You go to schools, EMS training programs, and you're trying to help new EMS students or future EMS providers to understand aphasia.  What do they need to know?  Avi Golden: So I call or I email all the time, every day, like three or four, three or four different websites or even uh websites or people. And I ask them, I say, “I have, I have a stroke so it's hard to communicate. But before I was a paramedic in New York City, and then unfortunately, I have a stroke and aphasia. I was wondering whether it is okay to speak, or now Zoom about aphasia with EMS or hospitals with a speech pathologist all together.”  And about half of them don't go or don't call me. That's okay. And half of them say, “Yes, please come and teach them about aphasia.” Is there something particular that you want EMS, the new paramedic to learn? Because you actually pointed out to me how little information is shared with EMS during training by the textbook itself? You said it's like a 1000-page textbook, and what's the problem? (Avi holds up four fingers) That's four, four what?  You're holding up your hand, four?   Avi Golden: Four words, four words. About aphasia?  Avi Golden: Yeah. So before, before, also, I was reading a lot is, you know, 1000 pages, whatever. And I have is, aphasia is small and saying, “They speak not normally.” So, it's like, I don't know, whatever. It's, it's so small, who cares? You know, I don't do it. I have to go to hospital, I go to, I am going to ambulance to ride with a heart attack or trauma, whatever. So, no problem.  But then after the stroke, and aphasia, I went to the textbook, the same textbook, and I read aphasia, and it's four words. And I say that (high pitch voice) it’s only four words, in my head, With your fingers you’re showing me teeny tiny, just teeny tiny. I will share that our next guest is going to talk about part of her story that was really frustrating to her--something that the EMS responder said to her at her stroke. I don't want to spoil her story now, but it just went to show that that EMS provider must have not been to one of your speeches because he really didn't seem to understand the aphasia.  Have you been asked any surprising questions by any of your EMS audience?  Avi Golden: One or two times? Yeah, I don't remember, They get interested and they get engaged and you put a real face on what it means to have aphasia and share your experience. Avi Golden: I mean, thank God for you, or EMS. But for me, I'm still, still, not crying but I’m saying, “I want to go to medical school, I want to go to medical school.”  but I'm still speaking, so that's, so that's good for me. You do a lot of your aphasia advocacy with EMS because that is your peer group, that was your passion, and you have a strong connection, and they understand that you know their work really well.  And you also go out to medical schools and to speech pathology schools and occupational schools and help people go beyond that two or three lines in the textbook, right? I think it's incredibly important work. So, thank you for continuing to do that. And if you think about the many hundreds of presentations you've done, it's having an impact.  So I'm going to transition from your life as a public speaker advocate, and ask you to talk a little bit about your involvement with disability sports.  Avi Golden: Awesome. Okay. So again, before I was, it's called, it's called Jewish Outdoor Club.  Is a lot of people who hike or also like skydiving or scuba diving or small things. So I hike as well together. And then I have a stroke, and aphasia. So I, so, I went to, oh, so, I was in hospital. And I saw the flyer says disability gliding. I said, “What is that?” So I went to the website, and I see is climbing. I said, “Oh, my God it’s disability sport, disability people, disability sport, disability.” And I, and I say, “Oh, and it's right down the road.” So I am driving, I was driving, and I went to the plane and sailing with a pilot. And it's like, oh, my God, and it’s disability. That's crazy. I love that you brought up that you saw a flyer. Our next speaker, Angie, is also going to share that she saw a flyer and that led her to a really important place. I guess that the lesson is that the resources that we have available in the office or in the waiting room, you never know what people are going to see. And we need to keep those resources fresh and available.  So you started the Facebook page that you manage called NYC Outdoors Disability, and we'll put the link in the show notes. How did you start organizing outings?  Avi Golden: Now for me, but I live in New York City. So, a lot of, a lot of EMS, sports, like for example, Burke Rehab or Helen Hayes Hospital or Leap of Faith is a disability sport. In the summer water sports and winter skis, you know, and stuff like that. And I, I go and having good time with different sports. And then I say, I ... I, I email, I Facebook with a lot of different disability. But I also speak about, please come with a lot of sports.  So, this isn't just for people with aphasia. You're saying it's for people with all different kinds of disabilities.  