Camp Klicek: A Dose of Nature and the Universal Language of Play

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I remember the endless swath of time that summer brought when I was a young child. Unstructured free time in nature, with neighborhood kids, and my family. I also played alone, exploring the back roads on my bike and the woods on foot. At the age of seven, I would be gone for hours, playing in brooks, creating forts under the shelter of giant boulders, climbing trees, making up stories in my head, and writing poetry.

These days, we are hard put to find children at play in this kind of open-ended, unsupervised milieu. Their play is planned, highly structured by adults, and often close-ended. When left to their own devices, kids often choose tablets, smart phones and video games as their go to. Child life specialists and hospital play specialists know the value of deep, open-ended play that encourages self-expression, exploration, self-regulation, social development, and problem solving. My friends at the Klicek Foundation in the Czech Republic provide these play opportunities at their summer camp for children and families affected by illness and loss. This year, they invited me to partake in a unique camp experience, and I immersed myself in the healing environment of Camp Klicek, which has been in operation since 1992.

 

Children after a long-term therapy (and sometimes even patients under treatment, if their health allows it) take part in the camp, as well as their friends, siblings, parents and pets. Several bereaved families come too.

Our camp activities began as an attempt to offer a two-week stay in beautiful natural surrounding also to those children who couldn’t participate in a “normal” summer camp. We have always tried to create a friendly, open-hearted and open-minded atmosphere in our camps, and we hope that the camp program gives its participants enough opportunities to have fun, to do some useful work, to talk about things that are important to them, to simply be with friends.

The camp games and plays (mostly non-competitive) follow the make-believe story of a man who decided to spend some time with nature and is thus confronted with new situations and thoughts and starts to meditate on his own life and on the civilization he lives in.

Children live in big Indian “tee-pee” tents which are able to accommodate up to six inhabitants and have a fireplace inside.

Since 2000, we organize our camps on a meadow just behind the respite hospice building at Malejovice – thanks to this, children whose condition requires special attention can also participate in the camp program, backed by the safe environment of our house.

 

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Indeed, I found myself amidst a remarkable mix of campers and staff, a combination of people and circumstances that is hard to imagine anywhere else. The youngest camper was seven years of age, the oldest, twenty. The children’s diagnoses differed significantly, as did their abilities, disabilities, ethnic and socio-economic backgrounds. There were children undergoing treatment, survivors of serious illness, siblings, friends, parents, and bereaved parents who had lost a child. The camp leaders, Jiri and Marketa, are purposeful in their choice to bring children and adults together where they might not otherwise interact in larger society. Watching connections form between the campers and staff of varied backgrounds was a blessing on so many levels.

The focus of our days involved living in nature, eating good, healthy food, exploring tough topics such as “What is evil?” and “How can we make the hospital experience more pleasant?”, and above all, building community. The virtual lack of technology at camp was so refreshing. I felt myself detoxing from my smartphone addiction as I wrapped myself in nature, old fashioned, simple play, and grand company.

Many friends have asked me what it was like for me to be surrounded by children who spoke Czech. Did I learn any Czech? How did I communicate with them? Well, I was immersed in a foreign language – of that there is no doubt. Most children spoke no more than a few words or phrases in English, and my Czech is abysmal. But the children understand more English than they speak, and play is a universal language.  The children’s welcoming of me was profound, inviting me into play, making me feel immediately part of the group. “Frisbee?” “Will you play?” “Come play football.” “Ping pong?” “Draw.” Once engaged in a game or project, there was much good will and laughter as we all tried our best to communicate.

I too, grew my Czech vocabulary one word and gesture at a time. I made it my goal over the week to learn everyone’s name – a challenging feat with names that were not familiar to me.  But with each name and greeting, I could see the rapport growing, the shy kids responding, the teens warming. Some of my favorite moments were when I would board the 1970’s retro bus for a field trip, and a kid would smile at me and pat the seat beside them to show they’d been saving it for me. Or that wonderful moment, when the quietest camper, one who spent much time alone and looked down or sideways rather than meeting your gaze, took my hand as I stepped off the bus and walked quietly with me to our destination.

It’s the small stuff, really.

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Children berry picking on a picnic in Czech countryside

 

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Klicek Foundation cofounder Marketa leading us in a trivia game in the camp’s mess tent, where we ate all of our meals.

