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From hard times, come good memories and enduring friendships "Now, take a deep breath." Drs. Jaeden and RJ (right) don gloves and surgical caps to check their patient's heartbeat. Experimenting with medical equipment and accessories in a safe play environment with Child Life Specialist Robyn helps to ease the boys' fears during actual medical procedures. Nine-year-old Kassian Neal was becoming depressed and withdrawn. He had already lost his hair as he underwent cancer treatment at Kapi'olani Medical Center for Women & Children. Ryder Lum, age 7, lay in his hospital bed with a drain tube for fluids attached to his head after a brain biopsy revealed a tumor. Now he was scheduled for surgery to have a permanent shunt placed in his body to continue to drain the excess fluid. When very sick children are confronting the kinds of hospital procedures that could weaken the knees of even stalwart adults, they need the specialized kind of support provided by Child Life Services. It is a profession that began during the first half of the last century to help children deal with hospital experiences that can be frightening and traumatic. One, two, three…Blowwwww! Kaylin McLaughlin shows Child Life Specialist Robyn how to blow bubbles while receiving her IV treatment. Kaylin has a complex medical condition that brings her to the hospital for regular treatments. Therapeutic play, such as blowing bubbles or a pinwheel, is often used in place of medical implements such as a spirometer. The result is the same -- to test and exercise the lungs -- but therapeutic play makes treatment fun. One important tool for the child life team is "medical play" between the specialists and their young patients. "By staging medical play sessions, we give kids back a sense of control in what is often an unpredictable hospital setting," says Kapi'olani Child Life Specialist Robyn Chow-Hoy. "Sometimes we use medical play with dolls to help teach kids about their bodies and prepare them for medical procedures. Sometimes we introduce medical equipment and supplies to them. They get to handle the items, ask questions and express their fears in a supportive environment." Boosting spirits, calming fears Play is such an essential part of a child's life that Kapi'olani operates a Playroom that Chow-Hoy describes as "a safe haven." She explains, "No treatments or physical exams are performed here, and no medications are given." The family that plays together, stays together. Julian Flojo-Opetaia challenges Robyn to a race on one of the Playroom's game stations. He has racked up many hours of practice during his brother Jaeden's hospitalization. Last year, Jaeden was diagnosed with leukemia. The two siblings spent many hours in the Playroom with mother Angelica and the Child Life team. Keeping the family together is one of the team's goals. Jaeden Flojo-Opetaia, age 3, and RJ Apuya, age 4, (both pictured below) are two Playroom veterans. Both boys were diagnosed with cancer last year. Jaeden had been in and out of the hospital for a few months when RJ first arrived. Thanks to the Playroom and Child Life team, the pair became great friends. The Playroom is like the Grand Central Station for the department, encouraging interaction and fostering camaraderie. Jaeden's and RJ's parents have become close as well. Says RJ's mom Cheryll, "You make good friends in the hospital because we're all going through the same thing." Child Life specialists perform a vital role in assisting physicians, too. "Some of our procedures are very stressful for a child," says Dr. Wade Kyono, Kapi'olani pediatric hematologist and oncologist. "Child Life Services provides support to lessen the trauma. They can relieve the child's fears, help us avoid or reduce sedation or medicines, and make the process easier for the child and parents. They also share their observations, which help us understand how the children and families are coping." When Kassian's depression sent him deeper into his shell, for example, Chow- Hoy was able to coax him back out. Recalls grandmother Bonnie, "Robyn is Miss Happy Face. She just won him over with her winning smile and goodies from the Playroom. Kassian has always been a shy boy, but Robyn gave him full-on attention, as if he were the only one. She was able to turn him around pretty fast, in about two weeks. I'll always be grateful to her." Sweets for Valentine's Day. RJ Apuya carefully attaches each heart to complete his special Valentine's card, as Robyn looks on. To top off the day's festivities, the team organized a Valentine's Day Parade. RJ and his friends led the procession through the pediatric floor, presenting every woman they passed with a magic princess wand. "They definitely had fun doing that, giving smiles to all the ladies," says RJ's mother Cheryll. And when Ryder needed to have an NG (nasogastric) tube placed, Dr. Kyono turned to the Child Life team to explain what would happen and comfort the youngster. Recalls Ryder's father David, "Robyn was special to Ryder because it was a time when everything seemed scary and intimidating. It was the first time in his life for him to go through this. Certainly my wife and I never faced anything like this, and we were scared and intimidated. Robyn was the one person who was always there with a big smile on her face. She gives everyone a sense of reassurance that things are going to be okay." Besides birthday parties, Child Life turns to activities such as celebrity visits by athletes and entertainers to bring a sense of normalcy to a child's hospital stay. Another popular event is Movie Night, first created in 2002 as "Reel to Heal" on the first Friday of every month in the hospital auditorium. The staff prints up fake movie tickets, and the children redeem them at the concession stand for popcorn. Child Life also pays close attention to the siblings of sick children. "Because there's so much focus on the hospitalized child, it can be very hard for everyone else in the family," she says. "Siblings are no exception. They may wish to get attention too, or fear that the illness may be contagious. They may feel bad for being healthy." The Child Life team encourages families to bring siblings to the hospital. They spend time helping families understand what brothers and sisters are going through. Siblings are also encouraged to hang out at the Playroom. Positive memories for the future Ryder's brain tumor is gone following chemotherapy and radiation, and his prognosis is excellent, says his father. "We'll have to administer whatever hormones he needs for the rest of his life, and there is still a long medical path ahead. That's why having positive memories in the hospital is so important." The impact of Child Life couldn't be more evident than the day Ryder left the hospital, eager to play with his dog and sleep in his own bed. He had been terribly homesick, but as they got in the car to go home, he told his dad, "I'm really going to miss the hospital because of all the nice people like Robyn." His father couldn't believe his ears! But Chow-Hoy and her colleagues understand the bonds formed from such trials. Many families return to give updates on how their children are doing, and friendships are formed that extend far beyond their hospitalization.