The Holiday Parade

The Holiday Parade

by Abbacor

Wednesday, Oct. 12^th 2pm – boardroom in Children’s Medical Center

Mr. Frederick Hastings gently knocks on the table to get everyone’s attention.

“Ok people, it’s time to start working on the annual parade again. I’ve gathered the eight of us here to get the ball rolling. Hellen, I’m afraid that we’ve gotten started a couple months later than normal which is going to make your job as the new parade organizer a bit difficult; but if your credentials that you presented us with are correct then you should be able to work it out successfully.”

“Yes Mr. Hastings, it will be a challenge with so little time, but I am confidant that I can get the job done for you.”

“Excellent. I’m always pleased to see a new employee rise to a challenge.” He has a smile on his face as he says this, but the smile does not extend to his eyes. 


“Let me introduce you to the others here. Going around the table to your left we have Doctor Andrew Irvine, Director over Immunology, Endocrinology, and Gastroentology.”

“Hi Hellen, pleased to meet you.” Dr. Irvine is a man in his early sixties with salt and pepper hair, a ‘middle age paunch’, and wears glasses.

“Next to him is Doctor Vanessa Yarbor, Director over our Critical Care, Trauma, and Emergency departments.”

“Hi there honey,” she says with a genuine smile and a small wave. Dr. Yarbor is a mid forties black woman with short dark hair and an athletic build.

“Doctor Sharron Bezzleman is our Director over Hematology, Oncology, and Pulmonology.”

Dr. Bezzleman is approximately sixty-five years old with grey curly hair, vivid blue eyes behind a pair of half-glasses, with a gentle smile and soft voice. “Hello dear.”

“Coming around the corner we have Doctor Randall Mongomery. He is the director over Neurology, Neuro-Oncology, Neurophysiology, and Ophthalmology.”

“Nice to meet you Hellen,” says Dr. Mongomery; a small man in his late forties to early fifties with a receding hair line.

“Over here we have Doctor Waren Zimer who came to us several years ago from Germany. His expertise quickly gained him the Director position over Occupational Therapy, Orthopedics, Physical Therapy, Rheumatology, and Urology.”

“Guten Tag Fräulein Amaya,” says a man who looks like he has not smiled since he was born. Dr. Zimer is probably seventy years old and sits straight in his seat as if his spine had been replaced with an iron rod.

“Finally we have Doctor Henry Everstt, Director over Psychiatry and Psychological Services.”

“Greetings young lady.” Dr. Everstt is in his mid fifties with dark hair and a tall thin build.

“Of course I am Frederick Hastings, Head of Public and Media Relations. Ladies and gentlemen, this is Hellen Amaya, my newest employee, who will be taking over organizing the annual holiday parade this year.”

Hellen smiles and waves, “Hello everyone.” She is a young woman in her early twenties and of apparent mixed Anglo-Oriental descent. She has a slight body build weighing about ninety-five pounds and only stands about four feet nine inches tall.

“Now, I want to cover just a few basics here with everyone then we can all get back to our jobs and Hellen can contact you all individually as required. The parade will be on the first Saturday of December as usual, which this year will be the third day of the month. That gives us just over seven weeks, or fifty-one days from today to get it together. Hellen, normally we have children from the hospital as participants in the parade which is a given. But, for the last few years we have managed to fail representing all the various wards somehow through one reason or another. So this year I want you to make sure that EVERY ward has several children in the parade to represent them. You will need to work with the people in this room, or the individuals they direct you to, and make sure this happens. I don’t want any excuses short of ‘unplugging the child’s life support will kill them’.”

He looks around the table at this point to make eye contact with everyone seated there. “This goes for everyone. I want kids from all wards in the parade this year. Ok?”

All at the table either nod or reply in agreement at this statement.

“Good. Now,” and he looks back at Hellen, “you will have on your desk by the end of the day the complete list of our usual sponsors for the parade along with a list of potential sponsors who have contacted us. I know it’s late, but I want all of our usual sponsors included and as many new ones as possible. You will also have all the contacts for the various floats and balloons, the city planning committee, police, etcetera that you could need. Most of them are used to the parade by now, so hopefully they have set aside resources for us this year even though we have not officially contacted anyone yet. Also, I’ll have our lawyers start drawing up the usual legal agreements for the various families or legal guardians of the children to sign giving them permission to be in the parade.

“Those of you who have a few minutes now please feel free to stay and talk with Hellen, the rest of us can get back to work. Thanks everyone.”

Mr. Hastings stands up and leaves the room followed by most of the others in the room with only two of the Directors staying to talk to Hellen.

An hour later – Mr. Hastings office

A knock on the door alerts Mr. Hastings to a visitor, “Come in.” The door opens and Dr. Zimer enters the room.

“Please Doctor, have a seat.”

Dr. Zimer closes the door, shakes Mr. Hastings hand in greeting, and takes a seat.

“How did such a young slip of a girl manage to get put in charge of the parade this year Frederick? And why are we starting so late on it?”

Mr. Hastings frowns a bit as he answers, “She got the job with me a couple months ago, and there was some name dropping during her interview with ... gentle pressure let’s say, a few days later to hire her. Apparently she impressed some important people and they made strong references to having her organize the parade this year. No, I won’t say who, but they were not in the room earlier.”

“I see. I take it from your reaction you were not entirely pleased with the situation then?”

Mr. Hastings snorts, “No, I was not. But the girl has tried to prove herself since being hired and done a reasonable job so far.”

“And the late start to the parade? It is one of our best yearly events, I’d hate to see it fail,” Dr. Zimer asks with a raised eyebrow.

“Yes, well, there have been several financial hurdles for the hospital this year, and budgets everywhere have all taken a hit causing cutbacks and delays across the board. I admit I may have stalled a little bit getting the parade started this year, but it would have been a late start in any case. Just maybe not quite as late as this.

“I have to admit that she is probably going to pull it off successfully in any case, which is what I want. I do not intend to intentionally sabotage her any more than I already have; I love the parade as much as you do and don’t want to see it fail either. But if the girl makes a few pressure related mistakes here or there to discredit herself a little and bring her down a peg or two I would not be dissatisfied.”

“And the ... directive ... about ‘unplugging life support’. Are you honestly going to be that insensitive?”

“Of course not. I put it out there to put pressure on the girl. I will not condone having any child in the parade if it could adversely affect the child’s health. If any physician gives a reasonable excuse that a child should not participate then I will back them up one-hundred percent on it. We are a hospital after all, and our focus is to make the children better, not worse.”

Dr. Zimer nods in understanding. “Good, as long as the parade is not ruined then so be it. If there is anything I can do to help your ... cause, let me know.” He stands up and shakes Mr. Hastings hand, “Guten tag, Mr. Hastings” and leaves the office.

Same day – elsewhere in the hospital

After talking to the two Directors who remained in the meeting room, Hellen spends the rest of the day either talking to the other Directors she has been introduced to or going over the files she has been provided for the parade. The data in the files is quite informative and has everything she thinks she will need to get the parade up and running successfully. The various Directors have given her names of Doctors and Nurses who are the heads of their individual departments or wards of the various floors, and have nearly universally told her to use their names when contacting individuals to help get compliance or assistance in getting what she needs or wants as long as it is within reason.

She spends the rest of the week contacting numerous people both in the hospital and out to start the initial steps of getting all the varied parts of a parade together. By the end of the week Hellen realizes that the extremely late start she has been given for the project is going to require her to work very long days, and over the next several weeks she work twelve to sixteen hour days seven days a week to get things done.

Friday, Nov. 18^th 4pm – two weeks before the date of the parade

Hellen has been working extremely hard for the past five weeks, and has accomplished a lot in getting the parade running.  Thankfully, Mr. Hastings prediction that many of the supporters, businesses, and organizations normally involved in the parade may have set aside resources again this year proved to be true in about ninety percent of the places she contacted. Along the way she has been grateful that the majority of those she has had to work with have all been quite supportive of the parade and fairly eager to participate once again.

This does not mean that her job has been easy in every case though. She has had to drop a few names and rack up several favors owed to some powerful people to get individuals underneath the powerful to toe the line, which means that she has stepped on a few toes along the way. Toes including her own boss at one point when he seemed to be constantly forgetting to sign one agreement form or another, or failed to follow up with this person or that one making it harder for Hellen to complete various portions of her job. She complained about this to her friend at one point out of simple frustration, not realizing nor intending to have them say anything to Mr. Hastings. But a quiet one-on-one conversation did occur, and Mr. Hastings was much more prompt at giving Hellen what she needed in a timely manner after that.

Hanging up her phone she smiles and puts another check mark on her list indicating that everything is on schedule outside of the hospital. The city, police, media, floats and balloons, etc., are all right on track and working successfully to have an exceptional thirtieth running of the holiday parade.

Switching pages she looks down the list of internal departments and verifies the list of children who will be participating in the parade, making note to follow up with three doctors about some children who are listed as ‘maybe’. When she gets to the bottom of the list she tries to frown and smile at the same time and decides to go to Mr. Hastings about a problem she has run into.

A few minutes later she is knocking on the door to Mr. Hastings office.

“Come in,” she hears and enters the office.

“Miss Amaya, welcome. Please, take a seat. How are things going with our parade? Are you having any problems with someone that I can help you with?”

“For the most part it is going well and is right on schedule. Everything is falling into place. Almost.”

“Almost?” asks Mr. Hastings. “What’s wrong?”

“That’s what I came to talk to you about. I’ve run into a little problem. It’s kind of embarrassing yet at the same time it’s a pleasant surprise. You see, it looks like we won’t have any children from the Orthopedic ward to be in the parade.”

“What? You mean to tell me that none of the doctors on that floor will release their patients to participate in the parade?”

“No no, nothing like that. It’s that there won’t BE any children on the ward.”

“What?” Mr. Hastings looks at Hellen with a confused look.

“See, that’s how it’s a nice surprise, in a way. All the kids on the floor are going to be released to go home. They’re all healing well and ready to go home again. The last one will be released this coming Monday, and there’s no new kids coming in. And if we do get new patients on the ortho ward then chances are their injuries will be too new to allow them to move around yet. Unfortunately that means we won’t have anyone to put in the parade for Orthopedics.”

Hellen gave Mr. Hastings a lopsided grin as he sat back in his chair.

“Well. I see what you mean. It’s wonderful that the kids are all healthy enough to go home again. And no new kids coming in is good news too, means kids are all staying safe right now.”

Mr. Hastings sat for a minute in thought then looked back up at Hellen.

“We need to figure out what to do about this. Aside from the cancer patients with their bald heads, the Orthopedics ward is the most visibly noticeable group of kids with the various casts and braces they have to wear and be seen in. While it’s kind of an ogre’ish thing to say, they always have a large impact on the media in the parade and I really don’t want to lose that this year with the decline we’ve seen on donations due to the economy.” He looks at Hellen expectantly waiting for her response.

“I understand Mr. Hastings. I’ll try to figure something out. I’ll have something for you to at least consider by Monday morning,” Hellen tells him confidently.

“Very good, Miss Amaya. I’ll see you first thing Monday morning then.”

Monday, Nov. 21^st 9am – Mr. Hastings office

“So Miss Amaya, what have you come up with to fix our little problem?”

“Well Mr. Hastings, I’ve got an idea that I think will work, but I’d like to kinda go over my thoughts I had over the weekend on this so you can see where I’m coming from.”

“Go ahead.”

“Thank you sir. Well, the obvious thing would be to have kids with injuries of course, but we’re going to be releasing our last patient today. People and kids do plenty of stupid things to get hurt, but trying to, well, cause an accident so we can have some kids for the parade is just wrong not to mention illegal.”

“Of course.”

“So, then I thought about the kids who have been here recently and are getting out. What if we were to ask them to come back? We could put them back in their cast or brace again just for the parade. Then I thought about a childhood friend who had to be in the hospital for a while in a big cast. She was so sick of being in the hospital and in a cast that the day she got it cut off was probably the best day of her life at that point. If she had been told she would have to be in the cast again it would have just killed her, so to speak. I just can’t ask a kid who just got out of a cast to be put back in one again. It would be too mean.”

“Mm-hm. Go on.”

“Well, then I thought about contacting some of the other hospitals in the area to see if we could kinda borrow some of their kids. But that would mean we’d have to advertise where the kids came from, which would draw attention away from the Children’s Medical Center, and would be counter-productive to what you wanted.”

“I assume this is going somewhere?” Mr. Hastings asked with an obvious tone of disapproval in his voice.

“Y-yes sir. I-I was just getting to the point,” Hellen stammered. “You see, I was up late and had my television on in the back ground, not really watching it but as kinda background noise while I worked. I looked up and realized it was playing a re-run of an old TV hospital show and it dawned on me, we could do that! We can hire children actors!”

“Hm, actors. Children we would then put in a cast or brace and put them in the parade. An interesting idea. Do we have enough time to make it work? And do you have enough time with everything else on your plate?”

“I think so sir. I’ve already looked locally and there are several talent agencies that deal with children I can contact. I’m not sure just how many kids we can get on such short notice, and the job is more than a little weird, but we can probably get enough by the end of the week to make it work. It would mean the cast and brace departments would have to work extra hard next week to have any braces ready we want in time though.

“As far as having too much on my plate at this point, that’s not a problem. This week is going to be primarily follow-up with people to make sure things are on schedule. Next week is just tying up the loose ends and leaving time for any last minute emergencies, which I don’t anticipate having any. Everyone is doing their best work on the parade in my opinion. I can easily fit in working with the talent agencies this week and the kids next week if I have to.”

“All right Miss Amaya. I will tentatively approve this. I will talk to Dr. Zimer and the legal department this morning. Final approval will depend on the outcome of those conversations. Start contacting those talent agencies and see how many children might be available on short notice. Don’t let them know what the job will be yet though.

“IF this gets approved, and IF everyone is willing to do the extra work you propose, then I want our lawyers to hash out the terms of a contract with the talent agency lawyers before any ‘actors’ are presented with the details. Is that understood?”

“Yes sir, understood.”

“Very well. Get out and get to work, I have to go bother some people about this. I’ll let you know this afternoon if it is approved.”

15 minutes later – Dr. Zimer’s office

“Our young Miss Amaya has come up with an interesting solution to a potential problem with the parade stemming from one of your departments, Dr. Zimer.”

“Oh? A problem with one of my departments you say? And would that be the lack of patients in the orthopedic ward per chance?”

“Yes it would. Actually, I agree with her that it is a happy circumstance that we’ll have nobody in the ward.”

“As do I Mr. Hastings. I’d prefer to have an empty ward, but people do stupid things so I’m sure it won’t stay that way.”

“Interesting, Hellen said something similar. She also pointed out that even if we do happen to receive new patients it would most likely be too early to allow them the freedom to move about that would be required to put them in the parade.”

Dr. Zimer thought for a moment, “She would essentially be correct. Anyone who would be admitted as an in-patient at this point would probably require complete bed rest long enough to keep them out of the parade.”

Mr. Hastings nodded, “As I thought. So, instead she has devised a way for us to have children from the ortho ward in the parade without endangering the well being of said children. She has recommended we use children actors. We can bring them in next week and fit them with casts or braces as we see fit and still have them in the parade. No real injuries to worry about so no health concerns with having them moved around. But it means that the brace fabricators will have to work hard to get what we want done in time.”

“Yes, that would work. There is still several health concerns involved in such a project, but nothing that can’t be easily dealt with. Casts are no problem; those are done in no time the same day they are ordered. Braces tend to take time, but with no current patients the workshop will have a bit of available time on their hands. It can be done. Have you given her permission to get the actors yet?”

“Not fully. I told her I need to talk to both you as the Director over ortho, and the legal department before a green light can be given. But I did tell her to start making initial contact with local talent agencies.

“Now, a few weeks ago, you told me that if there is anything you could do to assist me with putting Hellen in her place that I should come to you. Well, as it stands Miss Amaya has made herself more than a little bit of an annoyance to several people I am friends with as well as myself.”

“I see. And you want to have some revenge then.” Dr. Zimer leaned back in his chair and gave Mr. Hastings a calculating look, “What is it I can do for you?”

Mr. Hastings gave him an oily smile. “Well, this actor thing has given me an idea of how I can put her in her place. It will involve the orthopedic department, and I want to add in a couple of clauses to the contracts the lawyers will be working up for this to make it at least quasi-legal what will happen to her. She’ll be required to sign a legal binding contract giving her consent and agreement after all.”

"Sie ist ein Schmerz im Arsch auch hier," muttered Dr. Zimer.

“Pardon?”

“Ah, um, as you said, she has been an annoying presence. I think we can work something out.”

“Excellent. Here is my idea ...”

1:05pm that afternoon – Hellen Amaya’s desk

Hellen hung up her phone then pumped her fist in the air, “Yes! It’s a go!”

She had just gotten off a call with Mr. Hastings letting her know the use of actors had been approved and the lawyers were working on the rough draft of a contract. They would have the final draft ready by the end of the day Wednesday if not sooner and Hellen was to line up as many child actors as possible by then. She would be allowed to tell them that the role they would be playing would involve a public appearance for a hospital, but not the details of said appearance.

Her phone calls to talent agencies that morning had been surprisingly productive. She had found out that there were potentially upwards of fifty or sixty kids that could be available on short notice. When she’d informed Mr. Hastings of that he had decided that the maximum number of kids would be limited to ten, and that he’d prefer children who were new to acting so the possible payroll of the actors could be kept as low as possible.

She asked Mary and Dave, her other two co-workers under Mr. Hastings, if they could help her cover call backs for the parade then immediately got back on the phone and started calling the talent agencies back to have them start lining up kids for the parts. She stretched her boundaries a little and informed them that the role would be a hospital scene ‘with appliances’ and would include a public appearance with local media present. When asked what ‘appliances’ meant she would tell them that was all she had been told, that final details and contracts would be made available on Thursday morning at the latest, and the contracts had to be signed no later than Friday afternoon because the part would potentially start as early as Monday.

Friday, Nov. 25^th 8pm – Hellen Amaya’s desk

“Well this has been a busy week,” Hellen stated. “And interesting. Especially this one,” she said while picking up one particular folder out of a stack of ten. Hellen reflected back on the week while semi-focusing on the name typed on the folder in her hands.

Mary and Dave had wound up handling the majority of the calls for the parade over the rest of the week since Hellen had been busy with the agencies then hiring children. For their part, the talent agencies had gotten busy contacting families or agents of child actors in the area with the initial offer they had been given. Fifteen of those contacted had turned it down right away, leaving forty-three possible actors to choose from. The legal department had done overtime and gotten the final draft of a contract done by midday on Wednesday, so Hellen had been busy all Wednesday afternoon getting copies over to the agencies and giving an over view of what they were expecting. Once the actual description of what the hospital wanted was provided the number of families started to drop out dramatically. Hellen was ready for this and had expected it, and by the end of the day was pleased to find she still had seventeen possible children to work with. She worked late that night and eliminated four more from the list after hearing the minimum salary those agents were demanding.

The next morning, Thursday, she had started with meeting all twelve children and their families all together at the hospital. They had appropriated the auditorium to accommodate the number of people who would be present as various families were also bringing their own agents and/or lawyers with them. As the organizer/director for the parade Hellen found she was required by the hospital lawyers to be present for all negotiations, and that she would also be signing all contracts in the same capacity.

It was explained in detail that the children would be playing the role of ‘patients’ for the orthopedic ward and appear as such in the coming parade because there were no actual patients available in the hospital. The fake injuries the children chose would determine what type of cast or brace they would be put in, and they would then be admitted to the hospital on the ortho ward as a patient where they would be taken care of by the doctors and nurses as actual patients until after the parade. The last day that could be used to admit a child as a patient would be Wednesday so the children would have a minimum of two days prior to the parade to get used to their casts or braces. The part of the contract detailing the fake injury had been left blank and would be left up to the child and their family to decide exactly what they wanted, how far they wanted to take it, and for how long.

After the initial meeting with everyone, one of the children decided that they didn’t want to play the part and left with their family leaving eleven actors to continue negotiations. Dr. Zimer was brought in with two other doctors after a lunch break to discuss with the group just to what extent the child could become a patient. To the surprise of everyone except the hospital doctors and lawyers, the hospital was offering to give the children any level of simulated injury they asked for short of actual amputation. Further discussion revealed that if the child wanted it, and the family agreed, then the hospital would in fact drill rods into bones and apply external traction or external fixation devices along with IV lines, feeding tubes, catheters, and even breathing tubes.

By mid-afternoon everyone had gone home with a copy of the contract in hand to discuss with their families and personal lawyers or agents if this was a role they wanted, and if so then what injury they would have. The three doctors present along with Hellen as well as the hospital lawyers would be available at any time to further discuss the offer, and it was made clear to everyone that a signed contract had to be in Hellen’s hands by no later than seven P.M. Friday evening.

Over the course of the rest of the day Hellen had several tele-conference calls and face to face meetings with potential ‘patients’ discussing the role, and at the end of the day another child had been pulled from the group dropping the number of actors to ten, her parents deciding they did not want their child to be a part of it. Three children did choose to accept the role that day, and signed contracts were given to Hellen with the chosen ‘injuries’ explained and approved by the hospitals doctors and lawyers and clearly listed in the portion of the contracts provided for that purpose. The next day the calls and meetings continued with another child also being pulled by the parents in the afternoon further reducing the number of children from the group available to nine.

More children and their families continued to accept the offered role given to them and at the end of the time limit Hellen had a total of ten children with signed contracts who would be participating in the parade as patients for the hospital. The ages of the children who would be arriving to become patients the first part of the next week ranged from as young as six years to as old as fourteen and hitting every age in between, with a mix of seven boys to three girls in the group. As a part of the discussions with each child, and before the contracts were signed in each case, it was made completely clear by the doctors exactly how much the child’s chosen injury would disable them, and how much support they would need as a result of the cast or brace they would be wearing.

One child had actually expressed an interest in having external fixation devices drilled into his bones, so Hellen brought the child and his family in to have a long and very frank discussion with Dr. Zimer and the Head of Orthopedic Surgery about what that would fully entail and the pain and risks he would endure if he chose to have it done. By the end of the discussion the child had changed his mind and settled on something involving less pain and no cutting or drilling.

There had been just one exception to the crowd of actors, parents, lawyers and agents which filled in their tenth slot. The folder for the child Hellen was holding in her hand, David Williamson. Early Monday evening she had gotten a call from a talent agent informing her that he had a child who wanted to bend the rules some and talk to her immediately about details. When Hellen tried to tell the agent that they would have to wait he told her that this particular child’s family had some pull in the city and was being quite insistent. Hellen had agreed to meet with the child that evening and the agent said she should have legal and medical representatives with her for the meeting.

Hellen was able to get one of the hospital lawyers and Dr. Lawson Copely from orthopedic surgery to come and meet with the child. When David arrived he showed up not with his parents, but with two of his family lawyers instead. The discussion that took place that night lasted for about three hours, and was focused on the fact that David was unhappy with his parents and wanted to try and use this unique opportunity to run what basically amounted to an intervention on his parents. David’s parent’s were both very successful and extremely devoted to their jobs, working long hours on a daily basis seven days a week. This had the effect of neglecting their personal relationships with each-other and, more importantly, with David. They had not taken a vacation as a family in over five years and their last one had been cut short after just one day due to an ‘emergency’ at work that just had to be dealt with at the expense of the vacation.

Over the years David had tried to get their attention with extra-curricular activities and exemplary grades in school, but they never showed up at games or events and his good grades were looked upon as expected and otherwise ignored. So he went the other direction for a time and acted out frequently in an attempt to get their attention, but all that ever happened was one of the family lawyers being sent in their stead to deal with the situation and basically blank signing any legal documents that required their direct signatures. David’s latest attempt to get their attention was to try professional acting, which was working about as well as all of his other attempts, good or bad, and which had brought him to this point.