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In my next several posts, I will dive deeper into some of the activities we did, the games we played, the lessons I learned.

 

Kiddos

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A headline caught my eye this morning:

Miss USA 2018 Sarah Rose Summers on Her New Job, #ConfidentlyBeautiful, and Working with ‘Kiddos’

I searched the article to see if she was quoted as using the word, “kiddo”, and couldn’t find any reference to it in her eloquent and passionate description of her work as a child life specialist. So I am going to put the use of the word down to creative journalism.

But I do read and hear that word often in the vocabulary of child life specialists far and wide, in person and in writing — and it has never fallen easily on my ears. I wonder sometimes if I am being nitpicky. But I looked it up on the internet and my intuition was backed up, first by the definition I found, and secondly by several conversations in the media by everyone from teachers to business women and journalists.

Here are two definitions I found:

Google Dictionary says that it is “used as a friendly or slightly condescending form of address.”

Webster’s New World College Dictionary describes it as a term of affectionate address sometimes mildly patronizing

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THAT is the nuance that has always been pricking the back of my brain. It is the fact that there is such a thin line between an affectionate colloquial term and one that imparts a power deferential, demeaning the individual to whom we are referring.

In an article entitled “The word every boss should ban“, Leigh Gallagher says, “But kiddo can also be patronizing and condescending, and while the person using the term may think of it as an expression of benign affection, it doesn’t always come across that way. For a young woman who is trying her best to be taken seriously, ‘kiddo’ can very quickly wipe all that away.”

In a conversation between teachers, the opinions are all over the map, but the underlying message for us is one of being conscious of the language we use, and how it informs our professional relationships with children.

When I think of children in hospitals, I think about how disempowered they are by virtue of being a patient in a medical institution. It seems that anything we can do, including refraining from using unintentionally demeaning language, can usher in more humanity to an inherently dehumanizing environment. Calling children and parents by their given names, even asking how they prefer to be addressed, taking the time to note names and refer back to them, seems like the least we can do to show children and families that we see them for the unique individuals they are – beyond the confines of the hospital.

 

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Wonder

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“Doctors have come from distant cities just to see me. Stand over my bed disbelieving what they’re seeing. They say I must be one of the wonders of God’s own creation. And as far as they see they can offer no explanation… Oh I believe Fate smiled at Destiny. Laughed as she came to my cradle. Know this child will be able. Laughed as my body she lifted. Know this child will be gifted. With love, with patience and with faith she’ll make her way.”

–Natalie Merchant

I am not sure of when it was that I first heard Natalie Merchant’s song “Wonder”, but each time I do hear it, it resonates deeply with me and I feel incredibly witnessed and uplifted.

In the early morning hours of my birth, the doctor gravely informed my parents that he had little hope for my survival. He actually discouraged my mother from naming me, in a misguided effort to help her accept the inevitable. I was born with a rare genetic skin disorder, Congenital Ichthyosiform Erythroderma (CIE). I made my first appearance on earth encased in a collodian membrane  – a tight outer layer resembling plastic wrap, looking as my father loves to say, like a “shiny red sausage”. The doctors didn’t know what to make of me. They had no name for my symptoms, no explanation for my appearance. But their worry about my skin’s ability to provide a sufficiently protective barrier led them to believe that I would not survive.

 

I spent one month alone in the hospital, as doctors searched high and low for a diagnosis. Parental visits were discouraged. They finally suggested that my parents seek an answer at a larger children’s hospital. My parents held me for the very first time in the back seat of the car, as their friends drove them the hour and a half to New York City. Another month passed before I was discharged, still without a diagnosis. The hospital cautioned my parents that the road ahead would be a rough one, and they highly recommended that my family employ a full-time nurse to see to my complicated needs. My mother balked at this. “I’m her mother,” she said. “I am the only nurse she needs.”

 

My diagnosis came soon after, when Dr. Charles Sheard, a dermatologist in Stamford, CT, observed that I appeared to have the same symptoms as one other patient he had read about in some obscure medical journal. Dr. Sheard took me on as a regular patient, seeing me once a week for the first year of my life, then monthly, and as I continued to grow and develop, annually throughout my teen years. He never charged my parents a dime. Although I suffered some complications and hospitalizations during childhood, my health stabilized and I have grown to live a full and rich life with few limitations. When dermatologists examine me, they remark at the seemingly mild case of ichthyosis I have, compared to other patients whose condition hugely impacted their development, mobility, and appearance.

