Most of my patients have experienced a neurological event, e.g. strokes or head injury. Reverend or James is an African American patient I have seen over the last month. Reverend was a minister for a local Baptist church until he retired in 1966. He is now eighty-three years old and remains an inspiration to his family and to the many people whom he has served. Over the last few years, he has experienced some medical problems, including several strokes, which impaired both his movement and speech.
Reverend speaks very little and generally communicates with a slight nod or shake of the head.
On January 24, the day of our final dress rehearsal for the New Spirituals Concert, I found Reverend unusually alert. He actually vocalized responses, although they were almost completely unintelligible. He smiled slightly in response to comments that his family or I made. I asked if he would like to start our daily mouth care routine. He nodded yes .