I first met Ramji in 1985, an incredibly happy 10 year old. At our first meeting, bright-eyed Ramji followed the medical staff around on the daily ward-round with a stethoscope around his neck and a big smile on his perfectly round face. He had nephritic syndrome (a difficult to treat kidney disease) and had lived for months on the ward where I was a medical student in India. His vibrant and cheerful personality made a huge difference to the otherwise grim atmosphere of the hospital. He made the children laugh and involved them in his play.
Ramji’s father told me that he made a living selling peanuts on the streets of Bombay. His frequent bouts of kidney failure resulted in his little body becoming puffy and swollen. He needed frequent antibiotics and medicines. He loved fizzy drinks which were unfortunately not very good for his condition.
In his quieter more subdued moments, Ramji often asked me some heart-rending questions: What had he done to get so sick? What would happen to him if his kidneys stopped responding to treatment?
I had no answers to his questions. All I could do was look the other way while he sipped on his fizzy drink that he had smuggled in to the ward.
Ramji made a huge impression on me. He was a child with great inner strength and a wonderfully positive attitude. At the age of ten, he had intuitively learned that one way to cope with one’s illness was to look beyond oneself and to focus on others. He had learnt to make a difference to those around him.
I learnt some crucial lessons from Ramji. He was one of the reasons I decided to become a children’s doctor. Working with children in hospital can be challenging. There are so many difficult questions and no easy answers. Besides the privilege of being entrusted with a child’s life, it is above all, an opportunity to make a difference.
I often wonder what happened to Ramji. I’d like to think he is healthy and happy doing something he really enjoys. He certainly deserves to be. Besides, I owe the young man a few fizzy drinks.
Six years ago I met a child in a hospital in Rotterdam who had such a brightness, such a positive attitude to life, that I was shocked to learn that she was very likely to die, a fact she was well aware of. She was a mini-adult, it seemed to me, having had to grow up incredibly fast and to confront the black-and-white fact of mortality. She was wise, a little old person.
The idea grew since that first encounter to create a piece of theatre where a group of young people, working with a professional company, would explore this extraordinary area of life, or, more accurately, of life poised on possible death. We would ground the production in reality, that is, the entire show would be based on interviews with young patients, parents, doctors, nurses, therapists and cleaners, working on paediatric wards and units. What interests us as a company is the inner life of all those involved in this world: their dreams, hopes and fears. Our aim was to animate the ghostly spaces of the building you are now travelling towards, with theatre. How could the contemporary theatre respond, with empathy, even with wit ad humour?
The hospitals involved in this project have been fantastic, so open and welcoming. In particular I would like to mention the courage of the many parents who allowed me to interview them, sometimes in the midst of absolute crisis. The thing I discovered was that it tends to be immediate pain that children in hospitals fear: particularly the day-to-day discomfort of multiple injections, whereas what the parents fear is losing their child. The focuses are different. The paradox of medical care is of course that you have to hurt the child before s/he gets better. Another paradox of hospital spaces is that they are places most people want to leave as soon as possible after they arrive; and yet they are also communities where happiness and love, founded on mutual trust, can flourish.
At the heart of all these researches, and in the rehearsing and staging of the play itself, two central ideas remain with me. Firstly, that hospitals are places where other people breathe for you, either literally or metaphorically, until you are well enough to breathe easily for yourself again. Secondly, they are places where the natural order of things can find itself reversed, with devastating results. There is a famous Chinese story of a nobleman who goes to a philosopher to ask for the secret of a happy life. The philosopher answers: “Grandparent dies, Parent dies, Child dies.” The nobleman is horrified until the philosopher comments: “What other way would you have it?”