David’s idea was to have his parents kidnapped legally and forced into family counseling using the parade and hospital as the initial means to ‘get their attention’. David loved his parents, and was sure they loved him, but they were too focused on their jobs to really listen to him or be a family. He wanted to work out a plan that would be legal between his lawyers and the hospital lawyers to get his parents, and himself, into a situation where they could not just get up and walk out and would be forced to stop and listen. The two lawyers who were with him currently had access to both of his parent’s companies and could make appropriate arrangements for an extended absence away from their respective companies so that David’s family could go through a period of un-interrupted counseling together with the counselor that David had been seeing for the past two years.

The story had pulled at Hellen’s heart, and she had done what little she could to get the hospital staff to sit and talk about what could be done and get the lawyers from both sides to start working out any legal necessities to make it happen. David’s arrangement, due to the added legal wrangling involved, could not be finished in the same time the rest of the contracts had been completed. It took until late Friday afternoon for everything David wanted to fall into place and get all the needed documents in place and signed. As David had indicated, when any documents were presented to his parent’s by their lawyers they simply signed them without even looking at them. When the papers were brought to Hellen to be signed as the hospital’s representative, David’s lawyers had tried to make her aware of certain clauses they had found in the agreement but Hellen waved them off saying that she had talked to the hospital’s lawyers about the clauses which were present in all of the contracts. She had agreed to the others already and was sure that there was nothing different in David’s contract from the rest of them.

Monday, Nov. 28^th 8am – Hellen Amaya’s desk

Hellen had been at her desk for two hours trying to get caught up with what she had missed last week, due to all the meetings she had been required to attend, when the phone on her desk rang.

“Hello?” she answered.

“Hellen,” said Mr. Hastings, “What are you doing at your desk? You’re supposed to be down stairs with the first two kids in ortho this morning.”

“I’m trying to finish up my tasks for the parade Mr. Hastings. What do they need me for, I thought my part was done?”

Figuring that using the children as an explanation would get her attention Mr. Hastings explained. “They need you there to help the kids through the procedures; you’ll help be a calming influence for the children. It’s all part of the contracts. They’ll need you all this week, so just leave everything that’s related to the parade on your desk and I’ll have Mary and Dave take care of it all and they can bring to me anything they can’t handle. Hurry up and get downstairs right away, they’re waiting for you in procedure room five. They’ll explain it when you get there.”

“Yes sir, right away.” Hellen quickly pulled out and went over everything she knew needed to be handled, made several notes which she left on top of the pile, and in about ten minutes was on her way down.

Monday, Nov. 28^th 8:15am – procedure room five

When Hellen arrived on the first floor she found one of the hospital lawyers she had been working with, Harold, waiting for her. He led her into the room where a nervous looking young boy, his mother, and several of the medical staff were all talking.

“Here we are Hellen has arrived. Hellen, this is Steven. His chosen injuries require the most work to be done to fabricate the extensive braces he will be wearing for us. Now that he is here he’s feeling a bit nervous about what is going to happen to him. That is where your part comes in Hellen. As stated in the contract you will be going through the same procedure he will as an example that it is safe and will be ok for him. That way he can see an adult having the same thing done to them, in this case you, that the doctors will be doing to him, and that there is no harm in it.”

Hellen looked surprised for a moment and looked at Harold, “I am?”

“Yes Hellen, you are. It’s all a part of the contracts that we went over with you and you signed. It’s to help the children feel better about what we do with them for their part in this.”

“Yes, of course. I’ve just been so busy I forgot,” Hellen said, realizing that she had failed to read the contracts but still agreeing with wanting to do what she could to help ease the children’s minds. Seeing Hellen was working with them, Harold left to attend to other matters.

“What do you think about that Steven? Would seeing me go through the same thing you do make you feel better?”

“Yes Ma’am.”

Hellen smiled warmly at Steven, “Please, call me Hellen, we’re all friends here and want you to be happy with this. Ok?”

“Ok. Do you get to do it first so I can watch?”

“Well, let’s ask the doctors here. Do we have enough time for me to go first and still get things done?”

“Sure Hellen, we can do that. Lauren, the other child needing braces fabricated, will be showing up in an hour or so, so she can sit and watch too until we’re ready for her. Steven here had to come in early as his braces are more extensive.”

Hellen was handed an armful of cloth and told to get completely undressed and to put on the garment she was given. She went behind the curtain and a few minutes later came out wearing what appeared to be a leotard that covered her torso and her crotch. Next she was directed over to a standing frame where the first part of the mold would be made over her torso. A long tube of cloth called stockinette was pulled over her head and down her body so it covered her from her neck to mid-thigh with holes to put her arms through. She then stood in the middle of the frame and a harness was placed under her chin and around the back of her head that was attached to a cable going up over the top of the frame. Her feet were strapped into boots that were attached to the bottom of the frame then the harness around her head was slowly pulled up with a ratchet winch until Hellen was stretched out as tall as she could go. The doctors had her hold onto a couple of handles to the sides and above her head and strapped them in place. After giving her several minutes to relax and let her body adjust they asked her how she was doing.

“I’m ok,” she said. “It’s tight but not bad at all. Think you can do this Steven?”

“It doesn’t hurt at all?” Steven asked.

“Not one bit. In fact it’s kinda nice to be stretched out nice and tall.”

After being reassured that it was ok, Steven got changed into a pair of what looked like short speedo swim trunks and let the doctors put him into a second standing frame that had been positioned where he could see Hellen.

While Steven was being hooked up to his frame and stretched, some of the doctors began marking on Hellen’s stockinette with grease pencils while a nurse started dunking rolls of plaster in water. The marks were made around the bottom of her ribs and over the tops and down the sides of her hips. Once the marks were all done they began tightly wrapping the plaster around Hellen.

“Um, guys, I thought I was just an example to get the kids started here,” she said quietly so Steven would not hear. “What’s going on?”

“Oh no, you’re getting the full deal here. By the time we’re done you’ll have your very own set of braces just like Steven is going to get. That way he can see how it looks on someone else when he has to wear them.”

“Oh. I see. Well I guess I can’t stop you the way I’m all trussed up here.”

“Nope, we’ve got you right where we want you now,” joked the doctor.

The plaster was wrapped from just below the shoulders all the way down to the tops of her legs and back up then back down again, encasing her in three layers of plaster. Once they were done smoothing out the plaster and making sure it was well molded the extra stockinette at the top and bottom was cut away. By this point Steven was in the process of having the first layer of plaster wrapped around the top of his legs just before going up again. They were told that they would have to stay in the frames for half an hour while the plaster dried hard enough to be cut off.

While they waited for the plaster to dry, Hellen talked to Steven about how he felt and what he had decided on for his fake injuries. She remembered that Steven had been the nine year old boy who wanted to have rods drilled into his bones for external fixation and commented on it.

“Steven has always been the one to try and out-do other kids,” his mother said. “I’m glad you made him sit down and really talk to the doctors about what that would be like, I don’t think he would have liked what it would be like if he had gone for that. As it is he still made some choices I’m not sure he’s going to like when they come up.”

Steven agreed that after talking to the doctors he had changed his mind, but still came up with something that would be the biggest brace in the group.

“So, doctor, what are Steven’s injuries here? And just how big a brace will he be getting?”

“Let’s see, the chart here says that Steven has suffered multiple injuries to his lower body. His hips knees and ankles have all been traumatically dislocated, which has also caused tearing and rupturing of many of the tendons and ligaments that normally hold those joints together. There also appears to be some soft tissue and organ damage to the lower abdomen causing some incontinence. For injuries of this type it would require surgical intervention to re-align the joints and sew together the soft tissues followed by a time of extensive brace support from the waist down.”

“My goodness Steven, you really did a number on yourself there. Are you sure you can handle all of that?”

“Sure I can.” By this point, with Hellen and the doctors all trying to make the process fun, Steven had gotten his confidence back and was enjoying what was happening. “It’ll be easy, even the yucky parts.”

Hellen was released from her frame and the cast-mold cut off her body, and shortly afterwards Steven was free from his. They were directed to get up on a pair of exam tables in the room so the cast-molds could be made of their legs when Harold came back to the group with seven year old Lauren and her mother. Lauren was invited to sit and watch as the doctors worked on Hellen and Steven, then it would be her turn.

Lengths of stockinette were pulled up Hellen and Steven’s legs at the same time that went over the toes to the top of their legs. More marks were made with grease pencils over the bony parts then wet plaster was wrapped around from top to bottom two times, completely covering everything including their toes.

While everyone waited for the new plaster to dry some, Lauren decided she was ready to get started too. Hellen realized with the way everything was being made to be fun, and Steven made out to be ‘special’, that Lauren wanted to get involved and be special too. She told the doctors to get Lauren started if she was ready, so they pulled up a stool next to Hellen and had Lauren take off her shirt and sit down. The doctors quickly got Lauren involved and soon were doing the same process of casting Lauren and Hellen together like she has seen done with Steven, except with their arms instead of their legs.

As the stockinette was pulled up their arms Hellen asked what had happened to Lauren that she would need braces.

“Oh, Lauren didn’t want full time casts and can’t stand to have her legs restrained at all,” her mom said. “So we talked about it and decided that she could get braces on her arms instead since they could be taken off a little bit to wash.”

Lauren was a quiet shy girl, but Hellen got her to talk and found out that she decided that she fell and her arms got twisted up. The doctors informed them that Lauren had suffered torn tendons and ligaments in her arms and wrists which would need time to rest in braces after surgery. By this time both had their arms wrapped in plaster from their shoulders to their finger tips and were waiting for the plaster to dry.

Hellen, having both arms and legs in hardening plaster, jokingly complained that she was helpless and the kids would have to help her do everything now and waved her arms around in the air. That got the kids to laughing and making fun of her until it was time for the cast-molds to be cut off. While waiting for the plaster to dry the doctors asked both children if they wanted a specific color or printed design on their braces and showed them examples to pick from. Since the arm casts had used less plaster they were ready to be cut off at about the same time as the leg casts, and Lauren wanted to get out of them already. Steven said it was ok, so they carefully cut off Lauren and Hellen’s arm-cast molds first then told Lauren to hold her arms still.

“How come?” asked Lauren.

Realizing that the doctors were getting into the roll of treating the kids as actual patients Hellen answered. “Well, your braces won’t be ready for a while and your arms are injured, so they don’t want you to move them around.” Seeing a doctor nod off to one side she continued, “That means they are going to wrap them in temporary splints until the braces are ready for you to wear.”

“Oh.” Seeing the casts that came off Hellen, Lauren asked, “Does that mean you can’t move your arms either?”

Getting another nod from the doctor Hellen said, “I guess it does.”

“Do you want to see where the scars would be if we had to do surgery on your arms?” a nurse asked while holding up a marker.

“Nuh-uh.”

“Ok sweetie, we don’t have to.”

“I do!”

The nurse looked over at Steven, “Ok champ. When we get to you I’ll make sure to show you.” Steven grinned, happy to hear that.

Getting shy again Lauren waited and watched while the doctors wrapped a couple layers of thick bandages around Hellen’s arms and hands, then brought over long wet plaster splints and formed them along Hellen’s arms then wrapped more bandages on to hold them in place and finally wrapped elastic bandages tightly over top. By the time they were done Hellen’s arm were three times as thick as normal and covered from her shoulders to her finger tips so she couldn’t move her elbows or wriggle her fingers. Once Hellen assured Lauren that her arms were in nice soft bandages and felt snug and warm, Lauren let the doctors do the same thing to her arms. Once they were done a wheelchair was brought in and Lauren got to ride in it up to her bed on the orthopedic ward.

By this time Steven was quite excited and nearly bouncing off the table for it to be his turn. They quickly got his cast-molds cut off, then the nurse came over with a red marker pen and started drawing fake scars on Steven. While Hellen got her leg-cast molds cut off the nurse made scars on both sides of Steven’s ankles, and both sides of his knees.

“Now, for the next scars, and the next part of your treatment, we’ll have to take off your pants. Is that ok? We’re all doctors and nurses here, so there’s nothing to be embarrassed about.”

Steven had no qualms about taking off his pants he was so excited, so the nurse cut them off and she drew long scars down the sides of both hips, and a big curved one on his lower abdomen.

“Do Hellen and I get a big splint now too?” Steven asked.

“You sure do, but it will be a bit different than what Lauren got. Since you have more injuries we need something a bit bigger for you.”

Hellen sighed, knowing she was going to have to undress too.

The nurse looked over to her, “Don’t worry, we’ve got you covered here.”

A curtain was pulled closed around Hellen’s table so she could be undressed, then a sport bra was put on over her breasts and a pad was taped on to cover her privates with. Once the curtain was opened up again the doctors had brought over the splints that they would be putting the two of them in. Because Hellen was so small, she was only a little bit taller than Steven, the splints being used for both of them were the same size.

The splints were made of metal and one solid piece from top to bottom. They were shaped like the lower back half of a person and would go along the back from the ribs, down the back of the legs, and finally along the bottom of the feet, and were curved to fit on the torso and legs with the legs spread out at about a thirty degree angle and had an opening for the buttocks. They also had a layer of blue sponge-like foam in them where the body would lay in.

The exam tables the two of them were sitting on had been positioned with the back raised so they could sit up. Now the tables were laid flat, and the same type of soft thick bandages used on Lauren’s arms were wrapped around Hellen and Steven from the waist all the way down to their toes using three layers of bandages. Then, they were laid in the splints and two layers of elastic bandages were used to secure them in place.

Hellen tried to sit up or wiggle her legs and found that with the rigid splints and layers of elastic bandages secured around her she could do neither, but was not uncomfortable due to the layers of soft bandages being compressed under the elastic ones. She tested her arms and found the plaster had hardened enough to be solid as well. She was not thrilled to find herself in this situation, while on the other hand Steven was happily testing his restraints and finding himself in a similar situation minus the arm splints.

Two flat gurneys were rolled in and brought up next to each of the ‘new patients’. When Hellen asked why there was one for her she was reminded that she was to undergo the same procedures as the children, and they were not done with all of Steven’s yet so she would be going along up to the ward where they would finish up. The two of them were carefully transferred over onto the gurneys, then they were covered with a blanket from the armpits to the ankles and wheeled on out. Once they arrived in the ward they were each taken to a bed and transferred over. Lauren was there alone, her mother having left Lauren in the care of the floor nurses, and she looked at the two of them in curiosity.

After being transferred into bed, the curtains were pulled closed around Hellen and Steven. A minute later Hellen could hear a nurse talking to Steven.

“Ok Steven, time for the next part. Your chart says you have some damaged internal organs that had to be operated on. One of them was a ruptured bladder, which is what holds your pee until you normally have to go. Because it was hurt and had to be fixed, we have to remove all pressure from it until it heals. That means we have to insert a catheter into it to keep it empty.”

“What’s a catheter?” Steven asked. Hellen knew and dreaded the answer, knowing she was probably going to get one too.

“A catheter is a rubber tube that is pushed up inside your penis all the way to your bladder. A balloon on the end of it is inflated with water inside the bladder to keep it from coming out again. Once it’s in place your pee will drain out through the tube without you having to go to the bathroom and gets collected in a special bag or bottle.”

“Oh, ok. Is Hellen going to get one to?”

“Yes she is.”

“Can I watch her go first?”

“Not this time sweetie. That’s a private part of a woman’s body, so you can’t watch I’m afraid.”

“Oh. Is it going to hurt?”

“Well, not really. I’ll use plenty of lubricant so it will go in easy, but it is going to feel strange. Once it’s in place you’ll get used to it and in no time you won’t hardly notice it, I promise.”

“oh.”

A nurse walked into Hellen’s bedside with a bundle in her hands. “Do I really have to?” Hellen asked quietly.

“Yep, sure do,” was the answer.

“Are you ready?” Hellen heard the nurse ask Steven.

“Hellen? Are you getting a catheter too?” Steven called out.

“Yes Steven, the nurse is here to give me one too.”

“Can you go first, then tell me if it hurt?”

“Yes Steven, I can do that for you.” Hellen looked at the nurse standing beside her and nodded with a little sigh. Hellen was able to remain quiet during the insertion so as to not upset Steven, and a few minutes later she told him it was over and did not hurt but like the nurse had said felt really weird.

“Ok, I’m ready, I guess.” Steven said. For his part Steven did not scream and only cried a little bit when the nurse put his in.

“Hey! I don’t want a diaper on me!” Steven yelled.

“But Steven, it’s procedure for patients who can’t get up or move and have had surgery like you have.”

“NO! I’m not a baby!”

Seeing a tantrum in the making Hellen looked at the nurse beside her, “Quick, put one on me,” she whispered. While the nurse hurried to get one on, Hellen called out to Steven.

“Hey, Steven. I know it looks like a diaper, but it’s special.”

“Really?”

“Yep. It’s special for people like you and me. Since we can’t move around and we can’t go to the bathroom normally we need to wear it to keep from having accidents in bed. You don’t want to have an accident and mess in your bed do you?”

“Noooo.”

“Look I have mine on already.”

Looking down Hellen made sure the nurse was done putting her diaper on then nodded to the nurse who proceeded to pull the curtain back. The nurse taking care of Steven pulled his curtain back too so he could see that Hellen really was wearing a diaper. Once she was done getting one on Steven and made sure he was ok, the nurse came over to Hellen and gave her a big hug.

“Thank you,” she whispered in Hellen’s ear. “You being here and doing this for the kids is such a big help, and I think it’s absolutely wonderful of you and so do all the other nurses.”

Monday, Nov. 28^th 12 noon – orthopedic ward

A couple of doctors entered the floor at the same time the orderlies brought up lunch for everyone. As the food was passed out the doctors checked all of the splints to make sure none were too tight and all fingers and toes had good circulation. While the doctor was checking Hellen’s fingers and toes he told her that they would come to take her down to procedure soon so she could be there for the kids who would be coming in that afternoon. They told everyone that the arm braces should be ready some time tomorrow morning, and the bigger HKAFO braces would be ready late in the afternoon. Steven wanted to know what HKAFO meant, so the doctor explained that it stood for Hip Knee Ankle Foot Orthotic which described what parts of the body it would support.

Two nurses came in so they could feed both Lauren and Hellen who couldn’t use their arms with all the bandages on them. Steven had settled down quickly and was eating his lunch with gusto. When a nurse had him take several pills she brought in for both him and Hellen, he wanted to know what they were for.

“Why do I have to take pills?”

“These are for the other part of your treatment honey. Remember what the doctors told you would happen if you decided to have the surgery on your belly?”

“You mean the yucky part?”

“Yep, the yucky part. These pills will make that happen like you agreed to.”

“Ok, I guess I can take them then.”

“Good boy. Now, once these pills take effect you need to remember to get a nurse to come help you right away when you need to go. If you don’t, then you’ll have an accident. Can you do that?”

“Uh-huh.”

“Ok. Just press this button here when you need one of us and someone will come right over.”

Hellen only partially listened to the conversation with Steven and didn’t give it her full attention as Steven did not sound upset and she was still being fed her own lunch that she was concentrating on. Lauren on the other hand got upset and started crying, saying that she wanted the bandages off her arms which got Hellen’s full attention. Once again Hellen quickly intervened and got Lauren’s attention.

“Lauren, sweetie. What’s the matter? Why don’t you come over here and sit next to me. Would you do that for me?”

Lauren quickly got out of bed and ran over and crawled up into Hellen’s bed with help from the nurse feeding Hellen.

“What’s wrong honey?” Hellen asked.

“I can’t do ANYTHING for my self,” Lauren cried. “I wanna eat my food myself, not have her feed me.”

“Lauren, your arms have been hurt, remember? Mine too. See, I have someone to feed me my food too.”

“Well, yea. But I don’t like it. I can’t do ANYTHING.”

“That’s not true Lauren. Sure, you can’t use your arms or hands. But think about this. You got out of bed and walked on your own over here to me. Look at Steven over there, he can’t get out of bed. In fact he can’t even move his legs right now. Steven can’t move and has to stay in bed. You can get up and walk around and go over to the play area any time you want. That’s better than Steven, right?”

Lauren gave a small nod at this.

“And look at me. I can’t use my arms or hands just like you. And just like Steven I can’t move my legs or get out of bed either. So I have even more reason to cry. But you don’t see Steven or me crying do you?”

“Nuh-uh,” she said with a little sniffle.

“And the doctor said your arm braces will be ready tomorrow morning, so they can take off all the bandages then. You can be a big girl and make it ‘til tomorrow morning can’t you?”

Lauren nodded a couple times at this.

“Good. Now, would you like to finish your lunch over here with me?”

“Yea.”

The nurse who had been feeding Lauren brought over the rest of her lunch and the two of them finished eating, with Lauren snuggling up next to Hellen as best as she could. A short while later a couple of orderlies came up with a gurney to take Hellen back down to the procedure room and Lauren went back over to her bed.

Monday, Nov. 28^th 12:50pm – procedure room five

Hellen was wheeled into procedure room five to find just one person there waiting for her, one of the hospital cast techs. Hoping that she would soon be free of her multitude of splints she asked how fast he could unwrap the bandages. He grinned and took hold of her right arm and started unwinding the layers of elastic and gauze bandages with little regard for neatness. In a matter of just a couple minutes her arm was free and bare again.

“How’s that for fast?”

“Pretty good. Here, keep going with the other one,” Hellen said, holding up her left arm.

“Sorry, you just get the one arm free, and only until the next kid gets here.”

“Oh come on. Nothing else? No legs?”

“Nope. Not right now. We’ll change the legs some though when Mike gets here.”

“Can’t you at least remove the catheter?”

“Sorry, no can do right now. The next kid is due any minute.”

Hellen closed her eyes and sighed in frustration. “Damn. Fine. Then at least tell me who the next kid is and what he or she is in for.”

“That, I can do. Let’s see here, the chart says we’ve got Emily coming in. She’s six years old and it would seem she has suffered a crushing injury to her dominant arm affecting the hand wrist and forearm. Not an unusual injury, see it from time to time with families that have an older sibling. The younger one winds up getting their arm slammed in the door to the van, or something similar, by the older one. Usually an accident because someone wasn’t paying attention. Going to require a cast from the armpit down to the fingertips of all five fingers on this one.”

A few minutes later Harold escorted in Emily along with her mother and an older brother and another cast tech followed them in.

“Hi Emily,” the first cast tech said. “You ready to get that broken arm in a cast?”

“Yes,” she said and held out her right arm.

The tech laughed and had her climb up on the exam table. While he pulled a length of stockinette up her arm the other tech got started doing the same thing with Hellen.

“Do you remember Hellen here? She is the one who hired you for the part you’re playing.”

Hellen smiled and waved her right arm which had the stockinette on it.

“Uh-huh.” Then Emily got a curious expression on her face. “How come she’s lying in bed and has her other arm all wrapped up?”

The two techs continued to work as they answered, wrapping cast padding around Emily and Hellen’s arms starting from the top and working down.

“Do you see how Hellen is getting a cast just like you are?”

“Yea.”

“She’s doing that to make you feel better about getting one. Don’t you think that’s nice of her?”

“Yea. She’s a nice lady.”

The techs continued to wrap padding up and down creating two layers of padding on the arm, holding the elbow at a ninety degree angle and making sure it was well padded.

“Yes she is. Well Hellen is such a nice lady, that she is doing the same thing with all the other kids who will be acting parts along with you. And there are two other kids upstairs already who have bandages on for their parts, so Hellen already has the same kind of bandages on that they got.”

“Oh. Ok.”

When the techs got to bandaging the hand, they switched to smaller rolls and began wrapping each finger individually in a layer of padding. Once all five fingers were covered they wrapped the fingers all together but left the thumb free and covered it in a second layer. A final layer of padding was wrapped from top to bottom.

“There. That’s the soft part done. Now to do the wet messy part,” and the tech poked Emily in the ribs which got a giggle.

Plaster bandages were soaked in water then following the same pattern starting from the top they began to wrap Hellen and Emily’s right arm. The bandages were pulled firmly to get a good mold of the arm, but not so tight as to cause a problem with circulation. Smaller bandages were used to wrap the hand with the thumb remaining separate and the four fingers held tightly together. Several bandages were used and when the techs were done both had a solid plaster cast that held the elbow at a ninety degree angle, the wrist was bent outward at about fifteen degrees, and the fingers and thumb were curved like they were holding onto a ball or juice can.