 

I did, however, struggle with post-hospital trauma in the form of sleep disturbances, sensory issues, and severe separation anxiety. Then came the bullying in school. But I had several resilience factors at play in my life. I grew up listening to my parents tell me stories of my early health challenges, referring to me as a survivor and a fighter. My mother too was a fighter and fierce advocate for my medical and emotional needs throughout my growing years.  It should come as no surprise that I became a child life specialist as an adult, advocating for the emotional and developmental needs of children facing illness in hospitals and their communities.  Natalie Merchant’s song “Wonder” reminds me of the miracle of my birth and life, how I surprised the naysayers, and how my mother saw the possibilities and joy in my birth and life more than the dire prognosis.
To learn more about the many forms of icthyosis, check out the Foundation for Icthyosis and Related Skin Types.

Child Life in Private Practice: Supporting Parents and Children through Medical Encounters

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Studies show that children who are prepared for medical procedures recover faster with less emotional stress. Even routine procedures such as vaccinations can cause children undue stress and lead to treatment noncompliance and avoidance of medical care. Children require developmentally appropriate information about what they will see, feel, hear, taste and smell that will prepare them without overwhelming them. Through hands on demonstration and guided play, I can prepare you and your child for medical encounters, and coach you both in coping strategies. Calm, informed parents are the best support for their children when facing routine and unexpected medical visits and hospitalizations.

I am pleased to announce the expansion of my private practice as a Child Life Coach on the upper east side in Manhattan. Child life specialists are trained in child development, education, anatomy, health care systems, family systems, ethnocultural issues, advocacy, and bereavement. In and out of hospitals, we help children and families prepare for and adjust to medical encounters by providing education, medical play, support,  coaching and advocacy.

Here are several of the services I offer to parents & schools:

  • Coaching and Support for Parents in::
    • how to prepare their cildren for medical events, from routine wellness appointments to surgery or long term treatment.

    • how to support siblings when a child is ill

    • how to support children through a parent’s serious illness.

    • Child centered play skills to caregivers who wish to connect more with children in this digital age.

    • In home preparation for elective medical, diagnostic, and surgical procedures.

    • Workshops: Please see my listing on Cottage Class Parents As Heroes: Supporting Children Through Medical Encounters
  • Professional Development: Training and Support for Teachers
    • How to support your class (school) when a student faces illness and loss

    • Child-centered play techniques

    • Emotionally responsive teaching

    • State mandated child abuse detection and reporting

  • Video Conference Consultation and Support
    • If traveling is an issue, I am available through video chat to support parents at a distance

More information about my practice can be found on my website at  debvilas.com, and please take the time to like my FaceBook page at Pediaplay

I greatly appreciate any referrals to parents and caregivers who need this kind of support. I can be reached at debvilasconsult@gmail.com

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All the best,

Deb

Deborah Vilas, MS, CCLS, LMSW

Follow me on Twitter:  @DeborahVilas at Twitter

CLC Video with Deb Vilas Appearance: That’s Child Life!

Child Life United: Practicums & Missions Abroad

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Ever since I first stepped off a plane in New Zealand over three years ago, I have become fascinated by what my profession looks like in other countries. Whether you call it Child Life, Hospital Play or Pediatric Psychosocial Healthcare, I have learned that there are many ways to ease the stress of medical treatment for children across the globe. I was in conversation recently with a mover and shaker in the Child Life world, Courtney Moreland, founder of Child Life United. Courtney has been busy creating practicums in partnership with child life programs on the international front, in addition to coordinating child life volunteer positions in her mission work.

Courtney noticed an increasing level of competition for a sparse number of practicums in the United States. Tapping into a growing interest within our field in international work, she came up with the idea of partnering with child life professionals abroad to create more practicum opportunities for budding child life specialists.

First stop — the Middle East! Courtney teamed up with Bank Street College alum, Rachel Werner, a child life specialist pioneer working for Save a Child’s Heart in Israel. Courtney supplied supervision for practicum students, while the students shadowed Rachel in her day to day work. This way, students benefited from Rachel’s modeling, and Courtney shouldered the responsibilities of supervision and training. Courtney provides a curriculum and leads the students in reflective practice. This unique set up means that the students get 100% of Courtney’s attention, energy and expertise, while Rachel can concentrate on her clinical duties. Anyone who has ever supervised or precepted a student knows that this is a win win for everyone. The pilot rolled out this Spring with three students as a one month, full time practicum. They were from America, Canada, and an expat now living in Israel.

