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                                                                                    Fall 2003




                           M            A     T      T       E       R        S
                           The Newsletter of the Children’s Hospital at Dartmouth



                                                              Circus
                                                              Smirkus
                                                              And a Good
                                                              Time Was
                                                              Had by All




                                                                   PainFree Program
                                                                   Recognized
                                                                   Friends of CHaD
                                                                   Pediatric
                                                                   Neuroscience
                                                                   Makings of a
                                                                   Champion
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         Bringing Summer
         Camp to Kids                                       Child Life Specialist



        I
                                                            Jessica Laperle watches
             T ’S CALLED “FLUBBER,” A GOOEY GREEN
                                                            as Kristy Belliveau plays
            substance made from mixing water,               with "flubber."
            Elmer’s Glue, Borax, and food coloring.
         “It looks like my grandma’s spaghetti,” says
         one patient. “It looks like moldy eggnog,”
         says another. Even the most ill-feeling pa-
         tients can’t resist touching the glop, which
         continues to harden to a consistency re-
         sembling silly putty.
             Today is “mad scientist day” at Camp
         CHaD (Children’s Hospital at Dartmouth),
         a program that offers “play breaks” twice
         a day for children staying in the hospital.
             According to Jessica Laperle, child life
         specialist and interim coordinator of
         CHaD’s child life team at Dartmouth-
         Hitchcock Medical Center (DHMC), the
         idea for Camp CHaD was conceived two
         years ago when a child was admitted after
         being badly injured in an automobile acci-
         dent on his way to summer camp. “He was
         just a great kid,” says Laperle. “We felt so
         bad for him, what he was missing out on,         them up and moving around.” By spend-               Often, visiting siblings want to get in
         and about how special the first summer           ing time with their peers, children have        on the fun, and it’s not uncommon for nurs-
         camp experience is for kids.”                    the opportunity to connect and talk about       es and physicians to stop and sit down with
             Originally slated to run for the month of    their experiences, both inside the hospital     the kids for a few minutes. “The activities
         July, the program has been so popular it’s       and out. “It really helps to normalize their    really help us to build trust with the kids
         being extended into the fall. “We’re very        day,” she says.                                 and to establish a positive relationship with
         excited to see it continue,” says Laperle.                                                       them,” says Laperle. They can even be an ef-
         “We’re looking for more volunteers and           Calming Fears                                   fective bargaining tool. “When it comes
         supplies.” Alyssa Beaty, 16, who volunteers      Staying in a hospital can be a scary experi-    time for me to prepare them for an MRI
         at CHaD as well as at DHMC’s Child Care          ence for children. “We’ve always done a         or other type of test, it really helps to mo-
         Center two days a week, is impressed with        good job comforting children by provid-         tivate them and give them something to
         the program. “It’s really nice to see the kids   ing diversion and by making sure that they      look forward to,” she says.
         interacting with each other,” says Beaty.        have a favorite blanket, toy, or stuffed ani-       Parents also like the idea of Camp
             Whether it’s playing with flubber, mak-      mal to help them feel more safe and secure,”    CHaD. “It’s nice to come back and find
         ing “indoor fireworks” (a concoction made        says Laperle. Camp CHaD takes it a step         them out of their room and engaged in
         from mixing milk, dish washing detergent,        further. Children often use play to gain mas-   an activity rather than just sitting and
         and food coloring), or having a watermelon       tery over objects. “For example, the other      watching TV,” says Stacey Panoushek,
         seed-spitting contest, the emphasis is on        day we painted using syringes instead of        whose son Eric, 10, has diabetes. “It’s pret-
         fun. “Kids in the hospital tend to feel iso-     brushes, and the kids used the syringes as      ty cool,” adds Eric. Alyssa Deline, 13, a
         lated and it’s easy for them to become with-     squirt guns. An activity like that can help     patient admitted for surgery, agrees. “It’s
         drawn, especially if they’re suffering from      kids, especially those with diabetes, to be     fun,” she says. “Especially playing with
         a chronic illness,” says Laperle. “This gets     more comfortable with needles.”                 the slimey stuff.”

         2                 M AT T E R S
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      Student Art Brightens Hallways of CHaD
      I
         t all started with the inaugu-                                                                                    With each new rotation,
         ration of the Children’s Hos-                                                                                 teachers, students and their fam-
         pital in 1992, when students                                                                                  ilies are invited in for a tour. “We
      from Lebanon High School                                                                                         take them around to show them
      were invited to submit artwork                                                                                   the different art sites,” says
      for the grand opening celebra-                                                                                   Brown. “We’ve tried to expand
      tion. What they provided ex-                                                                                     the shows, as more areas of the
      ceeded everyone’s expectations.                                                                                  hospital have been designated to
      “The artwork was so fabulous,                                                                                    CHaD.” Small signs are print-
      we thought, ‘wouldn’t it be                                                                                      ed next to each painting or
      great if we could find a way to                                                                                  drawing, indicating the artist’s
      display it on an ongoing ba-                                                                                     name, age, and school. Often,
      sis?’” says Sharon Brown, di-                                                                                    kids will bring their parents and
      rector of community affairs for         volves more than 50 pieces per       eye and does an incredible job      grandparents along to take pic-
      CHaD. “Perkins Foss, a CHaD             showing—in two days, a process       putting each show together,” says   tures of the art and enjoy the
      volunteer who was very in-              that she still enjoys after all of   Brown. “The quality is like a       healthy snacks. “They’re very
      volved in the arts, got the proj-       these years. “It’s like Christmas    gallery showing.”                   proud of their work and they
      ect off the ground.”
          Foss purchased re-                                                       Artwork
      usable frames, so that                                                       From all Ages
      artwork from differ-                                                         CHaD decided to
      ent schools in the area                                                      approach local
      could be displayed on                                                        school districts
      a rotating basis.                                                            from both New
      Nancy Franklin, a lo-                                                        Hampshire and
      cal artist who had                                                           Vermont, so that all
      worked as a secretary                                                        schools in the Up-
      in the intensive care                                                        per Valley Region
      nursery at Mary                                                              would have an op-
      Hitchcock Memorial                                                           portunity to par-
      Hospital in Hanover,                                                         ticipate. The art
      saw an ad in the Plain-                                                      teachers and their
      field school newslet-                                                        students, ranging
      ter. “They were look-                                                        from elementary to
      ing for somebody to                                                          high school in age, have been       like knowing that they’re helping
      help with the proj-                                                          only too happy to oblige. “We       to make CHaD a brighter place
      ect,” Franklin remembers. “I had        when I get to open up the art-       haven’t run across two of the       for the sick kids and families
      an interest in art and thought it       work from each school,” she          same school systems in over a       who are here,” says Franklin.
      would be fun to get involved.”          says. “Nancy has a great artistic    decade,” says Brown.                    “The shows are a wonderful
          Franklin assisted Foss with                                                                                  way to create a sense of child at
      the first rotation, hanging 30                                                                                   CHaD,” says Brown. “They re-
      pieces of art from the Randolph                                                                                  ally help to make this a warm
      School System in Vermont.                                                                                        and friendly place.” If anyone
      Soon after, she assumed full re-                                                                                 is interested in helping with the
      sponsibility and settled on a six-                                                                               project, please contact Sarah
      month rotation schedule. “We                                                                                     Salo, CHaD Community Re-
      rotate the art twice a year, usually                                                                             lations Office, 603-650-3431.
      in the fall and in the spring,” she                                                                              Artist contributors Grantham
      says. With help, Franklin can                                                                                    Village School, clockwise
                                                                                                                       from top: Arianne - Grade 5;
      complete the preparation and                                                                                     Erin - Grade 2; Madison - Grade 1;
      hanging of art—which now in-                                                                                     Taylor - unknown grade.