“There, all done,” the tech said as he placed Emily’s casted arm on a pillow on her lap. “How’s that feel?”

“It’s warm.”

“Yep, it should be. That means the plaster is getting hard like it’s supposed to. Does it pinch or hurt anywhere inside?”

Emily waved her arm around. “Nope.”

“Good. Now don’t go around banging it on anything or squeezing it or sitting on it. The cast still has to dry out, and until it does you could break it. Got it?”

Emily nodded and stared at her arm that was now covered in a dingy white cast. Hellen tested the cast on her own arm and found that it was more restrictive than the splint she had been wearing. Where the splint had given her some room to wiggle this cast did not. The inside was soft against her skin, but the plaster bandages conformed to the shape of her arm so closely that it felt like there was no wiggle room at all. She could feel the cast firmly pressing around the entire arm and could not move her elbow, wrist, thumb, or fingers at all. The tech had done a good job while molding the cast to make sure it was a good tight cast.

“Don’t worry,” the tech said to Emily’s mother, “the nurses upstairs will keep an eye on her.”

A nurse was called in and he took Emily and her family on up to her bed and to meet the other two kids upstairs.

While Hellen and the techs waited for the next child to show up for a cast, they made changes to Hellen’s big splint to get her ready. First the splint was completely removed but to Hellen’s disappointment the catheter was not. A brief discussion was had about how to keep the right leg and her lower torso immobilized while still allowing the techs to put a cast on the left leg. It was decided that they could use a long leg splint similar to the larger splint she had been in, and use a rigid plastic TLSO brace for her back that would go from her waist to her sternum. It would leave her hips free, but was the best solution given the circumstances. Hellen was glad to hear that it would not be needed for very long anyways.

The back brace and leg splint were quickly acquired, and the brace was strapped on in no time. Hellen tried to sit up and found that the brace would not allow her to bend her back hardly at all and restricted her a good deal more than the splint which had only come up to her ribs. The techs did raise the head of the gurney she was on so she was sitting up at a forty-five degree angle and could look around a bit easier. While they were finishing up wrapping the final layer of elastic bandages around the new splint on Hellen’s right leg Harold walked in with Michael and his father. The techs finished up and quickly placed a blanket over Hellen’s body and leg to cover the splint and catheter bag while leaving her left leg exposed and elevated on some pillows.

Michael was eight years old and eager to get his cast. He told everyone how he was a runner, to which his dad gave confirmation, and he had decided that his injury would be directly related to his favorite activity and that he would have a ruptured achilles tendon. When he was asked how he had decided on this, he told them that his running coach had told the team all about his achilles injury when he was younger and made sure that everyone stretched and warmed up properly so they would not have the same thing happen to them.

Michael stripped off his shoes and pants then hopped right up on the table without even being asked and waited for the tech to get started. As the lead tech got the stockinette pulled on he asked Michael if he had ever had a cast before and Michael had not, but had apparently grilled his running coach about his so he knew the cast would cover his entire leg and hold his foot pointed straight. The tech was impressed and went into more detail explaining about the different parts of the cast such as what the stockinette was for, why the padding went on just so and why more padding was used over the bony parts to keep the hard cast from putting too much pressure on them which could cause sores. He taught Michael that plaster was better initially because it could be formed better to the shape of the leg, and explained that the foot had to be pointed straight down so the tendon was fully relaxed while it healed and the knee would be held at a ninety degree angle so the foot could not be put down on the ground which would keep him from putting any pressure on the achilles tendon.

Hellen listened to the lesson while the techs were working on putting matching casts on Michael and her, and before long they both had their left leg encased in a drying cast and resting on several pillows. A wheelchair was brought in for Michael to take him up to the ward, but he was told he would be getting crutches to use first thing in the morning so he could get used to walking on them in time for the parade. Hellen was wheeled back up to the ward on her gurney and transferred back into the same bed she had been in earlier.

Monday, Nov. 28^th 2:35pm – orthopedic ward

The kids already present welcomed Michael to the floor, and he soon got them talking about their various injuries and how they had gotten them. The parents in the room, seeing that the kids were getting along, decided to go to the lounge and talk amongst themselves for a while. Lauren was still moping on her bed, but when she saw Hellen come back with her two new casts she got up and walked over to Hellen’s bed.

“How come you have casts now?”

“Same thing that’s been happening to me all day sweetie. See Michael and Emily over there? Look at their casts and then the new ones I have. Do they look the same?”

Lauren looked back and forth a few times then said, “Uh-huh, they do.”

“Right. It’s the same thing I did with you. I got the same injury they did, so I have to have the same cast as they do.”

“Oh. So, you’re gonna be an actor too? Are you going to be in the parade with us?”

“I guess I am being an actor, aren’t I? But I don’t think I will get to be in the parade, that’s just for you kids.”

“Oh. How are you going to try on your braces with me tomorrow if you have a cast on your arm?”

“That’s a good question Lauren. I’m sure the doctors have thought about it and will have something figured out.”

After their talk Lauren seemed to have a better attitude and joined in with the other kids around Steven’s bed. A short while later Hellen noticed that Steven was getting quiet and grumpy and fidgety all at the same time. The other kids seemed to notice and wandered over to the little play area on the floor leaving Steven and Hellen alone in their beds. A few minutes later Steven started quietly crying.

“Steven? Are you ok? What’s the matter?” After a minute of no response Hellen tried again.

“Steven, please answer me. If you don’t tell me then we can’t make it better. Does something hurt?”

“No.”

“Well what’s wrong?”

“I pooped,” Steven said quietly.

“You pooped in your diaper? Is that it?”

“Uh-huh.”

“Steven, that’s why you have the diaper on. Remember? In case of accidents.”

“But I couldn’t stop it,” he whispered.

“You couldn’t? Tell me what happened.”

“I started to feel like I had to go potty so I tried to hold it until a nurse could help me like they said and I couldn’t. It just came out.”

“Has this ever happened before Steven?”

“No.”

“Did you press the button like the nurse told you?”

“No. I forgot.”

“Well press it now. We’ll get a nurse in here to help you.”

A nurse arrived in just a couple minutes to see what was going on. Seeing Steven with tears on his face she turned to Hellen.

“Hellen, what’s wrong? What’s going on?”

“Apparently Steven started to feel like he needed to have a BM but he forgot to press the call button. He tried hold it until a nurse could come in and help him but it just let loose anyways, he had no control over it at all, and now he has poopy drawers.”

The nurse turned to Steven and quickly hugged him. “Oh honey, don’t cry. It’s OK. This is going to happen. Remember, this is the yucky part. With your injuries you won’t have control over your BM or your bladder. It’s expected. That’s why you have the diaper and the catheter. You just need to remember to press the button to call a nurse when you feel a need to go. We’ll get you cleaned up here in no time.”

The nurse left for a couple of minutes and returned with a bowl of warm water, a washcloth, a large under pad, and a new diaper. She pulled the curtain around Steven’s bed and took care of his ‘accident’. After getting him cleaned up and taking away the dirty parts, she stayed and sat with Steven and talked to him to try and make him feel better.

As Hellen sat in her bed and listened to the nurse talking with Steven, she wondered about his reaction and how he had said that it had never happened before, yet the nurse was sitting there and telling him that the injuries he had were going to cause this problem to occur for a while until he healed up. Injuries which were not real so should not be causing any problems for Steven. Hellen looked down to see her own diaper and the drainage tube connected to her own catheter, just like Steven had. As she contemplated what was going on, she noticed that she was feeling uncomfortable herself, like she was going to need to have a bowel movement soon. She tried to ignore it, but in just a few minutes the feeling had intensified to where she was actively trying to suppress it and she was not sure if she was going to be able to do so. Then Hellen remembered the pills Steven had been given at lunch time and the explanation the nurse had given Steven when he asked why he had to take them. Pills she had been given for her lunch as well. Right as Hellen realized what was going on her bowels let loose of their own accord and she had an uncontrolled bowel movement of her own.

Ashamed and upset for having lost control of herself, but believing she knew why it had happened, Hellen quietly called to the nurse until she got her attention.

“I’m afraid that I’ve had an accident over here as well,” Hellen quietly told the nurse without looking up.

Hellen waited until the nurse had returned with the necessary supplies to change and clean her up and pulled the curtain closed before she quietly questioned her.

“Steven and I are being given laxatives, aren’t we?”

“More or less. You’re actually getting two medications. One is a stool softener and the other is a relaxant to make bowel movements easier. A known side effect of the two particular medicines when combined is they have the effect of causing uncontrolled bowel movements in the majority of patients. So essentially you are correct.”

“Don’t you think that’s taking this role-play a bit far? Look how it upset Steven. And to be honest I’m more than a little upset about it myself.”

“We’re all aware the kids on this floor are being paid as actors to portray a role. And we have all been instructed that the treatments prescribed and ordered by the doctors are based on the agreements made and signed in each child’s contract with the understanding of the child and their parents or guardians, and those orders have been carefully thought out and are to be strictly adhered to. I know Steven got a little upset, but we are to treat the kids as much like real patients as possible, so I did exactly that and got him to understand what happened. As far as the medications go, it’s only for while he’s here. The initial reaction is fairly quick, as you both have found out, but the full effect of it does not set in until twenty-four hours of repeated ingestion have gone by. After that, once the drugs stop being administered the effect usually goes away in forty-eight to seventy-two hours.”

“So if the medicines are stopped now it will clear up quicker?”

“Probably in about twelve hours. But that’s not going to happen with the current treatment plan. And no, I won’t change it. I’m sorry. It’s not worth losing my job to go against a doctor’s orders for this.”

“I see. In that case could you let Dr. Zimer know that I would like to see him please?”

“I’ll make sure to do so as soon as I’m done here. Promise. Oh, and you have one more kid coming in later this afternoon. Thought you’d like to know.”

“Thank you.”

The nurse had continued to clean up Hellen’s accident while they talked and was done a few minutes later, leaving Hellen with a fresh diaper and a large absorbent pad underneath her to help protect the bed linens.

Monday, Nov. 28^th 3:30pm – orthopedic ward

Dr. Zimer walked into the orthopedic ward and came up to the bed Hellen was lying in.

“I understand that you want to see me Fräulein?”

“Yes Doctor, I do. There are a couple of things that I feel need to be discussed here. Would it be possible to move to a more private area so that young ears do not have to over hear us?”

“Hmm, I suppose that something could be arranged.”

Dr. Zimer looked around the ward for a minute then called in a couple of orderlies to assist him. They shifted a couple of beds around and pulled one out of the way then moved the bed Hellen was in across the room to the space that had been made in the corner and moved the empty bed to where Hellen had been next to Steven. Once she had been moved Dr. Zimer pulled the curtain closed around them so they could talk.

“Very well, Fräulein, will this be sufficient?”

“Yes. Thank you Doctor.

“The first thing I would like to address is a question Lauren asked me earlier. She noticed that I have a cast on one arm now instead of bandages like her, and she wanted to know how I would be able to try on my new arm braces along with her tomorrow morning. I’m assuming that will not be a problem, will it?”

“Hm. It should not be a problem, but I will check on progress downstairs to make sure.”

“The next thing is the current treatment plans for the children, specifically Steven. These kids are here to be actors, just playing a role. Yes, we intend to put them into various casts and a few braces, all of which they decided upon and is in their contracts. But just how real do we intend to make their various injuries?

“Steven’s fake injuries apparently include soft tissue and some organ damage to his lower abdomen. From what I have gathered, had the injuries been real he would have experienced loss of control of both his bladder and bowels to some degree. When it came time to have his catheter inserted I thought it was a bit much, but went along with it as he seemed to be aware it would happen and had agreed to it. But just a short bit ago he experienced an uncontrolled BM which upset him and one of the nurses had to clean him.

“Afterwards I found out that, per doctors orders, he is being given a combination of drugs that are in effect causing the actual loss of bowel control. Is that really necessary? He’s only nine years old after all, and something like pooping in a diaper can be very upsetting to a child of that age.”

Dr. Zimer looked out around the curtain for a moment then turned back to Hellen.

“Ah, yes. I recall young Steven. If I recall correctly, he is the child whom you personally called in for a long talk with myself and another doctor. The one who you wished to dissuade from a more invasive treatment. Yes?”

“Well, yes, he is. And you did just that, which I think was for the best. But why the drugs? Do we need to take the level of realism that far here?”

“Fräulein Amaya, you were present at that very meeting with young Steven. Did you not listen to what was said, and what all was explained to him during those hours?”

“Well, no, not exactly. When the talk got into the technical details of what various injuries would mean I’m afraid I did kinda tune it out.”

“Hmpf. As I thought. And I suppose you did the same thing with each of the other children you were hiring as well.”

“Um, yea, I did. I’m not a doctor and let the professionals, you since you were there every time, handle that part.”

“I see. Had you listened like you should have you would have heard just how detailed we got with each of your actors to determine how far they were willing to go in the role they would be expected to play. I and the other doctors present made quite clear just how each child would be affected and what would happen with their treatments while they portray as our patients here at the hospital. We made certain that to the best of their ability the child understood what that meant, and the parents were made very clear on what was going to happen so they could help to educate the child on their choices.

“The children and their parents have all agreed and signed off on their individual treatments. The course that has been set will not be changed at this point. We did expect some of the younger ones to not fully understand, and the staff has all been instructed on how they should handle the situations when they arise. Which, from the reports I have heard so far, they are doing exactly that.

“I suspect that this is about to bring us to your next concern which is going to be your part in this now in some way, is it not?”

“Well, yes it is. I was given the same drugs that Steven was and I also had a BM that I could not control. It was quite embarrassing. It would seem this is a part of me being here. How is it I am having to go through all this as well?”

Dr. Zimer shook his head. “Fräulein, I am getting the strong idea that you did not actually read your portion of any of the contracts, did you? Has it not been explained to you yet why you are here like this?”

“Well, no I did not read them word for word. Our lawyers gave me a briefing about my part, and I was aware that there were some clauses that I would have to follow, but I did not know that it would entail this,” Hellen said with a wave of her bandaged and casted arms over herself. “Harold did quickly explain my part in this a little bit better earlier this morning when I was late and had to be called down to meet Steven for his, and my, casting session to get molds for making braces.”

“Then you know that you will be getting the same treatments as each and every one of the children you have hired for us. This is spelled out in each contract that you signed and agreed to, and does detail that you will be receiving the exact same treatment the child receives. There is no going back on this now.”

“*sigh* Fine. I get it. The kids come in each day and I get the same treatment they do to help them feel better. I can deal with that. This should teach me to read a contract for myself from now on. And I’ve got ten of them to go through.”

“Good, I am pleased to hear it Fräulein. And I have heard that you are doing quite a good job at helping the children already. It is being noticed and appreciated.”

“Thank you. At least tell me that once I have met the last child for today and gone through their treatment, then I will be able to get out of all of this and go home and sleep in my own bed tonight.”

“Nein. You are already in the bed you will be sleeping in tonight.”

“*groan* I was afraid you’d say that.”

Dr. Zimer frowned at Hellen’s interruption. “This is your bed which we have assigned for you here on the floor. Your request to have a more private place to speak has actually corrected an oversight on our part. As you are an adult, it is not proper that you be so directly mingled in with the children, so your bed will remain here slightly separated from the children but still where they can have access to you as appropriate.

“You will be here for the duration and continue to receive your treatments just like the children will. You can consider yourself one of our patients as well, junge dame. The children will be our patients until after the parade, and you shall be one as well for as long as they are. And speaking of the next patient to be entering our ward I do believe that she will be arriving soon so I shall have someone come take you downstairs now to be ready for her.

“Guten abend, Fräulein.”

Monday, Nov. 28^th 4pm – waiting room near procedure room five

Dr. Zimer was incorrect in his timing of when the next child would be arriving, and Hellen was taken down to an empty procedure room shortly before four in the afternoon. The girl, Sarah, was scheduled to arrive at four-thirty, but apparently she was a bit nervous and anxious at the same time so arrived shortly after four. When she walked in, Hellen was surprised by the entourage that came in with her. Seeing as the doctors were not going to be available for the next thirty or more minutes Hellen had everyone move into a semi-private waiting room nearby where they could talk. Once everyone was seated Hellen introduced herself as there were several people present that she had not met before.

“Hello everyone, my name is Hellen Amaya. I don’t recognize all of you, so for those I haven’t met before I’m the person who hired Sarah and all the other kids. I know you are wondering why I’m lying here with all these splints, casts, and brace on me.

“Well, as a part of my job, I have several positions to fulfill all at once. First off, I’m the lead coordinator for the upcoming parade. Next I’m the hiring manager, director, and liaison for all of our actors. Then just this morning I found out that per my part of all the contracts I signed I am now the ... mental well being and direct support individual I guess you could call it, for all of the kids which brings me to how you see me now. As a part of the contracts, and because we have several younger children involved, I will be going through the same procedures and treatments the children go through and at the same time. That way the kids see an adult being put through the same things they are and that it’s not going to hurt or feel any worse for me than it will for them. That way they can feel better about what’s happening.”

“Does it work?” someone asked.

“Yes, it does. We’ve got four other kids upstairs right now and I’ve helped to calm at least two of them and make them feel better about what’s happening to them on more than one occasion. Finally, since I’m going to be right here in the hospital with you anyways, the last hat I wear is to be your friend while you are with us in the hospital.

“Now, I see a lot more people here than I expected, and that makes me think there is something of a story to be told here. We’ve got plenty of time.”

At this Sarah’s mother spoke up. “You’re right, there is a bit of a story here. You’ve met Sarah, her dad, and me already. This one here is her brother.”

“Hi, I’m Dan. I’ll let mom tell the story, but I just want to say how proud I am of my little sister for doing this.” Dan appeared to be about seventeen and looked like the stereo-typical average teenager who was finally growing out of the lanky awkward stage.

“Thanks Danny,” Sarah said while blushing.

“Over here we have our next door neighbors and some of the best people we’ve ever know, Ellen and John. This is their son Mike who is home from college, and this girl here in the wheelchair is their daughter Suzy, Sarah’s best friend, and the reason we are all here.”

Suzy waved and smiled shyly, but when Hellen saw her turn back to look at Sarah the girl’s smile grew immensely and her eyes sparkled. Suzy had straight, mid-length brown hair which was a bit longer than Sarah’s and ended in a curl just above her shoulders. She had a bright multi-colored silk scarf tied around her neck that matched the t-shirt she was wearing. Her wheelchair was a rigid ultra-light with metallic pink tubing with the spokes on the rear wheels and the hubs on the front wheels being a matching pink.

“When we moved to the area seven years ago, Sarah was just six. We were leaving behind us ... well; let’s just call it a bad situation. The town we came from was not the right place for us and we had no real friends there.

“The very day we arrived with the truck to start moving in Suzy came right over and introduced herself to us. Besides being a very polite and proper girl, we were astonished when she insisted that she help us to move in instead of running off to play. Of course her parents had to come and find out where their little girl had run off to, and they joined right in with helping us move our belongings into our home and even got their son involved too.

“I’ll never forget that day, ever. It re-established our belief that there are good people in this world. Anyways, to try and keep a long story short, the two families got along wonderfully and we have grown quite close to each other over the years. The girls bonded in such a way that if you look up the meaning of Best Friends Forever in the dictionary you’ll probably just find a picture of them there. By the time birthdays rolled around it was no surprise to anyone to find out the two of them were born only two weeks apart with Suzy being the elder.”

“Only by the accident of two weeks,” Suzy said. “We should have been twins, but someone was stubborn.”

Apparently this was a regular subject for teasing because Sarah shot right back with, “No way, you were in too big a hurry to stick your nose in everything and didn’t wait.” That got a giggle or chuckle from everyone, then Suzy’s mom took over the tale.

“Well, about a year and a half ago one of the worst things that can happen to a mother, happened. Suzy was involved in an accident at the local swimming pool. The short of it was that she was fooling around on the high dive and slipped which caused her to fall off the side. When she landed she hit the side of the pool then fell into the water.

“Of course Sarah was there, the girls were inseparable by then, and when Suzy failed to come back up right away she was the one to keep her head. Seeing the blood in the pool she dived in and pulled Suzy up to where the life guards could get her out of the water. Sarah saved our baby’s life that day. Suzy was rushed to the hospital where we found out the extent of her injuries. In short she had shattered her jaws, which is where most of the bleeding was coming from, and had broken her neck at the C7/T1 level.

“We were devastated, both families. Suzy was paralyzed and nobody knew how bad it might be. In the end, it turned out that Suzy’s spinal cord was not completely damaged, her injury is considered an incomplete. She is able to move her arms and has about seventy-five percent use of her hands. Her level of sensation fades from about the shoulders down to just below her breasts, and from there down is completely paralyzed with no movement and extremely limited feeling.

“The days, weeks, and months immediately following her injury were hard on everyone, but Suzy took it especially hard and did not respond well at all initially. Everyone here did their best any way they could, and we all had our various breakdowns that we helped each other through. Everyone that is, except for Sarah.

‘Through it all Sarah was the rock that we all wound up clinging to. She was there at Suzy’s side every single day, without fail. She managed to find a way to the hospital, and later the rehab facility Suzy went to, every day. Either a ride from us, or her mom and dad, or older school mates who could drive, or the city bus lines which required several transfers between busses, and a few times on her bike. When school started back up again as soon as she got out of her last class she was at Suzy’s side. Her stubbornness was what we needed to get through the worst parts, and played a big role in kicking Suzy in the butt when she needed it. She never had a breakdown; at least not that anyone saw or knows about.”

“It wasn’t stubbornness, it’s love,” Sarah softly interjected. “I couldn’t let her sink down and drown herself in the despair and self loathing she was dredging up. I wasn’t going to lose the most friendly, cheerful, outgoing, and loving person I had ever met and is my twin sister in heart and soul if not body. I had to keep the Suzy I knew and loved alive and with us. I had my share of breakdowns too, I just did it when I was alone in my room so Suzy wouldn’t know.”

“I knew. I always knew. Somehow I could tell. And the Suzy you know is still here because of you,” Suzy whispered.

Everyone in the room took a couple minutes to blow a nose or wipe away some tears while the two girls hugged tightly. When everyone regained their composure Sarah took up the end of the story.

“Well, getting back on track again as to why I’m doing this and everyone is here. Like it was said, I was there with Suzy every day, and I saw everything she went through at the hospital and in rehab. I helped her with everything that I was allowed to, and participated in every exercise or therapy she did. I felt like I was going through it with her at times, and we even talked about that some recently, but I didn’t really know what it was like for her from the inside. I couldn’t. I didn’t have to go through the surgeries on my body, wear the huge cast, have my jaw wired shut for six months, or any of the other things she had to go through, and still does for that matter. I was there with her every day, and as close as we are I had more empathy than others, but in the end it was Suzy who did it all and I don’t really know what it was like for her.

“Then I heard about this job of yours through our high school drama club teacher last Tuesday. The word was put out pretty quickly from the agency I came through, and our teacher is a friend of someone in the agency. I bet you can guess which hospital Suzy was at, can’t you?”

Hellen smiled and said, “Would it be the one we are sitting in?” to which Sarah grinned and nodded.

“When I heard it was this hospital I just had this feeling that this was it. I have always wanted to really know what Suzy had to go through, and I just knew that this was my chance. I talked to Suzy first that night because we had talked about this kind of thing before but could not figure out a way without having to actually hurt me too which would be totally foolish and might kill me instead. I admit we were doing a lot of guessing that night, but we got really excited and managed to convince our parents to let me sign up. And it turns out that my gut feeling was right, what you want me to do here is going to let me know how it was and experience almost everything Suzy did during her recovery.”

“That is an amazing story, and I am so glad that this is what you need to fulfill your desire. But have you really thought through what is going to happen here? What this is going to entail? From what you’ve all said Suzy was hurt pretty bad, and went through quite a bit. Are you ready for that, even for the short time we need you here?”

“Oh yea, absolutely. I’ve had a lot of long talks with everyone about this, and I want to do this. I have to know what Suzy went through, or as close as I can.”