Rachel reflects: “I loved the novel idea from the beginning and Courtney’s initiative to bring child life specialists around the world to learn, even to places like Israel where Child Life is not a known field. Although Save a Child’s Heart is an alternative setting, we agreed that it could be a one-of-a-kind learning experience for students seeking an international practicum. In the end I know a lot was learned, and the children will remember the three wonderful women (four including Courtney) when they think back of their time in Israel.”

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Courtney and Rachel – A fabulous partnership!
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Playing doctor

All Child Life United Practicums will follow the Recommended Standards as set forth by the Association of Child Life Professionals – ACLP (formally the Child Life Council)

Child Life Practicum

The child life practicum is designed as an introductory experience for individuals interested in pursuing a career in child life. Through experiential learning and observation of Certified Child Life Specialists, child life practicum students begin to increase their knowledge of basic child life skills related to play, developmental assessment, and integration of child life theory into interventions with infants, children, youth and families. Child life practicum students will increase their comfort level by interacting with infants, children, youth, and families in stressful situations, health care settings and/or in programs designed for special needs populations.  Through these experiences, child life practicum students will enhance their knowledge of the child life profession and investigate the process of applying child life and developmental theory to practice.  

The next practicum will be held in Sydney, Australia this summer. You can find details in the  Student Information Packet – Australia Practicum. Courtney seeks applicants who have completed 100 hours of volunteer work in a child life department. It is a plus if you have at least one child life course under your belt, but it is not required.

Applications are DUE June 1st, 2017

The application is also located on the Child Life United website www.childlifeunited.org

Mission Work

This summer Courtney is also happy to announce the exciting opportunity to serve as a Child Life Specialist on a medical mission trip. Missions are typically a week long.

In August, she will be supervising Child Life students on a mission to Mexico as Child Life United brings Child Life services to Florence Nightingale Global Health Missions .

This trip requires a fundraising effort to collect the teaching supplies and toys needed to meet the needs of the kids and their families. All trips provide medical care in grossly under served areas of the world. Please consider supporting this effort. Every sticker, ball and mask masks a difference.

She has created a Wish List on Amazon of supplies needed.
https://www.amazon.com/gp/registry/wishlist/307DPAFB2HQZG/ref=nav_wishlist_lists_2

If you are looking for a child life adventure abroad that will further your learning and expand your horizons, all in the service of easing the healthcare experiences of children, please contact Courtney at Child Life United to apply.

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We can’t wait to hear where she will be partnering next!

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Playing for Good: Touch-Tables in Hospitals

 

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Interview with guest Tom Bannon, Vice President, AFTER-MOUSE.COM on PLAY for Good, an initiative of AFTER-MOUSE.COM Twitter: @AFTER_MOUSE. I “met” Tom through an email when he read this blog and reached out to me. I think that his products are a great match for Child Life in Hospitals, so I offered to spotlight him on this blog. So, Heeeeeeeeeere’s Tom!

Tell us a little about who you are.

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I have been working in the technology and software licensing space for over 20 years. My career is about helping partners and customers make technology work for their business and their customers. Through my work, I have seen how technology can be transformative – making an experience more enjoyable for or helping connect people when communication barriers seemed impenetrable, among so many other benefits. I believe in my work, because I believe there is a lot of positive potential when technology is used for good.

What is AFTER-MOUSE.COM? How did you get involved with them?

AFTER-MOUSE.COM is a fast-growing industry leader in multi-touch technology applications. I joined five years ago to lead the U.S. sales team and be a part of business at the cutting-edge of multi-user collaborative technology.

We work with retail, real estate, automotive, financial, education, healthcare and other industries to provide unique customer experiences through interactive and collaborative touch-table applications. With more than 180 custom applications and 20 multi-touch, multi-player games for all age groups, our PLAY touch-table brings customers, families and colleagues together to experience truly collaborative activities. Whether it is in a waiting room or at a resort, our PLAY table delivers an experience that builds community and pure fun. Check out this video of guest using the PLAY table in a Novotel lobby: https://www.youtube.com/watch?v=40OniciXvDA

How did you get involved with Hospitals?

