Recently I was reminded of work I did with a 10 year old boy, we'll call him Alex. Alex was admitted to the PICU after a terrible accident that left him paralyzed from the neck down and he sustained a traumatic brain injury (TBI). After Alex's body was stabilized through many surgeries and medical intervention, the staff began to wean his sedation to assess his mental status and injury from the TBI. It was unlikely Alex would ever communicate again and he seemed to be neurologically devastated.
Alex was admitted during a particularly slow time in the PICU (otherwise, I am ashamed to say, he may not have received as much attention from me). I was told he had no child life needs. But things were slow so I would go in at least once a day to read to him. He would stare blankly at the wall and gave me no indication that he even knew I was there.
While spending time with him I would always ask him to blink once for yes and to blink twice for no, but never had a response. One day I came in to some cartoons geared toward toddlers on the TV. I appreciated the effort of whoever turned the TV on, but laughed out loud and said, "I bet you love these baby cartoons huh Alex? We should find something cooler to watch". And I thought I saw him blink.
I asked him to blink again.....nothing. He stared right through me and I started to second guess myself. But I realized how scared he must have been and I wondered if anyone had explained what happened to him. I introduced myself to him again and explained that he was in the hospital after a very bad accident. I told him the doctors and nurses were taking good care of him because his body was very sick and needed help. He didn't respond. I didn't want to overwhelm him so I stopped there and started reading again.
Every day I reminded him of my name, that I was there to read and that his body was hurt, but there were lots of people to help. One day I asked him if I could start a new book and I showed him a Spider Man book and he responded by blinking one very long, purposeful blink! He was scared and since he couldn't get up and run away, he did what he needed to do to protect himself. But when he felt safe enough he started to communicate through blinking. In building rapport, we were able to learn that he loved superheroes, Pokemon and the window blinds open.
Soon Alex no longer needed intensive care and he was transferred to an area where he eventually was able to get in a wheel chair and use a communication device to interact with others.
In the ICU, there are many faces and it can be difficult to have consistency. I am so thankful that child life specialists can often be a consistent, familiar face in a time of crisis! Happy Child Life Month!