Laughter spills out of the room, followed by the sounds of children playing with blocks and video games blasting aliens out of the sky.
This is laughter with a purpose, an integral part of the medical treatment of chronically ill children at Downstate's University Hospital of Brooklyn. Central to their treatment is the Playroom, a place filled with toys, games, video play stations, and individuals who understand the importance of play.
"Play is children's work," says Laurel Whitaker, director of the Child Life Program at the hospital. "It is how they learn about the world; how they practice relationships with others."
For children who have been hospitalized, play has other benefits. It may, for instance, give them an opportunity to make choices at a time in their lives when so much seems beyond their control. Or, it may be used to console them.
Dr. Margaret Clark-Golden, a pediatrician at University Hospital of Brooklyn, remembers how the Child Life staff helped a young girl recover emotionally from an acute illness. After being unconscious for several days in intensive care, the girl was terrified when her parents were out of sight. So strong was her fear, she could not even fall asleep.
"The Child Life staff played peek-a-boo with the girl for a day and gradually the trauma she associated with her parents' leaving diminished," recalls Dr. Clark. "She came to understand that her mom and dad would go away for awhile and then return."
For twenty-five years, the Playroom has served as the core of the Child Life Program, providing children and adolescents with a haven within the hospital. It is a therapeutic program that eases the emotional impact of illness, disabilities, and hospitalization on children and their families.
Members of the staff work closely with the medical team and are instrumental in helping a child understand and cooperate with treatment. At the program's best, children become partners with the medical team, speeding their recovery.
Staff members have backgrounds in education, nursing, and art therapy, and they often work with student interns and volunteers. Many of these students plan to pursue careers in medicine, nursing, social work, and education.
Melinda Blaise, a psychology major at the New School for Social Research, recently completed a two-month internship.
"At first, you think that your job is simply to come in and play with the kids, but you quickly realized that it was much more than that," she says. "You have to be sensitive to the child's feelings, and you have to be their voice, when they won't speak for themselves.
"It is amazing how therapeutic the Playroom is," she adds. "There is a lot of magic in that room."
Part of the room's magic is that it emphasizes the normal aspects of the child's life. No procedures are performed in the room (although children sometimes play with medical equipment to familiarize them with treatments they will encounter). They celebrate birthdays with pizza and ice cream. They listen to stories. And they laugh at the antics of Daffy Daisy, a clown who visits weekly.
When children are required to remain in their rooms, staff members and student interns simply move the Playroom--or at least some of its equipment and all of its goals--to the child's room.
The Child Life staff and volunteers also help parents cope with their child's illness by listening to their concerns and frustrations. They can also help parents to understand their child's behavior and how to meet his or her developmental and emotional needs.
For many years the Child Life Program has participated in the Board of Education's Summer Youth Employment Program. Each year, five or six chronically ill teenagers work as summer interns. Maureen Walsh, a Child Life staff member, calls it "one of our favorite parts of the year. It is very rewarding to watch the intern offer patients services they once received. They understand what these patients are experiencing."
Gabriel Zarzuela is one of those interns. Diagnosed with kidney failure, he began dialysis treatment at University Hospital when he was 11 years old. Three years later, he received a kidney transplant.
"I've been through tough times," he says. "When I play with the kids now, I keep that in mind. I remember how well I was treated, and I try to be a friend."