after the last tear falls...

note: there are two posts for today. the other one is actually yesterdays.

It’s quite fitting that this song is what’s playing as I sit down to write my blog tonight. If you’ve never heard it before, you need to download Andrew Petersons “After the Last Tear Falls.” I have a really hard time picking favorites, especially when it comes to music, but this is definitely one of my favorites. Just a taste of the lyrics (note- this is my interpretation of the lyrics. I used to think the song Whoomp There It Is was Whoomp Aid Adidas, so some words may be wrong…):

After the last tear falls
After the last secrets told
After the last bullet tears through flesh and bone

After the last child starves
And the the last girl walks the boulevard
After the last year that’s just too hard
There is love

And in the end is oceans of love and love again
We’ll see how the tears that have fallen were caught in the palms
Of the giver of love and the lover of all
And we’ll look back on these tears as old tears
‘Cause after the last tear falls, there is love.



Today was definitely a day of tears. They started when I walked on the ward. My first job is usually to walk through and write down which kids are in which bay and then help divide the list among Caroline, Taylor and myself. My kids are usually in the last bay, so I had almost finished when I walked into their room. There are only 3 kids left in there now as many have gone home. Missy was one of those. As soon as she saw me, she started to cry for me to come pick her up. How could I refuse?! I greeted her with a good morning hug and a little TLC. I had to put her down though, so I could get some of my morning responsibilities done. She cried, but I put my finger up in my “I’ll be back in a minute” way and she settled down. We’ve developed a bit of a sign language so that we can communicate without speaking the same language. She knows the sign for “all done” now and we use it when she’s done eating. I went about some of my morning duties, but every time I walked by her door, she would start to cry. At one point I was playing a game with another little girl out in the hall and Missy started crying because she could see me through the window. I flashed the “just a minute” sign and she quieted, but she just lay in her bed and stared at me with expectant eyes. I’m pretty worried about her. While she’s starting to show more emotion (which is good), I worry about her attachment. Her parents came to visit this weekend and the other mothers told me she was very cross with them. (note- cross is the word of choice when kids are angry or sad or any similar emotion). They said she wouldn’t talk to any of her family members. I’m sure she doesn’t understand why she’s been isolated in this hospital away from her family. She doesn’t understand that they live far away and the mother has a newborn baby she has to take care of. I’m sure she perceives this as punishment and I’m not good enough at charades or signing with her yet to address her misconceptions. ☺ I’m glad that I can be here to provide a consistent support for Missy. I worry what would have happened before Child Life services were available. The staff are very caring, they’re just so short staffed it’s difficult to provide all the care these kids need. Missy needs love an attention, but I know that I can’t provide all she needs. So, I give what I can when I’m there and try to remember that there are oceans and oceans of love available for Missy and pray that she will feel the waves of that all throughout her life.

I accompanied Missy to theatre today. Again, I have to brag about the surgery team here. Missy cried when I tried to put her on the stretcher, so I was allowed to carry her to surgery and hold her on my lap while she got the anesthesia. She was calm the whole time. What could potentially be very stressful for her wasn’t stressful at all.

