Early in my OT practice I worked home care for patients of all ages including children. One patient I will never forget was a boy of 10 named “Paul”. Paul had been diagnosed with cancer a year earlier and was terminal. He had tumors in his spinal cord and was confined to a wheelchair. As Paul was withdrawn and depressed, his oncologist had ordered OT for play and engagement.
I was determined to bring a smile to this child’s face. I talked to him and to his mom about the activities that Paul had enjoyed prior to his illness. Each day on my way to his home, I would stop and buy Paul a small McDonald’s fry – one his favorites. I also planned a new activity for each day – games, puzzles and crafts all made it through my rotation. I tried themes – dinosaurs, spaceships and tractors. I tried singing, reading, even puppets. But each day our hour would end the way it began with little interest or enthusiasm from Paul. Day after day the weight of his illness won the battle.
One day as I prepared for my visit with Paul, I spied a grabber in my trunk and decided to bring it along. Paul’s day-to-day needs were taken care of by his parents, but I was coaxing him to be a little independent as well. We were sitting at the kitchen table as his mom stood at the sink and washed dishes. I tried to interest Paul in using the grabber to pick up one of his French fries, or the book I had brought, or the game I was trying to get him to play. As usual, he sat disinterested and withdrawn. He tried the grabber halfheartedly and put it back down saying he just couldn’t manage to use the device.
At that moment the phone rang and Paul’s mom left the room. I reached over to the counter with the grabber, picked up her dish towel and handed the grabber to Paul. I whispered, “Hide it under the table.” Paul’s eyes lit up, and his smile got bigger and bigger when his mom returned to the room and started searching for her dish towel! As she started opening drawers to search, Paul broke out into laughter and waved the dish towel in the air. His dad, working from home that day, rushed into the room with tears in his eyes; he had not heard his son laugh for months. I left the grabber with Paul and he used it to tease his parents and siblings until his death two weeks later. When his parents called to let me know Paul had passed, they also thanked me for bringing a little fun and mischief into the last days of a 10 year old boy.
This experience early in my career helped me grow as an OT in three important ways.
Embrace spontaneity. Sometimes those spontaneous moments generate the results that you are seeking so try to move outside your comfort zone.
Remember who your patient is. Boys will be boys and this harmless bit of mischief brought the boy out in Paul during a very tough time.
Laugh more. Try to bring laughter and joy to all your patient encounters, because it’s not just what we teach our patients, but how we do it that is most remembered.