But do they seem to understand aphasia when you come or do you have to teach them sometimes? Avi Golden: I don't care, you know. You're not worried about it. You know that you'll deal with it when you're there. Avi Golden: Exactly. (Laughter) Okay. All right. Avi Golden: And I, and I say, you know, before I was a paramedic, but then I have a stroke and aphasia, so it's hard to communicate. Don't worry, it's all good. I understand. So let's go. Okay. And it's like, Alright, let's go and then all right. So it sounds like your Facebook pages are really a clearinghouse in a way. You're keeping the pulse on what new and exciting activity might be happening. And then you post it on your page to encourage other people just to come try it. Avi Golden: That's it. That's it right there. Ah, so you're not sponsoring these trips, but rather you're getting the word out. You're kind of giving people free PR.  Avi Golden: And I'd say just come one time, just one time. Come and just try it. Because first of all, it's free. Disability sport is either cheap or free, I swear, free. And number two, you can try and have a good time. So you know. So you're just trying to get people to engage in activities that will be fun. And to show them that there are things that maybe they thought they couldn't do because of their stroke, but they can do because there's all sorts of efforts being made to adapt, accommodate, and make it happen. Avi Golden: Yes. And also, I have a lot of magazine called, is a lot of magazines. And in the magazine, is either magazine about people with disability, or sports. So, you can go to a website and look for disability sports. And you can see a lot of more things to do for either me. So, you're saying that if you're not in New York, because you're mostly posting the things that are in your area, which makes sense. So you're telling me that if you're not in New York, and someone's listening to this, they should go and Google ‘disability sports’ in their area, and they're likely to start seeing activities come up.  Avi Golden: Also, unfortunately, it's big cities. But small city, I'm sorry, it's hard. It's hard is walking, uh is driving. But for me, I drove all the time, because I like driving as well, but driving for two or three hours, because it's fun. But that’s me. The thing that strikes me is that you've decided to try to become an educator, because that's meaningful to you. It's challenging for you to practice your communication and you enjoy that. And you enjoy the collaboration and connection with the people you're talking to. It seems like you really enjoy talking to students and to new EMS responders and spreading the word about aphasia.  And then you also find the reward in disability sports because you're just trying to stay active. And we know that the incidence of depression and the sense of isolation is really high in aphasia.  Avi Golden: No, absolutely. Absolutely. And it's so sad. I mean, it's not sad. It's, it's, it's so... I, I say also, also, there, I say, please, I know...I know, it's hard to communicate, and a lot of people, even for me, I, in the beginning, I cried for two weeks, but then I fight because in my head I said, “I want to fight with, I want to go to medical school.” That's my head, my story. But other people, says... in my head, their head, let's go fighting, fighting, fighting.  But a lot of people also is depression. And it's so sad. So, I am speaking about depression and say, please come try a lot of things to do-- sports, hiking, working, cooking, whatever you want, but just try, well are more and more  We know that exercise alone can elevate mood. So that's the bonus with activity like exercise-related activity. And number two, we know that having something meaningful to do, a meaningful activity also tends to help with depression. So, you get a twofer here-- disability sports are really amazing.  So I knew this time would fly by I knew this would happen. But I've really enjoyed it. I will ask you one last question. Oh, go ahead. Go ahead.  Avi Golden: The No Barrier Summit. I swear. Sorry.  You want to bring that up? Okay. So, tell us why do you like The No Barrier Summit so much?  What so, so, so three times, every year in the summer, is disability sports, No Barrier Summit is a disability sports or wounded warriors or kids, whatever. So, in the morning, skiing, scubbaing, hiking, whatever you want, it's fine is really good. But in the evening, people who have disability speak about their story. And it's, it is so powerful because everybody is like, Oh my god, really! You hike. You do it, you, you have blinded, you and you do it or, or scuba lessons, or whatever. Everybody is like holy crap. It's amazing.  So you are inspired by what people are able to do. And you think why can’t I do it too? Maybe, is that... Avi Golden: Yeah, and I am, and I am now speaking as well. Speaking and also schools, not school, sports. Also too. Have a good time.  So that's really been motivating for you.  Avi Golden: Yeah, yeah. I will look for that link and put it in the show notes too.   