When a Wag and a Wet Nose Are Good Medicine

Child Life program uses dogs to help children cope with scary medical procedures

With eyes swollen from crying, Katelyn Fox hid under the blanket, anxiously awaiting surgery in the preoperative area of Lucile Packard Children’s Hospital Stanford. The thought of having another procedure—the fifth in six months—terrified her.

Who wouldn’t be scared? A shunt was being placed in the 11-year-old’s head to treat severe pseudotumor cerebri as a result of Chiari malformation, a condition that causes the brain to herniate into the spinal canal, thus impeding the normal flow of cerebrospinal fluid. Diagnosed at 7 years old, Katelyn had been in and out of the hospital repeatedly for numerous procedures and tests, including major brain surgery. The stress of it all had left her fearful and anxious about anything medical.

As the time to go to the operating room drew closer, her anxiety burgeoned. But just at the right moment, Donatella made her grand entrance. On all fours.

The highly trained yellow Labrador retriever facility dog jumped on Katelyn’s bed and immediately put her head on the girl’s chest. This outpouring of love made all the difference for Katelyn, who quickly stopped crying. “It was like magic,” said mom Sheri Fox, a registered nurse.

“I feel like Donatella absorbed all of Katelyn’s fears, and the stress melted away,” said the Salinas mother of two. “There’s no other explanation. It was extremely therapeutic. Seeing her anxiety go away—and not need medications to calm down—was huge. It was very reassuring.”

Dogs at the bedside

Donatella, or Donnie, is one of five facility dogs at the health system. Part of the Packard Paws facility dog program, Donatella and her team work at the hospital and at the outpatient clinics and physician practices run by Stanford Medicine Children’s Health. Donatella, Ireland, and Margie were trained as service dogs and donated by Canine Companions. The program also includes Echo and Sonya. The dogs are handled by members of the Child Life and Creative Arts team and other medical providers who care for them as their own pets at home, according to Molly Pearson, a certified Child Life specialist and Donatella’s handler. Pearson co-founded Packard Paws in 2018 with co-worker Alyssa Giacalone, a cardiovascular physician assistant.

“When I saw Katelyn crying, I knew that she had been through the process of talking with a child life specialist more than once before and didn’t want me to explain things,” said Pearson. “I knew she didn’t want to talk about her fear. She was so anxious; I just wanted to show her Donnie.

“When Donnie got up on the bed, Katelyn melted into her. She immediately looked better, and was less anxious and super-appreciative of Donnie,” she added. The dog spent about an hour being cuddled and left when Katelyn was wheeled calmly to the operating room.

“The dogs make a phenomenal difference in healing in a way that medicine, nurses, and moms can’t,” said Fox. “They come into a room and change everything.”

Celebrating Child Life Month

Dogs aren’t the only resource that Child Life and Creative Arts uses to distract and calm children. The 45 specialists use developmentally appropriate education, support, and therapeutic play to minimize stress and create better patient experiences. The health system marks national Child Life Month in March, celebrating the work of its child life specialists through music, art, play, conversation, and more.  

The dogs are always crowd-pleasers and can role-play to help children understand routine medical procedures. For example, the dogs can pretend to have their blood pressure or vital signs taken. They can also drink a syringe of water, pretending it’s medicine. “The kids will say, ‘If Donnie can do it, so can I,’” added Pearson. Sometimes, simply having a dog present is calming. “Rubbing Donnie’s soft ears and having her on a lap can decrease heart rate and blood pressure, relax a child, and relieve stress. Having Donnie is like having a comforting weighted blanket.”

In some instances, a dog will pick up on a parent’s or caregiver’s anxiety, rather than a child’s. “Donnie often uses her own intuition. I will assess a patient first to see how a dog can help, but Donnie may have a different plan,” said Pearson. “She’ll pick up on parents who may be anxious, or indicate something that I didn’t see. She can sense it.”

The bonds between animals and people are amazing, Pearson added. “It’s a trust that can’t be explained. I usually grab a lot of attention when I’m walking Donnie on a leash at the hospital.”

Love in lieu of medications

This was the case for Katelyn, said Fox, who was relieved that her daughter didn’t need the usual medications to calm down, only Donnie’s love treatment. “The Child Life team and the Packard Paws program were phenomenal,” she said. “They exceeded excellence.”

The facility dogs can work with children facing surgery, outpatient, and inpatient procedures, and even follow-up care or checkups. The Packard Paws program was set up carefully over two years, making sure that all safety and infection control standards were met, said Pearson. She hopes to grow the program to add more dogs.

Contributions buy the little extras

The program accepts donations, using contributions to buy toys, leashes, costumes, and accessories for the dogs. Donatella, for example, wore a Chinese lion costume to celebrate Chinese New Year for the Year of the Lion. “She was a big hit,” said Pearson. “The dogs always boost the kids’ morale.”

Katelyn is doing well after her February surgery, which her mom expects to be the last one for a while. She’s grateful to the Packard Paws program for greatly improving Katelyn’s patient experience. “Every child needs a Donatella,” she said.

Fox also expressed great admiration for Katelyn’s doctor, Gerald Grant, MD, a pediatric neurosurgeon at the Chiari Malformation Center at Stanford Medicine Children’s Health. “He’s our hero,” she said.

Dr. Grant is a world-renowned expert in Chiari malformation, a condition that can increase pressure in the brain and cause waves of spinal fluid to pulse down the spinal column. If left untreated, Chiari malformation type 1 can cause painful, disruptive, and sometimes disabling symptoms. Although the structural abnormalities are present at birth in most cases, symptoms usually don’t appear until late childhood or early adolescence, when most cases are diagnosed. Common symptoms include headaches, dizziness, sleep and vision problems, and depression.

For more information, or to make a donation to Packard Paws >