The look of surprise remained on her face. Rather than deal with it, I said, 'How did Cassie let you know her head hurt,' 'By pointing to it and crying. She didn't tell me, if that's what you mean. She only has a few words. Daw for dog, bah-bah for bottle, and even with those, sometimes she still points. Dr. Eves says she's a few months behind in her language development.'
'It's not unusual for children who've been hospitalized a lot to lag a bit. It's not permanent.'
'I try to work with her at home-talking to her as much as I can. I read to her when she'll let me.'
'Good.'
'Sometimes she likes it but sometimes she's really jumpyespecially after a bad night.'
Are there a lot of bad nights?'
'Not a lot, but they're hard on her.'
'What happens?'
'She wakes up as if she's having a bad dream. Tossing and turning and crying. I hold her and sometimes she falls back to sleep.
But sometimes she's up for a long time-kind of weepy. The morning after, she's usually jumpy.' jumpy in what way?'
'Has trouble concentrating. Other times she can concentrate on something for a long time-an hour or more. I look for those times, try to read to her, talk to her. So that her speech will pick up. Any other suggestions?'
'Sounds like you're on the right track,' I said.
'Sometimes I get the feeling she doesn't talk because she doesn't have to. I guess I can tell what she wants, and I give it to her before she has to talk.'
'Was that what happened with the headache?'
'Exactly. She woke up crying and tossing around. First thing I did was touch her forehead to see if she was warm. Cool as a cucumber.
Which didn't surprise me it wasn't a scared cry. More of a pain cry.
By now I can tell the difference. So I started asking her what hurt and she finally touched her head. I know it doesn't sound scientific, but you just kind of develop a feel for a child-almost like radar.'
Glance at the bed. 'If her CAT scan hadn't come back normal that same afternoon, I would have really been scared.'
'Because of the headache?'
After you're here long enough, you see things. Start thinking of the worst things that can happen. It still scares me when she cries out at night-I never know what's going to happen.'
She broke into tears again and dabbed at her eyes with the crumpled tissue. I gave her a fresh one.
'I'm really sorry, Dr. Delaware. I just can't stand to see her hurt.'
'Of course,' I said. And the irony is that the very things that are being done to help her-the tests and procedures-are causing her the most pain.
She took a deep breath and nodded.
I said, 'That's why Dr. Eves asked me to see you. There are psychological techniques that can help children deal with procedural anxiety and, sometimes, even reduce the pain itself.'
'Techniques,' she said, echoing the way Vicki Bottomley had, but with none of the nurse's sarcasm. 'That would be great-I'd sure appreciate anything you could do. Watching her go through her bloodwork is like.
.. It's just horrible.'
I remembered what Stephanie had said about her composure during procedures.