Avi, what, what would you say are the most valuable lessons that you have learned as an aphasia advocate? Do you have anything final you want to go out with? Avi Golden:  Basically...uh..fight, work, working with aphasia. That's number one. Number two, remembering that, in my head, I want to do it. Whatever you want, Meaning, fight, fight, learn, and then have a good time. Three lessons: fight, learn and have a good time. Thank you, Avi. I've had a wonderful time with this interview and getting to know you more than just seeing you in different places on Facebook and waving to you at conferences. So this has been a delight. Thank you so so much. Avi Golden: Not a problem at all, please.  Okay. Hopefully we'll have you back in the future. We just hit the tip of the iceberg today. So, thank you so much,  Avi Golden: Not a problem. My pleasure.  I'm really excited to introduce our next guest, Angelique Cauthorn better known as Angie, she is the proud wife of Charles Cauthorn. And they live in Morristown, New Jersey along with their cat Tigger. And that's a gorgeous cat that you're petting right now I can see on Zoom. Beautiful!  Prior to Angie stroke, her jobs included a national top selling manager of Radio Shack, a mortgage banker, and at the time of her stroke in 2017, the finance manager of one of the largest car dealers in the country, pre stroke, Angie was on the board of the Eleone Dance Theatre for 15 years, as well as youth leader and basketball coach. Angie was a panelist at the aphasia access 2021 Leadership Summit, and she is now an ardent aphasia advocate and his co-founder of the newly formed Aphasia Resource Collaboration Hub (ARCH). ARCH is working to become a clearinghouse for available aphasia resources and services in South Jersey, Philadelphia and the Delaware areas.  Angie, thanks for helping me with the name of that dance company, which I know has a very special place in your heart. Angie Cauthorn: Yes. It was founded by my brother, Leon Evans, in 1992. So, thank you for making sure I said that correctly.  I am just going to start with my first question for you, which is, how did you end up being a panelist for Aphasia Access at the Leadership Summit? I am so, so grateful that you said yes, when we invited you to come be a guest today. Thank you. Angie Cauthorn: Thank you so, so much for having me. Thank you for that wonderful introduction. As for the leadership summit, Dr. Gayle DeDe of Temple University called and asked me to be part of the summit. Because of the pandemic, I had done some online work with some very young, talented people. And I was asked to give my, my opinion on some tricks and tips that I had learned, and my general feelings about receiving therapy online. And I was happy to lend myself and my time when I was asked. You mentioned tips, and you gave us all a tip about passwords when you did your presentation to the Aphasia Access Leadership Summit. Would you share with our listeners today? What was your tip about passwords when you're on Zoom if you're working with people with aphasia? Angie Cauthorn: Well, what everything is, when you send the link it, you know, you can just click the link, but sometimes it asks you to prepare a password for security reasons. But that, remember you're dealing with people with aphasia and numbers can be very confusing. And they can cause an additional barrier to someone maybe joining your group session or your private session. So just be mindful of the passwords that you use and try to use something that's aphasia friendly.  I think that's a really important tip because you don't want that password to be the first barrier before they even start. Angie Cauthorn: Before they even start. Then they're coming in with kind of a down feeling. It's just again, showing people what they can't do, rather than how they can participate. And Angie, we were so glad to hear your message at the Aphasia Access Leadership Summit. I was wondering what did you, as a consumer, get out of being at the summit?  Angie Cauthorn: Well, I was at the summit and I was on a panel with Dr. Charles Ellis, which is the one where I gave the tip and then I did a presentation. But I stayed the whole week. And I was literally inspired by the people, the kindness, the generosity of the speech pathologists. The, it gave me a different idea of health care. Everyone was just, no one was really, there was no, I'm sorry. There were no panels on how they can get more money from Medicaid or Medicare or anything like that. It was all about how they can maximize people's health. And it was an absolutely, I want to say, loving experience. It was how everyone was concerned about how they could help a stranger get through a hard time in their lives. It was very refreshing. You know, I have to agree with you. I found it really refreshing and inspiring too as I listened to each and every panel, and poster.  