Kids' Health Blog

Jeanine Clapsaddle is a Child Life specialist from Children’s who is in India for two months to help set up Child Life services at Manipal Hospital.

Jeanine’s trip is in partnership with the Priyanka Foundation, which was established in memory of a former Children’s patient who wanted other kids around the world to get the same Child Life services she received during her cancer treatment.  Jeanine is documenting her experiences through this blog series.

This is the second report from her trip:

Several days ago, I met a boy, Ballal, who was admitted to the PICU with an injury from an accident. He left his home in search of something fun to do and wandered into a factory that was in full operation. He came into contact with a machine that wrenched his right arm off at the shoulder and left him with a gash from above his eyebrow, down his nose to his chin. He is 6 years old.

A referral was made to Child Life from the attending nurse to “bring him toys and make him happy.”  I hear this request at Children’s as well and understand that it is an easy way to compartmentalize a creative and varied therapeutic practice.  In this case the statement was less about knowing the full offerings of Child Life, but more about a cultural belief that children should not be unhappy, for any reason, and playing with toys is a curative for unhappiness.

Although I may not speak the language, the gestures of pacifying and soothing are universal, as are some of the coping reactions some parents lean on when a child is in pain.  Things like shushing to the point of a parent putting their hands on a child’s mouth to get them to stop crying, giving them money or prizes to soothe them, tricking them into coming to the hospital or not properly informing children about the need for their healthcare experience so as not to upset them—these are all easy traps to fall into that can actually increase tension for a child.

In Ballal’s case, he was attempting to talk to his mother about his accident to better understand what had happened to him, to sort through emotions of guilt and shame, and to plead with her to stop the antibiotic infusions, which he found painful.

His mother was afraid of upsetting him so she shushed him and told him not to talk about it. We were able to talk with Ballal’s mother and explain the potential reasoning behind his questions. We also developed a plan for giving him some basic information to help him cope with the infusions as well as provide some diversion for him during the infusions. Although she did not come to a point where she could engage her son’s questions, Ballal’s mother was able to make room for services that could support him and she witnessed his decreased stress level through play.

When I came to India, I anticipated that the cultural rules and mores would be so different from my own that it would take me the entire duration of my stay for me to begin to see and vaguely understand these customs. What I have come to find is that the dynamic between parents and children is one that changes very little regardless of where you are at on the globe.

Ballal’s story is not so far removed from patients who come to Children’s who are involved in farming accidents, children who are too young to be left unsupervised, children who just do not want to be in the hospital, and parents who do not want their children to suffer, emotionally or physically.  How many times have I approached new families at Children’s and faced parents reluctant to educate their children because the medical information is too frightening for them as parents that it is too scary for them to know how to share with their children.

Sometimes when we meet families who come from a cultural background that is different from our own, we quickly call to light the differences between us in hopes of acknowledging and respecting those differences. Somehow, when thinking about Ballal and his mother, I am reminded of the small ways in which we are the same and how much progress can be made by acknowledging our sameness.

Jeanine Clapsaddle
Child Life Specialist
Children’s Hospitals and Clinics of Minnesota

The first report from her trip can be read here.

Jeanine Clapsaddle is a Child Life specialist from Children’s who is in India for two months to help set up Child Life services at Manipal Hospital.

There to fulfill the dying wish of a former Children’s patient who wanted other kids around the world to get the same care she received, Jeanine is documenting her experiences through this blog series.

Here is the first report from her trip:

After my first days at Manipal Hospital, I feel hard pressed to capture all that I have experienced in a way that does justice to the people I’ve met and the unmistakable presence of hope that lives here.

Much like Children’s, Manipal is in a perpetual state of renovation and construction. Some areas we toured are quite archaic by our standards; multiple patient beds in the same room (children and adults together), metal beds with peeling paint, IV bags that run on gravity rather than with any sort of pump, dented metal bowls used as bedpans for children, parents sleeping on the floor next to their child’s bed, dim and sporadic lighting, etc.

I discovered that the inpatient units of the hospital are separated not by diagnosis or specialty, but rather by an individual or family’s ability to pay for the healthcare. This unit is for people who cannot afford better healthcare. The most luxurious rooms in the hospital are utilized by celebrities, dignitaries or people from other countries who can afford to pursue healthcare wherever they choose.

The more technical areas of the facility such as radiology are quite modern and similar to what one would find in the US. In some ways it is difficult to grasp the extremes between these two settings and simply chalk it up to the renovation process.

