I am going to call her Mia. Many of us rarely ever saw her talk. No one ever saw her laugh. And so the treatments continued and the frequent readmissions followed each other on a routine basis.  Our days were full of shift reports, discharges, admissions, transfers, transports, meal set-ups, medication passes, repositioning, IVs, tube feedings, dressing changes, tray collections, intake and output recording, call bells, and the never-welcomed always-possible codes.  Despite all of this, we still found time to try and get them to laugh.

Mia hid behind her parents as we entered her room.  She would play quietly, or just sit and watch the movies or cartoons. She frequently cried during the numerous tests and treatments. I had lost count of the number of times different ones tried to make her smile. Her parents insisted she did. We never saw it.

Recently one of my old buddies from there said “We were their family.”  Although I had been there for years in the past, hearing this today had a much greater impact on me. Yes! We were their family. Even if the family occasionally slept in the rooms, or stayed nearby, there were lots of times the kids were alone.   We were there, 24/7. Answering every call, question, or need to the best of our ability.  We cried, often together, mostly alone, at the tragic reality of their lives. The various diagnoses they faced from simple wound healing to end-stage disease processes washed over us in every room we entered; we revolved through our day in multiple stages of grief, joy, relief, or sadness. And we tried to make them laugh.

The day finally came. The RN was sitting quietly charting in my pod. She had been there close to 12 hours so her feet were propped up on a second chair as she busily shuffled papers and recorded events. The tape dangled from my belt around my hemostats as I walked by. The urge was irresistible. Quietly, I crept up behind her and quickly secured tape to the back of her chair.  In moments she was trapped as circles of tape wound round and round her with the help of another nurse who was walking by and quickly joined into the devious plot. Within minutes she was fastened helplessly to both chairs by surgical tape. We rolled her into the main hallway and delivered water-filled syringes to the remaining children present on the unit who didn’t already have them. And I placed a giant stuffed dog on her legs as we began our procession to the doorway of each room.

We intentionally planned on skipping Mia’s room as she likely would have only hid or cried had we entered and she was in an isolation room anyway. But as we rolled our reluctant dripping victim past her room I saw her look up. I stopped.  Mia burst into laughter! She rolled on the bed and pointed and squealed with delight! We quickly armed her with a water-filled syringe and she laughed even harder as she soaked our poor co-worker even more. So, she could laugh after all.

Caring Choices understands that the reality of some situations can be overwhelming and seem to have impassable barriers.  It is these extreme circumstances that require the most delicate approach. Often the spontaneous, most outlandish approach could be the key to opening the way for dialogue. Humor is where I have found the most available path through the darkness of life. Not every case can be solved with laughter. Never is forever. Life is happening now. It’s worth a try to investigate every possible road as we approach our final destination. Discussing what makes us feel good along the way does not have to be done without a smile.