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         PainFree Program Reco
       T
                 HE PAINFREE PROGRAM AT CHAD               An Innovative Approach
                recently received the 2003 VHA             Cravero designed a centralized
                Leadership Award for Clinical Effec-       approach for pediatric sedation
                tiveness, in recognition of improve-       services at Dartmouth-Hitch-
         ments made in the effectiveness and safety        cock. “Initially, George Blike and
         of pediatric procedural sedation care. VHA,       I received two grants and stud-
         a nationwide network of community-                ied how services could be im-
         owned healthcare systems and their physi-         proved,” he says. Prior to the pro-
         cians, has more than 2,200 members in-            gram’s launch two years ago,
         cluding some of the nation’s leading              individual departments within
         healthcare institutions. “We’re very              the hospital were responsible for
         pleased,” says Joe Cravero, MD, medical           coordinating and administering
         director of CHaD’s PainFree Program.              sedation services to pediatric pa-
         “The award reflects the hard work and             tients. “We decided to take the
         commitment put forth by all of our team           people who were already trained
         members.”                                         to do the job and create a dedi-
             In addition, Ronald McDonald House            cated unit, rather than try to go
         Charities (RMHC) of Eastern New Eng-              out and train individuals in all of
         land received two awards for their support        the departments.”
         of the PainFree Program’s Comfort Corner.             “Now, we can do it all for
         “The awards were presented to us at an in-        them–from patient preparation
         ternational conference in June,” says Edie
         Stevenson, executive director of RMHC of
         Eastern New England. “We placed first in
         the world in the grant giving category, and                                                       gist. “By using drugs like Propofol, which
         also won the ‘best bets’ award for the best                                                       are very predictable and ultra fast-acting,
         overall project worldwide. It’s very gratify-                                                     we’re able to get kids through the process
         ing to receive this recognition–the Com-                                                          much more quickly,” says Blike. That
         fort Corner is a concept that we wanted                                                           means the drug is out of their system (with
         Ronald McDonald House Charities around                                                            a very low nausea rate) in minutes rather
         the world to hear about and hopefully take                                                        than hours or days, as was often the case
         back to their respective children’s hospitals.”                                                   with traditional sedatives. “For example, a
             According to Cravero, the key to the          to sedation to monitoring to recovery,”         child who comes in for a CAT scan is in
         PainFree unit’s success is its team approach.     Cravero says. One result is that the process    and out in an hour and can go downstairs
         “We have a group of highly-trained indi-          is safer. “We’ve been able to show decreas-     and enjoy breakfast with their family.”
         viduals who work very well together,” he          es in the number of problems that occur
         says. “Our sole function is to prevent pain       with patients that are sedated.” Another        Adapting to Each Child’s Needs
         and anxiety for children who need to un-          is improved efficiency. “While it is logisti-   Using medication is not always necessary.
         dergo a procedure or test.” The staff—which       cally a little more challenging at times,       Sometimes, a child’s attention just needs
         includes an anesthesiologist, a registered        we’re able to get more patients through         to be diverted away from scary-looking ma-
         nurse, a patient care technician, a child life    our process with a higher rate of success.      chinery. “Our process is to always start with
         specialist, two business unit specialists and     For example, we’ve seen a 40 percent in-        the least invasive tool and then escalate
         an administrative assistant—bring diverse         crease in the number of sedated MRIs done       from there if we need to,” Blike says. “For
         areas of expertise together to form the           this year.”                                     instance, we have a portable DVD unit for
         essence of a team model. Staff members are            PainFree’s innovative approach includes     kids that has been quite effective in keeping
         as committed to each other as they are to         utilizing some of the most advanced med-        them still during some tests.”
         their patients–all eight traveled to Boston to    ications available, says George Blike, the         Understanding children is one of the
         accept the VHA award on April 7.                  program’s co-director and an anesthesiolo-      things that makes the unit so unique. “One

         4                  M AT T E R S
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cognized T                                                “Huggables” Calm Children’s Fears
                                                               here’s nothing like a soft and cuddly
                                                               stuffed animal to ease a child’s fear of
                                                               having surgery. “It turns their whole
                                                          personality around,” says Lynn Cote, LPN,
                                                          a nurse who works in the Same-Day
                                                                                                          “As word of the project has spread, more
                                                                                                          requests have come in from other areas
                                                                                                          of the hospital, like the emergency unit.”
                                                                                                              “We’ve been giving the stuffed animals
                                                                                                          to sick or injured children who come into
                                                          Surgery Unit. “When a child is frightened,      the ER since April,” says John Markowitz,
                                                          they can become quite agitated and the          a patient care technician in the unit. “They
                                                          tears start flow-                                                           really help to
                                                          ing. But as soon                                                            pick up their
                                                          as they receive a                                                           spirits and they
                                                          stuffed animal                                                              can also serve as
                                                          from one of our                                                             a helpful diver-
                                                          nurses, their faces                                                         sion. We keep
                                                          light up and                                                                them in a
                                                          they’re not quite                                                           wicker basket
                                                          so afraid.” The                                                             adjacent to the
                                                          idea for the proj-                                                          nurse’s station,
                                                          ect started when Cote began talking to a        so the nurses, technicians, house staff, and
                                                          patient last summer about the ways peo-         volunteers have easy access to them.”
                                                          ple contribute to the hospital.                     So far, the unit has given out more
                                                             “I told her about the Rainbow Girls of       than 250 stuffed animals of different va-
                                                          Nashua who brought in stuffed animals a         rieties and sizes including Annalee Dolls
                                                          few years ago and how the kids loved them.      and Gund teddy bears. “We’re finding
                                                          We had depleted our inventory and were          that they can be comforting to siblings,
                                                          looking for other people to get involved,”      teenagers and elderly patients, as well.
                                                          says Cote. The patient, Kathy Nelson of         They’ve also brought joy to the staff be-
                                                          Littleton, and her husband Jim are mem-         cause of the way they help patients feel
       of the things we’ve focused on is that kids        bers of Eastern Star, a large Masonic-based     better and get their minds off procedures.”
       are fundamentally unpredictable, so we’ve          organization. “We wanted to help,” says
       designed a highly-adaptive approach to             Nelson, a speech pathologist who works          The “Bear Man”
       manage that unpredictability,” says Blike.         with children. “As a child, you don’t un-       Jack Lessard of Hampton took on the
       The staff’s child life specialist, for instance,   derstand why things are happening to you        moniker “Bear Man” 21 years ago on a
       works closely with the kids and their par-         and it’s comforting to hold onto some-          sad occasion that would end up giving
       ents and she is attuned to their emotional         thing of your own that’s warm and cud-          joy to countless children. “That was the
       status through the course of the process.          dly—it’s a great way to take the fear away.”    year I lost my daughter,” says Lessard.
       “This allows us to better attend to the               The Nelsons reached out to their East-       “She was 28 years old and she died of a
       unique needs of each child and make ad-            ern Star sisters and brothers in the 34         brain aneurism. She had been very ac-
       justments as we go along,” he says.                chapters across New Hampshire for sup-          tive as a volunteer at Children’s Hospital
           Bringing together the best people, en-         port. The response was overwhelming.            in Boston. Her favorite thing to do was
       vironment, and tools requires considerable         “Our Grand Family started out with a            giving teddy bears to sick kids, so in her
       resources and funding. A partnership with          goal of collecting 400 by August of this        honor I decided to pick up the activity
       RMHC–which established the Comfort                 year,” Nelson says. “We’ve exceeded our         where she left off.”
       Corner in October of 2001–and other lo-            wildest expectations by collecting a total          Lessard makes five or six trips a year,
       cal charities provided the financial support       3,146.” So far, supply of the animals has       delivering boxes of new teddy bears from
       needed to jumpstart the program. “Our              stayed ahead of demand and Eastern Star         the Seacoast to Lebanon. “I bring them
       orientation has been to be a really good           wants to keep it going—the organization         whenever they need them,” he says. “I
       microsystem within the hospital,” Cavero           has pledged to provide the animals or           gave more than 3,300 away last year be-
       says. “Over the last two years, every sec-         “huggables” as they’re now known for            tween CHaD and Children’s Hospital.
       tion that needs to sedate children has cho-        four more years. “We’ve given out more          I love to do it—there’s nothing nicer than
       sen to use this service. It’s very nice to have    than 1,600 in same-day alone,” says Cote.       helping a child that’s sick.”
       it work that way.”

