Transcript: Season 2, Episode 5
Dr. Rik Lemoncello
Terri Trespicio:
Rik Lemoncello wasn't sure what he would do until he came across a description of speech pathology one day when he was researching careers. Language, communication, health, it kind of ticked all the boxes. So he came to check out Emerson's master's program in speech language pathology, and boom, he was hooked. This was when he started his career in earnest and also when he started baking cakes. Those things seem unrelated, but they have a lot to do with Rik's success. After earning his master's at Emerson in 1999, Rik went on to earn his PhD at the University of Oregon in 2008 and today, is an associate professor at Pacific University. What's earned him accolades however, is a program he founded and runs called Sarah Bellum's Bakery and Workshop in Portland, a nonprofit organization providing return to work opportunities for adults with acquired brain injury.
What's earned him accolades however, is a program he founded and runs called Sarah Bellum's and Workshop, a nonprofit organization in Portland, Oregon providing return to work opportunities for adults with acquired brain injury, cerebellum. See what he did there? He's been able to blend what he loves with how he serves and he's changing lives one cupcake at a time. He really is the sweetest. I give you Dr. Rik Lemoncello on making it as a speech language pathologist.
Terri Trespicio:
Well, Rik, Dr. Rik, you should be called Dr. Rik. You've earned it.
Rik Lemoncello:
Rik is fine. Dr. Rik is fun. Yeah.
Terri Trespicio:
Okay. Well I mean, people in your field understand what you do, but how do you explain what you do to people who aren't sure they really understand, or even if they care? How would you explain what you do?
Rik Lemoncello:
That's a great question. A speech language pathologist is not a very well understood profession and we are misbranded. So in the communication disorders and sciences department at Emerson, that is the speech language pathology program, we are specialists who focus in on communication and cognition and swallowing, all different aspects of helping a person be able to receive information, process information, and speak or express information, and all of the thinking skills that go into that, and we've adopted the field of swallowing and swallowing disorders because all of these muscles involved with speech are also overlapping with the muscles involved with swallowing. So that's our field in a nutshell.
Terri Trespicio:
It's interesting because when people describe what they do, when we hear about what people do with regard to communication or say the physical body so someone says they're an acupuncturist. We know that at some point in the practice, they're sticking a needle in someone even if it's affecting these other things that are happening in the mind and body, but you're a communications expert. At the same time, it completely involves swallowing. It is the science and art of what happens in the mind, but what's happening in the body. It's so embodied in that way.
Rik Lemoncello:
It is embodied in the body. Absolutely. Yes. And the anatomy overlaps and I love teaching the classes.
Terri Trespicio:
Because you can't communicate without the body. Unless you're a mental telepathist, you cannot communicate without the body in some way.
Rik Lemoncello:
Absolutely. It's all happening through the brain.
Terri Trespicio:
Now you studied linguistics, University of Rochester before you went to Emerson to earn your master's. So someone who is interested in linguistics, is this something you knew you kind of wanted to do? How does someone get involved with that? I get English major, but linguistics is something different.
Rik Lemoncello:
Linguistics was a fantastic undergraduate degree. So I actually started out as a biochemistry major in Rochester and thinking that I was going to go pre-med, and then I think it was my junior year, I ended up going to the career center and figuring out, okay healthcare, what do I want to actually do? I should probably figure this out before I start applying to medical schools, and so read up several books about different allied health professions in all of the medical fields and specialties I thought that I would want to specialize.
Rik Lemoncello:
Nothing really resonated with me, but at the back of one of these books were all of the allied health professions and I was reading about physical therapy, occupational therapy, recreational therapy, all of these other therapies, and the very last chapter was speech-language pathology and audiology, and I said, "huh, that sounds intriguing. It's got healthcare, it's got education, it's got counseling, it's got teaching, it's got language, and we do swallowing and I love to eat and cook so how bad could that be?"
It seems like the perfect marriage. So I switched from a biochemistry to a linguistics major because we didn't have a speech language pathology undergraduate program, which was great preparation. So psychology, linguistics are two good, strong footholds for going into speech language pathology.
