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MODERN MEDICAL AND SURGICAL TECHNIQUES HAVE DEVELOPED TO such an extent that children who would previously have died may now be kept alive, but at a cost to the emotional development of each individual. There is an increasing literature on the psychological meaning of even apparently minor investigations as well as major surgery to children. In this paper I want to concentrate on a group of children who had to have a limb amputated. Fortunately, this is not a very common procedure, so that the number of children in this group is small. I am concentrating on these because there is relatively little in the literature about children requiring amputation of a limb, and even less about its psychological effects on young adolescents.
These children must face and come to terms with problems in at least four areas: (1) the effects of being in the hospital and being subjected to investigations; (2) the anticipation, and in most cases the actuality, of having a limb amputated; (3) the effects of long-term chemotherapy; and (4) the anticipation, and in some cases the reality, of death. These four areas are, of course, closely interrelated, but I shall concentrate on the second and third because