“She really is ready for this,” Sarah’s mother said. “We did mention her stubborn streak didn’t we?”

“Mo-om.”

“Love you sweetie.”

“Love you too mom. Now where was I? Oh yea. Once we all knew that Suzy would be using a wheelchair to get around both families went to work re-modeling both our homes. Everyone is always going back and forth between houses so much that it just made sense. I mean, Suzy and I even have half our clothes at each others house at any given time and we will just go to bed in the house we are at when it is time to sleep. When Suzy finally got to come home we all went right back to doing the same thing again with no big problems because both houses had been changed to accommodate her wheelchair. Mom and dad had a bit of a learning curve to help take proper care of Suzy at first, but that was no big because I already knew it all and they caught on real quick.”

“She’s right. Both families pretty much have two daughters,” Sarah’s mother said, which got a nod from Suzy’s mom as well.

“So, I’m going to go through it all just as close as I can to what Suzy did, and everything will be ready at the home end when needed. The doctors we talked to were really good about it, one of them was even on Suzy’s team of doctors and remembered her, and they are going to get me into a lot of the things Suzy had done to her, and if I feel up to it maybe a few more. But we’ll have to wait a bit first and see how I do with the first part before we can find out if those things will work.”

“So what exactly are you going to have done,” Hellen asked, wanting to know what she was about to be in for.

“Suzy had to wear a big cast around her body and head, so I’ll get that. And because her jaw got broken so bad they had to wire her jaws shut and I’ll get that. Due to her jaws being wired shut she couldn’t eat normally and had to have a tube up her nose that went down to her stomach to feed her so I’ll have one too. Because the paralysis affected her hands she had to wear these braces on her wrists for the longest time, it’s only recently she doesn’t need them all the time any more. So I’ll get a couple of those, but like Suzy did it won’t be right away, they’ll come a little later. Also because of the paralysis she can’t pee or poop normally anymore and the doctors said they have a way they will simulate that too. It’s really gross, ‘cause I’ll be pooping in my pants, but it’s what Suzy had to go through until she learned her bowel and bladder management routines so I’m going to do that too. They said that they couldn’t do the whole no feeling or movement things, at least not so it was one-hundred percent safe, but we’ll see later on about that one and for now I can just not stand up or move my legs on my own and use a wheelchair to get around when I’m allowed to.”

“Good grief, That’s quite a list Sarah. You realize I’m going to have to go through all that too you know.”

“Oh wow, yea. You said that you have to go through all the stuff that I do as a part of the contract. I hope you’re going to be ok, this is what I really want.”

“I think I can deal with it for a few days, and I’ve already got two of those things happening now actually. One of the boys already here has some fake injuries to his abdomen so he can’t urinate or have a normal BM. To simulate that he, and by contract me too, has a catheter inserted in his bladder and they are giving him some medicines that duplicate the effects of bowel incontinence and he has to wear a diaper. I’ve got a urine collection bag here under my blanket right now and I’ve already had my first uncontrolled BM. You’ll probably get the same things to simulate it for you too. I’ll warn you now, once they start giving you the medicine it acts pretty quickly. You’ll have your first BM in about three to four hours. At least that’s how fast it happened to me and Steven.”

“Oh gosh, ok.”

At that time a knock was heard on the doorway and everyone turned to see a doctor standing there.

“Hello everyone. We’re ready to get started on the procedures for Sarah’s ‘injuries’. Since wiring the jaws is going to actually require some minor surgery we’re going to do that first. We’ll put you to sleep which is the best way, and then we’ll wait for you to wake up before we get going with everything else. The surgery should only take about an hour tops. Everyone not getting their jaws wired can wait right here and we’ll let you all know when it’s done.”

A couple orderlies came in with a gurney and hospital gown for Sarah, while another came in and took charge of Hellen. When she asked about her current casts and splints she was told they would be no problem and would stay, and even the back brace she was wearing would stay in place through the surgery but would be coming off when it came time for her cast. Sarah and Hellen were wheeled into separate operating theaters and after counting backwards while breathing gas from a mask held over their faces fell fast asleep.

Monday, Nov. 28^th 5:45pm – procedure room five

The surgery had run right at an hour like the doctor had told them, and Sarah and Hellen had woken up together in the recovery room. They stayed there for around fifteen minutes before being wheeled out and back over to the procedure room for the next step. Sarah’s family, which for them included Suzy’s family as well, came in briefly to see how they were doing. Suzy had a little fun at Sarah’s expense when she saw her.

Rolling up and taking Sarah’s hand, Suzy asked, “So how does it feel?” Sarah tried to answer but found all she could do was make an un-intelligible grunt.

Suzy snickered and said, “Oh yea, you just found out you can’t talk any more. Sucks, doesn’t it. Now let me see what they did. You’re supposed to have the same treatment I did and I never got to see it from this side.”

Sarah leaned over and Suzy gently used her fingers to spread Sarah’s lips apart and take a look. “Yep, that’s the same thing from what I was told and saw in a mirror. You’ve got two thick wires called arch wires, one top and one bottom, that are anchored with screws or posts, or something like that, into the bones of your jaws just above and below your teeth. They go all the way around from one side to the other. The arch wires have these little bends in them at regular spaces that kinda look like arrows pointing up or down towards the opposite wire. Between the matching arrow points they used what they call ... ligament, no that’s not right ...”

“It’s ligature dear,” one of the doctors said.

“Thanks. They looped ligature wires two or three times at each spot really tight to tie them together. You’ve got ... one - two - three ... yep six places where the top and bottom are wired together. Looks like they got fancy with it too, the vertical wires are all twisted around some how.”

“That’s how they make sure the wires are tight,” the same doctor said. “Once enough wire is looped around a few times the loose ends are pulled to get the initial set point. Then, a neat little tool is used to twist the wire from the center to pull them good and tight and the loose ends of the wire are then stuck through opposite sides of the hole between the vertical strands and tied off to keep it tight. The potentially sharp ends of the wires should all be right next to the teeth if it was done right to keep them away from the soft cheeks and lips.

“Is everyone good now? I don’t want to be rude, but we need to get started on the next step of Sarah’s treatment. Once we’re done we’ll take her up to her bed and you can all visit with Sarah upstairs.”

Everyone kindly agreed that was a good idea and the room cleared out of non- medical personnel or current patients. Several of them stopped to check on Hellen and thank her on their way out.

“Ok you two. Since you need a nasogastric tube and are about to get a minerva cast applied, it would be easier to get the tube in place while you can still move your heads around so we’re going to do that first. There’s no two ways about it, this is not going to be pleasant. We have to shove a tube up your nose and all the way down your throat to your stomach. We’ll spray a numbing agent in your nose, and use plenty of lubricant gel to get it started, but you’re still going to feel it. Don’t fight us, and swallow when and as often as you’re told, and we’ll get this over with as fast as we can.”

The doctor was correct, the procedure was very unpleasant, but they did what they were told to do. The nasal spray was squirted up the left nostril and given a couple minutes to work. Then they were told to tilt their heads back and look up at the corner of the ceiling and the wall. While they were looking up one person held their head still and a second took the end of the tube, which was smeared with liberal amounts of lube, and began pushing it in. With many aborted coughs and a lot of swallowed water sucked through straws the tubes were pushed through the nasal cavity, down the back of the throat through the esophagus and into the stomach and in about five minutes they were done with the external end of the tube taped down to their cheek.

The doctors gave them a few minutes to recover from the unpleasantness then wheeled them over to a couple of frames for the next part of being put in a minerva body cast. Sarah was asked if she wanted to watch Hellen get her cast first and Sarah shook her head no. Hellen had her back brace removed and both of them had their gowns and bras removed. A stockinette shirt was pulled down over their heads and their arms pulled through the short sleeves. They had a small problem with Hellen’s arms due to the bandages and the cast, but got the shirt on eventually.

Once the shirt was on, the doctors lifted them off their gurneys and placed them lying down in the frames that had been setup. The shirts were pulled and shifted around until they were smooth and covered the body from the neck all the way down past the hips and left a bundle of cloth around the neck like a turtle-neck sweater. Next a harness was wrapped around their hips under the shirt and straps from the harness were pulled tight around a bar at the foot of the frame and the shirt was pulled back down and smoothed out again. Finally a second harness was placed around the back of the head and under the chin and the straps from it were attached to a ratchet winch at the head of the frame. The winch was turned until they could feel it pulling them tight then stopped. After fifteen minutes it was tightened again with a second fifteen minute wait then tightened one more time.

Their arms were brought out to the sides so their forearms rested along the support bars of the frames and bandages were wrapped around to hold them in place while their legs were suspended together in a sling with allowances made for Hellen’s cast and splint. The doctors told them to just lay still and try to relax and let them work then the collars of the shirts were pulled up so they covered their head and face. Then the job of actually making the casts got under way.

Felt pads were measured and cut to go over the shoulders and hips and under the chin. To hold those in place rolls of padding were wrapped tightly around starting from the hips and working up. When they got to the head the doctors kept right on wrapping the padding around their head all the way up, completely covering their face. They were told the padding would be cut back later and the plaster would not cover their faces. More padding was wrapped around them until three layers covered them from top to bottom. The girls heard water being wrung out and shortly after felt the first rolls of plaster being wrapped on. The plaster followed the same path as the padding, starting from the bottom and working up, and was being pulled quite firmly to make a tight form fitting cast. When their breasts were wrapped the doctors let up a little bit so as to not completely smash them flat, but it still felt like a tight sports bra had been put on by the time they were done.

When they worked the plaster around the head, the doctors were true to their word and did not wrap plaster over their faces. They could even feel that the doctors were trying to make holes over their ears so they could still hear. Once the first couple of layers of plaster were done bare plaster splints were brought over and smoothed into place in several places. One covered the back of the head and down between the shoulders, a second was laid from the chin down the front of the throat to the middle of the sternum, two long splints were placed over the shoulders diagonally so they crossed between the breasts in front and the shoulder blades in back, and two more shorter but wider splints were placed over the hips and pulled tight to conform to the shape created by the harness underneath. Two more layers of plaster rolls were wrapped on from bottom to top again then the padding and stockinette over their faces were cut back and pulled open so they could see again.

The doctors carefully removed the head and hip harnesses from under the casts then Sarah and Hellen were lifted out from the casting frames they had been on and laid down on their gurneys again. Their arms and legs were moved around to check range of motion and how well they could sit up, then marks were made on the casts around the arms and over the front of the hips. Saws were used to trim the casts according to the marks, and finally all the loose ends of the stockinette and exposed padding were pulled up over the casts and a final few rolls of plaster were used to secure them in place and leave soft edges all around.

Since they had matching casts Hellen and Sarah looked at the other to get an idea of how the cast looked on their own body. The cast started low on the hips and had two curves over the top of the legs with a dip down in between and looked like it came down quite low in the back around the buttocks. As the cast came up over the sides of the hips there was a pronounced indentation where the harness had pulled in on the torso around the waist then angled outward again as the cast continued on up over the chest. The breasts were noticeable only as a moderate bump across the front of the chest, and they could feel that their breasts were firmly and snuggly held in place by the cast. The openings for the arms exposed the armpits while completely covering the top of the shoulders. The cast continued up completely covering the throat and neck and the back of the head. They could see smalls openings had been left over the ears so they could still hear, although the padding underneath had been left in place and not pulled away so their ears were still covered. Where the cast came up the throat and around the front it fully cupped the chin on all sides and even curled up around to just below the lower lip so the chin was completely hidden. Going up, the edge of the cast followed the line from the corners of the lips to the outside corner of each eye and they could actually see a little bit of the cast if they looked to the extreme left or right. From the eyes the edge of the cast turned and ran along the forehead at the level of the eyebrows. Their foreheads were fully covered and the cast continued on up past the hairline. The cast came up quite high leaving only a small oval opening on the top of the head that was about four inches front to back and three inches side to side. Hellen’s hair was long so came out the top, and there was a foot long tube of stockinette around the hair to keep it off the wet plaster. Sarah’s hair was short and did not extend out the top of her cast. The stomach tube in their nose was clearly visible where it came out and looped around once on the left cheek under the eye and then was taped in place so it would not swing around or get caught and pulled on.

“Ok, the casts are done,” the doctor stated. “Sarah needs to get a catheter inserted, and since you’ve got a bunch of people waiting for you upstairs we’ll do it here and put you in a diaper before taking you up to your bed. Hellen already has a catheter and diaper, so if you want to see what it looks like going in we’ll have to see if we can’t get a mirror for you to watch. Do you want a mirror?”

Sarah was silent for a moment thinking about it, and realized she couldn’t talk and now couldn’t move her head at all. She grunted several times and waved her hand around like she was writing. A pen and a note pad were produced and Sarah wrote out a single ‘Yes’.

“Very good. Give us a minute while we get the cath tray and we’ll find a mirror at the same time.”

A few minutes later the tray was brought in along with a mirror and a diaper. Sarah’s panties were removed and the mirror was positioned so she could watch as the catheter got inserted up her urethra and into her bladder. As it went in Sarah moaned a little bit and the doctor asked several questions to determine that it didn’t hurt, it just felt strange and uncomfortable. Once the drainage tube that was connected to the opening of the catheter began to show urine flowing through it the balloon was inflated and a gentle tug made sure it was properly seated in place and would not come out.

Hellen noticed that Sarah was already starting to get into her self imposed role of not being able to move her legs. While the doctors were getting her positioned to insert the catheter, and again when they were done and putting the diaper on, she would not move her legs, instead letting the doctors move her legs where they needed them. A blanket was placed over their laps for some privacy and they were taken back up to the ward and their beds.

Tuesday, Nov. 29^th 7:05am – orthopedic ward

Hellen was woken up by a nurse checking on her early in the morning. She had another bowel movement during the night so the nurse set about getting her cleaned up. While the nurse worked Hellen reflected on the previous evening.

Once Hellen and Sarah had been brought up to the ward they found out they had missed dinner time, but since they would be getting fed via the tube in their stomach their food had been kept ready. The bag of ‘food’ that got hung up and attached to the feeding tube looked like mush and Hellen was glad she didn’t have to taste it. Sarah had enquired about any medications and they were told that all necessary drugs were added into their food to simulate the treatment she had asked for.

Both Sarah and Hellen had worked on trying to talk with their teeth firmly clenched and were able to make them-selves understood if they spoke slowly. Suzy had given Sarah a hard time about it, saying she had been on a ventilator twenty-four/seven for the first two months and had the trach-tube in her throat for as long as her jaws had been wired shut. Hellen guessed the scarf was to hide the scar from when the tube had finally been removed.

Lauren had come over to see Hellen and had tried to ask her about the new cast Hellen was in, but because Hellen couldn’t talk clearly she had gone away frustrated. This had bothered Hellen, and she’d requested Dr. Zimer again. Once Dr. Zimer arrived Hellen had carefully explained the situation and requested that the wires be removed from her jaws so she could talk to answer the children’s questions. Dr. Zimer had brought Sarah over to include her since the request would be a change to the treatment plan that had been established for Sarah. After hearing the reasoning Sarah had agreed that it was a reasonable request and it would be ok for Hellen’s wires to be removed. Dr. Zimer had decided that Hellen would remain as she was for the night, and in the morning when it was time to get Hellen ready for the next round of treatments the ligature wire would be cut so Hellen could talk to the children again.

Sarah’s and Suzy’s families had stayed for a while to visit and see how Sarah was handling her situation, and had even entertained the younger children on the floor. A few hours after being fed the medication had started to affect Sarah and she had experienced her first uncontrolled BM and accident. The two families had decided it was late and left to go home at that time since Sarah’s bed was going to be curtained off for a short time while the nurses took care of her. Due to the staff being instructed to treat everyone on the floor as close to real patients as possible, the rest of the night the nurses would come in frequently to check on both Sarah, who was listed as a spinal cord injury, and Hellen, who couldn’t press her call button or call for assistance on her own. Since they were in the ward checking on two of the ‘patients’ already, they also checked on the other children as well and the night passed with no big commotions. A couple of unexpected BM’s occurred between the three people on medications, but were quickly and quietly taken care of.

The nurse finished taking care of Hellen and hung up a bag for her morning breakfast, letting her know they were feeding her early since she would be busy most of the day with the next set of kids to be brought in. Shortly after the bag was empty and Hellen’s feeding tube was flushed out with water, a couple orderlies showed up with a gurney for Hellen and a wheelchair for Lauren.

“Time to take you two down to have your braces fitted.”

“Will Hellen get both arms in braces too?”

“That’s the plan kiddo.”

“How will she get the cast off?”

“Just wait, you’ll get to see when we get down stairs.”

Tuesday, Nov. 29^th 7:53am – procedure room two

The orderlies took them down to a different room then had been used yesterday, and a minute later a couple of technicians came in wheeling a cart with a pile of colorful plastic and metal on it followed by a doctor.

“Good morning ladies. We worked extra long yesterday to get these braces ready for this morning, since it’s going to be a busy day again. Now, we’ve got to do a couple of extra things here to get Hellen ready to try on her braces so we’ll start with her first if that’s ok with you Lauren?”

Lauren just nodded, and the doctor approached Hellen while taking something out of a pocket on his lab coat.

“I’ve been told you get to have the wires in your mouth cut, so I’ve got the wire cutters right here. Once the wires are out, you’ll have only limited movement due to that cast you’re in, but it will be more than you’ve got now and you should find it a little easier to talk again.”

He carefully spread Hellen’s lips and proceeded to cut the wires holding her mouth closed while a tech used a pair of forceps to grab and remove the wires as they got cut and in about five minutes they were done and the doctor left. Hellen wiggled her jaw and opened it a couple of times to loosen up the muscles and found she could only open her jaw about an inch at the most before being stopped by the cast. Next, one of the technicians picked up a cast saw.

“Ok, time to remove that arm cast. This is a special saw that vibrates back and forth really fast. That way, it will cut the hard bandages but not the soft padding or skin underneath it.”

The cast was cut free and removed quickly; all the while Lauren stared at it with her eyes wide. Hellen noticed her expression once the tech was done and spoke to her.

“Lauren, what’s the matter sweetie?”

“Are you ok?” she asked quietly.

“Sure, I’m fine. See, no harm done.” And Hellen turned her bare arm around and over so Lauren could see it.

“I don’t have to have my bandages cut off with that do I?”

“Oh no Lauren, we only had to use the saw on Hellen because her arm was in a hard cast. We don’t use the saw for soft bandages like you have. We can either use scissors to cut them off, or we can unwind them if you prefer.”

“Which do you want Lauren? Cut the bandages off or unwind them. Yesterday when I got the cast they unwound the bandages. I kinda want to see how the cut them off today. What do you think?”

“You first.”

“Ok,” Hellen laughed.

The tech took out a pair of heavy-duty bandage scissors and quickly cut through the bandages on Hellen’s left arm.

“Wow, that was fast. Do mine now.”

“Sure thing honey.”

Both technicians set to work cutting off the bandages on Lauren’s arms and she soon had both free.

“Now for the fun part. Time to try on the new braces. Ready to see how they fit?”

Lauren looked over at Hellen who said, “I’m kinda excited to see what they look like. What was it you picked out yesterday for them to look like?”

“I wanted blue with teddy bears on it.”

“And that is exactly what we made Lauren. I think they look really cute. Want to see?”

That was enough to get Lauren interested, and shortly she and Hellen were wearing braces on their arms which were light blue with teddy bear print. The braces extended from just below the arm pit down to the knuckles leaving all five fingers free. They wrapped around the arm and were held on with velcro straps, two on the upper arm and three on the lower arm. They had two hinges at each elbow which could allow a range of movement but were currently locked, and the wrists were held rigid. The inside of the braces were lined with soft foam padding for comfort. After getting the braces on and checking them for fit, the techs made adjustments which required taking them off and on a few times to get them just right.

“There you go, your very own braces. What do you think?”

“Um, They’re nice I guess,” Lauren said while waving her arms around some. “I still can’t move my arms very much. How will I eat?”

“Well, your arms are still injured Lauren, so you shouldn’t move them too much just yet. But I bet we can have the doctors allow you to bend your elbows enough to eat during meal times.” Hellen looked at one of the techs and asked, “That would be ok don’t you think?”

“I’ll check with Lauren’s attending physician and see what they think about that, but it sounds like a fair compromise to me.”

“Ok. Do we get to go back upstairs now?” Lauren asked with a hint of excitement in her voice.

One of the techs laughed, “I think someone here wants to show off her brand new and very cute arm braces, don’t they?”

Lauren just grinned and nodded at that. “Well, you can go back up, but Hellen here has to stay and meet the next kid to come in. He will be here soon and we need to get Hellen over to room five to meet him.”

Lauren was helped back into the wheelchair and taken back to the ward while Hellen was wheeled down the hall to meet the next child.

Tuesday, Nov. 29^th 8:45am – procedure room five

“So, how many of the kids are scheduled for today?”

“We’ll be receiving four new patients today with varying levels of casting going on, and we have to get Steven back down here in between to get his braces fitted too.”

“Guess that means I’ll be busy all day then, huh?”

“Yep. Between getting the same casts the kids do, and taking off casts that are in the way so we can put a new one on, you’ll be down here all day it looks like. We’ll be sure to get your lunch meal down here and feed you at some point in there. How are you doing by the way?”

“Ok I guess. Still a bit shocked at this whole thing to be honest. It’s my own fault though, I didn’t really read and understand the contracts before hand. I’m getting used to it. Um, you do know I’m on medication that causes uncontrolled bowel movements, right?”

“Yes, we are aware of it. Be sure to let us know as soon as you feel the need, that way we can get a bed pan or something before it becomes messy. We’ll also be giving you plenty of water too since you’ve got a catheter. Have to make sure you stay well hydrated. Speaking of which, we should give you some now. Do you want a glass with a straw, or can I hook up a bag of water to your feeding tube?”

“Well, our next actor is due any time now. Who is it, and what are they getting?”

“The chart here says Robert is next. He is ten years old and has broken both arms. His radius and ulna, that’s both bones in the forearm, have a couple of breaks each, and he has broken both of his scaphoid bones. Those are a particular bone in the wrist. That means he’ll be getting full length casts on both arms that are going to include his thumbs. There’s also a note here that the injuries may require some supination or pronation, that’s palm up or palm down, depending on what Rob decides, and a bit of flexion.”

“*sigh* I guess we should go with the bag then. You can hook it up so it will be out of the way can’t you? I still want a drink of water from a cup though; my throat is a bit scratchy with this tube going down it.”

“Yea, I can do that. I can even set it up with a larger bag with a valve so it drains slowly and we can make it last most of the morning for you.”

Robert arrived with his mother while they were getting Hellen setup with her water. Robert’s mother was a bit shocked to see Hellen in a big body cast with braces on both arms while Robert was simply curious about the cast. Hellen explained about the contract obligations, and told them about Sarah whom they’d get to meet upstairs and suggested they ask her to tell them her story. When Hellen asked Robert what story he had come up with for his broken arms he launched right into telling his tale, barely noticing the cast techs as they first removed Hellen’s braces then began the process of putting casts on the two of them.

“I was outside in the forest –“

“We have a small field by our community with a small copse of trees on it that the kids like to play in.”

One cast tech took Robert’s right arm and pulled a length of stockinette up to his shoulder while another did the same on Hellen.

Robert looked annoyed at his mom for interrupting before continuing, “I was playing in our tree fort with Eddy. We were pretending that it was a ship and had to defend it from pirates who were attacking it!”

The cast tech took a short length of narrow cloth tube and cut it part way lengthwise then pulled it over Robert’s thumb so the cut ends extended over the front and back of his hand.

“Eddy is Robbie’s friend and will be a part of this whole acting thing too. They worked up the story about the pirates together, but the boys won’t tell each other what they are doing for their acting parts.”

“So, Ed is going to come in and be an actor too, but he doesn’t know that you broke both your arms huh?”

“Nope. And you can’t tell him either!”

“We promise we won’t tell him a thing.”

Next the cast tech took a narrow roll of cast padding and began wrapping it around Robert’s hand and thumb.

“A bunch of the neighborhood kids, with the help of some of the dad’s, built a fort that includes a multi-level platform around a couple of trees. It’s actually pretty sturdy.”

