Art Therapy in the Red Cross Burns Unit

This post is dedicated to one of my favorite clients who I only saw once before he died late last night. May your dreams and after-life be filled with brightly painted pictures sweet sweet boy.

It occurred to me that I've not really written anything specific about my art therapy work here. Sometimes it's just too hard, sad or exhausting to think about it or express it after hours and at the end of the day. But I do want to share some of what I'm seeing, feeling, experiencing, so here's me and some of my clients today at the Burns Unit:

Today I sat with an 11 year old boy with severe electrical burns running the full length of his arms and legs, helping him to paint and express the nightmare that he lived and witnessed in the last week. He has lost the only home he knows to the fire and he is all alone as his family can't afford to take time away from work or make the trip South from the Northern Cape where he is from. He is heavily medicated on morphine for the pain and very withdrawn and depressed. And yet he is happy to paint and with my hand over his small bandaged hand we do so. He laughs when he accidentally gets some green paint on my fingers and I tease him for painting me on purpose. These are the moments I live for.

I hardly notice the distinct smell of burning flesh and antiseptic or the extreme high temperature that they keep the burns unit at so as not to compromise the patients ability to regulate body temperature and maintain fluid balance. Not to mention most of the children with large burns are required to be uncovered and exposed (save for all the dressing/bandages). It is for his reason that it is so HOT and unbearably humid in the burns unit, which doesn't help with the smell. I have adapted to seeing severely disfigured and amputated children. I am able to hold back my tears, unlike the begining when I had to rush off to find a bathroom so I could shed some tears in private. The little babies and the agonizing screaming and crying during the daily dressing changes still gets to me, but not so much as those first early days.

I am proud of myself for being able to go to the hospital each week and sit with these children, to give them art materials and a voice/vehicle/means of telling their incredibly traumatic stories and an outlet. I should note that it's not always heavy or heartbreaking, some days it can be light and fun. Simply playing and enjoying the art materials is a good distraction and a nice escape from the reality of these children spending their days in hospital beds with little to no entertainment.

But today was a bit different. There is one single television in the burns unit room which houses approximately 15 very archaic metal hospital crib type beds and today the above mentioned boy lay watching a movie as I pulled up a chair next to his bed. I immediately noticed from the screams that it was a horror movie and within a matter of minutes there was a huge explosion on the screen and an entire building caught fire and burnt to the ground with a handful of children and adults in it. I honestly couldn't believe that in THIS UNIT the movie playing in front of all these children who have been severely burned in electrical fires, cooking fires, petrol fires, from hot water and so on was a horror movie in which people get trapped and killed in a huge fire. Talk about re-traumatizing the patients. At any rate I immediately went to the nurses on duty, inquired as to the inappropriate nature of the movie and insisted it be turned off. Unfortunately the response I got was that this was the movie the older boy wanted to watch. I explained that sometimes what children want or think they want (especially regarding media) isn't always what's best for them. No response. Some days I feel as though I am just a small man on the totem pole: an art therapist (of which many people here have no idea what this means or what I do) . . . a foreigner. . . from America. . . volunteering my time. . . in a hospital. . . in Africa. . . where there are so many cultural differences. Outnumbered and overridden. At least I know I tried. But it still doesn't take away from the disappointment of not having much of a voice at times, or being heard and the feelings of helplessness that accompany.

As of today I also have a new client. A 9 year old boy dying of a bone disease called Gorhams. I've recently been referred to see patients in the ICU and in other wards. I've had 2 clients die which has been painful to witness, but I've also had 2 patients who have made miraculous recoveries and have been released to go home after being in hospital for the better part of a year. For every tragedy there is also successes and happy endings which I believe is why we all keep coming back and doing this work.

At any rate, back to today's new boy. I was told he doesn't speak or understand any English, which is common. It's typically Xhosa or Afrikaans and this is why I work with a translator/counselor much of the time. However, at the hospital she is also seeing clients simultaneously so I'm typically left on my own with the universally understood body language of sign and gesture if you will. I have to admit that this is one of the biggest challenges of my work here: language barriers. Not so much in the hospital because I'm working with clients 1:1 and much can be conveyed in the art, but in my groups I run in the townships I feel like so much gets lost in translation and that's incredibly frustrating.

Anyways, again back to the boy. I was told he was heavily doped up and in extreme pain, that he most likely wouldn't be able to draw or paint and that I should do art for him as he is too weak and would likely not be able to hold a paintbrush or marker. However, it quickly became apparent that he did understand much of what I was saying and could answer simple/basic questions in English (this is quite common as the children whose first language is Afrikaans learn English in school). So after doing 2 paintings for him and a lot of encouragement on my part I was able to convince him to paint with me, which lead to him painting on his own and a huge sense of accomplishment and pride. Lots of smiles, laughter, joy, and painting after painting followed. Towards the end of our session he painted with one hand, and held my hand with the other. He played with the cuff of my shirt, and stroked my arm. Amazing how powerful human touch can be. When I asked him if he'd like me to come back next week he gripped my hand and adamantly said "No," which surprised me. "Tomorrow," he pleaded. "I wont be here tomorrow." "Please." It totally broke my heart but also deeply touched me. I don't know how much longer he has to live but I sure hope he's there next week so I can do my small part to bring an hour of color to his fading life.

I wrote this entry a week ago today but for some reason didn't post it as I felt it wasn't quite finished. Today would of been the next session with this boy whom I was very excited to see this morning. Last night before bed I thought about Christmas coming and had decided I would use all the pictures and paintings that this child and I would make over this month and I'd put together a book for him. I showed up in his room today with my paints in hand but he was nowhere to be found. They took him home yesterday so he could say his goodbyes to family and be in his own bed. He died last night after years of battling Gorhams Disease. I wish I would of just had a bit more time with him, I wish I could of seen him the following day like he so desperately pleaded for (in retrospect I think he knew his time was near). I wish I could of said goodbye. I wish my heart didn't hurt so much. . . Regardless I am honored to of met him. Thank you for touching my life and for spending some of your last hours with me creating beautiful art. Sweet dreams and rest in peace my little friend.