AFTER-MOUSE.COM has worked with hospitals and medical centers for more than 5 years. We have PLAY touch-tables in pediatric departments, waiting rooms and child life centers throughout the U.S. This is an important partnership for us as we work to promote the empowering and healing benefits of collaborative, playful learning.

Sometimes a hospital can be a scary and uncomfortable place for a child. Promoting collaborative, playful learning in these environments can provide positive emotional experiences and healing to help children cope.

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What are the benefits in your eyes of these interactive games? Any downsides?

The positive benefits of technology-based collaborative play inspired us to launch PLAY for Good, an AFTER-MOUSE.COM initiative working with partners to place multi-player touch-tables in nonprofit children’s hospitals and youth centers. The PLAY for Good team helps connect funders and donors with nonprofit hospitals and children’s health organizations that can use PLAY tables to promote collaborative play through our educational, multi-player children’s games.

Today, 91% of children between the ages of 2 and 17 play technology-based games. Despite the rapid uptake of technology, there is still little guidance on how to effectively harness technology as a tool for improving learning through play. Most guidance for children’s interaction with technology is based on “screen time,” the amount of time a child should spend looking at a digital screen. However, technology has progressed beyond the linear, sedentary relationship between child and screen, frequently thought of as watching television.

Technology-based play is not restricted to single user, sedentary experiences; rather technology can facilitate highly interactive and collaborative play activities that enable peer-to-peer learning. Unlike adult-child interactions, peer-to-peer learning allows for a balanced power dynamic which helps children refine planning, negotiation, and cooperation skills.

In a hospital environment, technology-based games can help a child cope with a stressful or uncomfortable situation. Children grappling with chemotherapy-related nausea or preoperative anxiety, for example, have had success playing technology-based games to help with emotional management.

What are your hopes for this product?

Our PLAY touch-table and children’s game bundle can provide entertainment to children in waiting rooms and lobbies – but they can also promote cognitive development, improves quality of life and can help a child manage emotional stress, when used appropriately.

In a world where technology is increasingly integrated into the way we live, we want to help promote the positive benefits it can yield. Interactive, technology-based collaborative, playful learning has changed the nature of children’s relationship with a device. When used appropriately, interactive technology can provide positive elements to children’s play and learning by facilitating exploration and experimentation in a dynamic digital multi-player experience.

What would you like Child Life Specialists to know about Play touch-tables?

We want to work together. While the body of research on the impact of technology-based play on child development is still in early stages, there is research confirming that, when used appropriately, interactive technology can be a valuable tool in promoting playful learning. PLAY touch-tables, when added to existing Child Life programs, have enhance a child’s experience in the hospital. Our PLAY for Good team understands the resources constraints of nonprofit organizations, so they can help identify funding opportunities with your development team and provide guidance on how the PLAY touch-table can be leveraged to support on-going fundraising goals through sponsorship programs.

Play for Good Program PDF

Tell us a bit about your international work.

We have worked with many companies around the world through our offices and partners in the US, Europe, Dubai and many other regions as well. We have now delivered projects in over 40 countries.  We continue to expand into new markets with our products.

 

Building Bridges Instead of Walls – Teaching & Learning in Mexico City

 

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One week post-election, I found myself bound for Mexico City, ready to teach and learn alongside my adventure colleague, Maria Busqueta. Marifer, (as I call her) hosted me in her home town, where she is a child life specialist, psychologist and educator. It was a whirlwind couple of days, as we visited the General de la Raza Hospital, learned about the Ayudarme a Sonreir ante el Cancer Foundation, The Vuela Foundation, taught a class on play techniques for adolescents, and attended a two-day conference on palliative care. Phew!

My first impressions of Mexico City and Marifer’s neighborhood: Unexpectedly cold and wet. Lovely hills rising up from the urban center. Cypress trees in plenty and Bougainvillea in bright, fuscea explosions amongst the trees and spilling down high stone retaining walls. Hilly, winding roads with speed bumps everywhere instead of stop signs. Heavy and erratic traffic. Cold mornings and nights. Marifer’s house has many levels to it, all encased in gingerbread auburn ceramic tiles. Like my home, the kitchen and living room are on the upper level, with bedrooms below. Marifer’s jaunty beagle, Duncan, lords over the front yard and threatens escape with each coming and going of a human being through the iron gate. Marifer’s mother cooks for us several times a day, filling me with homestyle Mexican fare. It is mere moments before I feel like family.

