CBIST Spotlight: Kathy Panther

Kathy Panther, M.S., CCC-SLP, is the Inpatient Rehab Director and the Brain Injury Program Director at Frazier Rehab Institute in Louisville, Kentucky. Kathy was one of the first speech pathologists in the United States to implement a free water protocol, having successfully managed thousands of patients on the Frazier Water Protocol since 1984. For the past 25 years, Kathy has been educating SLPs and other healthcare professionals on implementing free water protocols at hospitals, rehab centers and long-term care facilities. Kathy became a CBIST in 2013. Her clinical interests include neurogenic communication disorders, dysphagia, cognitive rehabilitation and rehab management. Kathy received her education at the University of Kentucky and the University of Louisville.

Why have you chosen a career in brain injury? What are you most passionate about in the field?

I was fortunate to be placed at Frazier Rehab Institute for a clinical rotation during my graduate studies in Speech Language Pathology at the University of Louisville. At the time, I had no idea where that experience would lead. Ultimately, it led to a 36-year career at Frazier that surpassed all of my expectations for my life’s work. I love the brain and brain science. My heart and mind connected immediately with service to people with brain injury. There is no more rewarding work. My team and I are inspired every day by the strength, courage and resilience of the individuals we serve.

Why is having your CBIST important to you and how has it benefited your practice and career?

I came to the CBIST late in my career. As director of our Brain Injury Program, I had determined we needed to advance our team’s breadth of knowledge in the ABI field. Our team had solid depth of knowledge within their specialties and within their particular segments of the rehab continuum. The CBIS seemed to be the route to expand our team’s ABI knowledge base. It was important to me that we build the knowledge base of clinicians who touch the lives of individuals with ABI across all disciplines and in all of our clinical settings, i.e. the acute rehab program, the comprehensive post- acute program, traditional outpatient clinics, a rural hospital, community hospital, and a trauma center. To date, 70 of our clinicians across our system have successfully achieved their CBIS and we currently have 33 candidates preparing for the exam. I feel practice has elevated because of this cohesive program we have embraced.

With your retirement approaching, can you reflect on your proudest contributions to the field of brain injury rehabilitation?

In the early 1980’s Frazier Rehab diverged from conventional dysphagia intervention by developing the Frazier Water Protocol (FWP). We were aware of many patients who were known aspirators who had not adhered to thin liquid restrictions. We were surprised to realize they were not acquiring aspiration pneumonia and we questioned traditional practice. Our team was mentored by Dr. Judah Skolnick, who had learned through years of pulmonology practice that aspiration of water was benign. We implemented the FWP, a humane, hydration program for thin liquid aspirators that allows dysphagic individuals to drink water. Quality of life has been enhanced for people with dysphagia, adverse medical events are rare, and widespread clinical practice has been changed. The FWP taught us that listening to our patients is paramount to effective practice.

In the early 1990’s we recognized a need in Louisville for a comprehensive day treatment program for people with ABI. We travelled to programs that existed in our region including Lance Trexler’s program in Indianapolis to observe and learn. We stole great ideas shamelessly, found a property in a suburban setting and launched our Community Re-Entry Program. This program remarkably has survived through multiple re-inventions and continues to thrive today. It is now called Frazier NeuroRehab Program, has solid outcomes, and boasts a team of dedicated, passionate professionals.

In 2011 we resumed providing acute rehabilitation to individuals with disorders of consciousness (DOC). In my early career we frequently admitted individuals to our inpatient program with DOC. Over time, however, these patients were denied inpatient rehab admission as they were judged to be unable to participate in acute rehabilitation. We took a stand to accept these patients into inpatient rehab and we piloted our EMERGE program for disorders of consciousness. This work has gone very well. The team is strongly invested in these patients and their families. 92% of the EMERGE patients have emerged into consciousness moving on to traditional acute rehab with many transitioning to the NeuroRehab Program and other outpatient services.

I have a background in the performing arts. Art is a great conduit for tapping into the wisdom and experience of people with brain injury. Through total happenstance, I became the curator of Frazier’s Healing Arts Gallery. Thanks to the generosity of donors and an amazing local artist (status post brain tumor) we have filled our walls with beautiful paintings and sculptures. Our art collection has created an environment that is simultaneously calming, stimulating, curious, and thought provoking. We have created visual art with our patients and we have brought in performing artists. These types of activities have elicited profound experiences for individuals with brain injury and the clinicians. It feels as if we are all placed on equal footing whether we are a patient or a clinician when we explore life after brain injury through music, movement, and creating art.

Educator is one of my favorite roles. Connector to education is another of my favorite roles. I am immensely proud of the continuing education offerings I have been able to offer my team and clinicians across the wide region. We have been fortunate to learn from the masters, such as Audrey Holland, Jay Rosenbek, Joe Giacino, George Prigitano, Mark Ylvisaker, Susan Langmore, and many others. I am proud of my team’s depth of clinical knowledge and their eagerness to learn.

Bottom line: I have been one lucky person to work in this field. I have learned every day of my career.