How a Ten-Year-Old Girl Faced Her Death

This article attempts to describe the work of a medical social worker with a ten-year-old girl with terminal cancer. The work, which lasted a year, was mainly with the little girl herself. A language barrier made working with the parents difficult, though they, too, appeared to have been helped. My aim was to be as honest as possible with the child and to stay with her through the difficult time which lay ahead. Recognising her verbal and non-verbal communications, I followed her lead when she wished to talk about her fears or thoughts of death. Sometimes she needed to regress and be a very little girl; at others she was mature and competent. The essence of working with dying children depends on the worker's capacity to stay open to the full range of the child's experience, tolerating the pain, sharing the failures and triumphs, and not to lose sight of the fact of the child's imminent death.

When Turia was referred to me, treatment of her cancer (Ewing's Sarcoma) with chemotherapy and radio-therapy had been started. Her parents brought her to see me weekly and I saw her more frequently when she was in hospital; these admissions occurred about every three weeks and the treatment consisted of an intravenous drip lasting twelve hours. The treatments caused multiple side-effects including nausea, vomiting and hair loss. Turia also had to undergo frequent laboratory investigations including repeated bone marrow aspirations.

Tuna's family, the K.'s, had come from Morocco three years previously; father was aged 38 and mother 36. There is one other child, a daughter aged five, who had been left with their maternal grandmother in Morocco until the parents established themselves enough to have both children in England. They had had one still birth, one son who died at the age of about one year, one daughter who died at six, and a son who died at twelve years. These children were severely handicapped. Turia denied any recollection of the death of her sibli