“Mom! I’m telling the story!”

 “Sorry honey, go ahead. I’ll stop interrupting.”

*huff* “So, I was fighting off the pirates. First they fired their canons but our ship held up good and we fired our canons back at them which damaged their ship. Then the pirates threw hooks over and swung across to our ship! We had to cut the ropes off with our swords so I had to climb up and down the ship to do it.”

The cast tech finished the roll around Robert’s wrist and switched to a wider roll to continue up the forearm.

“Some of the pirates still made it across because there were too many so I had to fight them then with my sword! I fought bunches of pirates all over the ship! From the front to the back and up and down! I killed all of them!”

“Then what happened next Robbie? Remember, this is supposed to be how you broke your arms.”

When the cast tech got to Robert’s elbow he bent it to ninety degrees and used another roll of padding to cover the elbow and go back down the arm.

“Yea, I know Mom. I was getting to that. Well, while I was climbing up to the first level to fight off a pirate up there another one attacked me from behind so I had to turn around on the ladder and fight back.”

A final roll of padding was used to wrap Robert’s upper arm and continued on down until the roll ran out.

“That’s when I slipped and fell. I fell backwards and tried to catch myself but when I hit the ground I landed on my arms and they broke.”

The cast tech broke in at this point, “Rob, I need to ask you a question here. We need to decide how to position your hands now. Do you want to have them facing up, down, or sideways?”

“What’s the difference?”

“Well, for most normal broken arms, we put the hand in what we call a neutral position, which means sideways. Sometimes though the break is worse and the hand has to be turned up or down so the bones will heal right.”

“Oh. Will it make it harder with my hand turned?”

“Yes it will. Since you broke both arms you’re going to have a hard time doing things as it is and will need help. With your hands in a neutral position you will be able to learn how to do some things for your self. But if we turn your hands around because you have a more severe break then you will not be able to do things quite as easily and maybe not at all.”

“Like what?”

“Well, at first you won’t be able to do anything until you get used to your casts. But eventually you should be able to feed yourself with long handle spoons or forks, or be able to pick some things up or dress yourself with your fingers with practice. But if we turn your hands, you probably won’t be able to do most of those very well and maybe not at all.”

“Oh. Um, I want to be able to feed myself and get dressed by my self.”

“Ok, we should keep your hands in a neutral position then.”

“Ok. Um, where was I?”

The cast tech starts to wrap wet plaster around Robert’s hand and thumb, following the same pattern he used with the cast padding. He goes slower with the plaster, overlapping each turn by two-thirds to make the layer thicker.

“You just fell and broke your arms.”

“Oh yea. Well it hurt really really bad. So bad that I screamed. But I didn’t cry. Well, not much. Ben heard me scream and came over to see what happened.”

The cast tech switches to a wider roll of plaster and continues to wrap Robert’s arm.

“Ben is his big brother and knows about Robbie being an actor today so he’s a part of the story too. He helped Robbie figure out what happened to his arms. He’s out in the waiting area.”

The cast tech had reached Robert’s elbow and was working on setting it in the proper position and wrapping it in plaster.

“So, what happened when Ben came out to see you?”

“I was hurt bad, my arms were all bent in places they’re not supposed to. So Ben picked me up and carried me home. Ben is seventeen and really strong. He lifts weights on the school team! When we got home Mom took one look at me and drove me straight to the hospital. And now I’m here.”

The tech smoothes out the plaster and pulls the ends of the stockinette back over the cast at Robert’s knuckles and upper arm then starts a fresh roll going back down, continuing to overlap each turn by two-thirds.

“So why isn’t Ben in here with you?”

“We thought that having too many people in the room might not be allowed, so Ben is waiting outside.”

“Not at all. One more person in here won’t be a problem at all. Now seven more like last night, that would have gotten crowded. Do you want your big brother in here to watch Rob?”

The tech finishes a roll of plaster around Robert’s elbow and soaks a fresh roll to continue down the arm.

“Yea! He helped come up with the idea so he should get to watch!”

Robert’s mother goes out and comes back in with an older teenager who resembles Robert and obviously does body building from the noticeable muscles.

“Hey champ, how’s it going? Have you told them the story yet?”

The roll of plaster runs out right at the wrist and the cast tech soaks a smaller roll of plaster to go around Robert’s hand and thumb.

“Yea! I told them all about the pirate attack, and then falling off the ladder! And how you came out and found me with my arms all bent up then carried me home ‘cause you’re so strong!”

“Good job. What do you think about the way they make a cast there, is it cool?”

The cast tech smoothed down the last roll of plaster on Robert’s right arm, “And we have one cast all done.”

“Really? That fast? You’re fast.”

*laughing* “That’s my little brother for ya. Get’s so focused on one thing he doesn’t even notice what’s going on right under his nose.”

The cast tech laughed. “I was working the entire time you were telling your story. Guess you didn’t notice. Look, Hellen’s first arm cast is just about done too. What do you think?”

Robert felt the cast with his left hand for a minute and moved his arm around some while studying it. The cast covered his right hand with the palm facing his belly while leaving all four fingers free from the knuckle down. His thumb was held so that it was pointing up away from his hand, and was covered up to the tip but still had a hole at the end where a tiny bit of skin could be seen. The wrist was bent in towards his body at about a thirty degree angle. His elbow was held bent at ninety degrees and the top end of the cast ended about a half-inch down from the armpit.

“Don’t try to move too much or you could damage it right now.”

“It’s kinda hard but wet at the same time. And it’s getting hot.”

“Yep, that’s just about right. The heat means it’s setting and will get real hard here in a minute or two, but it will still be damp for the next day or two while it keeps drying out. We need to do one just like it on your left arm now, so just rest your right arm on this pillow here and I’ll get the other one done.”

Robert watched closely while the cast tech worked on putting his left arm in a cast that matched the right one once it was done.

Tuesday, Nov. 29^th 9:50am – Procedure room two

Robert had been taken up to his bed and to meet the other kids, and Hellen was moved back to room two while waiting for Steven to be brought down to have his braces fitted. The tech brought over a cast saw and got busy cutting away at the body cast on Hellen to get it out of the way for when they put her new braces on like Steven would be getting. Once the cast was cut off and removed, he brought over a rigid neck brace and put it on Hellen. The brace was very much like the head portion of the cast that had just been removed. It rested on her shoulders and extended a few inches down her front and back. From there it came up the front and cupped her chin just like the cast had while on the back side it came all the way up the back of her head and included a wide strap that came around the front over her forehead, holding her head still once again. Once the neck brace was in place the tech then took the saw and started to cut the cast on Hellen’s left leg.

Steven arrived while the tech was still cutting the leg cast off of Hellen, and a minute later two more techs arrived with a couple of carts carrying the new braces Hellen and Steven would be getting. Steven’s mother showed up a short time later while the tech was describing the different parts of the brace.

“We just finished up with these a few minutes ago and brought them right down. So, who wants to see what these look like before we start putting them on you guys?”

Steven of course got excited and wanted to see. The tech picked up Steven’s braces and pointed out that while technically there were separate braces, they were all joined together to form one big brace that would go from the chest down to the feet. The color plastic that Steven had chosen had bright green, red, blue, and yellow swirls on a black background. The tech informed them the brace had been made in a clam-shell style. What Hellen saw was this meant the body part was in two pieces with three straps on either side to hold it together. The body portion would go from about the mid-chest, Hellen’s had a half cup formed for her breasts, down to just above the hips. From the body part there were metal hinges going down along the hips that attached to the next plastic part over the thighs. These too were done in two parts like the body portion and had a couple of velcro straps each that would go around the thigh to secure them. More hinges, two per leg, came down along side the knees and attached to the lower leg braces which were solid all the way down to the toes and would hold the ankles at a ninety degree angle. The lower leg/foot braces were once again done like the rest and consisted of two parts that would be held together with three straps around the calves, one crossing over the front of the ankle, and one more over the top of the foot about half way to the toes. The bottom of the foot portion of the brace was built up some and had a thick rubber-looking sole attached to it that appeared it was meant to be walked on. The tech opened up the front of the body brace and showed them the entire thing was lined with the same type of padding Hellen had seen in her arm braces, just a bit thicker.

By this point Steven was so excited to try it on he was wiggling in bed and trying to pull off the elastic bandages holding his splint on. The tech had him calm down and removed the diaper, then two of them proceeded to quickly cut the splint off while a third calmly unwrapped the splint on Hellen’s right leg. After the splints were removed, a fresh diaper was put on Steven then both of their catheters were disconnected from the drainage tube and a plug was inserted into the opening to keep them from leaking.

Finally the fittings began, and for the better part of an hour the techs were checking the fit and making adjustments to both sets of braces, which the room they were in was set up for so they didn’t have to go far to make the changes. The techs also pulled a couple of long socks up both their legs that came all the way up to the top of the thighs, and explained that they were for extra comfort and to help keep the padding inside the braces cleaner by absorbing sweat. They explained to Steven’s mother where she could get a supply of the extra long socks, and that using extra absorbent athletic socks would work almost as good since the thighs tend to sweat a little bit less but the feet absolutely needed socks. During the fittings Hellen had to go to the bathroom so she was taken out briefly to use a bedpan and came back to continue her fitting. Once the techs were satisfied with the fit, they showed Hellen, Steven, and his mother, how the hinges on the knees had what they called trigger locks. When the knees were fully straight the locks would engage so the knees could not bend. To unlock them they would have to pull up on a rubber covered wire behind the knees and the knees could then bend again. The hips had a different kind called a spring assisted drop lock on them, but unlocking was done by pulling up on a metal ring above either hip that was attached to the lock by a rod going down the middle of the spring. They also showed them that all of the locks could be fixed in place with some special set screws so they could not be unlocked.

The techs put Steven in a chair and helped him to stand up while wearing his brace and all the locks dropped in place leaving Steven unable to bend from the chest down. A pair of forearm crutches were brought over and adjusted to Steven’s size for him to use. Then, they showed him the proper way to unlock the hinges in sequence so he could sit down safely with minimal risk of falling and had him practice it several times. Once they felt he had the right idea, and his mother was familiar with the procedure, they showed him how he had to use the crutches to move around. Since his knees and hips would be locked in place he had to place the crutches ahead of him a short distance then lift up and swing his whole body through and put his feet down again a short distance in front of the crutches.

After about thirty minutes of practicing walking, sitting, and standing they showed Steven’s mother how he would have to wear a small leg bag attached to his catheter and strapped to his leg in a certain place to keep it from getting caught on the brace when he was walking, or bending the knees during sitting and standing, and explained how often the bag would need to be emptied. Once all the instructions and practicing were done Steven was told that at first the hinges on his brace would be locked down with the set screws for the next three days, but during that time they would get unlocked three or four times a day with a nurses supervision to give him practice moving around, and by the time the parade day came he should be ready to walk in the parade with his crutches. Steven was so excited moving around and playing in his new brace that he didn’t even notice that Hellen stayed in her bed the whole time while giving him encouragement and suggestions as he moved about.

At one point, with the way the techs were treating everything as a real injury situation, Steven’s mother forgot this was all a temporary act and asked them how long Steven had to wear the brace. They told her that he would have to wear it twenty-four-seven and could only take it off to be bathed. How long he would have to continue that schedule would be up to his doctor and depend on how well the healing went and whether or not there was any permanent nerve damage.

Finally, Steven was placed back on the gurney, the locks on his brace were fixed down, his catheter was hooked back up to the bedside bag again, and he was taken back upstairs. Hellen had her HKAFO removed and the same rigid back brace from yesterday was put on her and she was taken back over to room five again to meet the next child to arrive.

Tuesday, Nov. 29^th 11:15am – procedure room five

Edward was carried in to the room by an older boy and followed in by his mother. Edward’s legs were held together and pointed straight out with a two-by-four board placed between his legs and tied together with towels as a splint. The teenager carrying Edward put him down on the table he was directed to by the cast techs, and Hellen asked him what had happened.

“Goodness! What have we here! I believe that you would be Edward, and this is your Mom, but who just carried you in here?”

“Yep, that’s my Mom. That’s Kevin, my big brother. He goes to school with Ben and lifts weights on the team with him.”

“I see. Robert was here earlier and told us that the two of you were fighting pirates on your ship. Sounds very exciting! So, want to tell us what happened to you?”

“It was! Rob and me were the hero’s of the ship! We fought off and killed all the pirates! But it wasn’t as much fun after Rob got hurt and had to come to the hospital. What happened to him? Is he ok now?”

*laughing* “We promised we wouldn’t tell what happened to him. You’ll just have to wait until you get upstairs to see him. Now, what about you?”

“Well, after Rob got hurt and Ben got him, I still had to finish fighting off the rest of the pirates all by my self. There weren’t that many left and they were starting to run away. I jumped down from the second level at one point to the first level, but I missed and fell all the way to the ground instead and broke both my legs. It hurt real bad and I started screaming real loud and crying, but I only cried a little bit. Right Kevin?”

“You bet Ed. The screaming is when I got involved. I came over and found poor Ed here lying on the ground. He was in a lot of pain and when I looked at his legs they were bent in places they shouldn’t bend. I made him lay still while I got a loose board and a bunch of towels and splinted his legs like you see here. Then I carried him home to Mom and we brought him to the hospital.”

“Yep. That’s what happened, and here we are. Now I get to have casts on both my legs from top to bottom.”

“Well, that’s quite a story. What do you think about that Mom? Think you and Rob’s Mom might have to think about letting them play in this fort of theirs again? Sounds like a dangerous place to play to me.”

“That is a good question Hellen. With both the boys getting hurt on the same day we may just have to tear down the fort for being too dangerous for the kids.”

“Nooo! You can’t! Daddy and Kevin helped make it and said it was safe! Rob’s Daddy too!”

“I don’t know Ed, I mean look at what happened. You’re hurt so bad that Hellen’s legs are broken too and she is getting casts like you.”

Edward’s mother laughed at Kevin’s statement and so did Hellen. But when she saw that Ed was getting worked up and about to cry she gave him a hug and relented.

“Don’t worry honey, we were just teasing you. Right Hellen? We won’t tear down the fort. The daddy’s have all said it is safe and you all just need to be careful you don’t fall playing out there.”

Edward sniffled a little and wiped his nose. “Ok. I’m sorry Hellen, I didn’t mean to break your legs too.”

“Oh, sweetie, it’s ok. You didn’t break my legs. It’s a part of being an actor for the hospital, remember? We signed a contract with you and all the other kids. A part of that contract says that I have to get casts like you get because I’m your manager. And I want to do it because I’m your friend and it will make it less scary. I even have my own bed upstairs with all of you.”

“She sure does. Now, we need to get going on these casts here so we can get you done and upstairs and still have time to give Hellen her lunch before the next boy comes in this afternoon.”

Hellen’s legs were already bare and ready, so two cast techs began on her by pulling stockinette up her legs while the other two got the towels and board off Edward’s legs and got his pants off. The cast techs worked two per person, and got stockinette pulled up both legs all the way up to the hips. They were about to start on the cast padding when Hellen quietly mentioned to the techs working on her that Edward might like having a little bit extra to his casts when he got upstairs and saw his friend, and when she motioned to her hands and thumbs they got the idea.

“You know, with a fall like you had Ed, there is usually damage to the feet as well as the legs. If your feet are hurt too, then we can make some changes to your casts and even add a little to them.”

The techs working on Edward looked a little confused until one of the techs with Hellen pointed to her wrist and thumb then the two with Edward nodded.

“Really?”

“Yep.”

“What can you do?”

“Well, we might have to point your feet down more, and maybe bend your knees a little more than normal. We could even turn your feet some and add to the cast so it goes over your big toe and maybe even your other toes too. What do you think about that? Sound like something you want? It would be something different to show off to the other kids.”

 “Yea! I want that! All my toes too!”

“You got it.”

The techs all got busy working on rolling padding on both legs and working in the changes. To include the big toe, a length of tubular bandage was cut and pulled over the toe, then a hole was cut in the stockinette that had been left hanging over the toes so the big toe could be pulled through separately with its own covering of tubular bandage being held in place and smoothed out under the stockinette. The cast padding was started at the top of the foot just below the ankle and worked down. The big toe got wrapped separately with the padding and the rest of the toes were wrapped together with bits of cast padding torn off and stuck between them.

As the techs rolled the padding back up the foot they told Edward and Hellen to completely relax and not move their feet at all, then they pointed and turned the foot where they wanted it and wrapped the cast padding in place to start holding their feet in the correct positions. Extra padding was used over the heel and around the prominent ankle bones, and wider rolls were used going up the calf. The knees got bent to about a forty-five degree angle and extra padding was again used on the sides of the knees and over the kneecap. The padding continued on up the thigh and ended high up in the crotch to complete the first layer of padding. A second layer of cast padding was started at the top of the thigh and worked down the leg. Once the knee was done extra strips of padding were laid lengthwise along the shins and down over the top of the feet and held in place as the second layer of cast padding was wrapped on down the leg and foot. When the plaster bandages were started the techs switched to work together on one leg at a time instead of both at once.

Small two inch wide rolls of plaster were used first to cover the foot from below the ankle down to just above the toes and back up again over the ankle. Then a one inch roll was used starting half way down the foot and wrapped tightly around the big toe keeping it separate from the rest of the toes which were bound together using the one inch roll. A second one inch roll was used to add more layers around the toes and up the foot then a three inch roll of plaster was wrapped around all the toes together several times and worked up over the ankle while the foot was held in the correct alignment for what they had planned. Another three inch roll was used primarily around the ankle and ended part way up the calf then a four inch roll of plaster was started just above the ankle and wrapped up the leg and over the knee. A second roll of four inch was used in the same place as the first four inch roll then another was started just below the knee and rolled up to the top of the thigh. A fourth roll followed in the same place from just below the knee and up the thigh. The next roll started at the top of the thigh and worked down the leg until it ran out, and the sixth roll of plaster started an inch above where the last roll ended and worked down the rest of the leg and over the foot and ended over the toes.

Once the plaster was smoothed down, the techs brought out a pair of scissors and started trimming the plaster over the top of the four smaller toes to create a toe-plate under the toes. They were very meticulous and checked frequently to make sure the edge of the plaster over the top would just expose the toenails while still covering the rest of the toes. Once they trimmed the plaster like they wanted, the end of the tubular bandage was pulled back over the big toe leaving just the tip of the toe visible then a new one inch roll of plaster was wrapped around the foot and big toe. They wrapped the plaster around the big toe then pulled up the stockinette and cast padding under the rest of the toes and laid the one inch roll underneath so it got combined with the toe-plate. After doing this several times the stockinette and padding was laid back down, trimmed, and the loose ends pulled up over the foot. A roll of three inch plaster was used to cover the loose stockinette and worked back up the foot and leg until it ran out. A four inch roll started just below where the three inch ended and worked up over the knee to the top of the thigh and back down to finish it out. The stockinette and padding left exposed at the top of the thigh was pulled down over the cast and a final roll of four inch plaster bandage was used to cover the cloth and wrapped on down over the knee and finished on the calf.

They had been using slow setting plaster so it was just starting to heat up at this point, and the techs took the time to make sure the cast was well molded and held the leg and foot where they wanted it. One tech pressed in around the toes with the fingers of one hand while gently twisting so the bottom of the foot was turned in and held the foot pointed down at a bit more than forty-five degrees while the other hand held the inside of the foot over the ankle to help maintain the position of the foot. The other tech worked on making sure the knee remained at a forty-five degree angle and also formed the thigh of the cast tightly around the leg. They held the foot and leg in place for several minutes until the plaster had set enough to hold the position on its own. Once the cast was firm enough and they could let go they checked the cast padding that had been added in between the toes and made some adjustments, poking the ends down inside more so that it would not fall out.

After completing the first cast they got right onto finishing the cast on the other leg and a little while later Edward and Hellen had both legs firmly immobilized in plaster.

“There, two broken legs and feet in casts. What do you think Edward?”

“I can’t move my big toes at all, and my other toes can barely wiggle. It feels really tight around my ankles and I can’t move my feet at all.”

Edward tried to lift one leg with just his leg muscles and had to use his hands to help lift it. “It’s really heavy too.”

“Leg casts are generally thicker and heavier because the leg muscles are stronger than the arms; plus the plaster is still wet which makes it heavier until it dries. Your ankles are going to feel tight and may hurt a little for a couple of days until they relax and stop fighting the position the cast is forcing them in. We’ll update your chart here with the changes we made and the nurses can give you some pain pills if you need it until your ankles settle down and relax. Looks like we’re done here with you, so you can go upstairs and meet all the other kids and show off your casts to Robert.”

“Yea! And I can see what happened to Robert too!”

Tuesday, Nov. 29^th 12:30pm – procedure room five

The next child to come in had been scheduled for one-PM which left just enough time to get food for Hellen and the four cast techs. One tech left to get Hellen’s meal from the kitchen while two more left to get lunch trays for all four techs from the cafeteria. The remaining tech joked with Hellen while he unhooked the empty water bag from her feeding tube.

“You’re looking pretty banged up here Hellen. Both arms and both legs in casts and braces on your back and neck. Someone really did a number on you.”

“Heh. Yea. I did it all to myself too, when I signed those contracts without reading them.”

“Well, at least nothing is actually broken so it doesn’t hurt.”

“Not too much. I’ve still got some discomfort from pretty much everywhere right now after sleeping last night in a body cast and having to wear these braces. My wrists are a little sore and my ankles are starting to complain from the position you’ve put them in.”

“Your wrists and ankles will get some relief this afternoon I think with the next kids coming in. Maybe your neck and back too. Do you hurt anywhere else? Maybe I can get you a pain shot here.”

“The feeding tube is a bit irritating, but I’m getting used to it. I don’t even notice the catheter anymore unless someone mentions it or it gets pulled on while transferring me from place to place. My jaws are still sore from the surgery to insert the arch wires to close my jaws shut. And it could be worse. Thanks to the kindness of Sarah I got a reprieve from actually having them wired so I can still talk to the incoming kids. I suspect that I’ll have them wired shut again before too long though.”

“There is that. Hey, to get a little serious here. I wanted to let you know that the word had gotten around the hospital and pretty much everyone knows what you are doing for the kids here. From what I’ve heard the response is overwhelmingly in support of you. Everyone thinks you are the best person in the world right now for doing this to make the kids feel better and be there both for and with them. You can be certain that while you are playing at being a patient here, you’re going to get the best care that anyone has ever gotten.”

“Aww. You let everyone know that I appreciate it. I admit I was a bit shocked when I found out what those clauses in my part of the contracts were all about, but like I said that’s my own fault for not reading them. It’s important to me to support the kids with the things they have to go through. Going through it with them lets me know what they are feeling and I can help them get over any rough spots. While I was initially a bit frightened by all this I think I’ve gotten used to the idea at least; and I like being there with the kids.”

“Well it means a lot to everyone here, so don’t you worry. The nurses are all quietly letting it be known that you are going to be getting the royal treatment and top notch care while you’re here. We’ll take good care of you. And here’s lunch!”

The cast tech who had gone to get Hellen’s bag of food returned and they got it hooked up to her feeding tube so she could get her nourishment and medication, and the other two showed up a couple minutes later with trays of food for everyone else. Hellen wise cracked that she could still talk at the same time she was swallowing her food which got the techs all teasing her about what else she could or couldn’t do at the same time and the time passed quickly.

Tuesday, Nov. 29^th 1:00pm – procedure room five

One of the cast techs had just left with everyone’s empty lunch trays and Hellen’s empty lunch bag and a new bag of water was being hooked up to Hellen’s feeding tube when the next actor arrived and was escorted into the room by Harold.

“Hello everyone. We have Frank here to begin his stay as our next actor on the list. I picked him up from home as his family had conflicts and could not make it to the hospital with him this early in the afternoon. I understand they will be around later to visit.”

Harold made sure Frank was recognized then left the room.

“Hi Frank. We were just getting our lunch trays cleared up and getting ready for you. My name is Hellen in case you don’t remember me.”

“Hi. What happened to you?”