We are up bright and early my first full day there, ready to pay a visit to the Hospital Raza. Lisette Garcia Urenda, the founder of the Ayudarme a Sonreir ante el Cancer Foundation (which translates as “We help you smile after cancer”), is hosting us, and we meet her outside of the largest and oldest public hospital in all of Mexico. The sidewalks surrounding the building team with merchants hawking their wares, everything from pork roasting in a cauldron to magazines and fruit. We weave past the stalls and in through the back emergency entrance to the hospital. As we enter the foyer, several pediatric cancer patients and their families are exiting the hospital, bundled up for discharge and eager to be home. But they stop to hug, kiss and chat with Lisette. They shake our hands and offer “mucho gusto” as Lisette introduces us.

It is clear that the children and their caregivers adore Lisette. And it is easy to see why – she is all brightness, high energy and love. One teenage boy jokes for me to take him back to the United States with him. The younger children glance at us shyly.

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There are three events planned for the day, two presentations to patients and a therapeutic art activity to be conducted on the inpatient ward. The foundation grants wishes for pediatric cancer patients, and families have gathered to witness Lisette’s presentation of a wish to a young girl. They sit in tiny, child-sized plastic chairs around the parameter of an open roofed waiting area. The children sport face masks, bald heads, hats, and winter coats with good reason. It is cold.

The child is brought to the center of the room, and Lisette introduces her to everyone. I am regretting in the moment that I don’t understood more Spanish, but it seems that she is telling them how well the girl is doing post bone marrow transplant. With great flourish, Lisette hands the girl a large present. The child opens it with excitement and beams at its contents, an “alien” doll that  is apparently quite the rage. It’s hard not to note what a child with cancer might have in common with the toy. Both are bald; both might need to be isolated because of threatening germs in a hostile environment; both may need to be fed through a tube in the stomach. And, any child who has such a diagnosis may often feel like a misunderstood species hovering over the more typical lives of healthy peers.

The child hugs Lisette. The onlookers clap, and I wonder if they are envious of her.  Lisette explains to me that most of them will have a wish granted at some point, so that no child feels left out. Later, the child’s mother is crying in the hallway, sharing bad news with her social worker. Her daughter has relapsed. The bone marrow transplant didn’t take.

Lisette says that many of these children die, and that in order to do her work, she must get lots of therapy and continually study and obtain higher degrees. This is why she is a current student of Marifer’s. She does the work because when her father-in-law died, he told her that she must work for the forgotten children. She says that many of these children don’t have electricity in their homes.

The next planned event is the presentation of a natural hair wig made from five individual donations of hair. The recipient is a six-year-old girl. She is very shy and quiet. We are in a hall outside of the infusion clinic. The floors are buckled and seams of cement overflow the protruding tile. I wonder if this is from an earthquake. Nurses wear white and institutional green uniforms, donning plastic nursing caps in the same colors. I feel like I have stepped back into the 1950’s, except for the fact that they are all taking photos on their cell phones as Lisette presents the wig to the child.

Lisette speaks with the girl for quite some time. She reassures her that she needn’t speak if she doesn’t wish to, that they can communicate with their eyes. Lisette tells the child about the beauty of her heart, that the wig is just an accessory, that her beauty is not dependent on whether or not she has hair.

You must say to yourself every day in the mirror: “I am beautiful!”

The child tries on the wig and looks in a mirror provided by Lisette. Everyone poses for photos with her. In the end, her mother repacks the wig carefully in the box, and they are on their way.

Lisette leads us through a chaotic and crowded hallway to a packed elevator that carries us to the inpatient  pediatric oncology unit. In the hallway between two separate wings (one designated for solid tumors, the other for liquid), is a small but well equipped playroom. Siblings and patients mingle at child-sized tables. There are floor to ceiling shelves laden with cause and effect toys, a toy hospital, dollhouse, action figures (“for boys” says the playroom coordinator), blocks, puzzles, games and art materials. There is a large dollhouse in a corner, a kitchen play set, and several large bookcases overflowing with books. Lisette’s foundation supplies the  DVD lending library. One child sits with an adult working on a puzzle. Another plays with the dollhouse. A mothers group meets in the waiting room next door. The only thing I feel is missing is a medical play corner and sensory play materials. A flatscreen tv plays a Disney movie overhead.