Terri Trespicio:
Now not everyone would flip to the back of the book and stop in their tracks at audiology and speech pathology. What do you find fascinating about it? There had to be something that tripped a wire in your brain.
Rik Lemoncello:
Oh, everything about it. It's such an amazing and broad profession. So I think given my love of language, I had studied French starting in fifth grade and up through. I had taken Romanian and Spanish and Italian in college just to dabble as an undergrad. So I had this passion for language. I knew that I wanted to do something in healthcare and I love the idea of teaching. I was, at some point in my life, I thought maybe I would be a French teacher. So it just, I don't know what got me to go to that final chapter, but it was the one that absolutely resonated with me and married all my passions.
Terri Trespicio:
It's very rare to find something. Usually if someone says, okay, maybe they're going to be, I'm either going to be doing language or I'm doing healthcare. We think of them such in broad strokes, and it's such a nuanced science and art because communication is an art and a science. So it's fascinating. So then you did that. You are starting to discover this. Take me to the journey of Emerson. You're saying, "okay, well now I want to get my master's in this thing," because now, by the time you go to get your master's, you have an idea of what you want to do.
Rik Lemoncello:
Correct. Yeah. So Emerson was my top choice. This was my junior year. I started researching and figuring out what I wanted to do in undergraduate. So I figured out that speech language pathology was the track, switched my major, and started researching what it's going to take to become a speech language pathologist. A master's degree required. I knew I wanted to move to a big city. The fun thing about being in college is it's easy to move. You've got built-in friends, you've got built-in supports.
Terri Trespicio:
And you don't have a lot of furniture.
Rik Lemoncello:
Exactly.
Terri Trespicio:
Right.
Rik Lemoncello:
So I knew nothing about Boston, but I figured, hey, this would be a great big city to go have an adventure in. So Emerson was one of the top schools I was looking at and it did become my first choice as soon as I started reading about Emerson and the speech language pathology program. I came and visited and met with some of the faculty, and I was hooked because of the client centered, family centered focus and all of the faculty.
Terri Trespicio:
And you were coming from Portland, Oregon?
Rik Lemoncello:
No, I actually grew up in Florida.
Terri Trespicio:
Because I know you're in Portland now. So you came from Florida. Oh boy. You were like, I'm going to wear sweaters now.
Rik Lemoncello:
Yes. I had to get out of Florida. As soon as I turned 18, I hit undergraduate and went up to upstate New York, Rochester and decided New England was going to be the next step, yes.
Terri Trespicio:
Oh, interesting. So yes, of course, Emerson, known for how it teaches communicators of all stripes, entertainers and teachers and thinkers and writers and all kinds of things. What would you say is one of the things that when you were learning it at Emerson, it unlocked something for you or something you learned there that you didn't realize you would use and you do more than you thought?
Rik Lemoncello:
Oh, absolutely. Counseling. The class in counseling was a required class, which is not a required class at many graduate programs, and David Luterman, who's really the grandfather of counseling in our profession was on faculty at Emerson while I was there, and it was an amazing class, but I didn't realize when I was taking it, how profound of an impact that would have on my career. Dr. Luterman is an audiologist and his specialty is all about hearing and counseling families with when they have a child who is deaf or hard of hearing, and I was like, "well, yeah, I probably won't do that because I want to go into healthcare and medical work," but every client that we ever work with, counseling is the foundation to develop these relationships and be able to empathize and find out how their communication disorder is really impacting their life.
Terri Trespicio:
So that's interesting because you were like, "Oh, I have to take this one course, box checked," but then you realize, "no, no, this is a profession that's not just geared to the technical aspect. It's about in relationship to."
Rik Lemoncello:
Exactly. It's all about building those relationships and establishing trust.
Terri Trespicio:
So if someone's thinking about it, if someone's like, I don't know, speech pathology is really interesting, and like anyone, no one's born knowing what that is. We know that counseling has informed more of your own practice and approach than maybe you would realize. Is there anything else that you'd think, hey, people who don't know enough yet about what they might love about speech pathology should know this? What else would you want people to know about the profession because you're right. Not enough people know about it or what it is. What's something that you think doesn't get talked about enough?