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         SALUTING
         the Friends of CHaD
        T
             HE FRIENDS OF CHAD IS A VOLUN-                                                                     continues. “In particular, how we can
               teer organization formed in 1995                                                                 get the word out about all of the things
               to provide resources to support                                                                  that CHaD does and offers that would
         CHaD in its commitment to meet the                                                                     simply not be available if the Friends
         special healthcare needs of children. “The                                                             did not do the work they do to provide
         idea came from some remarkable peo-                                                                    the funds for them.”
         ple like Dr. John Brooks, former medical
         director of CHaD, and community                                                                         Helping Families in Need
         member Pat Goldman who foresaw the                                                                      “Being a CHaD volunteer gives you a
         need to develop a closer connection be-                                                                 chance to work with dedicated people in
         tween the children’s hospital and our                                                                   your community,” says John Xiggoras
         community,” says Sharon Brown, com-                                                                     who co-founded Friends of CHaD in
         munity relations director for CHaD.                                                                     Manchester two and a half years ago.
         “The Friends are absolutely vital to the                                                                The 15-member committee and its vol-
         work we do. They are a committed and                                                                    unteers build awareness and communi-
         talented group of people who are busy                                                                   ty support for Dartmouth-Hitchcock’s
         doing lots of other things in their lives.                                                              services in the greater Manchester area
         We’re very lucky to have them doing all                                                                 through activities like Wednesday Night
         that they do on our behalf.”                                                                            Bingo and a miniature golf event. “You
             The Friends is comprised of a 30-                                                                   know that your efforts are going to help
         member board along with several hun-                                                                    local kids who are being cared for by
         dred volunteers who work region-wide                                                                    CHaD—it’s neighbor helping neigh-
         to help raise funds, promote public               David Leatherwood, former Friends of CHaD             bor,” he says.
         awareness, and encourage community             president, is one of dozens of volunteers who make          Xiggoras is the founder of Kristen’s
                                                         the CHaD Ski and Ride Challenge a huge success.
         support. The group works to ensure that                                                                 Gift, a restricted gift designed to pro-
         the children of the region have access to        one way for me to give back to my com-             vide financial support to CHaD’s Pediatric
         the full range of CHaD services and pro-         munity. I have the added benefit of work-          Oncology Center. “I saw what a lot of fam-
         grams. In eight short years, the Friends of      ing with a tremendously talented group of          ilies have to go through emotionally and
         CHaD has built upon its grassroots begin-        very committed people.”                            financially when my daughter Kristen was
         nings to become an organizational power-            Candon first got involved in the Friends        being treated for cancer a few years ago at
         house, increasing its annual fundraising         of CHaD when a friend asked her to help            CHaD,” he says. “When she died, I estab-
         from a respectable $10,000 in its first year     out with another event. “Penny Cunning-            lished the fund in her memory. Having a
         to more than $500,000 in 2002.                   ham and I had served on another board              child who is sick or has a life-threatening
                                                          together, and she approached me to help            illness is the most difficult thing for a par-
         A Spirit of Volunteerism                         with fundraising for the Big Apple Circus          ent and family to go through.”
         “What I like most about being a Friend is        project—now Circus Smirkus.” Candon                    The Friends of CHaD is comprised of
         knowing that the work we do makes a              helped with that project for a few years and       people with an incredible variety of talents,
         tremendous difference to sick children and       then was asked to serve on the board. She          experiences, and backgrounds. But one thing
         their families,” says Marty Candon, board        has remained involved in Circus Smirkus            is the same—their commitment to the kids
         president of the Friends of CHaD in              fundraising and also helps out with the XL         at CHaD. From flipping burgers to chairing
         Lebanon and a member of the executive            92 radiothon event held just before Christ-        an event, everyone contributes in their own
         committee.                                       mas each year.                                     way, but all are vital to CHaD’s success.
            “My husband and I have one child, now            “In the past few years, I’ve enjoyed being          For information on how to join the Friends
         in college, and we have been blessed that he     involved on a more strategic level, thinking       of CHaD, contact Sarah Salo at (603)650-
         has always been healthy. Volunteering is         about projects we want to focus on,” she           3431 or Sarah.Salo@Hitchcock.org.

