What does it mean to be a child?  The answer is important because Ranken Jordan is a pediatric specialty hospital.  Pediatrics is the branch of medicine dealing with the diseases of infants and children. So the question becomes, “Who should we be caring for?”  Children between birth and puberty?  Only children who have not yet attained some arbitrary legally specified age like 18 or 21?  What about Webster’s most inclusive definition:  A son or daughter of human parents? 

Hannah was a child of 17 when she was involved in a head-on collision with a semi-tractor-trailer truck about a year ago.  She spent five weeks in an adult ICU recovering from her broken hip, arm, hand, and back.  Paralyzed from the chest down, she couldn’t feel the large bedsore that developed from lying in one position for days at a time.  She was anxious and a little depressed when I first met her, but who wouldn’t be?

Her parents had heard great things about an adult spinal cord injury program in town and were somewhat disappointed that until she was well enough to participate more actively in therapy, she would have to continue her recovery at Ranken Jordan.  Hannah, though, knew right away this was where she needed to be.  Having never been seriously ill before and having seen the adult medical world first hand, she immediately felt safe, protected, nurtured, and even a little pampered, which is precisely what she needed. 

In addition to close daily attention to her wound, what really helped was the attention we paid to the nonmedical issues.  The first real bath since her accident was like a trip to the spa.  Although she was too weak initially to be upright and was confined to her bed, getting out of her room for meals, therapy, and child life interactions really improved her outlook.  She began to internalize the sense that she was getting better after weeks of nothing but despair about her situation.  She saw other kids with equally or more severe injuries, not only accommodating but improving.  She began to set and believe in her own goals for recovery and made slow, steady, and remarkable progress. 

At one point, midway through her stay, Hannah participated in a book signing with Julie Parker, a Ranken Jordan therapist who had written a children’s book titled “Why Me?”  With amazing poise and confidence, Hannah recounted the details of her accident and recovery so far.  In front of dozens of people she made clear her intention to keep moving forward, wheelchair and all, and eventually help others in her situation. 

About halfway through her stay with us, her family wanted to move her to the adult rehab center they felt was best for her condition.  Within days, Hanna was calling and practically pleading with us to take her back.  It turns out that the distinction between child and adult in the rehab world is all too clear.  Adult rehabilitation units are no place for children, no matter what their age.  Back at Ranken Jordan, her recovery and home preparation process continued.  Her stay with us was somewhat protracted due to her large wound which was eventually closed surgically.  The focus shifted from physical progress to achieving a more complete sense of independence.  To be sure, we were only partially successful.  The day she was discharged, not long after her eighteenth birthday, she said, “Dr. Holekamp, I promise to do my best, but if I ever need to come back here, can I?”  I said, “You are going to do great, and you know we will do whatever it takes to take care of you.”