“My son spent an HOUR playing with a small metal tea kettle on the deck, the kind made for one serving of tea. He used that tea kettle in so many ways. He opened it and listened to its insides and then experimented with making noise into it. He explored each and every facet of it thoroughly. He experimented with different ways to open it and close it, put different objects in it and took them out. He watched his own reflection in it and then watched himself playing with it while he was reflected in the window. He banged it, rolled it, and talked to it. For an hour while I surfed the net and watched him through the window and my husband and I laughed in pleasure at his very serious play with the kettle… because make no mistake, it was some serious investigation going on!”
After Mama S. shared this wonderful account of her 14 month old son’s progress playing independently, I was taken aback when she added that her capable baby explorer is “almost blind” and will be having surgery soon. She then asked:
“Do you have any tips on how to talk a child through surgery? I am nervous. I bought a picture book (Curious George Goes to the Hospital) and I tell a story about using the pictures, but altered for his age and condition. We talk about how his eyes are and how they will feel better after his surgery and that he will be able to see much, much better. But I don’t know what else to do. I know that they will have to do things to him and he will fight them tooth and nail because, of course, he is so used to his bodily autonomy being respected and he is so fiercely autonomous. I do not want the surgery and recovery to traumatize him. Can you help me, especially with the language I can use in the hospital when they have to do necessarily difficult things to him?”
I could think of no one better to advise Mama S. than blogger Nadine Hilmar. Not only is Nadine deeply committed to respectful care for babies, she’s been there… Her son had heart surgery when he was only 6 months old.
Thank you, Nadine, for your graceful, thoughtful and tender response…
Dear Mama S,
First of all, I’d like to tell you how wonderful I think it is that you are approaching the surgery with so much care and love. I won’t lie to you – it will be a hard time – but if your son knows that you are there with him – it will be ok.
How do I know? My son (who is now 2) was born with a heart defect and needed open-heart surgery at the age of 6 months. It is fair to say that these were the hardest moments I have been through in my life. But when I look back I am also feeling some warm relief. It had to be done. It saved his life. It glued us together as a family.
Now I don’t know how old your son is, but one thing applies for all ages – be honest. Tell him everything you know. Ask the doctors what exactly they will be doing, how he will get his anesthetics and what will happen afterwards. Talk him through it as much as you can. This will not just help him – it’ll help you as well. Because it will make you find words for the worst that is on your mind. And that’s healing.
If he is old enough to talk and mention his fears – let him talk. We are often scared that we create nightmares in our children’s minds by talking about those things too long in advance. The truth is that it gives them (and us) time to deal with those scary emotions. Acknowledge his fears and respond honestly. Don’t try and shrink them by scaling them down. It’ll come back to you afterwards, because it will be painful to some extent. And you know that now.
Once you are in hospital – be only with him. Make sure you are not alone. Have someone to do the administrative stuff for you. Stay with your son and focus on him. Whatever they are doing to your boy, just focus on him. As much as you can, try to shut the people around out.
They might ask you to hold him and fix his arms or legs when they need to take blood or set the intravenous injection. He will not like that. Neither will you, but it has to be done and here is what you can say to him: “Now this will hurt. But it is important so the doctors can examine your blood (or send you off to sleep so you won’t feel anything during the surgery). You can scream as loud as you want. That’s ok. I’m with you.” If he screams and fights – repeat “You are scared. You can scream. That’s ok. I’m here.”
It might be difficult at first, especially if you have doctors around that aren’t that sensitive or patient. But you will get used to it and this honesty and acknowledgment will have a calming effect on you too.
Don’t look at your son as this poor little person that needs help. Try to look at him as someone who is scared as much as you are and you both have to go through this together.
Whatever they do to him – tell him, before, all the way through, and after. It is all you can do. He needs to know what is going to happen. Then during the examinations you can say “Now this is what I talked to you about earlier…” And afterwards you can tell him “This was really hard for you. You got really angry (scared) and you were right about it.”
There is no magic line that will make him cooperate silently. He just needs to know that his fears and pain are seen, accepted and not denied.
The recovery depends on how intense the surgery is I guess. Our son got some really strong sedatives when they transferred him to ICU and then soon they had to slowly withdraw him from them like a drug addict. This had really nasty side effects such as being very nervous and restless which resulted in sleepless days and nights. He wasn’t allowed much food either, so on top of that he was very hungry. It was quite hard for all of us (especially with impatient nurses around) and here he needed lots of love and care. All I could do was just stroke him and talk to him. I couldn’t even hold him because he was hooked onto monitors, drains and wires.
So do ask the doctors about the exact procedure. It will sound terrifying, but the more you know the better. I even read parents’ reports of their experiences with pictures of their children right after surgery. It was hard to look at those, but then when we went to see our son after his surgery I wasn’t THAT shocked. I knew what to expect and had energy left to be there with him.
Now you said that you don’t want the surgery or recovery to traumatize your son. I guess this is the greatest fear of all. I don’t know if and what exactly the surgery has done to my son yet. But I know for sure that it shook him up massively. We left the hospital a week after surgery, then had to go back again because of some bad fever, and after we left for good I could not leave him anywhere for even a minute. He needed me more than ever. I was not used to this because he wasn’t such a clingy baby and now suddenly he would breastfeed every hour, wake up constantly and cry A LOT.
This lasted for two weeks until we had the final talk with the head of pediatric cardiology about the whole surgery and recovery. I took our son with me and it was as if he had needed to ask all my questions too, as if he needed all those answers to relax and gain trust again. So whatever happens in hospital – make sure you know all about it. Get all the information you need to recover yourself too. If you are uneasy he will not be able to calm and recover in your arms.
Once it’s all over – again: relax. And then keep working on it. Don’t stop right there. To make sure he won’t be traumatized, tell him about the surgery afterwards as well: what happened, how you experienced his emotions, how you felt. Go back to the hospital with him, show him where you were (pediatrics, ICU etc.) and talk through it all again. Not straight away, but over the years. The smell, the noises – all this gets somehow soaked up in our unconscious and might pop up at night when we’re asleep. If you take your son back to the hospital every now and then while he grows up it will help him to place those noises, the smell or the aura that might scare him at night.
I guess he will have regular checks afterwards – they will help bring the topic on the table and talk about it.
Trauma gets worse when emotions and experiences sink into the unconscious, are denied and left alone. Make sure that doesn’t happen. Then he won’t be traumatized.
A friend of mine gave me some great advice as well: Use pen and paper as tools for communication. Draw the hospital. Tell him why you are going there. Give him a pen to so he can react to it (and he might!). See how this goes and you might be able to use it as a tool all the way through.
Books are also great. Maybe you could get a Curious George stuffed toy to take so then he really is in hospital with him. Everything.
And no matter how scary this all sounds right now. You will gain strength. When you think you might fall apart you will suddenly have energy from out of space. Believe me.
I wish you all the best and a fast recovery.
Warm wishes from Vienna,
Nadine, thank you again with all my heart.
Mama S, you and your boy will be in my thoughts and prayers.
Nadine Hilmar is a parent educator and family counselor in training. She shares her insights and parenting experiences at A Pikler Experience and also at Mamas in the Making (the blog she shares with friend and fellow Pikler /Gerber enthusiast, Anna Banas´)
(Photo by CeeKay on Flickr)