“Well, my job is to be the manager and liaison to all the actors, and a part of that is I have to get the same casts as you kids get. So what you see here is a combination of what several of the other kids upstairs already have.”

“Oh. How come you’ve got to do that?”

“It’s a way to show the kids that an adult, namely me, will go through the same thing you do. It’s helped some of the younger kids be at ease with having to get a cast for their first time. And it’s a part of my side of the contract too.”

“Sounds cool. I’ve been in a cast before, just a cast on my left arm when I broke it. I figured I’d try something bigger since I don’t have to actually break anything to get a cast this time.”

“What did you decide to go with and what story did you decide on about how it happened?”

“I’m going to have a cast on both arms and my shoulders and body all connected together. Uh, I haven’t really thought about a story for how I could have gotten it though.”

“All the other kids so far have various stories or reasons why they are in a cast or brace, so I’m sure they are going to ask you about yours. Maybe we can come up with something here with the help of the cast techs. They are pretty knowledgeable about what kind of injuries need different types of casts.

Hellen raised her arms in the air, “Looks like I’ll have to get these and my braces removed so I can be done up like you will be.”

“Yea, we’ll be with you in a minute to get things cut off Hellen.”

“Those arm casts look like you can’t do much with them.”

“You’re right, they are pretty restrictive. I can’t move my thumbs at all, and with the wrists bent like this I can hardly close my fingers to touch the cast.”

“Neat. Can I get something added to my cast like that?”

“Well, let’s try and figure out what happened to you that got you in what we call a bilateral-shoulder-spica cast and see if we can fit in something for your hands. Looking at your chart here it seems that you have broken both bones in your lower arm and the upper arm on both sides, and have also managed to break both of your scapulae which are your shoulder blades in your back. That’s an unusual combination since the shoulder blades aren’t a normal bone to break, but one that could account for the cast we’ll be putting on you. Do you do any kind of sports? Or do you do things that have a higher rate of injury related to them, like skate boarding, or snowboarding, or something like that?”

“No sports and I’m not into skating or boarding. What kind of accidents can cause those types of injuries?”

“Well, the breaks to the forearms can be caused by quite a lot, most commonly falls of some type. The upper arm bone is harder to break; a direct blow is the more common cause of a broken humerus, but a fall can account for that as well. The scapula though is the hard one. That is most often due to a severe and direct blow of some type. And we have bilateral injuries, which means on both sides. What about something you do outside that you might have knocked down while falling and had it fall on you? Anything like that?”

“Actually, yea, there is. There is this group of trees that a few of us like to swing from branch to branch on. Just last night I was out there alone. I was bored and swinging around on the branches and apparently one of them was rotten and broke on me. It was the older bigger tree and has some really thick branches on it. I had jumped from one tree over to the old tree and the branch I grabbed cracked in half. I let go and fell down to a lower branch and just kept doing this kind of controlled fall from branch to branch all the way to the ground where I landed. It knocked the breath out of me and I was shaking some but ok. About thirty seconds later the branch that broke fell down to the ground beside me and scared me a bit.”

“How big would you say that branch was?”

“I don’t know, probably half as thick as my body and about as long as I am tall I guess.”

“There it is. That’s the cause. You fell down to the ground face down and caught your self with both hands. That caused some of the initial injuries to your lower arms. Instead of taking another thirty seconds to follow you down the branch fell right behind you and landed across your back. That would cause the broken scapulae and the upper arm injuries. We can throw in some wrist and hand injuries too with the type of fall and direct blow from a heavy branch across your back while you were still holding yourself up. Sound like a good story?”

“Um, sure. Works for me. What kind of cast would that get on my hands?”

“Well, you’re not going to be able to do anything as it is with both arms completely immobilized in a cast, so we can just include all your fingers and thumbs in the whole thing and say you’ve broken bones in your hands and wrists.”

“Ok, sounds good. I’ll go with that story. Let’s do it.”

Hellen’s arm casts got cut off and the neck and back braces were removed as well. A curtain was pulled closed briefly to give Hellen some privacy while she got into a stockinette shirt to cover her body. When the curtain was opened again Frank was sitting up with his own stockinette shirt on and two of the cast techs were pulling stockinette up his arms. Once Frank had his stockinette in place they took him over to a frame and had him stand in place while a harness was brought down and placed under his chin and around the back of his head then pulled up tight to help him remain straight and not slouch while the cast was made around him. Because Hellen’s legs were in casts they brought the gurney she was sitting on over to a different area that had a pole sticking out from the wall with a harness dangling from it that they could wheel her underneath to get it on her and pull her up straight as well and made sure she was turned so that Frank and Hellen could watch the other as each of them were encased in plaster casts. For Frank they moved a couple of handles around to where he could hold them with his hands to position his arms, and for Hellen they brought over a couple of underarm crutches which they adjusted so she could hold them and keep her arms in the right place. The techs positioned their arms so that once the cast was finished their upper arms would be held pointing straight out to the side with the elbows bent at ninety degrees and the lower arms would point straight ahead, and the hands would be held with the palms facing towards each other.

Felt pads were cut to fit over the hips, across the tops of the shoulders, and on the underside of the elbows and wrists where the arms would be constantly resting on in the cast for both of them and taped in place. Six inch wide rolls of cast padding were brought out and wrapped around starting low around the top of the hips and working upwards. The padding was overlapped by about two-thirds, and took five rolls on Frank to get up to the arm pits with six being needed on Hellen to properly cover her breasts. The techs switched to four inch rolls of padding to work over the shoulders, and for the armpits some extra padding was used.

A whole roll of padding was unraveled then cut in half and re-rolled loosely so they had two even half rolls of padding which were then placed in the armpits and held in place with the rolls of padding used to cover the shoulders and upper arms. Hellen asked about why that was done and one of the techs explained that there were nerves running through the armpit that needed extra padding so they wouldn’t get pinched and possibly cause permanent nerve damage to the arms. As the techs worked on the shoulders they wound padding around the neck which Frank asked if his neck was going to be included in the cast. He was told the padding was being wrapped around the neck to hold it in place and that while the cast would come up close his neck and head would remain free. The padding continued on down the arm to the wrist where they stopped and explained that the hands would wait until after the arms were supported by the cast then the hands would be finished up. A second layer of padding was wrapped on like the first and the techs were ready to start with the rolls of plaster bandages.

Like the padding, six inch wide rolls of plaster were used to start working from the bottom up with the bottom edge of the cast being made an inch above the hips around the waist and coming down a few inches lower in the back. The rolls of plaster were wrapped firmly around their bodies and rubbed in as they went to make a good solid cast and join the layers together. Four inch rolls were used over the shoulders and down the arms all the way to just above the wrists leaving a couple inches of padding still exposed on the wrist. The cast techs reversed direction and worked back the way they had come making a second layer of plaster all they way back down to the waist again.

When the second layer was finished a wide sheet of plaster consisting of several layers was soaked and brought over and wrapped around the torso. The sheet was wide enough that it fit from the waist up to the armpits and was long enough to wrap around twice. The plaster sheet was rubbed in and smoothed down then several smaller plaster splints were brought over to reinforce the shoulders. One splint was placed so it went up the side from the waist to the armpit and along the underside of the upper arm to the elbow and rubbed in so it would stay in place. A second splint was started at the middle of the back and brought up diagonally over the top of the shoulder and wrapped in a spiral around the upper arm, and a third splint mirrored the second starting from the middle of the chest and wrapping in the opposite direction around the arm. Three more splints were used in the same way on the other arm then the rolls of plaster came back out and a third complete layer of plaster bandages were wound around to bind all the splints in place, with the exception that the rolls of plaster were stopped about half way down the lower arms.

Fast setting bandages had been used so the plaster was already heating up and setting enough to partially support the arms by this time. The handles and crutches were taken away and padding was wound around Hellen and Frank’s hands and fingers with padding being placed between the fingers before wrapping the fingers all together with the thumbs wrapped separately. Plaster bandages were started from midway down the forearms and wrapped down around the wrists, hand, and fingers then back up to just above the wrists and down again to make an even thickness to match the rest of the cast on the arms. The fingers were casted together with the thumbs separate and the fingers were held curved in a gentle relaxed position like the hand was holding a tennis ball with the wrist bent back slightly. The loose ends of stockinette and exposed padding at the waist, neck and fingers were all pulled back onto the cast and a fourth layer of plaster bandages was wrapped on to finish the cast and hold the loose ends in place. Finally wooden rods were brought over, measured, and cut to fit between the cast about two inches above the waist and the middle of the forearm which were then fixed in place with more rolls of plaster to provide extra support to the arms and the cast was finished. The harnesses were removed and Frank and Hellen were given a couple of minutes to explore their new “turtle shells” as the techs called them.

“Wow, this cast is really heavy and I can’t move anything between my neck and waist at all. You weren’t kidding when you said the cast would be close, every time I turn my head I can feel it gently rubbing my neck. I’m glad I don’t have both legs in casts like you do Hellen. At least once I get used to this thing I’ll be able to walk around.”

“Yea, well keep that in mind Frank. Wait until you want to eat, or have to go to the bathroom, and can’t move your arms and someone else has to do it for you.”

“Oh wow, I didn’t think about that. That’s going to suck. I don’t know if I can do this now.”

“Yea, it is gonna suck a bit. Kinda late to think about those things now though don’t you think? You’re in the cast now and I don’t think these guys are going to cut you out. You’re here to stay and be a patient for us in the parade this weekend.

“Look at it this way. When you get upstairs and see all the other kids up there think about this. Some of them are experiencing bladder and bowel problems and don’t have any control over when they have to go so they have to wear a diaper and a catheter, and one of them has her jaws wired shut so she has to be fed through a tube. Now remember that I’m supposed to have casts to match everyone else you see up there. You can see I have a feeding tube up my nose giving me water so I don’t dehydrate and that’s how I get fed too, but what you don’t see under this blanket is that I’m wearing a diaper and have a catheter as well because I’m experiencing all the same problems the other kids are.

“I’m here for the long haul too, just like you are now. I’m a patient and I have my own bed upstairs, but I have to deal with everyone’s treatments all at once. Think about how I’m handling all this already. And there are still two more kids to come in to complete the list. What you’ve got to deal with isn’t so bad now, is it?”

“No, I guess it isn’t that bad. Having someone wipe my butt for me will still suck, but it’s not as bad as you and some of the other kids.”

“That’s right, what you’ve got to deal with is not so bad. You’re twelve years old and almost a teenager, think you can deal with it?”

“Yea, I think I can.”

“Good man Frank,” Hellen said with a warm smile, “I knew you could. The orderly will take you on up to meet the other kids and I’ll see you before long once we get the next actor taken care of here.”

Tuesday, Nov. 29^th 2:35pm – procedure room five

About the time that the cast techs had been working on getting the abduction bars fixed in place on Frank and Hellen’s casts, Harold had come in and told them the last child for the day was there and waiting. After the orderly wheeled Frank out the next boy was brought in with his mother and introduced and Harold left right away as he had before.

“This is Gary, our next actor, and his mother Andrea.”

“Hello Gary, how are you doing today? My name’s Hellen. Are you excited about getting a cast? Have you ever had one before?”

Hellen waited a minute and when Gary didn’t answer looked to his mom.

“Gary is shy around new people I’m afraid,” she said with a loving smile directed at Gary. “He’s definitely excited to be here, it’s the only thing he talks about at home. Come on Gary, say hi to the people and tell them what you’re getting.”

“Uh, hi. I’m Gary and I’m eleven. I’m going to get a body cast for my legs.”

“Oh, a body cast for your legs, I see. What made you decide on that?”

“My little sister has one.”

“My daughter is currently in a dual-hip-spica cast for congenital problems, and Gary has been a bit jealous of her.”

“Goodness Andrea, two kids in big casts. Can you handle it ok?” Hellen said with a wink.

Gary’s mom caught the wink and went along with it. “I have to. My husband and I are dealing with it the best we can. What with Gary hurt and needing a cast now and his sister already in one we don’t have any choice but to deal with it.”

“Oh goodness, I guess so. Gary, do you have the same problem your little sister has? Is that why you need a cast too?”

“Nuh-uh.”

“Come on Gary, tell them why you need a cast. He’s come up with his own story which is pretty good.”

“Yea Gary, tell us what happened. Um, actually, why don’t you wait a couple of minutes, it looks like the cast guys want to cut off the casts on my legs and it’s going to be rather noisy in here.”

Two of the cast techs had cast saws in hand and got to work cutting off the casts on Hellen’s legs after re-arranging the blanket over her lap so it exposed her legs while still covering her diaper. After removing the casts on her legs they continued on up and started cutting through the shoulder-spica cast they had just put her in as well. The techs were careful to cover Hellen’s breasts with a blanket when the chest portion of the cast was lifted away for decency. It took about fifteen minutes and Hellen was free of any casts, although she knew they were about to put her back in one again and wondered how they were going to handle her diaper and catheter.

“Ok Gary, they’re done with the noisy part, so how about you tell me what happened that you need a big cast now.”

“Well, I was riding my bike. I was going down the street to the park. I got to the light where I had to cross the street and looked both ways and thought I could make it. As I was crossing a car came too fast for me and hit me and knocked me off my bike. Another car going the other way couldn’t stop and ran me over.”

“Oh my! That sounds bad! What kind of injuries do you have?”

“Um, both my legs are broken. Top and bottom. And my feet. And my hip bone too.”

“Yep, that’s a fairly accurate description of what we’ve got on the medical chart here. Gary’s going to be placed in a double-hip-spica cast for fractures to his pelvis, both femurs in the upper legs, both bones in the lower legs, the tibia and fibula, and both heels, which is the calcaneus bone. With the pelvis fractures the cast is going to start just below the armpits and go all the way down both legs.”

“Um, Miss Hellen?”

“Yes Gary? And it’s just Hellen, you don’t have to call me Miss.”

“How come you had casts on but they got cut off? Aren’t you afraid you’ll get hurt without them?”

“No Gary, I won’t get hurt. You see, I’m getting a cast put on me that is the same type of cast that each of the other kids get who are here to be actors like you. So, when some of the other kids came in earlier today I got casts on my legs like one of them did. Did you see the boy who got wheeled out just before you came in?” Gary nodded in response. “Well he was another actor and had the very same cast on him that I had on my body and arms. But now that you’re here to get a cast on your body and legs, all those casts would get in the way and they had to be cut off so I can get a cast on my body and legs just like you get.”

“Oh, ok. Are you being an actor like us too?”

“In a way I am.”

“Why were your toes all covered up and your feet twisted around?”

“That’s what the boy who got his leg casts wanted for his acting part. He’s upstairs with the other kids. Is that something you might like on your cast?”

“Um, maybe the toes, but not the twisty feet.”

“We can do that easily. With the injuries you already have listed including the toes in the cast is not unusual at all. We won’t even have to add anything extra to your chart for it. Ready to get started?”

“I guess.”

“In that case I’ll wait outside Gary. I’ll be right out in the waiting room if you need me.”

“Ok Mom.”

“Alright. Come on over here with me Gary. I need you to go behind this screen here and get completely undressed. Call me when you’re done and I’ll come around and help you get into a special pair of pants for the cast.”

 While Gary was getting undressed behind the screen Hellen was wheeled over to one of the waiting cast frames and transferred onto it. Her diaper was removed and the catheter disconnected and plugged again. They helped her get a pair of cotton stockinette pants pulled up so it covered her from the armpits down to beyond her toes. Gary called out when he was done undressing and one of the techs took a similar pair of stockinette pants around and got him dressed in it before bringing him over to the other cast frame and getting him up on it.

The cast techs suspended Gary and Hellen’s legs in slings and slid a pole up between their legs with a narrow pad for their butt to rest on. Most of the canvas straps were removed leaving just the one under their shoulders to hold their upper body and they were told to put their elbows out to the side and rest them on the rails of the frame and to grab the rail with their hands. Then their lower arms and hands were wrapped to the rail using elastic bandages to hold them in place.

Once the techs had the two of them positioned they started wrapping the cast padding around their legs starting at the feet. Small pieces of padding were ripped off and placed between the toes then the padding was rolled around the toes and on up the foot. The techs worked on both legs at the same time, and continued wrapping padding on up the legs. They used extra padding around the ankles and the knees, and as they went upwards would switch to wider size rolls as needed. When they got both legs covered up to the crotch the techs started working together to cover the torso.

Padding was wound around the hips and buttocks and over the abdomen in a figure eight pattern so that the crotch was also covered at the same time. Up to this point the largest roll of padding used had been four inches wide, but once they got the lower body done they switched to six inch wide rolls to keep working on up. Several short lengths of cast padding were ripped off and placed over the tops of the hips to cover the bony part and prevent pressure sores then the techs continued to wrap the padding around all the way up to the armpits. After getting to the top they turned around and started working back down with a second layer of cast padding, over lapping the wraps by two-thirds like they did on the way up, including the extra layers of padding at the hips knees and ankles again, and finished up winding padding around the toes.

Rolls of plaster were soaked and started down at the feet, tightly wrapping around the toes and slowly working upwards over the feet and ankles. About the time the techs were working up Hellen’s calves she stopped them.

“Guys, we have a problem.”

“What’s up Hellen?”

“I need to go to the bathroom.”

“Ok. We planned for this. Can you hold for two minutes while we get the gear?”

“As long as it’s no longer then that, I think so. And how about draining my bladder while you’re at it, I’m feeling a bit of pressure there too.”

“We’re on it.”

Both Hellen and Gary’s legs were laid back in the slings and all four techs moved to get what was needed. One went to get the screen for some privacy, another went over to a shelf and got a bed pan and some wet wipes for after, and the other two got to work cutting the padding over Hellen’s crotch and moving the support pole out of the way while putting the canvas strap under her hips back in place to hold her up. Everything was done and ready in plenty of time to avoid a mess, and once Hellen was finished with her BM and her bladder was emptied they got her cleaned up and back in the right position to continue working on the cast. Because the padding over her crotch had to be cut open which exposed her privates, the screen was just shifted in place so that Gary and Hellen could see each others faces and shoulders but not lower down.

After the excitement of getting Hellen taken care of was over, the rolls of plaster were continued on up the legs over the hips and up the torso, using wider rolls as they progressed. As with the padding, once the armpits were reached the techs simply reversed course and worked back down again until they reached the toes. With the second layer of plaster done they switched to adding in plaster splints to the casts for strength in the weak areas. Long splints were placed along the backs of the legs that went from the middle of the thighs all the way down to the toes. Somewhat shorter splints got placed on the sides of the hips that went from the middle of the thighs up to the bottom of the ribs. Two more splints were used in a fashion similar to what had been done with the diagonal splints over the shoulders on Frank. Four splints total were used, two per leg, and the difference was on these casts the splints started in the middle of the lower back or over the belly button and ran diagonally down over the hip and around the thigh in a spiral. A last, large, sheet splint was then used to wrap around the torso twice that covered from the armpits down to the hips.

With all the splints in place and rubbed in to hold them on, two more layers of plaster bandages were wrapped on to lock the splints in place from bottom to top and back down to the bottom again. The loose edges of padding and stockinette were folded back over the casts at the chest, toes, and crotch, after cutting the padding and stockinette open over Gary’s crotch, and held down with a final full layer of plaster bandages. The plaster over the toes was pressed from top and bottom while the final smoothing and molding were done, and two spreader bars were added in; one between the legs just above the ankles and one between the knees.

The finished casts went from the top of the chest and the top of the back with room around the arm pits, down over the hips abdomen and buttocks with an opening for the anus and crotch, on down both legs to end over the toes leaving just the tips of the toes visible. Their legs were spread at about a thirty degree angle and supported by the two abduction bars. Their hips were bent up about twenty degrees, with the knees bent down around forty degrees to bring the heels of the cast in line with the butt, and the ankles were held at a relaxed fort-five degree angle.

“Ok Gary, you’re all done. Time to take you up to your bed now. Hellen, you get to stay here, we have a little more to do with you.”

“Of course. What time is it?”

“About five o’clock.”

“Looks like you’ll be just in time for dinner Gary. Once these guys are done with me I’ll be brought upstairs. The other kids are all really nice so don’t be shy and tell them your cast story. I should be there in a little while.”

The cast techs transferred Gary over to a gurney and covered his crotch with a blanket and he was wheeled out by an orderly to meet his mother and be taken up to his bed with the other kids.

“Ok, I guess I’m about to lose the movement in my arms and head again, right?”

“Got it in one. Sorry Hellen, but those are the rules. At least we won’t be starting over from the beginning again, we’re just going to add on to the cast you’re already in.”

“*sigh* Well at least I won’t have to listen to the saws again and this should be quicker. Could you hook up my drain bag again, my bladder is full.”

The plug got removed and her catheter connected to the drainage bag then the bag of water, which was empty again, was disconnected from her feeding tube, and stockinette was pulled down over Hellen’s head and bunched up around her neck so her head was left uncovered. Next a harness was secured around the back of her head and under her chin then pulled tight by the winch at the head of the cast frame. More stockinette was pulled up over Hellen’s arms and over her shoulders. The stockinette bunched up around her throat was pulled back up to cover her head and cuts were made in the stockinette, both around her neck and the ones over her arms, so that they all over lapped and covered her exposed skin. Cast padding was applied from the top of the current cast on up over her head and down her arms with the fingers wrapped together and the thumbs wrapped separately. Plaster bandages came next starting on the hands and working up the arms, over the shoulders, down over the current cast to below her breasts, and up over her head. Several layers were applied, and by the time the cast techs were done Hellen was once again in a dual-shoulder-spica that included all of her fingers with abduction bars between her arms and waist, and had a minerva cast around her head that cupped her chin with a small four-by-three inch opening at the top and framed her face like the previous minerva cast had.

The techs pulled the head harness out of the top of the cast and looked Hellen over from top to bottom.

“I don’t think I’ve ever seen or heard of a medically necessary and applied full body cast, but you’re in one girl and we put you in it. How’s it feel?”

“Comfortable, I guess. I can’t move a single thing though. You guys do a good job making it tight. Time to get me up to my bed and my dinner now I suppose.”

“Almost. We just have to wait for one of the doctors to come down first so just rest there and get comfortable if you can. Dinner will be waiting for you when you get there.”

About ten minutes later a doctor arrived with a covered procedure tray in hand.

“Well aren’t you all trussed up. One last thing to replace and we’ll get you upstairs.”

“Oh no. Not the wires. Come on, how will I talk to the kids tonight? And what about the new kid tomorrow? Can’t it wait?”

“Sorry Hellen, Dr. Zimer decreed the wires need to be replaced tonight. If the kids need to talk just try your best. And I don’t think the last child coming in tomorrow is going to be worried about doing any talking once things get started with him.” The doctor knocked on the cast over Hellen’s left breast, “It’s not like you can stop me. You’re helpless and unable to even move a pinky in this cast. The best you can do is making your lips sore by fighting against me. Please don’t do that.”

“No, you’re right. I’m sorry. I was just hoping this would happen later rather than sooner. Go ahead and let’s get it done.”

The doctor nodded and got to work. Twenty minutes later Hellen’s jaws were firmly wired shut. The doctor and a couple of the cast techs wheeled her back up to the ward and got her immobile body back in her bed. The doctor made sure the head nurse on duty was aware of the amount of care their patient was going to need, and then he left. The nurses got Hellen’s dinner meal hung up and connected to her feeding tube and fielded questions from the parents who were present about Hellen’s current condition, explaining that she had multiple serious injuries over her entire body resulting in the necessity for the cast she was currently in for treatment. For her part Hellen was laid flat on her back, could do little more than lay there staring at the ceiling, and couldn’t see anyone if they didn’t come stand right by her head. She didn’t even feel up to trying to talk so let the nurses do the talking for her.

A couple of the kids came over to see Hellen in her gigantic cast, but after a few minutes of staring went back to their beds or the play area. Little Lauren was the exception. After gazing at Hellen for a few minutes she went to the play area and came back to Hellen’s bed with a book. She managed to climb up in bed with Hellen and after finding a relatively comfortable position on Hellen’s cast started to read to Hellen and didn’t leave until the book was finished.

