Wednesday, July 6, 2011

Gee...I wish I could play all day...

If I've heard it once, I've heard it a million times.....YOU know what I'm talkin' 'bout...."Gee, I wish I could play all day."   My first inkling is always to say, "You could, you just picked the wrong career...haha".....but.....I don't. Of course, that statement and the ever-famous, "You went to school to learn how to play" are both capable of getting our hackles up...and absolutely free of charge!  But....what DO you say to that? Well, for me it depends...on the situation, who said it, the "personality" of who said it, and....my mood.  Often times, I'll just say the above statement; it usually gets a laugh.

I've found that people who make those comments, generally mean no harm.  It's often an expression of appreciation for what I'm doing, and a genuine desire to join in on the game of cards....or cooking activity....or playing Rock Band. However, these people are also not usually around when I'm trying to help kids cope through some medical procedure where they are terrified. Or when I'm making hand molds of a child who has died. Or when I'm telling a 7 year old girl that her daddy isn't going to get well and will probably die today, while her mommy is numb and sits quietly crying. I've never had anyone say to me, "Gee, I wish I got to tell that little girl her daddy was going to die."

So what exactly DO I say? Usually, not too much. Sometimes just something generic like, "You know, it's times like this, when I do get to sit and help a kid be a kid, that has the ability to wipe away all the other parts of the job that aren't so much fun." Face it, is it in front of a child or family that you want to say,  "Oh yeah, well....just 1/2 hour ago I was making hand molds for the family of one of my favorite patients who just died. It was horrible. They didn't deserve to die, and now I have to sit here and pretend like I'm not heartbroken."  Nope, this probably isn't the right time.  And it truly depends on who it is and how it is said. If it comes from a nurse who generally doesn't understand child life, and might truly believe what he/she is saying, then I might chalk it up as a teachable moment....later. If it's another patient who sees me playing cards with a pediatric patient while they're receiving chemo, I don't worry too much about it. I think that most visitors see the name badge and just know that the hospital probably isn't going to pay money to an employee JUST to sit and play cards.

And here's what I've learned in my 20+ years of child life practice...I can do some of the "meatiest" child life interventions with a patient....I mean....REAL child life stuff....and what the kids always tell their friends is, "This is Debbie. We used to play video games together." I had one patient, a 17 year old, diagnosed with osteosarcoma at the age of 15. He spent weeks at the hospital right after diagnosis and had chemo every three weeks for a year. His tumor was above his knee, and in the middle of treatment, he had a rotationplasty (might need to google that one).  Essentially, this is an operation where the surgeon amputates mid-thigh. Then the surgeon makes another cut just below the knee. The portion of the leg from mid-thigh to below the knee, is discarded. Then the surgeon takes the lower portion of the leg (the calf and foot), turns it around 180 degrees, and reattaches it to the femur....mid-thigh. Sound freaky? Yup. Google it. What the patient now has, is a leg, with a backwards foot and calf, attached at his thigh. Why would they do that? The backwards foot then serves as the patient's knee joint and gives MUCH more flexibility than any standard prosthesis could ever give. They have a much more functional knee joint and can do things that they might be able to do as easily with a standard prosthesis. So what's my point? I don't remember....what was it? Oh...that was just a little background on my patient....we had been through a LOT together. We talked a LOT about that upcoming surgery, how he was going to look like a freak, no one would ever love him, etc. Then he got a life threatening infection at one point. As I sat in the PICU with him, holding his hand, with tears in his eyes he said, "Debbie, I'm not ready to die yet." Yeah, heavy stuff. This is the kind of stuff I'm talking about...the stuff not everyone sees. My point is, I had a really great working relationship with this patient....I'd been by his side through a lot of rough times. On the rare occasion when I'd meet someone in his family or a friend (he lived two hours away), how do you think he introduced me to them? "This is Debbie. She taught me about what it's going to be like after surgery. She held my hand when I thought I was gonna die. She told me that despite my physical appearance, there would someday be one VERY lucky girl (probably several) who would fall in love with me because of me." Nope. Guess again. He said, "This is Debbie. She tries to beat me in NCAA Football on the PS2." Yep, that's right. And for the record....I usually DID beat him...usually. Not so much because of my great PS2 skills, or because I understand the game of football and all its plays. More so because I had absolutely NO idea what I was doing. Oh...I'm pretty convincing. I squint while looking through the plays, look like I'm really evaluating my options...trying to outsmart whatever my opponent is doing. What I'm really doing is looking at the pretty patterns of the plays, planning dinner, wondering if my son got his homework done, and whether or not the gallon of milk at home smells funny?  Ahhhh....the wicked ways of the child life specialist.

So that's my point. See....I did have one. A "play lady" isn't the worst thing I could be called. There are a lot worse things I could be called....in fact....I've been called a few of ém. I used to get all bent out of shape about it. Now I see it as harmless banter or as a teaching moment....at the appropriate time. I always try to keep everything pretty lighthearted....don't want to be getting all visibly flustered...that won't do anyone any good. Keeping a cool head, using a sharp mind and NOT a sharp tongue is the way to go!!!