As a child life specialist, I’ve seen countless examples of play transforming a child’s mood in the hospital environment. I remember well the day when Steven lay curled in a ball beneath the covers in his hospital bed, his caffe latte bald head hiding beneath the sheets. He had not showed up in the playroom that afternoon, which was unusual. This was one of those kids who waited eagerly outside the door each day for the playroom to open and was often the last to skate his IV pole back to his room at the end of the day. I had yet to see Steven without a smile on his round, open face. He was a content child with a quiet maturity that went well beyond his seven years. He took his medical treatment in stride and enjoyed the company of his brother and sisters, as well as just about every activity the playroom had to offer.

But not this day. It was mid-afternoon and we had yet to see a glimpse of Steven. His mother stopped by and informed me that Steven had an infection in his Broviak catheter and that it would have to be surgically removed.

Steven was very upset and refused  to leave his bed or talk to anyone. The removal of the catheter that allows patients to receive chemotherapy without an IV is difficult for any child. But it was important to find out what was upsetting Steven in particular. Understanding the details of what was causing  this typically cheerful boy to retreat under the covers would give me a clue about what would help him cope.

With a soft knock, I entered his room and took a seat by his bed. His father sat vigil in a chair close by. I gently coaxed him to tell me what was wrong. He was having none of it.

“We were wondering why you weren’t in the playroom today. Your mom told me that you have an infection in your Broviak.”

Silence.

“It can be pretty disappointing to have to go in for more surgery.”

Not even a nod.

“I am thinking that you might be too upset to even talk about it. So I was wondering if you could draw a picture about the most awful part of having your Broviak taken out. That way, I can understand a bit better what you are going through.”

I placed a piece of plain, white paper on the bed, along with some markers.

It took a few moments, but Steven uncurled from the fetal position and scooted up to a half-sitting position. He reached for a marker. I breathed an inward sigh of relief and sat back to see what he would draw. Placing his hand palm down in the center of the paper, Steven outlined it with a green marker. He still wasn’t talking, but he was communicating something important. He held out the drawing, and I took it from him.

“I see a hand outlined in green,” I said.       

I had no clue what it meant. Steven’s father was the one who piped in with an explanation.

“Steven is mad because without the Broviak, he will have to have an IV in his hand. It hurts and it’s harder to play with an IV there.”

“Oh, I get it,” I said. “Yeah, having to get an IV is no fun. And having more surgery stinks, too.”

I paused to see if I was on the right track. He wasn’t speaking, but he was making eye contact.

“I do have an idea though.”

I continued, taking a chance. An idea had occurred to me and I wanted to try it out.

“How would you like to make a big mess that you don’t have to clean up?”

A tiny smile appeared on Steven’s face.

“Okay, then. I am going to set something up and let’s see what a big mess you can make.”

Stepping out into the hall, I headed for the utility room on the unit. On the way, I snagged Steven’s nurse .

“We are going to make a bit of a mess, but I promise I will clean it up,” I assured her.

She had no complaints. I gathered supplies for what I had in mind: one bedpan, a roll of toilet paper, a large piece of chart paper, tape, and an armload of towels and sheets….

       

 

Stay tuned later this week for Part II. I am not trying to torture you, but I am told blogs should be kept to about 500 words.