Blog 5: Does Advocacy Matter?
This blog begins Your Voice in Healthcare, a three-part series that examines my experience as an out-patient and what it may tell us about the impact of advocacy.
Blog 5: Does Advocacy Matter?
Blog 6: When Silence Isn’t Safe
Blog 7: Normalizing Communication Access
Our hope is that by seeing that positive outcomes can be achieved, you—as stakeholders—will feel encouraged to invest your time in the steps outlined throughout this series.
Outcomes - Surgery, NYU Langone Eye Center, October 2025
I arrived at NYU Langone Eye Center in New York City for my outpatient procedure, confident that I had addressed every aspect of my communication needs. Several weeks before my scheduled procedure, I had:
spoken in person with my surgeon and her assistant about my hearing loss and specific communication needs
posted my Communication Access Plan (CAP) in my patient portal
emailed Patient Services to request access accommodations and attached my CAP.
First Stop – Intake
Sitting at the intake desk, as staff began asking the standard questions, I was disappointed to learn that the voice recognition app I had requested was not available. I shifted to Plan B, asking staff to speak slowly and clearly. They were receptive and together we made it work.
When they directed me to the waiting room, I explained how difficult it is to hear my name when it’s called. As I sat watching TV - captions turned on, as required by the ADA - I heard voices behind me. It was the same intake staff, pointing me out to the nurse who would be calling my name when it was time to be seen.
I could feel myself begin to relax.
Pre-Surgery
Candice, my procedure nurse, came to me in the waiting room holding a sleek white tablet equipped with voice recognition software. It was already set up and working perfectly. From the very first moment, I could read every word she said – including our casual conversation as we walked to the prep area.
Throughout the preparation process, Candice and I marveled at how effective the assistive device was. I briefly shared my experience of hearing loss and explained why this accommodation was necessary. Candice spoke clearly and at a measured, comfortable pace, and as I grew accustomed to her voice, I found myself relying less on the tablet and listening more.
Enter Anesthesiologist
As the anesthesiologist greeted me, I asked if he would be using the tablet. He wasn’t aware that this was an option, but because he spoke clearly, I chose to try communicating without it. I also used teach-back, repeating what the anesthesiologist said to ensure that I had heard correctly. In retrospect, I found myself wondering if he and Candice had been prompted beforehand to use basic, effective communication strategies; both were excellent communicators.
Moving on to Surgery
When it was time to move to the OR, a nurse entered the room and introduced herself. I briefly explained my hearing loss and mentioned the option of using the tablet. Without hesitation, she immediately removed her mask (as all staff did upon request) and pulled out her phone.
“What about this?” she asked.
She already had a voice recognition app installed, allowing me to read her words perfectly if needed. With that simple adjustment, communication was seamless – and we were ready to proceed.
The OR
Everything moved quickly after that. The pace itself made clear how essential it is for communication supports to be immediately available, because once things begin, there is little time to pause or problem-solve.
In the OR, I was surrounded by four women - my surgeon, anesthesiologist, OR nurse, and one other medical staff. After a brief exchange of information and questions, I was handed an eyeglass case which also accommodated my cochlear implant processor (CI) and battery.
As the surgeon was completing her final prep, someone gave me another instruction. Without my CI processor, I could not hear a single word or sound. I had no way to know who was speaking – or what was being said. I felt a sense of panic as I looked up at the four women and said, “I have no idea what you’re saying…is there a whiteboard?” (I had requested this accommodation so staff could write words in large print that I could read without my glasses).
The OR nurse immediately held her phone near my face and turned on voice recognition. The words appeared in large print on the screen: “Keep your arms at your side and don’t move”.
It was a critical instruction, one that I would have completely missed without that last- minute workaround.
Mission Accomplished
I was briefly awakened at the end of surgery, to see four women looking down at me - masks on, smiling eyes, 8 thumbs up. I’ll never forget that image. The moment was unmistakenly positive and left me with a profound sense of inclusion.
One Final Word - Dignity
Looking back on this experience, one word keeps coming to mind: dignity. It’s remarkable how empowering it feels when your communication needs are acknowledged and supported. I didn’t have to ask staff to repeat themselves or jot down missed words; I never felt like I was being a bother or asking for “too much.” Staff time was used efficiently, and everyone could work together as a team. The entire experience felt comfortable, professional, and - most importantly – dignified.
Toni Iacolucci
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