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         Building Community
        Support in Manchester                                      PICU Expands
                                                                   L AST WINTER, THE BUTLER PEDIATRIC
                                                                       Intensive Care Unit (PICU) at
                                                                         CHaD was experiencing greater
                                                                   patient demand than ever before. This
                                                                   didn’t surprise Daniel Levin, MD, di-
                                                                   rector of the PICU. “Pediatric intensive
                                                                   care is very seasonal,” he explains. “Our
                                                                   busiest time is in the winter with the
                                                                   influx of patients we see with infec-
                                                                   tious disease, respiratory illnesses, and
                                                                   meningitis.”
                                                                       Historically, the demand for beds
                                                                   would lessen during the warmer
         John Xiggoros, founder of the Friends of CHaD in          months. “We originally designed the
           Manchester and Kristen’s Gift Fund, volunteers
          several times per month at bingo in Manchester.          space for 10 beds, but had only set up
                                                                   six when we moved down here in
        Support for CHaD is growing by the week in Man-
                                                                   March of ’99 from the ward upstairs,”                          PICU bed and high-tech
        chester, NH, thanks to the hard work and dedication                                                                       equipment near by.
        of the Manchester Friends of CHaD, a group of com-
                                                                   Levin explains. “But we knew it
        mitted volunteers who began meeting in the sum-            wouldn’t take long before we were
        mer of 2001. Since May, the group has been actively        busy on a year-round basis.” The ad-        the space and amount of privacy and
        involved in a new community based activity to help         dition of several new specialists to the    quiet we can offer patients and their
        build awareness and funds for CHaD—BINGO.                  CHaD team, such as pediatric neuro-         families,” says Levin. Because parents
        Every Wednesday evening, the Friends are at the            surgeon Ann-Christine Duhaime, cou-         and family members often stay in the
        Manchester Bingo Hall on John Devine Boulevard,            pled with a greater awareness of CHaD       unit, providing conveniences such as
        running the weekly games. Proceeds from the games
                                                                   and its expanding services hastened         sleeping areas and showers helps to
        support CHaD as a component of Mary Hitchcock
                                                                   approval for the PICU to expand to          make their visit and the whole hospi-
        Memorial Hospital at DHMC. The funds are split be-
        tween two funds at CHaD. Named in memory of
                                                                   its full capacity in April.                 tal experience more tolerable. “Our
        Kristen Xiggoros, Kristen’s Gift is one of the funds be-       Working in the PICU has its own         goal is to provide as pleasant an envi-
        ing supported by the activity. Kristen’s Gift was start-   special set of challenges. Physicians,      ronment for them as possible.”
        ed by her parents, John and Patty Xiggoros and rep-        nurses, and medical support staff care          Funding from the J.E. & Z.B But-
        resents Kristen’s legacy to support the children with      for the most critically ill and injured     ler Foundation and from other signif-
        cancer and their families. The other is an unrestrict-     patients. The fact that these patients      icant contributors such as Johnson &
        ed fund that helps all children at CHaD.                   are often young children can make the       Dix, WalMart and QLLA Charities is
            Bingo, a state recognized and licensed game,
                                                                   experience even more heart-breaking.        a major reason for the unit’s success.
        provides a community connection to CHaD for many
                                                                   “We see it all, from neurological and       “We couldn’t do it without them,” says
        Manchester residents who see Bingo as a social
        night out. Jodi Stewart, Friends volunteer says, “I
                                                                   trauma cases to kidney and heart dis-       Levin. “But you also need to have the
        love seeing the birthday parties and all the folks         orders to respiratory and lung cases to     commitment from your institution—
        who come each week to catch up with their friends          diabetes and cancer,” says Levin. “It’s a   we’re fortunate to have it and to have
        or family members. It’s great seeing young and old         physically and emotionally tough place      this space. We have one of the most
        enjoying themselves all to benefit CHaD.” Some             to work in at times, but we wouldn’t        physically accommodating and well-
        come with a very specific purpose; numerous bingo          have it any other way.” The expansion       designed units you’ll see anywhere.”
        patrons want to give back to an organization that has      of the unit has been designed with one          Community support through ac-
        helped their family. In accordance with state regu-
                                                                   thing in mind—to help patients and          tivities like the XL Wishing Wells for
        lations, volunteers are completely responsible for
                                                                   families cope with the serious nature of    Kids is also too important to ignore,
        running the games. Players have their favorite seats,
        their lucky charms, and their enthusiastic smiles.
                                                                   their illnesses and injuries.               Levin says. “When you see a child drop
                                                                                                               a quarter into a wishing well, it seems
        Doors open at 4:30PM and games begin at 5:45PM.
                                                                   Accommodating Patients, Families            inconsequential in the larger scheme
        For information about volunteering or playing to
        help CHaD, contact Terri Paradis at (603)650-              CHaD provides the only pediatric in-        of things. But it’s that kind of gesture
        3435 or Terri.Paradis@Hitchcock.org.                       tensive care unit in New Hampshire.         that really represents why we’re able
                                                                   “One big advantage we have here is          to do what we do.”

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                                        P E D I A T R I C                   N E U R O S C I E N C E



         Pediatric Neurology and Epilepsy a
         Budding Center of Excellence for C

     T
                   HE PEDIATRIC NEUROLOGY AND EPILEPSY PROGRAM AT CHaD

                   is fast becoming one of the most comprehensive in New Eng-
                   land. “We’ve very fortunate to have the collection of people we
                   have here at DHMC,” says Richard Morse, MD, director of
                   pediatric neurology at CHaD and a board-certified pediatric
         epileptologist. “We have the benefit of all of the knowledge and expe-
         rience gained over the past 10 to 20 years in the treatment of epilepsy,
         led by pioneers like Drs. Dick Nordgren and Peter Williamson. At the
         same time, we’re attracting leading experts in the areas of epilepsy re-
         search such as Dr. Greg Holmes, and pediatric neurosurgery such as Dr.
         Tina Duhaime. We’ve got a great program in the making.”
             This convergence of talent and experi-      that can help patients who don’t
         ence along with state-of-the-art technologies   respond to medications and may
         has ushered in a new era in epilepsy man-       not be candidates for surgery.”
         agement at CHaD, says Morse. “We’re ap-                                                      Dr. Richard Morse and
                                                                                                      Pediatric Neurology Nurse
         plying what we’ve learned in the treatment      An Interdisciplinary Approach                Coordinator Deb Gardner
         of epilepsy in adults and turning the spot-     According to Morse, CHaD’s                   monitor a patient with EEG,
                                                                                                      EKG, and real-time video.
         light to a younger audience.” This includes     broadening scope of neurological
         treating even the most complex cases. “Us-      services extends beyond its
         ing the new epilepsy modalities that are        renowned epilepsy program. “Our areas               This includes utilizing some of the most so-
         now available—such as digital EEG mon-          of expertise cross many disciplines and are         phisticated equipment available today. “We
         itoring, invasive monitoring with implanted     very well-integrated,” he says. “For exam-          have imaging technology that gives us a
         electrodes, and more sophisticated imag-        ple, the Pediatric Oncology Unit, led by            three-dimensional look at a child’s brain,”
         ing techniques—we’re able to localize           Dr. Eugene Hug, is offering some of the             Hug explains. “This allows us to employ
         seizures and better understand where they       most advanced treatments available to chil-         new techniques like stereotactic therapy to
         are coming from in the brain.”                  dren with brain cancer.”                            determine the optimal field for radiation
             As a result, epilepsy surgery is increas-      “A significant portion of patients we see        and to be very precise with our treatment.”
         ingly being performed on children with          suffer from brain tumors and require radia-
         excellent outcomes. “A child’s brain is more    tion therapy or surgery,” says Hug.                 A Flagship Case
         resilient and can develop around problems       “Through our interdisciplinary approach,            Darcie Ingerson first came to CHaD in
         more easily,” Morse explains. “Recovery is      we’re able to provide not just better care to       1992 as a 16-month-old suffering from pro-
         often quicker, and the long-term outcomes       patients, but care that results in fewer side af-   longed seizures. “She was treated with phe-
         are better.” For patients who are not surgi-    fects and reduced long-term risks.” For in-         nobarbitol for about a year and that stopped
         cal candidates, there are now a host of oth-    stance, if a child requires surgery, Hug’s team     the seizures,” says Morse. Then, at age nine
         er medical options available. “In the past 10   of pediatric oncologists works very closely         her teachers started noticing what they
         years, a number of new anticonvulsants          with pediatric neurosurgeon Dr. Tina                thought was attention deficit disorder. “She
         have been developed that are proving to         Duhaime. “Or, if a child needs to come in           was a bright child, but she had moments
         be very effective in helping many patients.     every day for six weeks for radiation therapy,      where she would stare off in the middle of
         We’re also learning about the affects of diet   we work closely with the team of pediatric          class. The episodes became more frequent
         on epilepsy and are designing special diets     anesthesiologists to coordinate their care.”        and Darcie’s mom began to notice lip