Wednesday, Nov. 30^th 8am – orthopedic ward

Hellen had been awake since about seven thirty in the morning and been thinking about the night before. Now that she couldn’t move at all, couldn’t talk or call out too well, and had to have every little thing done for her the nurses had been checking up on her every thirty minutes. Despite the frequent checks Hellen had still had an accident in the middle of the night and this time the diaper they had put on her was insufficient to contain it. The resulting mess had required the bed sheets be removed to be cleaned, and the nurses had to spend half an hour on Hellen and her cast to get her and it sufficiently cleaned. They had simply put several large adsorbent pads on top of the vinyl covered mattress in place of new sheets when they were done.

While the situation during the night had made Hellen feel humiliated, and reminded her how helpless she was in her current situation, what concerned her this morning was something she had been told last night. Shortly before they had left for the night, Sarah’s mother had come over to see Hellen. She told Hellen that Suzy’s teasing on Monday evening, while being in jest, had apparently bothered Sarah. She felt like she was not getting the full experience that she wanted with the current treatment level she was at when Hellen had last seen her. As a result Sarah had a talk with the doctors Tuesday morning about her course of treatment and what could be done to bring it closer to the real thing. The doctors had decided they could safely add in a muscle relaxant, so had setup an IV line that would give Sarah a continuous drip of the drug. The amount of relaxant was carefully administered so that it was strong enough to make Sarah too weak to stand on her own and even made it difficult to keep her arms or legs raised beyond a minute or so, and while the drug reduced her ability to breathe deeply it had not caused her any real problems with her voluntary breathing. One side effect for Sarah from the added muscle relaxant was that she had started experiencing more frequent bowel movements and they had been occurring much more randomly. Hellen figured that any changes to the children’s various treatments would probably be reflected in her own, and wondered if the bag of mush that had been hung up and connected to her feeding tube last night and for her breakfast a few minutes ago now had something added in with the other drugs in it since an IV would be difficult to insert with the cast she was in.

At least the nurses had given her some good news as well. The kids were all getting along with each other, and had been sharing their various stories and welcomed each new child to the floor as they had arrived. Lauren and Steven’s braces had been met with enthusiasm when they had appeared, and then as the two boys in the spica casts had arrived they had been the topic of the hour. When Edward and Robert had finally gotten to see each others casts they had laughed at how they had tried to out do the other and wound up doing the same thing, just one with the arms and the other with the legs. The children who could move about or do things fairly easily had started helping out those who couldn’t move about as easily with various little things and were getting a nurse or adult to help with bigger needs, and that had started happening without any prompting from any of the adults.

At about a quarter past eight Hellen was surprised to see David appear at her bed side.

She greeted him slowly so she could be understood, “Hello. David. You’re. A. Bit. Early. How. Are. You?”

“I’m good. I wanted to come up early so I could meet everyone before I got my cast and couldn’t move. Looks like you’ve beat me to it,” he said while knocking on Hellen’s shoulder, “this is one big cast. How are you doing in there?”

“Yes. It. Is. The. Nurses. Are. Taking. Good. Care. Of. Me.”

“How’s the food taste? It looks awful.”

“Can’t. Taste. Tube. Goes. To. Tummy. It. Does. Look. Nasty. When. Are. You. Supposed. To. Be. Here. Today?”

“My appointment is for ten this morning. I’m going to go meet the other kids here, so I’ll see you later.”

Wednesday, Nov. 30^th 9:30am – Procedure room five

An orderly and a couple of the cast techs arrived to get Hellen onto a gurney and wheeled her on down to the cast room to get her ready. By this time she had started experiencing feelings of weakness even restrained as she was inside of her huge cast and was fairly certain that she had been given something similar to what Sarah was getting. After arriving the two techs got out a couple of cast saws and proceeded to cut through the plaster surrounding her entire body. Once the top half of the cast had been removed Hellen had tried to move and found herself so weak that she was no help at all when they got her out of the back half of the cast. One of the techs checked her medical chart and confirmed the addition of the new drug and a note as to its effect on Sarah. The cast techs decided to give Hellen an enema to clear out her bowels so they wouldn’t have any surprises during the long casting session that was coming. Once done, they got Hellen into a stockinette shirt and pants then situated her on one of the casting frames. A small hole was made in the crotch for her catheter and the drainage bag was situated where it would be out of the way, then they laid a blanket over her to keep her warm while they waited for David to arrive.

David arrived at ten AM sharp along with a couple of doctors and a couple nurses pushing several carts of equipment. After making sure everything needed was present one of the doctors spoke up to get everyone’s attention.

“Ok everyone, this will be the last actor to get a cast, and is going to be the biggest and most involved one of the lot. Hellen and David, I’m afraid this is going to be a bit stressful on the two of you, but it’s what David wanted and has been ordered for his treatment regime. We’re going to be inserting a feeding tube and a catheter, which Hellen already has both. Then we’ll insert an endo-tracheal tube into your windpipe David, but since Hellen’s jaws are wired shut we can’t give her one. We’ll have to wait until her cast is finished to see if something can be done about that later. We’ll also screw a Halo ring onto your skull that will get connected to the traction on the casting frame while you are put into your casts. The Halo ring will get connected to a support frame that will get embedded into the body cast and will maintain the level of traction that has been applied. Finally your arms will be placed in full length casts.

“I know this is what you have agreed on David, and is in your contract, but I am going to give you this last chance here to change your mind and reduce what we are about to do here if you want to.”

“This is what I want. The body cast is going to include my legs as well and everything you just listed is going to be done to my parents when the time comes, correct?”

“Yes, according to the agreements between everyone’s lawyers, that’s the deal.”

“Then I’m not changing it. They need to be shocked out of their rut of nothing but work work work and I don’t want them to be able to just get up and walk out. I want to be a family again, and this is the only way I see it will happen.”

“Very well. Since this is the last casting session on the list for our actors, there will be some differences made to Hellen’s cast as the techs work to comply with her contract obligations. For example, her arms will be connected to her body cast where your arm casts will remain free at the shoulders. That way we won’t have to cut everything off and start over again.”

Hellen was shocked at hearing what David had decided on for his cast, and was glad when she heard that due to her jaws being wired shut she would not be having another tube shoved down her throat. She couldn’t object very well with her jaws held shut, and with the drugs in her system she was not going to be able to resist. She took solace in telling herself that it would only be for three or four days and after the parade was over it would all get removed.

David was handed a stockinette shirt and pants and sent behind the privacy screen to change into them, being told to strip completely and come back out with only the stockinette on. David got dressed as instructed and was led over to the second cast frame where he was laid down and the frame adjusted to support him in the right places.

While David had been getting changed the doctors and cast techs had been moving equipment around and getting everything setup and ready to go. Once he was situated on the frame one of the nurses opened up the kit to insert the catheter into David’s bladder. She informed him that it would feel strange and should be done and over with quickly if he just relaxed. She pulled down the stockinette pants to his knees and five minutes later she was done, the catheter emerged through a small hole cut in the stockinette that had been pulled back up at the end of the process, and David’s bladder was draining into a bag hung from the cast frame. Next the feeding tube was opened up and lubricated, and a numbing solution was sprayed up David’s left nostril. After giving the solution a couple minutes to work the tube was pushed up inside his nose, down the back of his throat, and down into his stomach with David swallowing water as instructed to get it in place. The end of the feeding tube left on the outside was taped to his cheek to keep it out of the way. With the two tubes now in place they gave David a few minutes to adjust to the sensations before continuing with the next one.

*cough* “Dang Hellen, you went through this to get your catheter and feeding tube inserted?”

“Yes. Not. At. Same. Time. Though. Not. Fun. Is. It?”

“No, it’s not.” *cough* “How long does it take to get used to them?”

“Not. Long.”

One of the doctors and a nurse came over with the kit to insert the tracheal tube.

“Ok David, now for the big one. When I tell you to, you need to cough for me so we can get this tube inserted quickly and properly.”

The kit was opened up and rubber blocks were inserted between David’s teeth on both sides to hold his mouth open. A long flat curved metal probe was inserted into his mouth and into his throat to hold his tongue down while his head was tilted backwards some to provide a clear view and path for the tube. The tube was inserted and when told David coughed and the tube slid down deep into his windpipe. The probe was pulled out and a small pump was connected to a valve on the side of the tube to inflate the balloon at the end of the tube down in his throat to seat it in place and seal the trachea closed. The doctor made sure that David could breathe freely through the tube then the bite blocks were removed and the end of the tube was taped across his lips to keep it from moving around.

A minute later a doctor, nurse, and one cast tech each approached Hellen and David with the kits for the Halo rings.

“This part is going to be a little painful. We’ll use an anesthetic on the flesh over the pin sites, but we can’t do much for when the pins enter the bone I’m afraid.”

“What. Are. You. Doing?”

“We are about to fit the two of you with a Halo ring as per David’s contract. We will be fixing them in place with pins that are hand-screwed into your skull which is the standard method.”

“Sc’ewin’. Pins. ‘N. ‘I. He’d?!? I. Don’. ‘Ahnt. ‘At!”

“This is what David wanted, we agreed to, and everyone signed. Including you. It’s all part of your contract Hellen, so just accept it. Or do we need to get Harold and Mr. Hastings in here?”

“ ... “

“No.”

“Very good.”

Measuring tapes were used to check the circumference of their heads along a line about an inch above the eyebrows and the measurements compared to the size of the Halo rings to ensure the correct ones had been selected. Once confirmed the kits were opened and the Halo rings pulled out and placed around their heads. The Halo was not a complete ring, it actually looked a lot like a horseshoe in shape with numerous holes spaced around the ring where the skull pins could be inserted. The positioning posts were screwed in place and tightened down and the appropriate holes in the rings for the skull pins were selected and six small marks were made with a felt tip pen by shining a light through the selected hole to get the exact position. One mark was made above and slightly to the outside of the middle of each eye on the forehead. Hair was moved out of the way and another mark was made on the side of the head above and slightly behind each ear. A final mark was made further back on each side that matched the last hole on the ends of the Halo then the rings were removed.

The hair on each side of the head was shaved off in a two inch square patch where the marks had been made then all six locations were cleaned with an antiseptic. With the pin sites cleaned a needle was inserted and the anesthesia injected at each spot and given five minutes to take effect. The doctors checked and made sure that Hellen and David could not feel it when they pokes the sites with the needle again then took a scalpel and made very small starter incisions just barely big enough for the pins to fit through in their skin at each location down to the bone and the nurses applied pressure to stop any bleeding that happened. The Halo rings were fitted back on and the positioning posts screwed down again then the six skull pins were threaded into the selected holes and screwed down by hand until the tips entered the cuts and made firm contact with the bone underneath.

A torque wrench was then used to begin tightening the pins one at a time. Each pin was turned about a half turn then the pin directly opposite was turned the same amount, the next two opposing pins were tightened the same amount, and the final two pins were tightened the same way. This continued until all six pins had been tightened to eight inches per pound each. The positioning posts were removed and the doctors checked the torque on all the pins to make sure they were still at eight inch-pounds then the lock nut on each pin was tightened down. With the Halo rings in place, clamps were attached to the ring on both sides which were then connected to a spreader bar via ropes and the spreader bar was attached to the winch on the frame with a strap for the winch. The winch was turned until it indicated that twenty pounds of traction was being exerted then locked at that setting.

Everyone split up so that there were two cast techs a nurse and a doctor working on each of the ‘patients’ to help get the casts done. Felt pads were measured and cut to go over the hips and shoulders, on both sides of the knees and ankles, and around the heels. Extra pads were measured and cut to fit on the underside of Hellen’s chin and the back of her head. Cast padding was started at the feet, and the differences between the two casts began to become apparent. Where David’s feet were held at a forty-five degree angle and kept in a neutral, relaxed position with his toes left free, Hellen’s right foot was once again turned inwards and pointed down more with her big toe being bandaged separately and the rest of her toes wrapped together with extra pieces of padding placed between them. Her left knee was bent to ninety degrees with the left ankle pointed down as far as it would go, then the toes were treated the same as the right foot. Hellen’s right knee was bent to a forty-five degree angle again while David’s knees were flexed only about fifteen degrees. At the hips both had their legs spread about thirty degrees out to the side, but David’s hips were bent upwards only about seven to ten degrees with Hellen’s hips bent at different degrees to accommodate the differences in her knees. When the cast padding reached the shoulders on David the padding was brought up over the top but did not include the arm pits or continue down the arm at all leaving a three inch gap between where the padding on the shoulder stopped and the padding on the upper arm started. On Hellen her shoulders were fully covered with an extra half-roll of loose padding included in the armpit and the padding continued unbroken from the shoulder down her arm. At the hands, David’s fingers and thumbs were left uncovered and Hellen’s were once again wrapped in padding with padding placed between the four fingers then binding them together and her thumbs wrapped separately. Also, the stockinette was pulled up and cast padding was wrapped on up Hellen’s neck and around her head below the Halo ring. Two thick layers of cast padding were applied to both of them with the felt pads being incorporated and secured in place between the two layers.

Many roll of various sizes of plaster bandages were used starting at the feet and working upwards over the legs hips torso and shoulders. As everyone worked the canvas straps supporting David and Hellen would get moved up or down or just removed to keep them out of the way while still giving sufficient support to their bodies with the slowly increasing weight of the wet plaster being added on. The methods used to wrap the plaster varied slightly depending on what was needed for each individual being encased.

With David, once the first layer was wrapped over the top of his shoulders the group working on his cast started back down leaving his arms alone and letting him know they would be finished once the main cast was done. When they got back to the feet and finished the second layer plaster splints were soaked and used on the back of the legs, the hips, and around the torso then a third layer of plaster bandages was wrapped from bottom to top to lock in all the splints. After completing the third layer a plastic harness was brought over that went over the shoulders and was connected horizontally across the chest while on the back the harness had separate horizontal extensions that interlocked. Attached to the harness were four black metal connection points for the four upright Halo bars to be slotted into. The cast techs made sure the four ports got positioned evenly in front and back then rolls of plaster were used to wrap the entire harness and hold it in place while leaving the connection ports exposed. Once the harness was tightly secured the team working on David continued on down to complete a fourth layer of bandages. The openings around the shoulders were checked and trimmed to a proper size, the padding and stockinette covering the crotch and butt was cut open and the plaster trimmed as needed around that area as well, and the stockinette around the toes was pulled back exposing them. A fifth layer of plaster was started at the top with the loose ends of stockinette being pulled back and secured as they went down. To complete the dual-hip-spica David was now in, abduction bars were measured and added in between the ankles and the knees. David’s arms were then wrapped in plaster using four layers of bandages with a couple of splints added in. The elbows were held at a ninety degree bend and the wrists were kept straight in a neutral position, creating standard long arm casts on both arms.

For Hellen the process was relatively similar. The differences being that her feet and toes were immobilized with the plaster bandages in the same manner as had been done with the long leg casts for Edward and Michael respectively, her shoulders were fully covered and included in a dual-shoulder-spica with her hands completely included like Frank’s and Emily’s casts, and abduction bars were included with two between the legs and one each between the torso and fore-arm on both sides. The cast also extended up around her neck to cup her chin again and came up the back of her head and around the sides so the top of the cast was about two inches below the Halo ring. Her face was left free so that there was a U-shaped curve that started at the corner of one eye, came down to the corner of the lip, curled around along the bottom of the lip and back up again to the corner of the other eye. This was done as the closest approximation they could create to Sarah’s minerva cast without covering the Halo ring and pins. A plastic harness with four connection points for the Halo bars was also incorporated into the body portion of Hellen’s cast. Once the cast was completed Hellen’s legs were left positioned with the left knee rising higher than the right which brought the foot up to where the end of the left toes were about even with the right ankle; but with the hips flexed to different degrees both heels would rest and be supported at the same level when Hellen was placed back in her bed.

After all of the plaster was wrapped, smoothed, and formed on both patients the doctors, nurses, and cast techs took a break for thirty minutes to allow the plaster to harden enough before adding in the rest of the support structure for the Halo system. When the casts were deemed ready the four bars were inserted into the appropriate ports, checked for height and angle then the bottom ends were partially tightened down. The structure to connect the bars to the ring were connected to the bars first and checked for position and tightened. Finally the connections to the Halo rings were loosely made then David and Hellen’s heads were positioned so they were looking straight ahead. All the Halo connections were adjusted as needed and everything was tightened down to their final settings. When the traction being applied from the winches on the cast frames was slowly released David and Hellen couldn’t tell the difference when the Halo system took over from the winch to hold their heads in place.

A final check was made of both patients to make sure the casts were done and the Halo structures were correctly positioned and tightened to the correct level.

“Very good everyone, looks good. Well done. Let’s get David on up to his bed now while we take care of one last thing for Hellen.”

David was transferred to a gurney and a couple orderlies rolled him out and up to the ward with the other children.

“Bring over a cast saw with the small detail blade attached and someone prep the insertion kit.”

“Here you go Doctor, we had the saw ready to go.”

“The insertion kit will be ready by the time you are done windowing the cast.”

When the doctor approached Hellen with the cast saw in hand she tried to wave him away only to find that she could not move anything.

“Hey. Wait. What. Are. You. Doing.”

“I told you at the beginning that we would have to come up with something different to get you on a respirator. So what we’re going to do is cut a window in your cast and perform a tracheotomy and insert a tube through the front of your throat.”

The saw was started up which effectively drowned out any sounds Hellen could make. She tried to struggle or move anything to avoid what was happening but the cast held firm, the plaster having cured more than enough to hold her drug weakened muscles immobile.

Four cuts were made in the plaster over the lower front of Hellen’s throat and the plaster removed. The padding and stockinette underneath was cut open, trimmed, and pulled back to create an opening exposing her throat and a small roll of plaster was used to secure the loose ends. Once the saw was shut off Hellen’s protests could be heard and it was apparent she was becoming agitated as she was not concentrating on speaking clearly.

“M’leese ‘on’ ‘oo ‘is. ‘Is is ‘oo muh.”

The Doctor took a syringe and injected Hellen’s throat twice with pain killer.

“OW! No! Don’! ‘Leese!”

The doctor and nurse assisting him laid out the necessary instruments which took about five minutes and allowed the injections to take effect then he put on a pair of rubber gloves and picked up a scalpel.

“NO! NO! ‘LEESE S’OP! AAHHHHHHH!” Hellen yelled as the doctor made the cuts in her neck for the tracheotomy. Tears began to fall from her eyes only to be caught and absorbed by the edges of her cast.

A vertical cut was made in Hellen’s throat deep enough to expose the trachea then a horizontal cut was made through the third tracheal ring just big enough to allow the tube to be inserted. With the trachea opened and allowing air to escape through her neck, Hellen’s please for them to stop dropped in volume to barely a whisper. The trachea tube was inserted and the cuff around the tube inside her throat was inflated to close off the airway which fully stopped any air from reaching her larynx. This rendered Hellen mute and she was only able to breathe through the tube. The doctor checked the positioning of the tube then two sutures were sewn above the tube and two more below to close the wound around the tube then a separate suture was made on both sides through the skin and holes in the external flange to secure the tube in place.

Hellen’s breaths began to whistle in and out through the trachea tube in short sharp puffs, and while she was unable to move anything from head to toe it quickly became obvious that she was struggling against the cast and Halo. Her eyes were open as wide as they could get and she was looking around franticly while not actually focusing on anything. The little bit of her body that could be seen was quivering as the muscles in her body spastically clenched and released causing the tube in her throat and the catheter in her urethra to visibly jerk around. The seizure of her muscles was so strong that despite the enema done earlier Hellen’s bowels let go.

“Dammit! She’s having a panic attack causing a seizure!”

“Hellen, you need to calm down and breathe slowly. This isn’t going to do you any good right at the moment and will only make matters worse if you can’t control it.”

Hellen was in a full blown panic by this time. Her breaths continued to get shorter and shorter and her muscles began seizing up completely without releasing which made it even harder for her to breathe and only increases her panic.

“We have to get her calmed down now! Give me a syringe of Anectine at 2mg per ML, 50 CC dosage! And get a respirator in here!”

Seconds later a nurse hands the doctor a syringe which he takes and, in about a thirty second period, slowly injects it into a vein at the top of Hellen’s thigh which is the only place available. Thirty seconds later Hellen’s body begins to relax and by the end of one minute her breaths have become long and shallow.

“This is only going to last for a few minutes. Prepare a syringe of 10mg Nuromax. Where’s that respirator! We need to get her ventilated!”

“Right here doctor!”

A blue plastic hose is connected to the tube in Hellen’s throat and the respirator is turned on. While the second injection of drug is slowly administered in the opposite thigh the respirator is adjusted and in about five minutes Hellen’s ability to breathe on her own is removed completely and is being controlled for her by the machine; the rest of the muscles in her body relaxed and quiet as well.

“Ok, good. We’ve got it under control. Hellen, if you’re going to panic like that then we are going to have to keep you calm whether you want it or not.

“Get Hellen cleaned up please. I want a continuous drip set up when we get her up to the ward and we’ll maintain the drugs for a few days. Let’s get her back upstairs and setup as soon as possible. And clean up in here.”

Hellen’s butt is wiped off before she is transferred onto a gurney, then a proper cleaning is done. When the nurses have her clean a smaller diaper is inserted into the cast around her crotch and a bigger one is tightly taped around the outside to secure the first diaper in place and Hellen is wheeled out along with the respirator and up to her bed by a doctor and two nurses.

Wednesday Nov. 30^th 12:09pm – orthopedic ward

Once Hellen was moved over to her bed and the respirator was put in place the curtain around her bed was pulled closed while the doctor ordered the supplies to insert an IV line to administer the continuous drip of the drug that had been ordered. He made sure the needle was properly inserted in Hellen’s upper thigh and everything was properly flowing before he left. One of the nurses stayed behind and sat down on the side of Hellen’s bed while one of the floor nurses was checking on all the lines and equipment hooked up to Hellen.

“What happened down there? Why is Hellen on a drip?”

“She had a full blown panic attack after the trach-tube got inserted. It was pretty much a grand-mal seizure. The doctor ordered her medicated to keep her calm for a few days.”

The nurse who stayed and was sitting on the bed turned to Hellen and stroked her hair.

“Hellen, I know this is upsetting sweetie. But we are concerned for you. If the seizure had continued things could have gotten really bad for you. Because your body is restrained in a cast you could have torn muscles ligaments or tendons in your body. Or if the seizure had gotten any stronger you could have actually cracked or broken bones. And the worst possibility, and the scariest, is that you could have actually suffocated. We want to keep you around, not lose you.”

“That’s right Hellen. Even the kids have been talking about you up here. They really look up to you and respect you for what you are doing. Just like everyone one of us.”

“Now, I know you probably don’t agree with this, but we’re going to keep you calm with the drugs for a little while until your body can adjust to your situation and you can relax on your own and just go with the flow. I have to go, but don’t worry, everyone is going to look out for you and take good care of you here.”

The nurse stood up from the bed, leaned over to kiss Hellen on the top of her head, and went back to her duties.

“With you unable to move or speak like this, it looks like we are going to have to come up with some way to communicate and keep it fairly simple. We’ll have to stick to just yes-no questions I guess.

“Blinking is probably going to be the best way for you to answer. One blink can be confused with your body’s natural need to blink to keep your eyes moist or clear out a speck of dust. Let’s go with two blinks for No. Make them solid one second blinks. And three blinks for Yes. Think that will work?”

Blink. Blink. Blink.

“Three, that’s a Yes. Excellent. I’ll tell everyone on staff and the kids so everyone knows. You’re going to be high maintenance like this so the nurses are going to be checking on you very frequently. Like Karen said a moment ago, don’t you worry, we’ll take very good care of you while you’re here.

“Now, are you feeling any pain right now?”

Blink. Blink. Blink.

“You are. Is it all the stabs and cuts from the IV, Halo pins, and trachea tube?”

Blink. Blink. Blink.

“Thought so. I’ll see what we can do for a pain medication that won’t react with all the other drugs we’ve got you on right now. Do you hurt any where else?”

Blink. Blink.