It was really an inspiring conference for me too. Angie Cauthorn: So kind, so thoughtful, and just wanting to help. And that's what I really kind of took from it, how everyone was on the same page. It was really inspiring. Angie, your bio is a small window into what a busy and active and full life you had before your stroke. And you shared with me yesterday in the email that today's actually the fourth anniversary of that stroke. Angie Cauthorn: Today is the day. Yeah, yeah, it's, um, it's a little different. It's, um, it makes you a little melancholy, I guess, in a way, but also joyful, because you know, you're still here. The alternative is everybody doesn't make it through a stroke. And so, you have to celebrate that. Never mind what you can't do, the fact that you can do anything has to be celebrated. And keeping a positive attitude with it is very hard to do sometimes, but absolutely necessary. So, I am celebrating. But also, taking it all in, taking full account of everything, is always a good thing, as well. But, you know, the, these milestones that you hit um...are...a lot. They're very meaningful. And I think you're right, we learn in life how to both carry the grief and the joy and make sure that we acknowledge and understand that, that we can do both together.  Angie Cauthorn: Yes, yes. You must. You must.  So you shared that after a long day at work, four years ago, you were winding down, and you noticed you couldn't reach for a glass of water. And your speech sounded a little funny. So, you actually told your husband to call 911. Can you share your experience with the first responder? Angie Cauthorn: I most certainly can. The young men, two police officers and two paramedics, came in. And the young man didn't seem to have a good understanding of what was going on. He told me, I was having... a panic attack. And as much as I could muster in my little box of words that I was now working with. I said, “Son, I don't, I don't do panic attacks. I don't, I don't even know what that is. I promise you. I don't know what this is, but that's not it. And I need to get to the hospital.” And they were almost kind of, what is the word, indifferent on if I, if I needed to go or not. And I was like, “Yeah, please take me now.” I think that that story supports the work that Avi Golden, who was my other guest today, is doing by trying to raise aphasia awareness with EMS schools, EMS students, EMS responders. He wants them to have a better understanding of what aphasia means, how to communicate, and how to be a better partner in these situations. So, we're gonna give him a shout out for continuing to do that work because this is a story that reminds us why it's so important.  Angie Cauthorn: It’s so important because if I would have said, oh, maybe I am having a panic attack, and maybe, maybe I would have went to bed. These are sometimes the stories that you hear, if somebody was having a stroke that they went and took a nap. That is so true. In fact, Angie, I will share that is what my mom did. She took a nap.   Angie Cauthorn: Yeah, because you don't know. Because when you don't lose consciousness. I did make it a point, as soon as things went a little to the left that night, I made it a point to try to acknowledge everything I was feeling. I made it a point to say, “Okay, stop. What can I feel? How does this feel? What's different?” And my hand, that was clo--, my right hand was cold to touch anything else. That was my biggest thing.   Alright, so just paying attention and knowing yourself. You knew that you needed to get to the hospital immediately.  Angie Cauthorn: Yeah.  Then you got to the hospital, and you needed your husband to help advocate for you there.  Angie Cauthorn: Because my language was disintegrating. It was just... not working. And so, I got my husband in the room with me. And I told him, “You have to go tell these doctors that I am... I’m smart.” Smart. You're smart. You want the doctors to know that. Angie Cauthorn: I want them to know I am smart. I am not on drugs. I don't know what this is. But I have to go to work in the morning, so we have to get this wrapped up. I was supposed to open the dealership that day. And I will mention, as a quick sidebar. I never made it to work. I still haven't been back. Instead of going to work, you spent three days in the hospital, you told me, then you were discharged home. I'm assuming next came therapy. Share with our listeners, how did you start to realize what you could or couldn't do? What was that process like?  Angie Cauthorn: It was trial and error. You don't know, when it comes down to aphasia, you don't know what you don't know until you're faced with it, until someone ask you. I didn't know I couldn't tie my shoe until I went to go tie my shoes. So, if I'm walking around in sandals for three months, I didn't realize that, oh, this is a problem. Writing my name, or the one I love is saying the alphabet. How often does, when was the last time you actually, Ellen, said the alphabet all the way through? Well, I'm a speech therapist so I do get to say it, but I know the point you're making. Yes. Angie Cauthorn: Right, nobody's, you know what I mean? So those things were very... telling to me. And it was just about trying to figure out and trying to navigate... what was missing. So, you started therapy.  I know you were working hard. Can you share how you found your first aphasia group? How did that happen? Angie Cauthorn: I was in my doctor's office. She had a flyer on the wall. It said... every first and third Tuesday, I think it was, and of course, that's, that's hard to kind of figure out with or without aphasia.  Okay, true, true.  