miércoles, 3 de noviembre de 2010

The space of the hospital II

Children with hematological conditions
In this children's hospital children with hematological conditions (different forms of Leukemia, anemias, or blood diseases) are treated by the Hematology unit. They will have these hematologists as the main doctors but if they need to be hospitalized they may end up at different clinic units that have beds, usually isolated single rooms since these children need to be closely checked to avoid infections. These children go through cycles of low defenses from their compromised immune systems. Given its unespecifity chemotherapy attacks all cells ("good" and "bad") and attacks more those cells that divide faster and this have major impacts such as decreased production of blood cells, mucositis (inflammation of the lining of the digestive tract) and hair loss; among others. The oncology-hematology unit has a 'day hospital' site where they provide children with chemotherapy, blood transfusions, immune-globulin, etc., but they lack of their own beds to hospitalized children. Then, these professionals rely on other doctors, especially residents at clinical units or at the communicable diseases units.
The oncology-hematology unit is a three-level building that has at the ground level a major waiting room, then it has 9 boxes to clinical check ups, and the 'day hospital' for chemotherapy. Then, at the first level it has three rooms for procedures such as bone narrow aspirations and lumbar punctures, and then several different offices for all the oncologists and hematologists. At the second level there is a big laboratory where professionals perform all kinds of lab tests to blood or cerebrospinal fluid. In this building children and families stay for hours, and days, and weeks, and months during children's treatment. They start 'staring at your own shoes' as one father described the waiting room to me. But then they recognize other faces, and children and parents become friends with other children and other parents. There is a 'metegol' (a soccer game to play with metal players and a ball) in the middle of the waiting room where children usually play, there is a big tv always on, and there are people passing by all the time. Doctors call patients and people enter to the boxes first to take a blood test when children arrive early in the morning, and then to be checked by oncologists and hematologists to decide if they are fine for the next cycle of chemo or whatever they need to do in the specific moment of each child treatment.
(to be continued)

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