“No. Good. I’m thinking that you probably need to be left alone and take a nap right now. How does that sound? We can leave the curtains closed and I can get you a sedative instead of the pain medication and you can get a little sleep.”

Hellen thought about it for a minute then answered the nurse.

Blink. Blink. Blink.

“Ok. You just take it easy and I’ll be right back with something to help you sleep for a bit.”

Wednesday, Nov. 30^th 5:15pm - orthopedic ward

            Hellen slowly woke up to the sounds of the machine breathing for her and the kids apparently having a good time on the other end of the ward. When she opened her eyes she saw the back of a nurse just going out through the curtain around her bed. Hellen wanted to stop the nurse, but realized that unless someone was looking right at her she had no way to signal she wanted their attention. She heard one of the kids ask the nurse a question.

           

            “Is Miss Hellen awake yet?”

           

            “No honey, she’s still sleeping.”

           

            “Ok.”

Hellen looked around to see if anything had changed while she slept. The pole her bag of food usually got hung up on was still empty so she figured it wasn’t dinner time yet. The pole the IV drip had been hung up on had changed though. Now, instead of just the one bag with a tube going down to the needle in her leg, there was one of those drug pumps attached to the pole with several bags of drugs hung up on it and being controlled by the pump. The machine was there to her left doing her breathing for her going whoosh-click*air in*, pause, whoosh-click*air out*, pause, and on and on. She timed it and figured the air pump was breathing in or our for her at just a little longer than one full second per breath, maybe as long as a second and a half, and the pauses in between were lasting for only a fraction of a second. At least she was getting very full breaths this way, but when her lungs got filled with air it was getting a bit tight inside of the cast around the chest. Hellen also noticed that the cast was not covered at all as far as she could tell, and she was feeling cold and clammy inside it.

About 15 minutes after she had watched someone leave her little room the curtain was opened a little bit and a nurse came in with a bag filled with a yellowish-cream colored liquid in it. Hellen’s dinner had arrived. At the same time she heard a cart or two get rolled into the ward and someone announced to the children that it was dinner time.

“Oh, you’re awake. Let me flush your NG tube with water and get this hooked up then I’ll see how you’re doing. Unless there is something that needs immediate attention? Does it feel like you need a change or are you in a lot of pain anywhere?”

Blink. Blink.

“Ok. This will take just a couple minutes.”

Erica, according to her name tag, got Hellen’s dinner hung and flowing down into her stomach in short order then checked the drainage bag connected to her catheter.

“Not as much urine in there as I would like to see, and it’s a bit dark. I think the drugs you’re on may be dehydrating you a bit. I’ll ask Alice about setting you up with a regular bag of plain water connected to your NG when you’re not getting fed to keep you properly hydrated. Now, is there anything I can do or answer for you?”

Hellen looked directly up to the IV pole with the bags and pump on it for several seconds then back at Erica.

“Ah, curious about the change to your IV line, right?”

Blink. Blink. Blink.

“Right. Well, with the added drug needing an actual IV drip we decided that we would change all your drugs to liquid form and regulate everything with a drug pump. This way we actually reduced the size of your dosages of some of the drugs since it is going directly into your bloodstream instead of having to get processed through your digestive tract and filtered by your liver. It will mean that the effect of the drugs will last longer and we don’t have to give it to you quite as frequently either, but afterwards when we stop the drugs some of the effects will probably last longer though too. Sorry about that, but it really is better this way in the end.

“We made some changes to whose bed is where on the floor so we could group those of you who need more attention closer to the door just in case we need to get to someone quickly. You’re right next to the door as you know, and we’ve got David straight across from you on the other side. Sarah has been moved down so she is next on your right. Steven got moved over next to Gary since they are in somewhat similar situations. Believe it or not, Gary has been looking out for Steven with his incontinence and Steven has not had another accident yet.

“The rest of the kids we let pick where they wanted to go and of course it wound up being a “boys side” and “girls side”. We were afraid that with twelve beds, six to a side, and seven boys, that there would be a problem with one of them having to be on the “girl side” of the room. Edward and Robert wanted to be together, and we already put Gary and Steven together, so that left Frank and Michael to decide who got the last bed in the row. Michael spoke up and said that he’d take the end bed on this side of the room which surprised us, but then Emily wanted the bed right next to Michael. Those two have been getting along really well so that resolved the problem for us. Honestly I think it’s a case of puppy love between those two.

“Lauren was a little upset that she couldn’t have the bed next to you so we explained that we had to have Sarah next because she can hardly move with her injuries. We might have to rush in to help her in a hurry, and the quicker we could get to Sarah the better. Lauren understood that and even said she would help, so she’s in the bed next to Sarah. She is such a kind helpful little girl, and I think it’s her influence by just being herself that got all the kids helping each other like they are.

“The kids were asking about you after you were brought back up and wanting to know if you were ok. We told them that you’re now in a really big cast that matches all the various casts they are wearing at the same time. They quickly figured out that your cast covers pretty much your entire body, so they are curious to see you. Lauren has a couple of books set aside so she can read them to you. We’ve kept them away for now and explained that you had a hard time downstairs and needed to rest for a bit.”

Blink. Blink. Blink.

“Yes? Oh, you mean thank you, don’t you? You’re welcome. David was complaining, he can at least write with his arm casts, that his big cast is cold and clammy so we turned up the heat in here a bit. How is your cast? Feeling a bit cold in there right now?”

Blink. Blink. Blink.

“Yea. We can’t do a whole lot about that beyond what we’re already doing. The cast has to dry out completely, but once it does the cold wet feeling will go away and you should actually be pretty comfy and snug in there. Once it’s dry a plaster cast, and especially one as big as this, acts like a decent insulator and you will hardly feel the external changes of temperature unless they’re big shifts up or down.

“Getting the air moving around the cast is the best thing to dry it out which is why we don’t cover you with a blanket. We could increase the air flow around you some by opening the curtains up, but that means the kids are going to want to come over and see you too. Do you feel up to it?”

Blink. Blink. Blink.

“Alright. They asked a lot of questions about David’s Halo and the respirator he’s on so they know about those, and they’ve heard your respirator working over here so they know you’re on one too. We’ve told them about how you can’t talk at all, not even write like David can, so they have to be patient with their questions and only ask ones you can answer yes or no to. I’ll open the curtains up and stay here with you to help out.”

Erica undid the diaper around Hellen’s waist and checked the inside diaper first just in case, then put them back together and opened the curtains

Hellen’s bed had been arranged so that the head was elevated about fifteen degrees with the foot of the bed raised up to firmly support her feet so she would not wobble if bumped. This meant that when the curtains were opened up Hellen was able to look down her nose and see David on the opposite side of the doors from her. He was in a similar position in his bed as Hellen with his head elevated a little bit further than Hellen’s was. At the angle Hellen was looking she could see right up into David’s crotch where there was a towel covering up his privates and she realized he could see the same thing on her.

Hellen’s eyes got really big and she looked right up at Erica, looked straight at David then at Erica again, and finally looked down towards her own crotch and up at Erica again.

“What is it Hellen?”

Hellen pointedly looked down at her crotch, over at David, and back at her crotch again.

“What ... oh. OH! Ok, I get it. Um, yea. Well, David is covered up by a towel and none of the kids have teased him or tried to pull it away. When Gary came up we explained that because of the cast he can’t close his legs and the cast has to be open down there to let him go potty; so it’s very embarrassing to point it out and it would be mean to try and take the towel or sheet away. They’ve all been very good and neither Gary nor David has had any trouble with it. We make sure that when we have to assist with the bathroom the curtains get closed so they aren’t flashing everyone.

“You are covered by your adult garment so nobody can see your private parts either, and the curtains will be used just as carefully for you too. If you’re worried about them seeing you in a ‘diaper’, well, there’s not much we can do about that. I wouldn’t worry about it though. Sarah and Steven are in ‘diapers’ too and the other kids have accepted the explanation we’ve given them about it. The curtains are used for them too when we have to change their garments. All the kids just accept it as a part of the injuries they have at this point. You’ll just have to get over the embarrassment of it like everyone else did. Right Sarah?”

“Sure. Thing. Erica. It’s. No. Big. Deal.

“How. Are. You. Doing. Hellen? You. Ok?”

Blink. Blink. Blink.

“Hellen says yes.”

“Can. You. Help. Me. Turn. Over. A. Bit. So. I. Can. See. Better.”

“Sure.”

Hellen looked out of the corner of her eye to the right and could just see Sarah sitting up beside her. Her bed was elevated so that Sarah was sitting up much straighter. She was obviously resting back against the mattress, and when Erica appeared Hellen could see that it was a real effort on Sarah’s part to just roll her sideways to where she could actually look over and see Hellen. Erica got her turned then arranged some pillows behind Sarah to keep her in that position.

“Wow. That. Is. Big. You. Can’t. See. Hardly. Anything. On. You. Just. The. Top. Of. Your. Head. And. Your. Face.

“Those. Screws. In. Your. Head. Must. Suck.”

“We’re going to be taking very special care with those Halo pins on Hellen and David both. Because they go through the skin and enter the bone we have to clean and disinfect them every day. We also have to move the skin around them a bit so the skin does not try to stiffen up and heal open like that or grown up the pins. We don’t want to leave open holes in the skin when the pins come out. I’m afraid the daily cleaning will be a little unpleasant, but it needs to be done to prevent infection and the skin will heal with minimal scaring afterwards.”

That got both Sarah and Hellen’s attention when Erica explained what was going to be happening every day.

“Wow. Glad. I. Don’t. Have. Those.

“In. Fact. Why. Don’t. I?”

“It’s because of the nature of your injury. With an unstable broken neck we would normally use a Halo device. But in your case there are two factors why you’re in a Minerva Cast instead. One is that we had to deal with the shattered jaw. While wiring your mouth shut supports your jaws to a point, the extent of the injury required extra support. Second, even though the spinal injury is considered unstable, the level is at the base of the neck at the C7 vertebrate and not quite as severe as it could be. With these two factors added together, your jaw needing extra support and your neck could handle a little less than normal, it was decided that a tight, form fitting cast could do the job. Honestly, as well fitting as that cast is, the difference between a Halo and that cast immobilizing your neck is minimal.”

“I. See. What. About. The. Hole. In. Hellen’s. Neck. For. The. Breathing. Tube. Suzy. Had. One. Like. That. Too. Does. That. Make. It. Any. Less. Stable?”

“No. Not really. Maybe while the cast is still damp it could be a problem if it gets knocked around hard enough. But once the cast is fully dry and reaches its full hardness a small, properly sized opening like that won’t make a difference.”

“Interesting.”

Saturday, Dec. 3^rd 9:45am – Hellen’s room

Thursday and Friday had come and gone with little to mark their passing. The children had continued to get long with only a little friction which the staff handled expertly. Hellen could do little more that lie in her bed and watch the hours tick by. The kids did come visit her frequently, but after the initial curiosity of her all-encompassing cast was satisfied her interaction with them was severely limited. Lauren continued to read books to Hellen when she as awake which Hellen really appreciated.

Hellen did notice that on Thursday Sarah had spoken with a doctor in the morning, then during the afternoon Sarah had been taken away for two or three hours. When Sarah came back Hellen couldn’t ask her what it was all about, and Sarah didn’t mention it to anybody on the ward.

The drugs Hellen was receiving left her quite tired and her sleep routine was greatly affected by them and the enforced immobility from the cast. She would doze off for a short time, up to three or four hours at the most and as short as thirty minutes, then wake back up again. When she woke up she would often be confused as to where she was and why she couldn’t move, and it took her several minutes to remember what was going on. All of this combined left her irritable and with no way to express that irritation, but the children has seemed to pick up on it all the same. The confusion and immobility upon waking up had gotten bad enough on Friday that late in the evening Hellen had another panic attack which set off the alarms on her respirator and other monitors. The nurses had to give her a direct injection of the drugs to get her to relax again, and the kids were a little freaked out by what had happened as well. They left Hellen on the ward for the night as the children complained when they tried to remove Hellen, but the nurses made sure someone would stay in the room in shifts for the rest of the night.

Saturday morning breakfast was brought in a bit earlier than normal, and while everyone was still eating several parents started to show up with favorite clothing to start getting the children ready for the parade itself, which is what they had all been hired for. Nurses, doctors, and orderlies soon started showing up as well and the ward became a hive of activity and conversations all going on at once. Hellen had over-heard little snippets of conversations, mostly louder exclamations from the parents along the lines of ‘What? Are you sure?’, that left Hellen wondering what was going on but nobody came over to talk her as they were getting the kids ready. By about nine-fifteen the last child had been taken out to get them in place for the parade which started at ten. Even David would be in the parade, having his breathing tube removed temporarily so he could participate.

Hellen had heard enough of the conversations with the nurses to get the idea that the children who were ambulatory on their own would be allowed to walk as much as they wanted to with what ever assistive devices they had, but if they got tired then a wheelchair would be available for them to sit down and ride in. To help minimize the clutter of bodies, only one family member would be allowed to accompany each child, with the age of that person being restricted to eighteen and above.

About fifteen minutes after the last child was taken out, a doctor nurse and a couple of orderlies arrived.

“We are going to move you to a room of your own in the intensive care unit,” said Doctor Brown. “After last night we realize that you need closer supervision, and the ICU is a better place for you to get that.”

Blink. Blink.

“Now Hellen, I know you want to stay with the children, and even though they were a bit upset with what happened last night they wanted you to stay here too, but it’s just not the appropriate place for a case like yours. With the extensive list of injuries you’ve sustained and the treatment required for those injuries, you need a high level of over-view and maintenance which Intensive Care is more appropriately setup to provide.

“We’ll explain it to the children when they get back so that they understand. And in your condition it’s not like you can stop us.”

With that, the group unhooked the necessary connections on machines, switching several to battery power, and Hellen was moved to a room in ICU where she could be more closely monitored and attended to. They had adjusted the television in her room so she could see it and turned it on to the channel that would be broadcasting the parade. The hospital had an agreement with one of the local news stations to provide a feed of the entire parade so those in the hospital who could not participate or take time to go watch the parade could still get to see it.

To her satisfaction the parade appeared to be a big success. From what she saw on the broadcast all of her hard work paid off and everything looked outstanding. She even got to see all of “her actors” go by, each of them smiling and waving to the crowds to the best of their various abilities. Several times during the parade different nurses would stop in to check on her, and stay for a few minutes to chat and watch the parade with Hellen. After the parade was over several of the nurses from the orthopedic ward came by to tell Hellen stories of how excited the children were and how well things ran. They let her know the children were disappointed that Hellen had been moved out of the ward, but understood when they were told Hellen required more care than they could give in Orthopedics and needed to be here in ICU.

Later in the day Hellen was surprised to learn that although a few of the children could have gone home, they were all staying in the hospital for the night. Erica, the nurse who stopped by to see Hellen, informed her that the kids had apparently bonded with each other and the ones who could have left were staying in support of those who could not. She also told Hellen that there was something going on between the kids, and when the time came to start removing casts on Monday Erica felt there might be a surprise. She wouldn’t tell Hellen any more; only saying the children were doing their best to keep what-ever it was a secret so she really didn’t know any more, she just had a feeling.

Monday, Dec. 5^th 11:42am – Hellen’s room

“Guten morgen, Fräulein Amaya,” said Dr. Zimer as he walked into Hellen’s room.

“Um, hello Hellen,” Mr. Hastings said as he followed Dr. Zimer in and closed the door then got a look at Hellen for the first time.

They each took a chair and moved it closer to Hellen’s head and Dr. Zimer raised the head of Hellen’s bed so she could see the chairs, then the two men sat down.

“To start off, as I’m sure you saw, the parade went off quite well. Your work on organizing the event has done the hospital proud. Your idea to use child actors was a good one and we are starting to see an up-swing in donations like we hoped for thanks to you.”

“But now, we have a bit of interesting news for you in relation to your actors, junge dame.”

Mr. Hastings nodded, “It would seem that I am going to be without my employee for a bit longer than I originally thought. We anticipated that the majority of the children would be getting their casts removed today, or remove their braces. We had figured that, with a couple exceptions, the longest we’d have a child in a cast would be about five days. Instead, none of them are getting out of their cast. A rather unusual circumstance.”

“Ja,” agreed Dr. Zimer. “It would seem that with the influence of several of the children they have all set a, um, test? Nein. A ... anfechten ... a challenge?”

Mr. Hastings nodded.

“Danke. The children have set a challenge for each other to wear their casts for the full length of time. We knew this would happen with young Master Williamson and Fräulein Levin as they had already expressed this as a part of their contracts. What we did not expect was for others to choose the same path.

“When the boy with the achilles injury ...”

“Michael.”

“Ja, Michael. When he heard the other two would be staying in their casts for the whole time he told the rest that he would keep his on the full time as well. This got several of the other children going and in turn they all talked with the nurses about how long it would take to heal and be in their various casts. Then it became a challenge. Michael and the boy with the HKAFO, Steven, became the ring leaders to challenge all of the others to stay in their casts. In the end every child agreed.”

Mr. Hastings continued, “You see, the normal length of time for recovery of each child’s injury was included in the contracts. We failed to set an end date for the children to pose as actors with their various injuries, assuming they would quickly grow tired of the casts, and in a few cases the medications, and want them removed after the parade was done. This left the assumed time frame of healing a real injury as the only time frame defined in the contracts. With the children choosing to remain in their casts and braces the hospital is contractually obligated to continue treating them as patients until they either decide to have their cast removed or the end of their recovery period is reached.

“An oversight on our part I’m afraid since we did not anticipate this, but it is what it is at this point. This brings us to you, and your signed contracts with the children. We were a bit surprised in the end with the level to which the children went to in some cases, and seeing you for the first time with the combined results of all their injuries shocked me when I walked in. But you signed the contracts and this is the result. Those contracts also state that you will be staying in your matching cast for the same length of time as the child does.

“Oddly enough,” said Mr. Hastings with a small, sly grin, “the clause in the contracts that states you will stay casted as long as the children do also seem to state that you will do so in consecutive order, not concurrently. That means that you stay in a cast the same time that ONE child does, THEN once that time is over you will start the length of time for the NEXT child, and so on and so on until you have gotten through all of them. We knew about our two full term kids and figured we’d work something out in relation to those two, but now this new situation leaves our hands a bit tied, what with signed contracts and all,” Mr. Hastings said with a smirk.

If Hellen could have said anything or even made a gesture of any kind to indicate what she was feeling at this point, she would have. But she was immobilized from head to toe right out to the very end of her fingers and toes, being fed medications that left her extremely weak, and hooked up to a machine that was breathing for her. All she had was her eyes to blink with, and Dr. Zimer and Mr. Hastings were quite obviously ignoring Hellen’s one available attempt at communication.

Dr. Zimer picked up the one-sided conversation at this point. “We thought that, with most of the children having their cast removed after only a few days, you would be in a cast to some degree for no more than a couple months at the most. Five days maximum per child with ten children is about fifty days, and as each time ended we could remove or alter a portion of your cast as appropriate.

“That no longer applies it would seem. With the children challenging each other to remain in their cast to the end we are now talking a matter of weeks per child, not days per. Calculating out the total length of time it will take for each child laid out end-to-end it comes to einhundert siebenunddreißig ... ah, one-hundred thirty-seven ... weeks; or slightly longer than two-and-a-half years. Of course, we will still keep to our promise of removing or altering portions of you cast as time goes, but you will be here as a patient for quite some time it would seem.

“Apparently having your own set of braces made was an act of Spürsinn, you will need them. Guten tag.”

“Good by Hellen.”

And without any further comment the two men move their chairs back and left the room.

Hellen did the only thing she could. She cried.

Epilogue

-- I’ve been here so long that I lost track of time. It didn’t take long with the boredom and the drugs they kept me on. Oh yes, all the drugs they put the kids on are still being pumped into me as well. It seems little Steven, being the one with the biggest competitive streak to out-do everyone else in some way, stayed on his drug regime. I have to admit that I’m impressed with his staying power. Of course, since I can’t wear my braces while I’m still in this cast that means that my time to wear my braces for as long as Steven does, or maybe did at this point, will have to wait until all the casts come off. --

-- The nurses are all still taking great care of me at least. They have been quite sorry about my situation and feel bad about it, but there’s nothing they can do about it other than continue to take care of my like a patient. Like I’ve been reminded numerous times - signed contracts. Oh well. At least I’ve been able to get a little bit of information out of them about myself. Once I figured out that I’ll be on these drugs for a long time I wanted to know what will happen to me once they are stopped. The answer is that they don’t know for sure. They think there could be some permanent effects in the end though. --

-- Those rotten bastards weren’t kidding when they said I would be spending my time consecutively from one kid to the next. After six weeks they came in and told me that Emily had come in and gotten her arm cast removed so they were going to take me out and make a change to my cast. They put me to sleep for their little ‘change’ saying it would be less stressful on me that way. When I woke up again I was back in my room and as far as I could tell nothing had changed. I was still in a cast that covered everything like before, pins still screwed into my skull, tubes still in place to feed me, breathe for me, drain fluids, give me drugs, everything the same. --

-- I was told later that they had actually changed my cast out for a new one because my body had atrophied and the old cast was getting too loose. Go figure. I didn’t notice because I had stopped trying to move anything after a couple weeks and just let the cast hold me. After four or so weeks of not moving it became a habit. –

-- I’m rambling a bit, aren’t I? Sorry about that. My mind kinda jumps from one thing to the next and it’s hard to stay focused. Sorry. Nine weeks later they came and told me that Michael had gone through the whole time with his casts and now my time was up for his term and it was time for another change. I woke up in my room again and guess what; nothing changed other than a new cast again. Everything still the same. --

-- I figured out what they are doing though. They started with the smallest cast and time and are moving up the chain to the next smallest size and time. But since I still have to wear the same cast as another kid who has a bigger one, like say Robby with both his arms in casts or Gary is his dual hip spica cast, then I can’t have my arm or leg freed until I’ve gone through ALL of the casts that involve that limb. Assholes. --

-- One of the nurses did tell me though that they are probably going to start setting a regular time for my cast changes after this instead of waiting for the next contract term to finish up. Something about it taking too long between changes and apparently the kids with longer terms were also going through a cast change or two as well. After that I stopped paying attention to when they come in and tell me another contract term is over. --

-- The first time I had my cast changed and I woke up, I noticed pain in several areas that I didn’t expect. My ankles, knees, hips, and abdomen all hurt for some reason. Turns out that little Steven, the competitive boy that he is, decided that he wanted real scars. And he made enough of a tantrum with his mother that she let him have his way. Spoiled brat. They actually made incisions in the same places that the nurse had drawn on his body with that red pen then stitched him back up again so he would have scars. That meant I got the same treatment too dammit. --

-- I also heard that the day after the parade Sarah had her throat cut open and a tracheotomy done just like I had. That was what she had disappeared about that day when she didn’t tell anyone about it. She had been in discussions about increasing her realism for what her sister Suzy had gone through. That frightened me a lot. What would happen to me if she managed to convince the doctors to go even further? --

-- I had a surprise visitor today. Sarah. And she was in a wheelchair of her own with a colorful silk scarf around her neck. From her I learned that I have been here for sixteen-and-a-half months, and that it might actually be over soon. Sarah’s no longer in a cast by the way. She found out what they were doing to me when she came in with Suzy for a regular doctor’s visit and asked about me. Sarah was able to get with all the other kids and got them to agree it should be over for me. They got David’s lawyers involved to start the process of legally altering all of my contracts with them to make it so that I’ve served all of my time and I’ll get released from the prison I’ve been in, so to speak. She didn’t want to come tell me until she had confirmation that it was actually going to happen. --

-- So it looks like I’ll finally get out of this cast soon, although I’ll still be in the hospital for a little while afterwards. The nurse who came in with Sarah told us that I’ll definitely need those braces of mine plus one for my neck while I start physical therapy to rebuild my body. They will also have to see what the after effects are going to be from being on all these drugs for so long. There’s a possibility I’ll be left with some residual long-term, and possibly permanent, disability after the long-term immobility and drugs. I’ll just deal with it if it happens. --

-- I’m going to be free! --