Angie Cauthorn: You know, you’re missing a lot. And so, my husband and I, we finally figured it out, which one we were going to go to, and he took off for work and he took me and it, I felt like I had come home. It was like a weight was lifted off of me. Because I found a community that was open, understood. And a place where my aphasia was a non-issue. So, we're, we're talking about the Adler Aphasia Center, right? I'm gonna give them a shout out. Angie Cauthorn: And you should. Why would you then recommend aphasia groups to other stroke survivors? What's your advice there? Sounds like it was a good place of connection for you. Angie Cauthorn: I would advise it for the friendship, for the validation, to be heard, and to more importantly, be listened to. And I'm not a, the person who is a group therapy Kumbaya person. That's not, that's just not my nature. But I have definitely...but it's been a godsend. It really has been a, such a huge help. And a lot of us are, you know, are more independent and this is, you don't know what you need until you find it in that particular instance. I didn't know that was something I needed or should have been looking forward to until I literally stumbled into it.  You also mentioned to me that you have a special place in your heart for Dr. Gayle DeDe’s aphasia choir, and I'm also a very big aphasia choir advocate. What has that been like for you, participating in the choir? Angie Cauthorn: I'm just going to, first of all, let me just say, the Philadelphia PACT choir is probably the best choir of aphasia of all time. I'm just gonna go ahead, I'm gonna lay it out there. Dr. DeDe knows what I'm talking about. This is great. I love it. I love it. Well, you haven't heard my choir yet. But that's okay.  Angie Cauthorn: We should have like, a community...like uh.. A sing-off?  Angie Cauthorn: Yeah, a sing-off. Not that we’re competitive, Angie!  Angie Cauthorn: No, no, no, just a friendly, let these cats know from Philly, Gayle DeDe takes it very seriously. No, she's such a genuine, she, first of all, she really does, with kindness and sincerity and a loving disposition, runs a tight ship. She is, she just wants to make sure everyone understands, everyone gets it. We don't move on until everyone is comfortable. We take votes on what we're going to sing to make sure that everyone is comfortable. It's just really, a really, a good time. And she really does an outstanding job of making it somewhere you want to be. It sounds like Adler Aphasia Center has been a place where you've made connections. The choir has been therapeutic and rewarding for you.  Now, four years later, you’ve become engaged in a special project, the Aphasia Resource Collaboration Hub, or ARCH for short. What is that budding nonprofit about?  Angie Cauthorn: ARCH is about being the landing pad for people with aphasia, the researchers, the clinicians, all of these different stakeholders to know and be made aware of the information that's available to for people with aphasia to be better. I was a, it kind of started with me having a very car..., I'm sorry..., a very…. conversation with Dr. Martin from Temple University. And she was telling me about all the resources that were available to me in this tri-state area. And it was a lot. And I wanted, we wanted to put a position, put ourselves in a position where there was one place where I could find out about all the research, clinicians can find out about the research, researchers can find people with aphasia, so we can do the research We wanted to find a way to kind of bridge the gaps, to fill in the gaps. So, people, it would be a smooth transition, and a smooth transfer of information. And that's really what ARCH is about.  So like a clearing house a place to help connect people who need the resources and people who want to give them resources.  Angie Cauthorn: Yes, exactly.  It's not as if you just accidentally stumble and happen to see a flyer posted on the wall behind you. You want to make it a much more intentional effort to connect people. Angie Cauthorn: Right!  Because aphasia is so... not well known. And I think that is one of the bigger issues. You know, if people have Parkinson's, you know what to do. You tell them you have aphasia. They want to know if you're contagious.  It's true. We know that only about 10% of the public even know the word aphasia, even though there's over two and a half million people in the United States with aphasia.  Angie Cauthorn: Yeah, right. You shouldn’t have to say I have a stroke and I have brain damage. I should be able to say I have aphasia. There should be a level of recognition and that's what we have to be working on constantly. I started to say, it shouldn’t just be flyers on the wall, but flyers on the wall are important because that’s how you saw the notice about the aphasia group. So we need that. And we need these clearing houses that will build more bridges. So what's your short term goals for the next six months for this new organization? Angie Cauthorn: It is to advertise, get some funding lined up. And to advertise, advertise, advertise, and educate. And I say advertise. But I probably mean educate. But we have to tell the public about it. We have to secure... give ourselves the opportunity for people to know what's going on, and the people that have had aphasia, that have kind of fallen out of therapy, because with aphasia, sometimes you don't even realize it until by the time therapy is over, is around, in my opinion, the time that therapy should be starting. So they need more resources. When they're discharged, they need to continue this process of learning to live well with aphasia, as we say.  