Rik Lemoncello:
Oh, so many things. We could talk for hours about this. I would say number one, we work in pretty much any setting across the lifespan. So we're working with newborns in early intervention, helping parents learn how to breastfeed their babies when they might have a swallowing or a feeding challenge, all the way through geriatrics and end of life care and helping folks be able to communicate about their advanced directives and their living wills, all the way through swallowing and oral care and dementia and Alzheimer's disease at the end of life. So from birth through death in a variety of educational settings, medical setting, school-based settings, private practice, it's really a broad, amazing field, which gives us great flexibility as well.
Terri Trespicio:
So it's not just one thing. If someone's like, "Oh, I want to be a speech pathologist," people who don't know anything about it might think, "it's just this one job," but you're saying it's actually a lot of room.
Rik Lemoncello:
Yeah, it's definitely a lot of room.
Terri Trespicio:
There's a lot of room, it seems, to develop and shape your own career, meaning there's no one right way or one prescribed way of becoming a speech pathologist or in how you use that degree, it seems.
Rik Lemoncello:
Absolutely not. Yeah. I love having these conversations, for example, when I go get my hair cut and just talking to the hairdresser and they ask what do you do, and I say, I'm a speech language pathologist. Most people have never heard about this.
Terri Trespicio:
No idea.
Rik Lemoncello:
They assume you're working with kids who stutter or have a speech disorder, and I get to say, "actually, that's not at all what I do." Yeah.
Terri Trespicio:
Where you think, "Oh, people who had trouble with a lisp or something." It's not limited to that, that it's so much bigger, but you studied to be an oral speech pathologist, but you're also a professor of it. You also teach it.
Rik Lemoncello:
Correct.
Terri Trespicio:
What have you found between there's doing the thing, there's teaching the thing? Which do you think is more rewarding or what do you find you're really spend more time doing? Teaching, I imagine now.
Rik Lemoncello:
Well, absolutely. Yeah. Currently I'm a professor so it's all teaching and research and service and committee work, but I really miss the direct clinical care. So one of the things that I've done is create a program to allow me to continue to have direct access, but yeah.
Terri Trespicio:
Let's talk about that because I was going to say, the move to go to academics is the move away from a direct practice of doing the thing you were trained to do. First, tell me that. What was that shift because the decision to be on faculty is very different from being a speech pathologist day-to-day. What inspired that shift for you?
Rik Lemoncello:
Correct. Yeah. Even when I was in the graduate program at Emerson, I figured that one day I would want to pursue my PhD because I do love teaching, and so I had a wonderful five-year clinical career in the Boston area. It was at New England rehabilitation center up in Woburn for most of my clinical career there and really got interested in brain injuries, which I never knew I was going to be interested in when I was taking classes there.
So that clinical career really got me questioning about brain injury, and I really struggled with memory and everything in rehabilitation is about teaching people new skills or teaching people to relearn skills that they lost after their brain injury, and what was I doing when I had someone who had difficulty remembering? It was really hard to teach, and so that got me interested in pursuing more and learning more about cognition and memory and learning and rehabilitation, and that's really what lit my fire to pursue the PhD and moved me out to Oregon to study at the University of Oregon with one of the leaders in cognitive rehabilitation, which is a subset of our field. There's only about a handful of us who really specialize in cognitive disorders.
Terri Trespicio:
This is what... Of course, you could have just done what you were doing, which is a lot of work as it is to teach and to pursue higher education, to get your PhD, to continue to teach, to study these things, but you also created something really innovative and exciting, and I want to talk a little bit about it. You are the founder and program director for Sarah Bellum's Bakery and Workshop in southwest Portland, Oregon. Of course, Sarah Bellum looks like someone's name, play on words as in cerebellum. Really, really brilliant. Talk to us a little bit about what this is, a bakery and workshop. Most people assume, okay, this must have something to do with we're going to learn to be French bakers, but no, it's something else. Tell us.
Rik Lemoncello:
Sarah Bellum's Bakery and Workshop is a great play on words. That was one of the first things we did is hire a marketing person to come up with this name and brand us.
Terri Trespicio:
Smart.
