"Mouse, what do you do?" asks my five year old sibling, X. We are alone in the house, doing crafts at the kitchen table.
'Well, I help the doctors fix kiddos when something is broken or injured.'
"How?" X asks again, idly colouring a picture of a hedgehog - or some other round object covered in an excessive amount of spiky, brown lines.
'Let's say that you fall off the trampoline and break the bones in your arm. You need your bones fixed, right? And if it hurts when we fall and scrape ourselves, it must hurt a whole lots worse when we break something, yea? So my job is to help the doctors drift you off to sleep so you don't feel pain, and then we can fix your arm.'
"How do you fix it?"
I pick up one of our (many) broken coloured pencils: 'It's like this, this pencil has been broken in two. We need to line it up like a puzzle piece so it slots back into place.' I move the two pencil pieces back together. 'Then we have to figure out, can we hold the pieces in place by holding it in a cast that wraps around the broken bit - like cellotape, or do we need to hold the ends in place with screws that go right the way through like Daddy used on that bookcase.'
X ponders this. "But Mouse, won't that really hurt? The screwdriver is loud!"
I nod. 'Yes, that's why we put you to sleep first. It's very important to make sure it doesn't hurt you.'
"But I'll just wake up and hurt then!" X says in alarm.
'This isn't normal sleep. This is medical sleep. We give you medicine to make you so deeply asleep that you don't wake up until we stop giving you the medicine.'
"Do you drink the medicine, Mouse? What if you don't like the flavour?"
'Nope, you can have it in two ways, we can numb your hand and stick a little straw in your veins to give you medicine. This is super fast because we both know the heart pumps our blood ALL around our body. Or you can breathe in a smelly gas, and the more you breathe the sleepier you get.'
X is now chewing on their fingers and they start scribbling grass lines. I gently tap their hand to remind them not to chew and slide a mouth-safe chewie in their direction. "What if it smells bad? What if you breathe so much that your lungs get to big and just burst? What if you breathe out and the gas escapes and spreads like Daddy's farts? If it escapes then you won't go to sleep and it'll hurt! Or will it just make everyone go to sleep and then everyone is napping and not reminding me to wake up again!"
I have to take a moment to blink. X has the most incredible brain, and those are some pretty intense questions. I am also distracted because I can't recall ever smelling their dad's farts... They must be pretty awful if there's a spread effect. I wonder what he eats. The colouring portion of the ?hedgehog? is finished. We now start stamping pictures and letters around the edge of the canvas.
'It takes a lot of gas to go off to sleep, even if we smell a little bit it won't be enough to make us forget to wake you up. If you don't like the smell, then you can breathe through your mouth and blow out really fast - basically blowing the smell away. And we won't let your lungs burst. It's our job to keep you safe, blowing you up isn't really safe, is it? Letting that happen would make us really bad at our jobs.'
For a while X seems content with this. We give ourselves a break to get some snacks. X wanders off to go play in the other rooms while I rifle through cupboards looking for their preferred munchables. Crunchy breadsticks, goldfish crackers and strips of bell pepper. We reconvene at the table and my sibling digs in to their eclectic horde while I tidy up the crafting bits.
"Then what?" They ask with an open mouthed chew.
'Hmm?' I ask, glancing back at them.
"Once I'm asleep!"
'Oh, then we need to give you some oxygen. We do this through a plastic mask that whistles like a seashell and smells all plasticy like a beach ball.'
"Like a plant!" I give them a blank stare. At my extended silence they start gesturing with a breadstick, "Plants need oxygen. It's why they don't grow on Mars."
'Yes, we need oxygen like a plant does. Sometimes we get so comfy while we're in medical sleep that we forget to do our breathing. That's why we give you oxygen - Our body gets lazy.'
X is frowning now. This is the you-just-said-something-stupid frown. "If you're not breathing, how do you get the oxygen?"
'We have to breathe for you. Gently push the oxygen into your lungs, then let it flow back out again. Sometimes you're still breathing a little bit so we only need to push a tiny amount and sometimes you're not breathing at all.'
What continued from here was the single greatest conversation of my life. X had so many questions. We discussed the mechanics of /HOW/ we breathe: what muscles we use, positive and negative airway pressures. We discuss /WHY/ we breathe: Co2 receptors in in the brain, the different depths of anaesthesia. We discuss CPAP, BIPAP, mechanical ventilation. This conversation is more in depth than ones I have with my nursing and ODP students, you would think that I was just pushing complicated information of this poor child, but you would be wrong. X is ravenous for information. They won't take any half answers, they need to know the WHY, the HOW, the EVERYTHING.
By the time we finish, my mouth is dry and I've run out of activities for us to do. It's been a solid hour and half of intense discovery. X seems to have run out of questions, and I collapse on the couch drinking my tea while they play with their superhero figurines.
*Approximately 10 minutes later*
"Mouse, in Star Wars..."
Ah, I think to myself. We are on to the familiar ground of superheroes and Sci-Fi. Our attention is officially diverted onto a new topic.
"...Darth Vader's mask makes a noise. Is it assisting his breathing with positive airway pressure?"
What. I just... Did they just... what?!
That extraordinary brain. That magnificent, curious, gorgeous brain! X had spent that period of silence digesting what we had spoken about. Tried to make sense of it in a way that is relevant to them. Then BAM! They found it, a link to help clarify these new concepts.
I remember when I was a student finally understanding what PEEP (positive end-expiratory pressure) was by walking up the stairs of the underground on a trip in London and finding the wind pressure so intense that it was hard to breathe. That was my Eureka moment, and this was theirs.
So yes, that was exactly what Darth Vader's mask was doing. After that, X has never asked me about my work again. Curiosity officially sated. To be honest, I'm not even sure if they /remember/ that conversation, five years later. I, however, will remember it for the rest of my life.
(Picture posted with X's permission, 27/05/22)
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