I have met many children and their families as well. Regardless of where they are, every family has nothing but praise for their healthcare experiences, and the hospital itself. Families travel by plane and train from all over India and in some cases Asia to receive care here. The bulk of their pediatric Hematology/Oncology service is made up of children with Acute Lymphocytic Leukemia (ALL) or Thalassemia. They have had some children with other cancers but they are considered uncommon.

I have been able to talk with many parents and in some cases their children about their experiences in the hospital. Their first response is consistently about how much their healthcare has improved since the introduction of the Play Therapy/Child Life services. Their commentary seems to stem from a place of true gratitude and excitement for the possibilities that come with my time here.

In one case, I talked with a father of a child with Thalassemia for over an hour about the need for more toys and how he could help with that project.  The two women who are currently providing play therapy services have enough toys, primarily puzzles and games, to fill one average double door kitchen cabinet – no play-doh, no video games or Barbies, no beads for necklaces, no toys with lights and sounds or other toys that at one time seemed commonplace to me, but now seem like a bit of an indulgence.  What a challenge to take a game that a child has played over and over again, and make it a new and different experience for them.

I have also seen the unpleasant side of life in India – the extreme poverty, homeless animals eating garbage for food, and filth beyond understanding. I’m not sure what the Indian equivalent of yin and yang is, but it is a palpable experience here.

I find myself tired at the end of the day from the simple mental dexterity that comes with being here and sorting through all the information coming my way – whether it is trying to piece together what someone is saying to me, even in English, as the accent is heavy here or trying to make sense of the cultural context in which things are happening. Despite the, at times, heart-wrenching realities of life here, I look forward to each day with hopeful anticipation.

Jeanine Clapsaddle
Child Life Specialist
Children’s Hospitals and Clinics of Minnesota

Jeri Kayser, a Child Life specialist at Children’s, wrote this post for families.

School plays a big part in all of our lives and that important relationship doesn’t stop when a child is hospitalized. Whether it is a brief outpatient procedure or a lengthy hospital stay, the classroom is impacted by the child’s absence and the child feels the loss of their normal routine and support they get from their classmates.

We all have a role we can play to help support those transitions in and out of school as kids receive the medical care they need. So, check out the following tips, jot down a few notes with your number two pencil and don’t miss the bus!

Kids

• Your hospital story belongs to you and you can choose to tell it to anyone you want.
• Your school will need to know if you will be gone and your friends will notice when you are not there so likely you will be sharing some part of your story.
• Bring a camera to take pictures of what you want to share.

Teens

• Find out what you will have for homework as soon as you can.  Working ahead can make it easier to stay caught up and bringing homework to the hospital can actually be a boredom buster.
• Consider using your hospital experience as extra credit for Science or English.
• As you stay in touch with your friends be mindful of what you put out on social media, your privacy belongs to you.
• Sharing your story can actually be a big help to your classmates if they are ever hospitalized. They are probably more likely to believe your description of what to expect than just about anyone else.

Parents

• Let the school know about your child’s hospitalization as soon as possible. This will help give the teachers time to plan appropriately.
• Coordinate with your child about what information they would like to share and how they want to share it.
• Plan for your child’s transition back to school. Find out from the care team what sorts of restrictions should be in place to support your child’s healing.
• Be available the first few days your child is back at school. They may not have enough energy for a full day of school and partial days can ease the transition.

Teachers

• Coordinate with the family as to what information is to be shared about the hospitalization and how that information is relayed.
• Be mindful of how this student’s story blends with others’ stories. Each patient’s experience is unique to them, but similarities can resurrect old emotions.
• We offer resrouces to help explain what happens in the hospital. You can find information for teens and kids, including a downloadable coloring book and videos explaining what to expect, in our Planning for Surgery section.
• We also have selections of wonderful children’s books that can help explain hospitalization and related issues.
• kidshealth.org and  teenshealth.org are excellent sites to get information for kids and teens on how their body works and the conditions that require hospitalization.
• Help plan homework assignments. Falling behind in schoolwork is one of the main concerns for older patients.
• Find a way to communicate classroom news back to your hospitalized student. Cards are a treasured item proudly taped all over patients’ rooms. Assign kids to be the “reporters” and jot down important information like what was for lunch, what happened in gym and who burped during science. This kind of information helps the patients feel connected and included when they come back to class.
• Consider Skyping or filming important events that happen at school to share.

These are only a small collection of helpful suggestions. If you need additional ideas, want to find out about our school reentry program or have any other questions, please contact the Child Life Department at (612) 813-6259.

Jeri Kayser has been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children, ages 21, 19 and 15, who have been a great source of anecdotes to help illustrate developmental perspective. They are wonderful at being good sports about it.