Rik Lemoncello:
Yes, it was a smart initial investment. So we are a nonprofit organization that is focused on providing return to work opportunities for adults with brain injuries. So all of my passion and work has been in learning more about brain injuries and helping to support adults with brain injury, and at the same time, I'm also a hobbyist cake baker and in fact, I started learning how to bake cakes while I was in graduate school in Boston at Emerson, and so I've been doing speech language pathology for about just over 20 years and I've been baking cakes for just over 20 years.
Terri Trespicio:
Oh my gosh. You have twin careers. Wait, what do you mean at Emerson? There were no cake classes at Emerson, are there?
Rik Lemoncello:
No, no, no. It was just an at home, a hobby.
Terri Trespicio:
You were just doing it. You just like doing it.
Rik Lemoncello:
Just doing it. Got to figure out how to bake cakes because graduate school didn't have enough to do.
Terri Trespicio:
Oh my gosh. Well, you love doing it and what's so fascinating is that you were able to blend these things together. So you have people who go through the program. This is something I want to understand. Are there people who enroll in the program, they have either sustained or acquired a brain injury of some kind and are going through your program to work through or do they just kind of work there? That's what I don't know.
Rik Lemoncello:
Both. Yeah. The original vision when we started four years ago has shifted a little bit there. The original vision was to have folks transition from our program out into other employment opportunities, but as we've been working with folks who have more significant challenges, we're also finding the value of being a place where folks with more moderate challenges can also have a place to come and work and create a community and feel safe and supported and have something exciting to do, even though moving on to other employment may not be in the cards for them.
Terri Trespicio:
This is a place where people who are dealing with these things, they are learning to bake. There's a reason why. I mean, look, if you had a passion for dog training, I think there'd be a Sarah Bellum's dog training and workshop, you know what I mean? It happens to be the lens you use, but talk to us about what is it in the baking of things and in the learning of these skills, how are they integrated? Why is it helpful to people to learn this?
Rik Lemoncello:
Yeah. Absolutely. The cupcake is not the magic. The structure, the support, the community is really the magic. So it doesn't matter. We could be doing dog-walking or landscaping or anything.
Terri Trespicio:
That's what I'm saying. It could be anything.
Rik Lemoncello:
Exactly. So this program is designed to create a supportive space because nothing exists for adults with acquired brain injuries. If you're injured after the age of 21, you do not qualify for developmental disabilities and you don't gain access to all of the other services that other adults with intellectual impairment or developmental disabilities might have access to. So this is an underserved marginalized population.
Terri Trespicio:
So take me through what that might look like. Someone who has acquired some kind of brain injury and they say, "okay, I'm going to do this program," and what will they do? And how long could they do it?
Rik Lemoncello:
As long as they want. Yeah. We have two broad approaches or two broad categories that folks might work in. So we are a functional bakery and we exist right in Portland and we're selling cupcakes. We're a cupcake specialty shop, and so folks might work, in the restaurant lingo, in the back of house doing the baking or in the front of house, doing the sales, and we will do a strength based assessment.
Rik Lemoncello:
When someone comes in and says, "Hey, I'm interested in getting involved," we'll interview them and find out about their injury, about their challenges, and really about their strengths and try to match the job to their strengths. Are they going to be better with socializing and not needing to do as many physical things? That would be great for the front of house for doing sales, or do they struggle a little more with some of the social skills, but have the physical abilities to do some of the heavier lifting and scooping and some of the baking tasks in the back of house, and some people do both.
Terri Trespicio:
And they're learning a craft. They're learning a craft which anyone could benefit from learning, but it's not an official rehabilitation type, right? So it's not like, well, I did my six weeks or my six months and now this is different. Are people changed as a result? How do you measure success with a program like this?
Rik Lemoncello:
Oh my gosh, that's a great question. So correct. We are not a traditional medical rehabilitation. We're not billing insurance. There's no fee for participating here. So that's the benefit of creating a nonprofit organization and having other funding sources. So folks come in and have their own individual goals that they want to work towards. Some people are still relatively new to their brain injury. Maybe it's only been a year and they have finished their medical rehabilitation, but they are not ready to return to their previous work on. Some folks have been living with their brain injury for five, 10, 40 years, and have continued to struggle in daily life or trying to find other work.
