To the Medical Community

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 passed 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 one of the new stuffed animals 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.

– End –

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