Lisette has plans for an expressive arts activity. She brings us to the liquid tumor wing, into a room with six beds. Five children between the ages of two and fourteen seem excited to see Lissette and very open to our visit. The six-year-old boy is talkative and funny. After some quipping back and forth, Lisette hands out crayons and art paper to the children with a body outline on it.  But before she can begin to explain the instructions, the two year-old’s mother leaves the room, and the toddler begins to cry loudly and  inconsolably . She sits in her cage-like crib, crying desperately, reaching both arms up as if asking her absent mother to pick her up. Either that, or she is imploring the Gods to bring her mother back!

Lisette approaches with kind words, but the toddler is having none of it. She screams louder. Lisette offers her crayons and a “Frozen” coloring book. The child cries “No!” and turns away. Lisette is unperturbed. Using the surroundings, she jumps quickly into a bit of improv. The room has been newly decorated with a brightly colored mural on all four walls, ceiling to floor. It is a nature and farm scene. Near the girl’s bed, close to the floor, a mother duck swims with her three ducklings on a bright blue pond. Lisette launches into a conversation with the ducklings, turning her back on the toddler, lessening the child’s stranger anxiety by ceasing direct eye contact. She engages everyone in the room in asking the names of the ducks. She suggests the proffered names, and the little girl shakes her head in protest at each one. But she has stopped wailing and is watching Lissette intently. Lisette blocks the child’s view of the mother duck and tells a tale of the ducklings searching for their mother. She reassures the girl that her mommy will always return. We all sing the song “Five Little Ducks”. Lisette offers the coloring book again, asking, “May I put it on your bed?” The child accepts and begins to color.

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Lisette conducts the art activity with success. She speaks to the children about the variety of emotions we all have. She says they will play a coloring game based on a game called “Basta!” (enough). She takes turns calling out emotions, and each time they must grab a crayon and color within the body outline to represent where and how much of that emotion they have until Lisette yells, “Basta!” Lisette is very lively and whips the kids up into a coloring frenzy. She begins with the emotions of fear, anger, and sadness, and ends with love and joy. I am sitting with the toddler, who is methodically drawing many tiny, blue circles on each page of her coloring book, while she listens and glances at the other children. She watches closely as a nurse enters the room and approaches the six-year-old. The boy grins and says, “It’s good that you are here. My IV is backing up.” The nurse adjusts his IV, then moves over to the toddler, preparing medicine in a syringe without a needle. The toddler opens her mouth complacently to receive it without complaint.

The fourteen-year-old has gone for a walk. I had noticed when I entered the room that she didn’t appear physically ill. She has all of her hair, and is not connected to an IV. She wore a contented, cheerful expression while she chatted on her cell phone. Soon, it is time for us to move on. The teen has returned to her bed. We all pose for photos. All the children except the toddler smile. She still appears a bit somber.  I am the first to leave the room, and the teen’s caregiver follows me and grabs my arm in the hallway. She asks if I understand Spanish and begins to pour out a story to me that even with my broken Spanish, I can piece together. She is not the teen’s mother, but her aunt.

Two weeks prior, she, her two sisters and family members were traveling by car in a caravan. There was a horrible crash. The teen’s mother and father were killed. Her brother lies in critical condition in the ICU. Although the teen was unharmed, the tests she underwent at the hospital revealed that she has cancer. She had only just learned of her parents’ deaths the day before. I struggle to match that news with the image of the calm, smiling teen I’d met. Was she in shock? Denial? Is it her Faith in action?

The aunt shows me photos on her phone of her family, as well as a video about a teen whose mother dies. She says she is a Jehovah’s Witness and believes that we will all see our loved ones again after death. I tell her that I will carry her family in my heart.  I think about how much good healthcare in hospitals involves helping patients and families to tell their stories. This seems true in every country I visit. And in every country thus far, families don’t hesitate to share their stories with a stranger. Perhaps it is easier to tell a stranger. But it is more than that. This woman, and others I have met, seem compelled to share their narratives, as if we couldn’t stop them if we tried.

Leaving the hospital, I am sad, exhausted and hopeful in equal measures. Lisette’s work makes a mark. Listening makes a difference. The children won’t be forgotten by us. Shared stories tear down cultural walls.

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