It's so simple to be wise.  Just think of something stupid to say, and then don't say it.     Sam Levenson (1911-1980)

Sunday, November 9, 2008

Another Typical Day at the Office

That's a misleading title, but it conveys the ironic reminder that I can label a workday "typical" only by virtue of its originality.  And no, I don't have an office.  Wish it were so...

This morning two Jewish girls, ages ten and thirteen, have sat down at the center table to join a medical play session.  The older girl, E, is large, bloated by steroids that have -- inexplicably -- helped to keep her bone tumor in check over the years.  She pulls up to the table with her usual high-spirited, dominating presence.   T, in  stark contrast to E, has a frail look, fine dark features and a wool cap pulled down low over thinning eyebrows.  Within seconds of arriving, these two have sunk into quiet conversation.

Across from them sits H, demanding my attention.   I am still setting up the supplies for our therapeutic medical-play session, but H's all-too-clear Arabic and four-year-old antsy-ness announces that he wants to start right now.

One by one, I help these three start designing their therapeutic dolls' faces.  Following that task is the all-important decision of whether, and how generously, to apply hair to the dolls' heads, each choice reflecting that child's particular stage of treatment and development.  E and T have decided to attach some hair, But not too much, T explains, since it might fall out soon.  H opts to leave his doll devoid of hair, paralleling his own state.

Our therapy group proceeds, with each child caring for her doll -- inserting a vein catheter, taking a blood sample, injecting Heparin (a drug that prevents clotting) and other tasks.  E moves from one action to the next, looking at me for guidance as to what she must do next.

What do I do with this? she asks, regarding a test tube full of "blood" (really, water dyed with red drink concentrate).   You send it to the lab, of course, I reply, without a trace of irony.  E stifles a giggle and steals a glance at T, three years her junior, for confirmation that it's OK to take all of this so seriously.  T offers a sly smile and nods.  She, like E, understands that this play is both imaginary and far too real.

Behind me a baby has started to cry.  His mother is nowhere to be found.  He alone lies on the bed, crying, crying, wailing.  The outpatient room is large, spacious enough for ten patients and several staff.  But this helpless child has all of our attention, making it impossible to focus.  The nurses are running around trying to reach all the children, but they keep glancing at the baby as another minute passes, and another, and his mother has not returned.   Her phone lies next to him on the bed, ringing and ringing as he screams.

He is miserable, and so are we.  There is no choice.  I turn around and pick him up.

A minute later all three of the children are laughing as I stand, bouncing, alongside the table trying to return our focus to the task at hand.  I gently toss a couple of catheter stoppers toward E as the now-peaceful baby sleeps against my shoulder.  Now it's time to hook up the fluids.  T, can you pass that stopper over to E?   She does, and we proceed in our play.  The baby's mother finally returns (she had been speaking with the physician) and once again I sit down  at the table, asking,  Now, where were we?  

More giggles...

Keep the balance,