Working with children who have also physical disabilities, it can be very important for the therapist to work closely with the doctor. Catherine Mathelin gives in her book The Broken Piano some interesting case studies relating to successful and not so successful collaborations between therapists and doctors.
She relates the story of Alexandre, a ten year old boy, physically disabled due to brain damage caused by brief respiratory failure during birth. Although he was a brillant student, his body could not follow suit. Mathelin describes her as a virtuoso whose only available instrument was a broken piano.
After his annual appointment with the chief neurologist the previous year, Alexandre had shut himself in his room, and had become quite oppositional. He did not want to go to school, and just wanted to be left alone. When Mathelin saw him he was oppositional and depressed, complaining about the injustice done to him. He felt caught between revolt and despair.
Talking about the consult with the neurologist he said that he was 'fed up with doctors.' He said that he 'tried to see the doctor's eyes, but it was hard, because he was not looking at me.' His eyes were on the 'chart.'
Every year Alexandre was brought before a specialist who did not look at him. Mathelin suggested to his parents to bring him to a pediatrician whom she respected, in addition to the visits with the neurologists. This pediatrician saw him alone, graphed his progress in a large notebook, explained all his interventions, and encouraged him to keep track of his development and growth. Alexandre was supposed to take care of the notebook and to bring it to every appointment. Unlike the chart, this notebook belonged to him.
'For Alexandre, going to the pediatrician meant that his body now belonged to himself, just like the precious notebook.' He would speak to the pediatrician about the sessions with Mathelin and with Mathelin about the physician. 'For certain children with physical ailments, collaboration between their doctor and therapist is essential,provided that the roles are clearly defined and not interchangeable, and that the confidentiality of thesessions and respoect for the child are always in the foreground.'