Rik Lemoncello:
So they come to our program and say, "I would like to be involved and here are my strengths," and we say, "here's what I think would be a best match," and we ask, "what do you want to get out of this program? What will you contribute to the program, and what goals do you have for yourself," and we individualize and customize those goals for what they want to work on. For some people, that's getting into another paid employment position that's not baking, and we work on skills to help them with organizing their schedule and communication and dealing with changes and sensory overload and all the things that they might need to do in another work setting.
Rik Lemoncello:
Others say, "I just want to have something to do. My life is really boring. I don't have a lot of outlets," and that's one of the biggest challenges for many people with brain injury five, 10, 20 years later, is it's hard to maintain friendships and have places to go, and their social world can be very limited. So for some folks, it's a weekly, regular thing to do and we're building the community of feeling good, feeling important, feeling like you have purpose and meaning in your life and helping to rebuild that identity and sense of self-worth, and that's been really powerful.
Terri Trespicio:
Yeah. I mean, Rik, most people struggle.
Rik Lemoncello:
Absolutely.
Terri Trespicio:
Regardless of whether they've acquired or sustained a brain injury, they struggle with finding meaning, finding community, and you have said that the real struggle we think like, "Oh, if you've had some kind of brain injury, it must be hard to do X, Y, Z," but you say the real problem is isolation.
Rik Lemoncello:
That's the core. Absolutely.
Terri Trespicio:
But that is also the human condition. It's worse for people who have lost the ability to do something they could do before, but what you're doing is fascinating when you look back and say, you got into this because you were interested in healthcare and linguistics, the real, technical aspects of these things, and then got involved in the counseling aspect and then realized, gosh, this really has stuff to, of course it has to do with the specifics of how to learn skills, but what you're really doing is how do you reinvent community when you have felt incredibly isolated and lost something?
Rik Lemoncello:
Absolutely, and communication is so critical to that sense of self, to that sense of relating to the world and to building and fostering and sustaining that community.
Terri Trespicio:
Could you have imagined that you might be doing this or maybe you're like, "no, this is exactly what I thought I'd be doing?"
Rik Lemoncello:
Never.
Terri Trespicio:
Really?
Rik Lemoncello:
Yeah. Probably not. So when I was in graduate school, brain injury was something that actually scared me. We didn't learn a whole lot about traumatic brain injury in my graduate program. We had an elective class and for two weeks, we talked about brain injury and two weeks we talked about Alzheimer's disease.
Terri Trespicio:
Two weeks.
Rik Lemoncello:
Two weeks. Yeah. It was a summer elective, and so I didn't get a whole lot of background and it kind of scared me because I didn't know very much about it, and one of the peak incidences of people who sustain traumatic brain injury that resonated and stood out to me was adolescents, likely from motor vehicle crashes or sporting injuries, and males are higher risk takers and at higher risk, and so one of the problems after brain injury is they can become agitated and can physically strike out at you too because of the brain injury, and that just did not sound fun to a 22 year old graduate student to be put at risk of having some strong adolescent take a swing at me.
Terri Trespicio:
That sounds really scary, actually.
Rik Lemoncello:
Yeah. So brain injury was definitely not something I thought that I was going to pursue, but fast forward to my clinical career and working in the hospitals, I realized actually, this isn't so scary, and then fast forward to my doctoral degree and continued education, I was like, "actually, there's a lot that we can do to help support someone who has memory and learning challenges." So brain injury was definitely not something that I saw on the radar for me, but starting a program or doing something that would have a big impact, I don't know that was necessarily in the cards, but I knew at some point early in my lifetime that I wanted to make an impact, and that's where I think health care and teaching and counseling and all of these things that I early on had passions toward, even though I didn't know what profession that would lead to.
Terri Trespicio:
And then baking.
Rik Lemoncello:
And then baking.
Terri Trespicio:
We had to figure out how to do that, but that's the cool part, that it could have been anything, but here's my thinking. People look ahead at their careers and they think they're supposed to know a thing. They think they're supposed to know what they're going to do, and that there's a right way to do it when really what ends up happening is you kind of throw a lot of things in there that interests you, that keep you involved, you with the overcoming of fears around a thing you didn't understand to understanding it better, and then what the hell, throwing in a baking workshop in the middle of it.
