I see the  lights blinking all around and above me. They seem to form  a circle, like the underside of a spaceship; shining down and pinning me to the bed.  I struggle to sit or pull myself up the cold, metal bars of the cage in which I’m ensnared but I can’t; I’m tethered to the mattress by wires, and tubes and rough cloth restraints.  I’m wild with fear and tear fruitlessly at the restraints that hold me captive. I scream for my mother, my father, for anyone. But, no one comes.  I’m trapped, helpless and alone. I felt like the butterflies my brothers catch and then kill in the jar with carbon tetra chloride and mount on a board with stick pins. I have very few words at my command to express my terror and there is no one to save me. No one.

It all happened over 50 years ago, yet the emotions, sights, smells and trauma remain seared in my memory – nearly as fresh as when it happened.

A horror movie? Well, in some ways, it’s my own private one. The year is 1956, I’m 5 years old and in the hospital for open heart surgery. In those days, children were routinely admitted to the hospital with little or no family support.  Parents were not permitted to stay with their children beyond set visiting hours and then, only a couple of days a week. For a child who was hospitalized, as I was, for several weeks, it was torture.  My mother told me many years later that it simply ripped her heart out to hear me screaming, crying and begging as she headed to the elevators at the end of visiting time. In addition, it was generally accepted that children did not experience pain the same way adults did. Indeed, pediatric sized instruments were a rarity in the 1950s and adult-sized needles and other equipment were routinely used on children. I have a “cut down” scar (a process whereby an incision is made and the tube sutured into the body for nutritional purposes) on my ankle where I was fed intravenously for several weeks. My father, a physician, remembered it being an adult-sized, large bore catheter. Children were tied down so the staff didn’t have to worry about them disturbing the tubes or climbing out of the cage-like cribs. These practices resulted in a profound loss of control, panic and, ultimately in a condition recognized today as Pediatric Medical Traumatic Stress. In other words, child-sized PTSD.

According to the Handbook of Attachment (Cassidy/Shaver) children underwent phases when separated from their parents during hospitalization: protest (primarily consisting of screaming and crying), despair and detachment.  At the time, it was thought that the arrival and departure of the parents or caregivers actually exacerbated or reactivated the “protest” phase since children would be vastly more upset and intractable when they were left alone again after a visit. The answer at the time was to restrict parent visits.  It was noted that “Parents were seen as ignorant and noisy intruders who only criticized the staff and disturbed the quiet and disciplined course of events on the ward.” (van der Horst, Frank C. P. and vand der Veer, Rene: Changing attitudes towards the care of children in hospital: a new assessment of the influence of the work of Bowlby and Robertson in the UK, 1940-1970)

Mothers were seen as “spoiling” their children in their quest to remain with them while they were hospitalized and, unbelievably, fathers were considered to be traumatized by the loss of their own creature comforts when their spouses were visiting children in the hospital.  Who would make his dinner, wash his clothing or make his tea?

Reforms were slow in coming. In 1952, British psychiatric social worker, James Roberts, released the now famous (in medical circles) film A Two Year Old Goes to Hospital which showed the emotional damage (potentially permanent) done to children who were hospitalized and separated from their families. The film was met with such hostile reaction and resistance by the medical profession, that Robertson opted to pull it from general distribution for two years. Like any other institution, medicine is resistant to change and sadly, it wasn’t until the mid 70’s and early 80’s that it was finally acknowledged that children suffered great trauma when hospitalized alone and, as a result, parents were not only allowed, but encouraged to stay with their children. The dark ages of pediatric psychological care were only yesterday and I remember them clearly.  The scars have been with me all my life and make me deeply ashamed, but I cannot seem to totally eradicate them.

Tomorrow, I’m going for a root canal.  I will be restrained in a chair while a dentist does things that could potentially hurt. Bright lights and cold steel instruments will be used on me. I will have little to no control over what happens to me. Is it any surprise that that little 5 year old will be present and feeling helpless? I’ll do my best to comfort her.

The roots of fear, indeed.