         8                 M AT T E R S
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                                                                P E D I A T R I C                  N E U R O S C I E N C E



sy a                                                     New Unit Improves
or CHaD                                                  Epilepsy Monitoring
                                                         T
                                                             HE PEDIATRIC UNIT HAS A
                                                               new facility that is chang-
                                                               ing the scope of pediatric
                                                         epilepsy evaluation and man-
                                                         agement at CHaD. Newly
                                                         opened this summer, the four-
                                                         bed Pediatric Neuromonitoring
                                                         Unit serves as a critical building
                                                         block in the development of a
                                                         comprehensive pediatric epilep-
                                                         sy program at DHMC.
                                                             At the central nursing desk           Paul Meagher
                                                         in CHaD’s Pediatric Neu-                  applies electrodes
                                                                                                   to patient Stephanie
                                                         romonitoring Unit, a series of            Murphy, age 16
                                                         large computer screens display
                                                         real-time video and digitized
                                                         electroencephalogram (EEG) in-
                                                         formation simultaneously. The
                                                         screens are part of a new state-of-
                                                         the-art recording system set up
                                                         to monitor seizure activity in pe-
                                                         diatric patients suffering from
                                                         epilepsy. According to Dr.
                                                         Richard Morse, the head of Pe-
                                                         diatric Neurology at CHaD, the
                                                         new equipment is helping clinicians to looks for abnormal variations,” Natola
                                                         zero in on seizure activity more quickly says. “When it detects sudden bursts of
       smacking and a tendency to look off to one        and accurately.                                    oscillation, it automatically creates a ‘red
       side.” That’s when Darcie was referred to             “It’s a powerful tool for analyzing seizure flag’ or marker. Digital video and EEG in-
       CHaD’s Pediatric Neurology Unit.                  events,” explains Morse. “It allows us to formation allows the physician to review
           “She had an EEG and it showed spikes          quickly pinpoint the exact moment that a seizure events instantly. It’s a much faster
       on her left temporal lobe,” says Morse. An        seizure occurs in a child. We can see what’s way for them to review patient cases com-
       MRI revealed a scar on the lobe. “She was         going on electrically inside the brain and at pared to videotape, which is still the most
       treated with medication and the spells im-        the same time observe the physical symp- common method used by hospitals.” In
       proved, but they didn’t go away complete-         toms the patient shows—such as how they addition, physicians can review data or
       ly,” says Morse. She was brought in again for     move their eyes or posture their limbs. watch live recordings from networked PCs
       monitoring and more testing. “During her          Where the seizure begins helps us to cor- in their offices.
       third visit, she went through invasive mon-       relate the electrical information we obtain            According to Natola, the new Pediatric
       itoring with implanted electrodes and brain       from the EEG. This correlation may help Neuromonitoring Unit has four rooms
       mapping,” Morse says. “We were able to            us to determine precisely where the seizure which are hard-wired to transmit patient
       capture the seizure and she went in for sur-      is coming from in the brain and whether data—from cameras, microphones, and
       gery—the anterior tip of her temporal lobe        the child may be a candidate for surgical re- telemetry equipment—to recording units
       was removed and she’s been seizure-free for       section of the epileptic area.”                    in a nearby control room. “The beauty of
       the last year. Darcie’s case is a great example       One of the key features of the new sys- it is that the data is written to a hard drive
       of how treatment modalities have evolved,         tem is its alarm component, says Mark and can be stored on DVDs versus thou-
       and how we’re able through early interven-        Natola, the unit’s senior electroneurodi- sands of videotapes. This makes the re-
       tion to help more children live healthy, pro-     agnostic technologist. “The system mon- viewing, editing, and archiving of data
       ductive lives.”                                   itors the child’s brain wave activity and much more efficient and cost-effective.”

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                                          P E D I A T R I C               N E U R O S C I E N C E


         Delicate Surgery Offers Hope for Children
        W
                 HEN CHILDREN NEED NEUROSURGERY, IT ’ S
                  either because their condition threatens their life
                  or their brain function. “It’s a very frightening and
         traumatic experience for both the child and the fami-
         ly,” says Dr. Tina Duhaime, CHaD’s pediatric neuro-
         surgeon. One such case involved a child named Emma.
             “In the middle of June, she started shaking and even-
         tually started having trouble walking,” says Emma’s
         mom Mandy. “Her pediatrician recommended a neu-
         rology consult and directed her to DHMC’s ED for a
         comprehensive assessment. The CT scan that night
         showed a mass, and a later test revealed the tumor had
         metastasized to her spine. My husband Tim and I were
         shocked as we listened to our daughter’s immediate
         need for surgery.”

       “We were stunned by how kind and
        compassionate the physicians and
        staff at CHaD were.
             Mandy and Tim met with pediatric neurologists Drs.
         Richard Morse and Helen Barkan, and then Duhaime.
         “I’m an occupational therapist and I’ve seen how cold and
         indifferent clinicians can be,” she says. “We were stunned
         by how kind and compassionate the physicians and staff
         at CHaD were. Dr. Duhaime was wonderful—she spent
         a lot of time with us, directly describing Emma’s condi-
         tion and all of the pros, cons, and risks involved. She
         told us there were no guarantees and invited us to seek
         other opinions if we wanted to. I found her level of com-
         petence and calm demeanor to be very reassuring.”
             Still, Mandy consulted her aunt, who works in pub-                                                                 Dr. Tina Duhaime
         lic relations at another hospital. “She said, ‘where you are                                                           performs delicate
         is the best place.’ Then she told me we should try to                                                                  brain surgery.

         get this great neurosurgeon she had heard about named
         Dr. Duhaime. That did it.”                                           intraoperative monitoring techniques. “With the help of this
                                                                              team, I have a better idea when tumor removal is occurring close
         A Delicate Procedure                                                 to vital areas of the brain and should be halted,” Duhaime says.
         “Emma’s tumor was very large and was attached to a number of             “We still have a long way to go—we’re beginning six, 12-week
         structures that control vital functions such as breathing, swal-     cycles of chemotherapy,” says Mandy. Once a month, Emma stays
         lowing, coordination, eye movements, and consciousness,” ex-         overnight for treatment and goes in randomly for clinic visits.
         plains Duhaime. “In some places the distinction between the tu-      “She has really bonded with the CHaD staff. Kids don’t ask to go
         mor and normal tissue was clear, in others it was indistinct. The    back to the hospital, but Emma will ask me, ‘when are we going
         challenge in cases such as this is to remove as much tumor as pos-   back to the doctor’s house, so I can have a tea party?’”
         sible from these delicate structures while minimizing permanent          Emma’s vivacious personality is coming back. “We’ve started
         damage which may leave the child with lasting deficits.”             with some medications to counteract the affects of the chemo. She’s
            During the procedure, Duhaime utilized high-tech equipment        eating more and has more energy. She’s not back to walking yet, but
         including tiny instruments, intraoperative ultrasound, and an ul-    she’s getting PT, OT, and speech therapy at home. She’s a real troop-
         trasonic aspirator which helped to dissolve parts of the tumor by    er. I think she’s doing her very best considering the circumstances.
         rapid vibration. She was assisted by Drs. Terry Darcey and Barbara   Rehabilitation is going to take a long time, but with the guidance of
         Jobst from Neurology who are specially trained in neurophysiologic   the oncology team and Dr. Duhaime we’re hopeful.”