Othathali (it’s really hard to make up African names, but that one’s for you Caro) on other hand was a very different story. She was burned about a year ago and after an extremely long hospitalization has had to return to the hospital for numerous surgeries to help wounds heal, as well as reconstructive surgeries to minimize the scars which cover her body. Othathali has spunk, though! She is feisty and funny and always getting into trouble. She’s probably about 5 or 6. She’s very brave when it comes to dressing changes, but the one thing that scares her more than anything is theatre. Guess what today was? Theatre day for Othathali. I tried to prep her with the mask and the prep book. She looked through the book, but would have nothing to do with the mask. She would watch as other kids played with it, but refused to touch it herself. When they came to get Othathali for surgery she cried and cried. Her mother carried her and I was able to briefly distract her, but as we got closer to theatre she became more and more anxious. One of my favorite anesthesiologist was her doctor today, so we began brainstorming what would be best to ease Othathali’s anxiety. She asked how the prep went and I told her about the fear of the mask. Othathali also reported that the lights scared her. The anesthesiologist prepped the room for Othathali, moving away the big lights and turning all the lights down. She turned on music and had everyone leave, except those directly involved with the sedation (there are usually a lot members from the burn team present). Othathali’s mom was given a chance to talk to her, then she was slowly brought into the room. She sat on her mother’s lap and while she cried, she remained still. The anesthesiologist slowly brought the mask forward, allowing Othathali choices when she could (she was so comforting!). Othathali cried, but she didn’t refuse the mask. It was much smoother than any of us expected. Her mother said in the past she had to be held down and the mask forced on her face (I wonder where her fear comes from!). While Othathali’s sedation was still stressful for her, I’m hopeful that with the help of a supportive staff, she will continue to overcome her fears. I could tell her mother was stressed, so I spoke with her afterwards. She told me Othathali has just gone through so much medically, that she can’t really say anything to make things better. I validated her feelings and assured her that while those negative experiences obviously have had an affect on Othathali, we will continue to work with her and give her opportunity to master those fears. I couldn’t help but wonder, however, what it would have been like if Othathali would have had Child Life available from the beginning of her hospitalization. If she would have been prepped for the first surgery, would she still be so afraid of the masks or the lights. If she’d mastered her fears with medical play, would it still create so much anxiety in her to walk the halls to the theatre. The answer may very well be yes, but I can’t help but wonder. We haven’t given up on Othathali, though. She’s coming back in on Friday for another surgery. They are going to try a different pre-med to help her rest before her surgery. I’m trying to come up with new medical play ideas and preps to assist her in overcoming her fears. Hopefully together we can empower Othathali to cope with her fears! After Othathli’s surgery, she was very weepy waking up in the recovery room. The anesthesiologist allowed the mom to come back to help assist in the wake up process – another amazing example of family centered care!

There were more tears throughout the day. I often just follow the sound of crying to take me through my day. The hard part is tearing yourself away to comfort another child. I can’t help but thinking about that song I mentioned – after the last tear falls is oceans of love. Can you picture that? I’ve had the opportunity to spend some time at the ocean this last week – it’s vast! It’s deep! It’s powerful! I just want to throw these kids into that ocean of love and have them engulfed in it. I have a lot of love in me, but I’m pretty sure it wouldn’t fill an ocean! But I give the trickle of love I have and pray that God will provide the ocean.

I have to leave for work at 6:30 tomorrow for the infamously exhausting dressing day, so I need to sign off, but wanted to include a couple neat conversations before I did…

The other day Caroline was accompanying a small boy to theatre. He’d been given a premed that caused him to sleep, but his surgery ended up being delayed until later that day. He woke up right before surgery and Caroline encouraged the mother to hold him. He went right back to sleep. He stayed calm and restful while the anesthesia was induced and everything went smoothly – seems like no big deal, right? Well Prof (the head burn doc) wanted to know when he’d received his premed. No one knew, so he made Caroline go find out. Caroline wasn’t really sure why he wanted to know, but she went to find out for him. She reported the time back to him and he said – See! The premed wore off a long time ago. This is because of you! He is calm because of you. ☺ It was a huge compliment…especially since Prof was admittedly uncertain about our presence here in the first place.

This afternoon I was also able to report back the progress I’ve seen in Larry since we began our work with him. I’m getting so confused with these made up names- but Larry is the one that was so weak, but now is sitting up playing and had the huge break through of singing bye-bye to me the other day. I was able to hold him for the first time yesterday. When I picked him up, all I could feel were ribs on his front and back. He laid his head against me and I sang to him. He continued the moaning that he so often does, but every now and then his moaning would match my song and he would sing a long for a while. He also explored my skin with his fingers. I’ve mentioned how tactile he is and as I held him, his fingers traced my face and up and down my neck and arms. He would sit up every now and then, but then rest his head against me and take a deep sigh and rest. It was an awesome intervention. Today I went back and he was sitting up in a chair eating his lunch. His mom was there and I think he might be going home soon. Anyway, I was talking to Dr. Jenny about this (the head of the pain management team that helped to bring us here). She was so pleased with his progress and complimented me on my role in that. I thanked her, but told her I wasn’t sure I had anything to do with it. She said that we too often don’t take credit for our work – that the impact we have had here is so great, that our presence is impacting these patients.

So to my Child Life friends – allow yourselves to accept the impact you have in the lives of the kids you serve today. The work you do is so great! Until you see what it’s like without you – you don't fully understand the magnitude of your work, but take it from me. It’s powerful! While the focus is on healing the children’s bodies, don’t underestimate the impact you have in healing their spirits!

And to all my other friends – may you be engulfed in an ocean of love today, and as you feel that love be able to spread it to the lives of others. Just image how wonderful this world would be if each person was allowed to swim in that love!