No doctors’ in white coats in the ward, medical equipment used in playing-acting, lessons that allow children to keep up with their schoolwork, and patients talked to at eye level and in age-appropriate language—these are some of the special approaches used by Hadassah Mount Scopus’s Pediatric Department as they treat children in need of healing.
Both the doctors and the staff in the department have been nominated for the Medicine with a Soul award, initiated by the Hadassah Medical Organization Board of Directors, headed by Dalia Itzik. The award, voted on by current and former hospital patients from all over Israel, honors staff members who work with all their heart and soul.
After three years of dealing with a global pandemic, lockdowns and disruption of daily routine, the department can finally get into a normal routine. “The exciting atmosphere of renewal is definitely present here,” agrees Dr. Rebecca Brooks, director of the department. “This time, the feeling is different: we are renewing ourselves in many things that we almost forgot, speaking more in the language of the past, but some of the “newness” are diseases. We had three unexpected years in terms of diseases and viruses that we had to deal with. We are returning to our winter routine that includes the flu virus.”
Dr. Brooks explains that the pediatric profession is more complex than the average person might think. And yes, indeed, there are positive sides to it as well. “We have the cutest patients here,” she says, “but beyond that, in pediatrics, it is important to remember that not only the child is the patient. The family and especially the parents are also an integral part of the treatment. The treatment of children is unique in that you need to know what language to speak. After all, communicating with a month-old baby is very different from communicating with a 1-year-old, and the same applies to a 10-year-old.
“As a pediatrician, you have to adapt to the child’s language when the language is not necessarily words and is often presented through gaze and body movements, and we are very sensitive to all these. Children are very honest and very genuine, and they don’t pretend. You see it when a child feels sick, and, when a child feels good, you see that, too. It’s fun to work with a very genuine and open population and to give of yourself in an equally warm and sincere manner, at eye level and fully sensitive to their needs.”
Dr. Brooks continues, “Part of our job as pediatricians is to know how to talk to the child and calm him down. Often, the question is asked why a child is afraid, and most often, it is due to an unpleasant experience he has had in the past. I think that, in general, we can provide the children a pleasant and positive experience when visiting us.”
The desire to make the experience of a hospital stay more pleasant led Hadassah Mount Scopus to adopt a friendly approach. "In our department,” she says, “the doctors don't walk around with white coats that might deter and symbolize something very formal, and there is also a great awareness of discourse at eye level. In addition, out of the same sensitivity, our hospital advocates a 'painless hospital' policy. We do everything we can so that the child is not in pain. For example, there are ointments that anesthetize the skin that we apply about an hour or an hour and a half before a blood test if it is not urgent so that the child experiences it as non- threatening and does not feel pain. The same applies to other simple procedures, such as inserting an infusion.
"We are sensitive to his condition, to his state of mind. It is important that everyone in the department ensure that the patient has as pleasant an experience as possible. And along with all this,” she emphasizes, “for us, the involvement of the parents and the transparency maintained between us and them is of great importance. The parents are involved and are partners in the care of their children, a principle that is an active and integral part of the treatment in our department.”
Surgery is not a simple experience, and quite a few concerns can accompany it, especially when it comes to surgery for a young child. Hadassah has long recognized the extraordinary complexity and sensitivity required in such situations. Therefore here, too, the staff expresses a friendlier approach in order for the experience to pass with minimal concerns.
“In terms of anesthesia, the approach at Hadassah for children is different from that aimed at adults, both in the experience of the child and the family that surrounds him,” explains Dr. Ido Vilchik, an anesthesiologist at Hadassah. “It's a somewhat scary situation, and we need to take care of everyone as a whole. But, of course, adults are also afraid before surgery. Still, a child experiences it completely differently and has less knowledge; it is important to adapt the situation to the child’s age.”
In practice, Dr. Vilchik points out, “We try to create an experience that is as calm and positive as possible for them. At each age, there is content that is correct to talk about and detail, and provide appropriate explanations on one level or another. A 15-year-old girl will want to know more than a 7-year-old boy would ask for, and she can receive and process more information. Our sensitivity is important for everyone, especially for children with complex malformations who come in for repeated surgeries so that we will get their cooperation in the future.”
The updating and maintenance of a sensitive discourse continues right to the entrance to the operating room and within. As Dr. Vilchik describes, “Before entering the operating room, we explain to the child, according to his age, what will happen in the next few minutes. It is important to note that the anesthesia is performed with a mask, which is also to save them from the discomfort of stabbing with the classic anesthesia. For younger children, we let them feel things, feel the anesthetic mask, or talk to them about the dreams they will have after falling asleep.
“There’s also an element of acting – to show the child that he has a mask like that of pilots with the smell of bazooka gum or to scout out what series he likes the most and link the whole thing to the things he knows around him. We try to understand each child and adapt ourselves to him. If there are children who don't watch TV series, then we think outside the box. The way to reassure them is to take advantage of the resources of the operating room, such as the bed that goes up and down like in an amusement park. With older children, you can talk and create a dialogue. Some of them are afraid and think that adults like us are not scared before surgery, and we explain to them that adults also encounter feelings of apprehension and it is okay to feel that way.”
It is a great responsibility to be an anesthesiologist for such young children. “True,” replies Dr. Vilchik, “especially when it comes to small babies who need to undergo major surgery. You have to be very professional in pediatric anesthesia. We work in collaboration with the pediatricians in the hospital, mainly with the Neonatal Intensive Care Unit doctors and the doctors in the Pediatric Intensive Care Unit, where the higher the sensitivity, the smaller the children are. At Hadassah, we do the full range of surgeries, from complex heart surgeries that are sometimes performed on children as young as a few hours, to urology, orthopedics, every possible field.”
And what do you do with the long absence from school? This, too, has a solution in Hadassah. The Pediatric Department has transcended all the difficulties with a particularly creative solution. “Hadassah operates an outstanding school under the auspices of the Ministry of Education,” says Dr. Brooks proudly. “The school runs special programs for hospitalized children, most of which are related to the different kinds of situations that they can encounter during their hospitalization, such as professional guidance for swallowing medications or special guidance before performing a blood test, and provides answers to many questions that may arise among the children. For example, what is a fever or an infection and questions from daily life in the ward. In addition, the school enables the children to fill in the gaps in their studies and even takes care to connect them by technological means to the children in the kindergarten or classroom. Furthermore, the school staff comprises many professionals who go over their school's curriculum with them so they can continue with the regular curriculum as much as possible.”
In small ways and in big ones, the Pediatric Department at Hadassah Mount Scopus delivers on the Hadassah goal of medicine with a heart and soul.