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I first met Leslie shortly after she received her NLD diagnosis. We quickly bonded as we're both older, have many interests in common, and while we knew we had problems never considered ourselves "disabled." This could be because we both assumed we would work in some profession. We both have excellent reading comprehension, aren't literal, and went to school before the era of IEP's, resource rooms and the like. We both almost failed the same subjects!
I received my NLD diagnosis in December of 2012 at the age of 56. In truth, it was a huge relief. I finally had an answer to the questions I’d always had as to why I was so very good at language-based skills and so very poor at anything requiring spatial understanding. I had long suspected that this disparity was outside the range of normal, and now I have proof that my suspicion was correct. What it did not explain though, was how I’d been able to master the training and to successfully work in the field of respiratory care for nearly 30 years.
My profession requires operating ventilators and other pieces of medical equipment and responding to medical emergencies and, in short, is about as NLD-unfriendly a profession as one could imagine. My new friends in the NLD community all ask the same question: “How did you do it?” I’ve been mulling it over for the last three months and now I think I have some answers as to how I made it work for so long.
Part of the answer rests in how the NLD manifested in my particular case. I was very lucky that my reading and comprehension skills were always excellent: by the time I was seven, I could read and understand books written for adults. Although I had poor handwriting, I had no problems organizing what I knew into book reports, essays and the like. I also tended to assimilate information quickly, which may have been the saving grace that allowed me to function in a difficult profession. My academic “failures,” on the other hand, were very predictable in terms of NLD: I nearly failed home ec because I couldn’t use a sewing machine, was kicked out of driver’s ed because I scared the teacher, and (of course) nearly failed geometry.
While my social skills might not have been the best, I did have friends in grade school and highschool. Once I was in college, I successfully ran the gauntlet of intimate relationships and got married when I was 19. While I often felt like a human oddity, in reality, I functioned far better than many others. If nothing else, I may have succeeded though sheer stubborn persistence!
After college, I knew that my political science major qualified me for very little in the bad economy of the late 1970s. I knew I was unfit for most menial jobs because I was too slow and clumsy. I decided that an allied health profession might be a good option: jobs in the field generally paid well and there were enough of them available that I could live wherever I wanted. I was divorced by this time and needed the assurance that I could support myself.
I realized that nursing required a level of nurturance that I didn’t possess, and I didn’t have confidence that I could learn the plethora of tasks required for the profession. But when I learned about respiratory therapy, I thought that sounded more doable. I enrolled in a two-year RT program and aced the academic content. I even did well enough in the clinicals, the part of the curriculum where we learned how to perform the hands-on part of the profession. In the mid-1980s, the amount of equipment used and the sophistication of the technology was manageable.
My first respiratory therapist job was working in a neonatal nursery, and it taught me what I didn’t want in a job. The stress level of caring for sick neonates was high and I knew I wasn’t as good at doing it as I would have liked. The staff treated me reasonably well, but I knew it wasn’t a good fit, so I decided to move to the west coast and take a job working with adult patients.
I started working for my present employer in 1988, and I felt good about the job from the beginning. The department was well staffed and my co-workers were kind. Our hospital featured an open-heart unit, a medical-surgical ICU and five floors where non-critical patients were housed.
Respiratory care tended to attract less conventional people who appreciated being able to work autonomously. This meant that my NLD “oddities” fell under the radar and I didn’t have to worry about being harassed for my differences. I became reasonably adept at time management skills and had no problems completing my work in a safe and timely manner. About seven years into my employment, I was even assigned the special project of revising the department’s procedure manual!
My home life was also pleasant. I bought a condo, adopted a pair of Siamese kittens, and spent my free time trolling the bookstores and movie houses. I made friends easily enough and even had a few romantic liaisons.
After living here for 10 years, I was fortunate enough to meet the man who became my husband.Raymond was a physician assistant who shared many of my interest—jazz, books (especially science fiction) and travel. He was, and is, a gentle, accepting and exceptionally grounded individual. He showed great patience and kindness regarding my differences. We also shared a strong wish for a calm and happy home life, which may have been the key to our success. As of Valentine’s Day 2013, we’ve been together for 16 years.
As time passed, the health care environment changed. My hospital was bought by a larger hospital group and our medical-surgical ICU was converted into a neurological ICU (NICU). Over time our equipment evolved and our duties expanded to include more procedures that involved assisting physicians. Our vented NICU patients required frequent trips on transport ventilators for special procedures and CT scans.
Although I had always preferred working on the floors because I could talk and interact with patients, that preference grew because I found it easier and less anxiety-laden than other hospital environments. It was also less likely to result in dealing with multiple critical situations at the same time—an increasingly common occurrence in the units. But I had never enjoyed duties that required assisting others with physical tasks, because it was hard for me to compensate well enough to anticipate another’s needs.
There had been a lot of turnover in the nursing staff over the years, and I often had to deal with young nurses who didn’t know me and mistook my frequent need to physically reorient myself for incompetence. I was told of these “complaints” and started to get increasingly anxious.
In retrospect, my fatal error may have been taking a new position that required me to work 12-hour shifts every other weekend plus be in charge on one of those shifts. My fatigue during the last four hours of those long shifts made it very difficult for me to think quickly enough to compensate and make good decisions.
Of course, there was finally a big incident, a perfect storm of unfortunate events that didn’t reflect well on any of the participants, and certainly didn’t reflect well on me. I got called on the carpet and I had no good explanation for why my brain basically decompensated.
I was well and truly terrified by this point, so it was only a week or so until severe anxiety got the better of me during an intubation. I was shaking so badly I was fumbling, which naturally annoyed the doctor. On my next trip to my supervisor’s office, I was asked if I wanted to resign or face being terminated.
Since I was just three years from early retirement, I demanded the right to see a neurologist and have a medical workup. My mother developed Alzheimer’s Disease in her early 60s, so I had good reason to make the request. The neurologist referred me to a neuropsychologist, who performed a huge battery of tests and found that although I didn’t have Alzheimer’s, I did have a non-verbal learning disability.
While this discovery was the end of my career as a respiratory therapist—my job cannot be accommodated to NLD—it did leave me eligible to seek other suitable work within the system.
Presently, I’m weighing my work options and spending time learning about NLD.
