A Hand to Hold

Joshua Rubin

It's 8:15 on a busy Tuesday morning at University Hospitals' Rainbow Babies and Children's Hospital. Toni Millar rushes down to the surgery center ready to see her patients. She approaches 7-year-old Joshua Rubin of South Euclid, who is awaiting eye surgery.

He is sitting up in his bed apprehensively. His parents, Ken and Gayle Rubin, sit beside him, and Lisa, a black-and-tan stuffed-animal puppy dog, is clutched in his hands.

Kneeling beside the bed, Millar asks Lisa, the puppy, how she's feeling. Is she nervous? Josh grins and has the dog nod vigorously.

Leaning toward Millar, Josh whispers, "I'm a little nervous. I'm scared."

That's completely normal, Millar explains kindly. Together she and Josh pass the time by dressing Lisa in a large, human-size sterile hair net and surgical mask, until momentary giggles have replaced fear.

Millar is not a doctor or a nurse, but she is an integral part of the care provided at Rainbow. She's head of the child-life department, a relatively young discipline that places the emotional and developmental well being of the pediatric hospital patient as high as the physical.

Child-life specialists serve a variety of functions, from helping children understand their diagnosis or what will occur in an upcoming medical procedure, to distracting patients during painful or frightening tests, to helping patients and families learn coping skills. But, often the most important thing child life specialists can do, Millar says, is just to listen, be a friend, and facilitate playtime.

Millar tells Josh (and his equally nervous parents) about what to expect. His IV will look like a long tube of spaghetti, she says, but what it really is is a "straw into your veins" to help give medicine.

She carries a bag filled with toys and bubbles, induction masks, and a variety of Bonne Bell scented Lip Smackers.

The point of the lip balm is "to give the child a sense of control and of choice," Millar says. Together, they smell each lip balm flavor, until Josh chooses his favorite. Millar rubs the balm all over the interior of his induction mask. Holding it to his face, Josh grins. It smells just like cherries.

When it's time for Josh to head to the operating room (OR), Millar follows him in, standing just behind his mom, and coaching both on how to get through the administration of anesthesia. Millar takes pains to make sure Josh's mom is first in an intensely nervous Josh's line of sight and doing the primary soothing.

When he starts to cry, Millar turns the OR into a game, showing Josh how changing his breathing can make numbers and lines on the monitor beside him fluctuate. She places Lisa, the stuffed animal, on his stomach so he can have her close. Soon, the anesthesia takes effect, and Millar escorts Gayle Rubin out so that surgery can begin.

"It's great that they have you," Rubin tells Millar, noting she wishes there had been a child-life specialist around when she had surgery in her youth.

"I think (kids) just want to be heard, like anyone," Millar replies. Before saying goodbye, she urges Rubin not to let Josh forget the experience of surgery. Next time he faces a difficult task, Millar suggests reminding him "how he used his own strength today and was able to cope."

This is only the beginning of a terrific article about Child Life. I wanted to include my favorite paragraphs from the article here, but the entire article is great. It's a long one, but if you get the chance, try to read through the whole thing. Sometimes I wish I were working again. . .