Guest Editorial: To Our Clinicians

By: Charles Van Riper

It's about time someone blew a horn for the unsung, forgotten clinicians, for the working stiffs in our vineyard who perform the services that justify our profession's existence. Without them, ASHA would collapse. It is time to give these men and women their due as well as collect their dues. Somehow, as our profession has grown, we have tended to honor the researchers, writers, professors and administrators (who after all are but the froth on the stein) and to neglect or forget the thousands upon thousands of our membership who each morning must tighten the belt and pull up the panty hose to face the next unwashed client. And the next and the next and the next!

Not that they think of them as merely clients! They think of them as people in trouble, as complex human beings, each with a unique history of hurt. And, secretly, despite their conscientious refusal to use the verboten term, these clinicians think of themselves as therapists, in the finest sense of the word.

Consider the tasks that confront them day after day, year after year. Somehow they must be able to see through the veil that envelopes each of the people they serve so they can be understood and motivated. Each of their handicapped children and adults comes to the therapy session not only with a different past history but also with different present needs, many of which are unknown. Even within the session the client's attitudes toward himself, the clinician and the process of therapy can vary. How then is it possible to effect any meaningful change? The incredible answer is that these unsung clinicians are successful despite these and many other difficulties. Only because they do succeed, do we have a profession.

A public school clinician was trying to explain why she was so tired at the end of a day: "I suppose there are many reasons -the difficulty in identifying with so many children in my daily caseload, not only successively but simultaneously in groups, the sharing of my faith and strength and patience -but I think the thing that drains me most is the need to be so constantly alert. I've got to pick up all those little cues that mean fatigue or frustration and respond to them immediately and appropriately. I've got to know when to push and when to wait and when and if to wipe that dirty little nose. When you have to do all this constant predicting and checking, not for just one but for five kids at once, it's almost mind boggling. I do it and I love it, but I sure get pooped!"

My hackles always rise when I hear some of my laboratory or classroom colleagues hint that our public school clinicians have jobs that demand less professional competence than their own. For several years I worked with all the children in our campus school who had speech and language disorders and I have never been so challenged. Also, for several years, I traveled with the local speech clinicians on their daily rounds and attempted to do diagnostic and trial therapy with their most difficult clients, an experience that was both illuminating and humbling. I have known thousands of public school clinicians and for sheer dedication and competence and caring they can't be matched by any comparable group. It's about time they got some appreciation!

I have found that one of the outstanding traits that characterizes most clinicians, no matter where they work, is their continuing hunger for new information. Who fills the meeting rooms at convention when anything remotely practical is being offered? Who attends any workshop within a hundred miles? Who listens when the rest of us spout off ? And who desperately hunts through the sawdust of our professional journals hunting for crumbs of information that might possibly be useful at that moment of truth when clinician and client confront each other?

And we must not forget that these workers in our vineyard have needs too. Often they feel terribly alone. They hunger for opportunities to share their problems and feelings. Often they feel guilty because they inevitably meet the occasional failures that come to all of us in this field. They need someone to help them understand that often there are forces impinging upon their clients which they cannot control and which can account for those failures. But, above all, they need a profession that cares for them as they care for those they try to help. Surely it is time to honor THE UNKNOWN CLINICIAN.