Angie Cauthorn: Right. and giving people a flyer when they leave the hospital, it just ends up on the dining table. You have to be able to reach them later. Because they may not be able to process everything that's being, all this paperwork. And there's something about aphasia in there. Okay, again, I can't tie my shoe. I have bigger problems right now. It gets lost.  So, we have to keep coming at it and keep making those connections again and again. Angie Cauthorn: Yeah, so, so important.  So what message would you like to share with speech language pathologists? What do we need to know when working with our clients? Angie, what's your take home? Angie Cauthorn: My take home would be to understand that your clients are still mid- avalanche when you see them, when you meet them. They are, you are reaching out your hand, telling them-- just grab my hand. And they hear you, but they can't reach you. And they don't really know what you're saying. You're just a person that they kind of, you're almost in their peripheral vision. Just know that and be patient with them, even when they're not patient with you.  Angie Cauthorn: And I one thing I can say I did get from the Leadership Summit, meeting all these speech pathologists, they are seemingly just innate with the kindness that is required. But just to say, again, be a little more deliberate with your patients. If you can, and just know that these, your patients, are... mid avalanche, and they have no idea how it’s going to go down. So, your kindness is so important. I think that's a good reminder. And would you give a different message to your fellow stroke survivor after discharge from speech therapy? What would you tell that person? Angie Cauthorn: Be consistent with your therapy, do not deviate from what you were told to do? Go get math books. Work on that on your own time. One thing I did is, I made a playlist of all my favorite songs from my youth, and I would practice those songs.  That's an upbeat way to go at it.  Yeah, yeah, I did that. And I call it, it says “aphasia stuff”. That's what I call the playlist. And it might be, you know, just old rap songs from 1984. But those are songs that I knew I knew. I know, I know these songs, okay. And I would work on my verbiage in the mirror and just try to sing the songs.  What I love about that is aphasia is so different for every individual, but you found something that worked for you that was creative. And that, I hope, with all that good music, also made you feel a little bit better too.  Angie Cauthorn: It did, it did.  It's so important, so important.  I'm going to wrap-up with a long-term life goal for you, Angie, Something you shared with me-- that you wanted to give a TED talk. I think that's going to happen someday. Because I think if anybody should give a TED talk, it should be you. You have so many insights and such wonderful energy to share.  What would be your topic and what might be two or three points you'd want to make in that Ted Talk? Angie Cauthorn: Well, I think I would call it Lost in Translation, the Battle with Aphasia. I will talk about how it changes us, and all our relationships. I would also talk directly with the people with aphasia. And let them know, listen, it's going to be hard. It's going to be tough. And every, all your friends that you have now will not all make the journey with you. But a few will, and be consistent, be kind to yourself, have a positive attitude, and to call aphasia by its name. That would be, the, what I would, I would talk about if given the opportunity, I hope you will because that's a message that needs to get out. And that's the perfect message for today's episode, given that we are celebrating June as National Aphasia Awareness Month. So, thank you. Thank you so much for being my guest today. Angie, I could sit here and talk with you for the next hour. And we could, we might just turn off the record and keep talking. So thank you so much.  Let me just wrap this up and say thank you again for sharing your expertise, your insights, your knowledge with us, with our Aphasia Access members. Angie, I appreciate it so much.    References and Resources  Avi Golden NY Outdoors Disability https://www.facebook.com/groups/nycourdoorsdisability Leap of Faith Disability Sports https://www.lofadaptiveskiers.org/ No Barriers Summit 2020 https://www.nobarriers.live/ No Barriers https://nobarriersusa.org/experiences/ Angie Cauthorn Aphasia Resource Community Hub (ARCH) [email protected] Philadelphia Aphasia Community at Temple http://www.saffrancenter.com/p-a-c-t/ Aphasia Rehabilitation Research Lab--Temple University http://www.saffrancenter.com/about-us/aphasia-rehabilitation-research-lab/ Adler Aphasia Center https://adleraphasiacenter.org/