Rik Lemoncello:
And why not open a business along the way? Yes.
Terri Trespicio:
But I love that you didn't know. I think it's just important to remind us that we don't know. You're not supposed to necessarily predict that, but that you're doing a thing and when you see the way it affects and changes people, that keeps you doing it, even if you never saw it in the first place.
Rik Lemoncello:
Absolutely. Exactly. Yes.
Terri Trespicio:
So if there's something that you think, well, there's so many ways to be a speech pathologist. You can go in the direction of medicine, healthcare, you can become an academic success and run programs, do all kinds of things. In your mind, in your field, what does it mean for you to make it in your industry and how will you know when you get there?
Rik Lemoncello:
The second question is the hard one. How will you know when you get there? I don't know.
Terri Trespicio:
Start with the first. What do you think it means?
Rik Lemoncello:
What does it mean to make it as a speech language pathologist? I would say that your clients will let you know and it's all about making an impact for others, and we're recording this on MLK, Martin Luther King Jr. celebration remembrance day, and I just saw a post this morning. I'm going to ramble for a second. We can edit this. Just saw a post this morning about being selfless and contributing to the world to make an impact. So I think that as a speech language pathologist, it's that selfless act of contributing to improve someone else's life.
Rik Lemoncello:
And that's really the crux of what we have the privilege of getting to do every day as a speech language pathologist. We are helping our clients change their lives, whether that's through speech, through swallowing, through thinking, through organizing, through reading, through literacy, and when you have those breakthroughs with your clients, and these can take several months and several years of hard work and therapy to really see these big changes, but when you see the functional changes and your clients succeed, that's how I would say you know you've made it.
Terri Trespicio:
I'd say you've made it. How's that feel? Apparently, I'm calling the shots. No, I do not call the shots, but honestly, if that's what it takes to make it, Dr. Rik, you have certainly made it and you've certainly made a big difference in people's lives and we thank you for that.
Rik Lemoncello:
Hey, thank you. Yeah, it's in our motto at Sarah Bellum's Bakery and Workshop is changing lives one cupcake at a time, and that's what we're all about.
Terri Trespicio:
What better way, what sweeter way to change people's lives? I love it.
Rik Lemoncello:
Literally sweet. Yes.
Terri Trespicio:
Literally. And if you're in the Southwest Portland area, how do you say the name of that town?
Rik Lemoncello:
Multnomah. Multnomah Village.
Terri Trespicio:
Multnomah Village in Portland, Oregon. Stop by Sarah Bellum's, pick up a cupcake, say hello to some folks who are taking real measures to relearn their lives and reconnect with community. Fantastic. Thanks Dr. Rik.
Rik Lemoncello:
Absolutely. And how do you know when you made it as an academic? The other measure that we have is publish and get peer recognition. So it's been fun. We're coming up on our fifth year of Sarah Bellum's Bakery and Workshop, and I've just submitted my promotion application to promote from an associate to a full professor, and I had to come up with all of the ways that we've had peer recognition of this program, and some of it has been through publication and through sharing at conferences and some of it has been all of these fantastic invitations popping up from across the country. Folks who have heard about this program and say, "Oh my gosh, that's fantastic. We want to learn more. How do we get the word out?" I would love to see one of the goals for Sarah Bellum's Bakery is that others will replicate this model and this program because there's just not enough support for adults with brain injuries.
Terri Trespicio:
Scale, Dr. Rik. Now is the time to scale.
Rik Lemoncello:
But it won't be me.
Terri Trespicio:
Not you? You're not going to scale it?
Rik Lemoncello:
Someone else can pick that up.
Terri Trespicio:
Someone pick that up, take the baton and pass it.
Rik Lemoncello:
Please.
Terri Trespicio:
Well, it's true. You are making it in two different areas and yes, you've nailed it.
Rik Lemoncello:
Someone with business savvy can take that to the next level.
Terri Trespicio:
Yes. Terrific. Thanks Dr. Rik. That was awesome.
Rik Lemoncello:
Yeah, thank you.