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                                         P E D I A T R I C                   N E U R O S C I E N C E


      Unlocking Mysteries Through Brain Research
     D
           R. GREG HOLMES, THE NEW                                                                                       is more plastic and more adapt-
            chief OF Neurology at                                                        Dr. Gregory Holmes              able to changes. If we can inter-
            DHMC, had his first en-                                                                                      vene early on, we can influence
      counter with epilepsy as a high                                                                                    brain development in a very pos-
      school student. “There was a girl                                                                                  itive way, and that’s exciting.
      in my class who suffered from                                                                                          “Treatment of many disorders
      epilepsy and she would often have                                                                                  has improved dramatically,” he
      seizures in the middle of class,” re-                                                                              says. “We’ve made great advances
      members Holmes. “She was a very                                                                                    in treatment of brain cancer, we’re
      nice person, but she was discrim-                                                                                  beginning to understand autism,
      inated against because so little was                                                                               we’re making progress with mus-
      known about epilepsy back then.                                                                                    cular dystrophy, and we’ve made
      Both the students and teachers                                                                                     great strides in the treatment of at-
      were frightened of her seizures and                                                                                tention deficit disorder. Many
      therefore tried to avoid any type of    Making Inroads                        fective and varied treatment op-     neurological disorders still do not
      interaction with her.” The expe-        Through Research                      tions are possible through the use   have a cure, but our progress has
      rience helped to spark an interest      This team approach, along with        of new drugs and surgical ap-        been phenomenal.”
      Holmes had in becoming a physi-         the combination of research,          proaches. “A significant number          “I believe the nervous sys-
      cian. After attending medical           teaching and clinical care is what    of children with epilepsy suffer     tem—the brain, spinal cord, and
      school at the University of Vir-        drew Holmes to Lebanon. “I was        from mental disabilities or learn-   peripheral nerves—represents
      ginia, he completed his residency       hired to improve and develop the      ing problems,” says Holmes.          the area of greatest potential in
      in pediatrics at Yale. Holmes then      research program within the sec-      “However, the immature brain         medicine,” he says.
      returned to the University of Vir-      tion of Neurology and work
      ginia for neurology training, be-       closely with the new Neuroscience
      ginning a distinguished career fo-      Center at Dartmouth,” he says.
      cused on neurology.                         Holmes spends about 50 per-
          Holmes comes to DHMC                cent of his time in his lab in the
      from the Children’s Hospital in         Borwell Research Building study-
      Boston, where he was director of        ing animal models of epilepsy.
      the Center for Research in Pedi-        He is also heading up a major
      atric Epilepsy and a professor of       clinical research project funded
      neurology at Harvard Medical            by the National Institute of
      School. Here he oversees a team         Health. “We’re going to be com-
      of 17 neurologists, three nurse         paring the effectiveness of some
      practitioners, and six residents        of the newer anti-epileptic med-
      who work in concert with                ications that have not been ade-
      CHaD’s growing areas of spe-            quately tested in children,” he ex-
      ciality—including pediatric neu-        plains. To Holmes, this is an
      rology, neurosurgery, psychiatry,       exciting prospect. “When I was a
      and electroencephalography—             resident, there were only three
      and coordinate expertise through        drugs we could use to treat
      the Neuroscience Center at Dart-        epilepsy—now there about
      mouth. “We have a team ap-              twenty, ten of which have been
      proach that allows us to coalesce       developed in the last ten years.
      the expertise on both the adult             “The perception in the past
      and pediatric sides of neurology.       was that the brain was like a black        Call us today to learn how gift planning can
      As a result, we’re able to offer a      box—no one knew much about                support the future of children's care at CHaD.
      comprehensive program to eval-          it,” Holmes continues. Now,                  Fred Moore, Director, Office of Gift Planning
      uate and treat neurological prob-       with a greater understanding of                   Phone toll free: 1-866-272-1955
      lems in patients ranging from           the mechanisms responsible for                   E-mail: Gift.Planning@Hitchcock.org
      young children to adults.”              neurological disorders, more ef-

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         Meet Dr. Reece
        C
               HAD WELCOMES DR. ROBERT REECE, a PEDIATRICIAN INTER-              abuse, whether it’s the physical
               nationally recognized as an expert in child abuse. Reece joined   abuse they receive or the violent
               CHaD’s clinical staff in July and is working as a medical con-    behaviors they observe. Even in cas-
         sultant for its Child Advocacy and Protection Program (CAPP). He        es of witnessed violence, we’re find-
         is also a visiting professor of pediatrics at Dartmouth Medical         ing that their brains go through
         School. “My wife and I moved up from Cape Cod to Norwich, Ver-          structural changes that can con-
         mont in June and we’re really enjoying the area,” he says. “I’m         tribute to cognitive and behavioral
         very impressed with CHaD and the quality of its people.”                problems they have later on in life.”
             In addition to his duties at CHaD, Reece is director of the In-         “The affects of child abuse man-
         stitute for Professional Education for the Massachusetts Society for    ifest themselves in many different ways, some that people don’t
         the Prevention of Cruelty to Children and a clinical professor of       think of,” Reece says. “Often, we see it come out through substance
         pediatrics at Tufts University School of Medicine. “I spend a fair      abuse and criminal behavior—for example, we know that almost
         amount of my time traveling internationally and educating physi-        90 percent of people who are incarcerated have a history of child
         cians, social workers, and various people about the medical as-         abuse. But even issues like obesity and smoking can be linked to
         pects of child abuse,” he says. Reece has authored many papers and      child abuse.”
         articles on the subject and is Executive Editor of The Quarterly            CAPP provides 24-hour consultation for hospital system cas-
         Child Abuse Medical Update.                                             es in which concern about abuse or neglect have been voiced by the
             He is also active on the research front. “A lot of the work we’re   healthcare team. “We are planning to expand the professional ed-
         doing now involves looking at how the brain is affected by head in-     ucational activities of the program as well as the research agenda
         juries,” Reece says. “Children are subjected to many kinds of           in the area of child maltreatment.”



                                                                                           Bill Boyle Honored
                                                                                           Dr. William E. Boyle, Jr., Professor of Pediatrics and of
                                                                                           Community and Family Medicine, was recently honored
                                                                                           with the 2003 Pediatrician of the Year award presented
                                                                                           by the New Hampshire Pediatric Society.
                                                                                              Boyle has practiced his brand of family-centered, com-
                                                                                           munity-centered care at CHaD since 1970. As both a
                                                                                           general pediatrician and a subspecialist in long-term and
                                                                                           chronic illnesses—like cancer, diabetes, and cystic fibro-
                                                                                           sis—he has seen a spectrum of conditions far beyond
                                                                                           those of the average pediatric practice.
                                                                                              In 1997, Dr. Boyle began a community pediatrics pro-
                                                                                           gram. The program teaches doctors in training about our
                                                                                           community and the need for family-centered care. The
                                                                                           William E. Boyle, Jr., MD, Community Pediatrics Program
                                                                                           helps young doctors connect on a compassionate level
                                                                                           with children and their families. The Boyle Program ad-
                                                                                           vocates a more comprehensive approach to care—an
                                                                                           approach in which pediatricians look beyond the disease
                                                                                           and see the whole child and family.
                                                                                              “Dr. Boyle is respectful, compassionate, curious, and
                                                                                           has a tremendous capacity to keep the big picture in
                                                                                           mind while providing family-centered care,” says Toni La-
                                                                                           monica, Boyle Program Manager. “He is passionate about
                                                                                           education and his actions remind me constantly of what this
                                                                                           program is all about: How to provide better care for kids
                                                                                           and families...especially kids with chronic illness.”




