The infant and toddlers unit is joined to the school age adolescent unit by a hallway. Rooms hold children in their cocoons safe from the word of nasties and meanies, that float in the air or creep up from beneath beds at night. Nurses sprint, sometimes literally, administering medicine and performing procedures with a gentle hand and comforting voices. Doctors come and go, sometimes working for, sometimes worrying for a toddler quietly sleeping, or an infant beneath warm lights. Walking along the hallways in the "IT" one can glimpse out of the corner of one's eye, children laying still, or moving about in the small world they occupy. Many doors are closed, but a few are open to varying degrees, depending on how much the attending adult wishes the door to be open and the outside world to be near.
My usual work area is the school age adolescents unit, rooms 345 through 364, but not exclusively those rooms. Often illness and opportunity take me to other rooms, other floors, or procedural rooms. I'd like to say that I see a child, during their stay at the hospital and then they move back into their home and school environment, leaving me behind as a distant memory. That's not always the way it works. Some children return for various reasons, life-threatening reasons sometimes. Sometimes they come for procedures that enhance life. Then some come, hoping that life will be extended, longer, brighter, without the mean nasties.
So it was that I was asked to see a child in the IT. I rarely work in this area; I thought that perhaps there had been a mistake. I went to the room I was given to meet a little child, a very ill child, with big eyes shining like a dark glistening river. She smiled shyly at me and her mother watched closely as we began to get to know each other. She sat straight on the side of her bed, little legs and littler feet barely reaching down beyond the side of the bed. Her hands were clasped on her lap and her head cocked slightly to one side.
As I knelt down to put her at eye level, I noticed beside her an array of syringes large and small, some with tape and instructions, some identified by name only. This is part of the world I work in, and I strike a compromise with this as part of my offerings. I never lose sight of the fact that what I offer is secondary to medical needs. But I never forget that what I leave behind in the room might help some children cope with the daily schedule they will accept, not always willingly, but almost always hopefully. I am part of a package deal, doctor, nurse, dietitian, social worker, child care specialist, those angels that clean rooms, and others I probably left out.
This child, this little one smiled at me. I am always struck by what a child gives me if I will listen, or wait. "I want to do my A,B,C's and I want to color, and I want to count numbers, and I want to ...", she quietly spoke. I waited and listened letting her distance herself from the reality lying beside her. Her baby teeth were completely intact, her hair, brown and thinned, her eyes open and expressive and that tongue, rapid fire. That wonderful smile, capturing, shy, she was indeed a beautiful child beaming at me. Her verbal ability for four years of age was impressive, her vocabulary was more than appropriate for her age. Her sentences, short and simple, but they followed a theme. Her parents instilled learning early, and she wanted to learn, to have fun and do what four-year-old children do. I left and returned to my classroom.
I put together some basic lessons, both papers and manipulative materials. I wrote a few simple plans and projected a time line for her based on how long she might be in the hospital. Knowing how long a child will stay in the hospital sometimes can be like rolling dice. Some come and go, some are suppose to stay for a certain duration and they don't; I think you get the idea. Lessons for a week were put together based on three hours of instruction per week. A bold projection, as instructional hours in the hospital can be like a full day in the classroom and just as exhausting for the child. It's best to overestimate actual instructional time, rather than come up short on instructional activities for a child.
Blushed with success and filled with self-satisfaction. I left my classroom and walked back to the IT. I entered the room to find this little child relaxing on her bed. "I have your lessons, and we can do a few papers now if you would like."
She sprang up, looked me in the eye and said, "Mr. Mike, the clown is coming to my room, I don't want to work now. " I looked at her and smiled, "Alright, I'll come see you tomorrow then. " She smiled, almost giddy with excitement over the clown's impending visit. I had learned a number of things today. My importance or lack of importance is directly related to the anticipation a clown produces in the fertile imagination of a little girl. Sometimes school isn't as good as it gets. Finally, never ever, mess with clowns, they aren't kidding when it comes to kids.
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