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To Our Friends in the Medical Community
Talk to us, more or less: During a visit to
the emergency room, I overheard a conversation between an ailing child and
a physician. The good doctor was trying to determine the cause of the
child's discomfort. He asked, "Does it hurt more here or here? What about
here? More or less? Which hurts worse, here or here?" The conversation
went on for a while, exhausting the child, the gentle doctor, and me. The
reason for the communication challenge? Language.
Abstract verses concrete: Most young children
do not understand the concepts of "more or less" and "most or least" until
first or second grade. These quantitative terms are abstract and require a
developmental level young children have not yet achieved. Therefore, when
this emergency room child could not sort out which hurt more and which
hurt less, he became frustrated.
When talking with a sick child, our friends in the medical profession may
want to avoid conceptual language and revert to a
more concrete vocabulary. When diagnosing pain, it may be more
expedient to ask questions such as: "Is this a big hurt or a little hurt?
Is this hurt bigger than this hurt? This small hurt, does it get bigger
when I do this? ..."
He hasn't done that since he was 3: When a
child is sick, he will revert to an earlier stage of development. His
emotional/mental age will temporarily become less than his chronological
age. Language may deteriorate and baby talk resume.
Insecurities and needs long since past will surface again. The
child may request a security blanket or other comfort item that may have
been put away long ago.
The act of holding something soft can reassure a child like no anxious
adult can. Unfortunately, during an emergency situation, such comfort toys
are often inaccessible. Emergency room personnel
may want to stock small stuffed animals sewn by church groups. Is it worth
the time? Read on ...
Twenty-five years ago, I was in a critical
care unit of a children's hospital when a 9 year old girl was brought
in. She had fallen out of the back of a speeding pick-up
truck. Miraculously no bones were broken but the look on her face and her
rigid body showed that she was in shock. So were her hysterical parents. I
took a new stuffed animal given to my own child and handed it to the
child's mother. As the child wrapped her arms around this rather large,
soft animal, her shoulders relaxed and her eye movement returned. How
simple that in the midst of chaos, 16 inches of synthetic fur comforted a
troubled soul.
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