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     The Makings of a Champion
     W
              HAT’S THE DEFINITION OF A CHAD          ten been misdiagnosed as cerebral palsy be-      with undiagnosed
               Champion? “It’s a company or           cause of its rareness. Wal-Mart’s 2002 gift      DRD,” says Filiano, a
               civic group that supports CHaD,        to the children’s hospital was $150,000,         pediatric neurologist
      helping to build awareness and raise funds      and a large portion of these unrestricted        and intensivist. “DRD
      for the children’s hospital,” says Sharon       funds has supported the hiring of a nurse        is a rare disease and it
      Brown, director of community relations          coordinator who will research other po-          won’t be the answer for
      at CHaD. “What makes them unique is             tential patients throughout the region.          every parent, but if we can
      their ability to motivate and encourage            “Current estimates indicate there may         help a few more Harrisons
      large groups of people to get more direct-      be as many as ten people in the region and       and Gracies the rewards
      ly involved with CHaD.”                         a few thousand people across the country         will be great.”
          Often, this ability to inspire participa-
      tion extends beyond a company’s own walls.
      “A CHaD Champion will use the influ-             Wal-Mart is Ace in the Hole
                                                        MUCH TO OUR ASTONISHMENT AND ABSOLUTE DELIGHT, WAL-MART            passed
      ence it has not just with its employees, but
      also with its customers and suppliers to cre-     a $250,000 check to CHaD on September 18 at their annual          Help a
                                                        Child Smile Golf Tournament in Hudson, NH. As the              culmination
      ate a broad base of support for CHaD,”
                                                        of their yearlong CHaD Champion Campaign, their              fundraising sig-
      adds David McWilliams, who coordinates            nificantly exceeded a very ambitious goal by nearly        $40,000. It was
      corporate and community relations activi-         an amazing day for everyone who was present.            Their committed gen-
      ties for CHaD.                                                                                          erosity and pas-
                                                                                                          sion for CHaD is
      Wal-Mart is a CHaD Champion                                                                      overwhelming.
      “The Wal-Mart associates have become                                                            There is no other way to describe it.
                                                                                                          It is also quite remarkable how Wal-
      champions for the kids through their net-
                                                                                                      Mart staff—specifically Skip Dykstra, chair
      work of vendors and customers,” Brown                                                           of the tournament—is able to bring together
      explains. “For some, it’s adding pocket                                                         major business competitors such as Coke
      change to the CHaD-a-saurus. For others,                                                        and Pepsi, Keebler and Nabisco, Kraft and
      it’s hard work to organize and host a golf                                                      Hershey Foods, and have them all behave
      tournament.”                                                                                    as friends and partners for the day. As their
          Wal-Mart displays CHaD-a-saurus coin                                                        mantra says: “It’s all about the kids.”
      banks in 30 different store locations year-
      round to promote its commitment to
      CHaD. Taking part in the annual “Help a
      Child Smile” golf tournament has prompt-
      ed Wal-Mart vendors such as Coca-Cola to
      get more directly involved in supporting
      CHaD. “As a result of their relationship with
      Wal-Mart, Coke is now helping with other
      CHaD events such as arranging for a
      NASCAR Driver to visit CHaD kids at our
      ‘Race to Victory’ event at NH Internation-
      al Speedway this summer,” says McWilliams.
          Wal-Mart is also helping CHaD’s Dr.
      James Filiano and the Colegrove family
      raise awareness of a rare genetic disorder
      called dopa-responsive dystonia (DRD)
      which struck siblings Harrison and Gracie
      Colegrove. The disorder, caused by an in-
      adequate supply of dopamine to the brain,
      progressively steals all mobility and has of-

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           Fun & Activities at C
           CHaD Gala                                                                                                          C&S Supports
                                                                 The home of Byron and Scooter Hathorn served
                                                                 as a lovely setting for the Second Annual CHaD
                                                                                                                              Children’s Cancer Fund
                                                                                                                          The C&S Charity Golf Tournament took over both
                                                                 Gala—An Evening in VerMonte Carlo. Held on
                                                                                                                          Mt. Snow and Haystack Golf Courses in Wilm-
                                                                 May 30, the event raised nearly $40,000—all
                                                                                                                          ington, VT, as well as the Hermitage Inn’s fishing
                                                                 to benefit the kids at CHaD! Dancing the night
                                                                                                                          and skeet shooting facilities, and brought togeth-
                                                                 away to the Al Alessi Band and playing their
                                                                                                                          er hundreds of grocery store owners, food ven-
                                                                 favorite games at the Casino, over 230 guests en-
                                                                                                                          dors, and C&S staff from all over the east coast—
                                                                 joyed a gorgeous spring evening on the banks of
                                                                                                                          all with the goal of supporting kids by raise money
                                                                 the Connecticut River. Ledyard National Bank
                                                                                                                          for CHaD. The day’s events culminated with C&S’
                                                                 and Can-Do Special Events provided significant
                                                                                                                          Ron Wright, President, and Phil Crowley, Assis-
                                                                 support for the event. The highlight of the evening
                                                                                                                          tant Treasurer, presenting Dr. Larsen with a check
                                                                 was the diamond raffle in champagne glasses—
                                                                                                                          for $75,000. C&S also donated all the food for the
                                                                 a $7,000 ideal cut diamond was up for grabs for
                                                                                                                          Pediatric Oncology family picnic before the Circus
           Drs. John and Christy Brooks (center), who            a $50 chance! The diamond, generously do-
                                                                                                                          Smirkus performances this summer. Thanks C&S for
           greeted all the Gala guests, enjoyed time with        nated by VonBargen’s Jewelers, helped make
           John and Leslie VonBargen who generously                                                                       all your support!
                                                                 the evening especially glamorous! A fantastic
           donated the diamond.                                  time was had by all!



           CHaD Classic
           Record Set
           This year’s CHaD Classic Golf Tourna-
           ment broke all records as Co-Chairs
           Sharin Luti and Lisa Lacasse delivered a
           $90,000 check to Mary Oseid and                                                                                Rubin Harris, Vice Chair of C&S Wholesale
           Kevin Donovan from CHaD. The two day                                                                           Grocers, and CHaD’s Pediatric Oncologist, Eric
                                                                                                                          Larsen, MD, rests after a hard day of golf,
           event started off on June 7 with “Rock
                                                                                                                          auctions and excellent food, all in support of
           for Kids,” an evening of excellent food,                                                                       children with cancer at CHaD.
           auctions, great music and dancing and the raffle of
           an Indian Scout Motorcycle. The golf tournament
           hosted a sold out crowd on the two prestigious
           Quechee golf courses, sponsored by Lateran Group      Racing to Victory at the Governor’s Breakfast
           and Centurion Corporation. Dinner, awards, and        On July 18, Governor Craig Benson presided at the
           prizes preceded the biggest prize of all, the gen-    11th Annual Governor’s Breakfast at New Hampshire
           erous check presented by Quechee Lakes Landown-       International Speedway. Nascar team owner and fea-
           ers Association Charities for CHaD. All totaled,      tured speaker, Ray Evernham, spoke to approximately
           QLLA Charities has raised close to $1 million for     300 race fans and distinguished guests about his
           CHaD in their 23 years of running the CHaD Clas-      family’s personal experience and his son’s battle with
           sic. Support from the tournament will help build      childhood cancer. Ray’s appearance at the breakfast
           the new CHaD Ambulatory Care Center.                  helped to raise nearly $20,000 for CHaD and David’s
                                                                 House through ticket sales and corporate sponsor-
                                                                 ships. Many thanks to Morgan Stanley, Ford Motor
              2003 APEX awards                                   Corporation, KPMG, NH Auto Dealers Association,
              In the category “Writing,” CHaD Nurses:            Fleet Bank, Hinckley, Allen & Snyder, Hawkins, De-
              Caring & Compassion in last fall’s CHaD            lafield & Wood, and TK Sports for their generosity to
              Matters received a 2003 APEX                       this event. As part of the day’s festivities, the Speedway
              award from Communications                          also sponsored 150 CHaD and David’s House children
              Concepts, a professional                           and families in VIP Suites during the day’s races and
                                                                 practice rounds for Sunday’s Sylvania 300. A visit to         During the breakfast, Governor Craig Benson
              communicators organization
                                                                                                                               took time to support the kids at CHaD, signing
              in Virginia.                                       the families by 2002 NASCAR champion Tony Stew-
                                                                                                                               an autograph for Jeffrey Linton, age 11.
                                                                 art capped off the day’s excitement.




