Imagine nearly dying while being unable to communicate your health needs, and the important medical decision-making doesn’t involve you. All that is left for you to do is to feel frustrated, helpless, and afraid.
I had such an experience at the height of the pandemic when I contracted COVID-19 and landed in the intensive care unit. I was put on a ventilator and then on extracorporeal membrane oxygenation, the highest form of life support. Once I was ventilated, I lost my ability to communicate about the direction of my own care.
The doctors told me I wouldn’t be able to speak due to the ventilator and tracheostomy that would be part of my care. Given my professional background as a speech-language pathologist (SLP), I understood this, and I waited for someone to bring me a communication board so I could impart my needs. But no one ever did.
The inability to communicate after I awoke from sedation was devastating. I had no way to ask questions, no way to share my wishes, and no way to ease the fear that consumed me. Others made critical decisions about my care, including sending me to a long-term hospital that I vehemently opposed, but I had no voice in the matter.
Eventually, someone tore the back off a tissue box, handed me a pen, and asked if I could write. That scrap of cardboard gave me back a piece of myself. Later, my family sent notebooks and a dry-erase board until finally, after weeks of hospitalization, a pulmonologist placed a small purple valve in my hand. I recognized it immediately as a speaking valve and instinctively attached it to my tracheostomy tube, allowing me to use my voice for the first time in over a month. The relief was indescribable.
My experience may seem dramatic but it’s not unique. Tens of millions of people of all ages have speech, language, or hearing disorders that affect their communication. Additionally, many patients lose their ability to communicate during a hospitalization, such as those who are put on mechanical ventilation, like I was. If a person’s communication is restricted in a medical setting, it can have unintended consequences, some of which can be severe.
Unfortunately, access to effective communication is often not prioritized in health care settings. In fact, only 4 in 10 caregivers to people with communication challenges say doctors ask about the person’s communication preferences before beginning an appointment, according to a 2025 national poll commissioned by the American Speech-Language-Hearing Association (ASHA) and conducted by YouGov.
The findings of that poll don’t surprise me. As an SLP with more than 30 years of experience, I have seen this marginalization far too often. In my work as an SLP, I help people find their voices through technology, gestures, and any other means to give them the power to communicate. I never imagined I would one day find myself on the other side. As someone who has devoted my career to supporting others’ communication needs, the helplessness cut deeply.
More than five years later, I still wrestle with the fact that tools and professionals like SLPs existed to help me communicate when I was hospitalized, yet no one offered them early on in my admission. The whole experience drove home just how critical access to communication is, not as a convenience, but as a matter of health and survival.
Too often, breakdowns in communication are treated as minor inconveniences in health care settings, when in reality they can have serious consequences for patient safety, trust, and outcomes. Raising awareness among health care professionals about the importance of effective, inclusive communication is essential to delivering high-quality care. Simple, intentional practices, applied consistently across every stage of the patient experience from admission and check-in to treatment and follow-up, can make a profound difference.
There are a few simple, but important, steps that health care professionals can take to help ensure they’re meeting these needs for their patients. Health care professionals should be equipped and encouraged to ask patients about their communication preferences and any accommodations they may need before care begins. They should communicate directly with the patient whenever possible, ensuring respect and autonomy, and take time to confirm that information has been clearly understood on both sides.
Creating an environment that minimizes distractions and allows clinicians to give their full attention can further improve interactions, as can slowing down conversations to give patients the time they need to process information and respond. When appropriate, providers should also be prepared to support communication through multiple methods, whether that’s gestures, writing, visuals, or assistive technologies, so that every patient has a meaningful opportunity to engage in their care.
Everyone, regardless of how they communicate, deserves a say in their care. By raising awareness among health care professionals and the public, equipping both practitioners and patients with the right training and tools, and committing to meaningful change, the health care system can end the marginalization of people with communication disabilities. In its place, we can build a culture of communication support with tools and strategies that are much needed, but often overlooked. This may be among the easiest and most cost-effective ways to improve health care for millions of Americans.
Chris Ross is a school administrator with Ohio Deaf and Blind Education Services, where she oversees all related services. She also serves as an advisory member of the American Speech-Language-Hearing Association (ASHA) “Communication ACCESS” initiative.
Since her illness, Chris has prioritized traveling with her husband and spending quality time with her daughter.
