She understands fully the line between reality and pretend. I asked her if she has had an x-ray before and she whispered "you mean in real life?", as if the pretend world before us would hear her if she spoke too loudly. She seemed more interested in the diagnosis and solution rather that the procedures, she would walk out of the room for more patients and tell me to finish the surgery on my own.
I was the doctor, she was my assistant. Her stuffed animals were our patients.
We had many common devices used in hospitals, improvised from objects around us. A stethoscope, a blood pressure device, a scalpel, a stapler, masks, gloves, a clipboard, and a cage for the replacement donor brains.
Mr. and Mrs. Dog came into my office and my assistant read me their problem from their paperwork. "They can't have puppies, they've tried everything!", she said. I was a little impressed at the sophistication of the scenario, but I figured she saw the very some problem on television somewhere. I was thinking I may have to let her down and say there is nothing we can do, if I wanted to avoid teaching her about the birds and the bees.
I contemplated giving Mrs. Dog some fertility drugs, pretending to reverse Mr. Dog's visectomy, suggesting different positions to the couple, or sending them to a sperm bank, but I thought that take too much explanation I didn't feel right giving her just yet. So I said there were some things we might be able to recommend to them, "but I think their best option is to refer them to an orphanage". She takes out 4 little tiny dog stuffed animals, and says that they have to keep the dogs who were sisters together. She lines them up and says "Let's see which one they like the best!" I tried to tell her that the couple could only afford to adopt one puppy, but I realized that making that decision would make her feel like life was unfair, so I said they would adopt all four puppies, and justified it in my mind by saying that dogs have litters of four or more puppies all the time.
A problem with playing doctor with an eight year old, is attempting to use as few medical words as possible, asking if she knows what complicated words mean, and having propmt understandable explanations of these words. I had to explain to her what a spinal chord was when she said the lamb's leg's "didn't work". Instead of telling her that the quadriplegic lamb had a near to none chance of regaining the use of her limbs, I said we could operate on her spinal chord.
After this point, I realized how hard it was to play this with her. I didn't know how realistic I was supposed to be. Do I tell her some things are hopeless? Can I ever tell her there is a high possibility of death?
She brought in some deaf and blind baby dolls for me to cure, and I said that I wouldn't operate on infants because it is a liability issue, and that it would be hard to tell if a baby was deaf, anyway. Then she picks up a monkey doll from the Dora the Explorer television show that says three different phrases when you squeeze it's belly. "He won't say anything else!", she says. I told her we'd send him to the psychiatry office on the third floor with Dr. Danny. (The room my boyfriend was playing video games in).
Another thing about playing with her in a pretend world which is supposed to be orderly and professional, such as a hospital or a tea party, is she behaves very well, is far more courteous than usual, and pretends to be an adult, saying things about herself which she admires in her role models, or saying that the things her real self does are bad. I was the pediatrician, and she was a mother of three infants. She said that her babies watch too much TV, and that they yell and scream when someone tries to turn it off. "They should only watch 3 shows a day, but they watch 10!" This is what she does in real life, she watches TV constantly. I then ask her, "What is their diet like? ...Um...what do they eat?" and she tells me how much candy and soda and "all the things that are unhealthy they eat" (just like her).
The pretend world is allowing her to be honest about what she does in reality, and what she feels bad about doing. It shows that she really does know when she is doing things she shouldn't be doing, and that she does have the capability of both recognizing it, and changing the way she acts to be more agreeable.
She just has to think she is playing for that to happen. That way, it's fun to behave.