         14                   M AT T E R S
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t CHaD
                                                            Circus Magic
                                                            Sponsored by the Friends of CHaD and NCCC, Circus
                                                            Smirkus troupes brought magic and excitement to
                                                            “sold out shows” in August. Over 3,000 kids and
                                                            families crowed into the big top, staked on the
                                                            fields donated by the Lebanon Elks, to watch this
                                                            excellent group of young international performers.


     Health and                                             The Smirkus Troupers ranged in age from 12 to
                                                            18, and boasted juggling, clowning, and ac-
                                                            robatic skills equal to any circus in the coun-


     Safety Fair
     Prevention, healthy living, and fun were the focus
                                                            try. Their delight, energy, and enthusiasm
                                                            was contagious as could be seen as the
                                                            audience left the tent with kids attempting
                                                            hand stands and cart
     at the 12th Annual CHaD Health and Safety Fair.
                                                            wheels. In addition to the
     Offered in collaboration with media partner KIXX
                                                            event’s supporting Pedi-
     radio, over 2,300 people visited 20 interactive
     exhibits during the day long event. In addition,       atric Oncology, over 150
     CHaD's Injury Prevention Center and NH SAFEKIDS        oncology patients and
     offered a car seat safety check where dozens of car    their families came as guests
     seats were replaced free of charge. Fair goers en-     to a pre-show cookout with
     joyed entertainment, clowns, and characters of         the Circus Smirkus perform-
     all sorts all while learning to be healthy and safe.   ers and feasted on food sup-
                                                            plied by C&S Wholesale Gro-
                                                            cers. Then all were escorted
                                                            under the big top to reserved seats
                                                            for the fun, fast-paced circus.




         These two young surgeons are intensely
        involved in a game of “Operation” at the
        “Dress Like a Doctor” booth sponsored by
                  the Child Life Program.




                                                                                            Circus Smirkus comes to CHaD
                                                                                            On August 12, members of the Circus Smirkus troupe
                                                                                            came to CHaD to visit with young patients unable to come
                                                                                            to their performances. They visited patients in the Pedi-
                                                                                            atric In-Patient Unit, siblings of babies in the Intensive Care
                                                                                            Nursery, and made a special trip to the CHaD Pad, the
                                                                                            children’s chemotherapy room at NCCC, where they en-
                                                                                            tertained young cancer patients, parents and nursing staff
                                                                                            with hand stands, juggling, and feather balancing. It is
                                                                                            hard to say who was more moved and excited, the young
       The JUMP program at River Valley Club was
                                                                                            patients or the talented young performers who said their
       just one of the interactive displays featuring                                       visit to the hospital was a high point of their summer tour.
                 fitness at this year’s fair.




                                                                                                                              M AT T E R S               15
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      XL92 Wishing Well For Kids                                                                                                                 Share
      The XL 92 Wishing Well for Kids Campaign                                                                                                   the Love
      is November 28 through December 19. Pro-                                                                                                   Deborah and Lawrence Holt
      ceeds will benefit the new CHaD Outpatient                                                                                                 shared their love by asking
      Care Center. Make a wish to make kids well                                                                                                 their wedding guests to
      and pledge today. All pledges received by De-                                                                                              make donations to CHaD
                                                                                                                                                 in honor of Deborah's
      cember 15 will be read on the air during the
                                                                                                                                                 daughter, Jackie Booth.
      XL 92 Wishing Well for Kids Radiothon.
                                                                                                                                                 Jackie, a frequent PICU vis-
      ❑ YES I want to make a pledge to help the                                                                                                  itor, presented the gifts to
          CHaD Outpatient Care Center                                                                                                            Dr. Dan Levin, PICU Med-
                                                                                                                                                 ical Director, asking him to
      Enclosed is my gift of :
                                                                                                                                                 buy a Nintendo and tools
      ❑ $100 ❑ $50              ❑ $25         ❑ $10    ❑ Other ______________________                                                            to aid staff communicate
      I would like my gift made               ❑ in memory of, or                                                                                 with deaf children.

      ❑ in honor of ____________________________________________.
      Please make checks payable to the Children’s Hospital at Dartmouth.                     CHaD Events Schedule
                                                                                              BINGO every Wednesday night: Join us         group today. All proceeds go toward toys,
      Thank you for your gift!                                                                any Wednesday night to support Kris-         books, and children’s supplies at CHaD.
                                                                                              ten’s Gift and other programs at CHaD.       Contact Sarah Salo at (603)650-3431 or
                                                                                              Doors open 4:30PM; Games start at            Sarah.Salo@hitchcock.org.
        Name                                                                                  6:45PM. Manchester Bingo Center, 165         February 28, 2004: CHaD Ski and
                                                                                              John Devine Boulevard, Manchester,           Ride Challenge at Dartmouth Skiway.
                                                                                              NH. For information, contact Terri Paradis   Think SNOW! Gather friends for the
        Address
                                                                                              at Terri.P.Paradis@hitchcock.org or          team challenge or bring the whole fam-
                                                                                              (603)650-3435.                               ily for a fun-filled day at the mountain.
        City                                                    State       Zip                                                            Food and great prizes. Contact Terri Par-
                                                                                              November 28–December 19: XL 92
                                                                                              Wishing Well for Kids Campaign. Listen       adis at (603)650-3435 or Terri.P.Par-
        Phone                                                                                 to XL 92 for campaign details including      adis@hitchcock.org.
                                                                                              Radiothon dates, where you can buy           June 12, 2004: Rock for the Kids,
                                                                                              your paper well, and other exciting new      Quechee, VT. A great evening of mu-
        Email                                                                                 features. To make an early pledge, use       sic, fine food, and the best silent and
                                                                                              the sheet on this page. Please help us       live auction anywhere around. Call
      Credit card information:        ❑ Visa ❑ Mastercard               ❑ American Express    build our new CHaD Outpatient Care           Sharin Luti at (802)295-9201.
                                                                                              Center. For details, please contact Sarah
                                                                                                                                           June 14, 2004: CHaD Classic Golf
                                                                                              Salo at Sarah.Salo@hitchcock.org or
        Credit Card number                                         Expiration date                                                         Tournament, Quechee, VT. Join us on
                                                                                              (603)650-3431.
                                                                                                                                           the prestigious Quechee Lakes Golf
                                                                                              January–May 2004: CHaD Readathon.            courses for a day of hitting them long
        Your name as it appears on the card
                                                                                              Kids helping kids; children read for         and straight for the kids at CHaD. For de-
      Please clip and send to:                                                                pledges. Sign up your school or church       tails, call Sharin Luti at (802)295-9201.
      CHaD, Attn: Sarah Salo, CHaD Community Relations, Dartmouth-
      Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756.                 CHaD Matters is published by the Children’s Hospital at Dartmouth. Please address
      For more information, call (603)650-3431.                     4.CHaD.201               correspondence to: Sharon Brown, CHaD, Dartmouth-Hitchcock Medical Center, One
                                                                                             Medical Center Drive, Lebanon, NH 03756.



                                                                                                                                                                  NON-PROFIT
                                                                                                                                                                 U.S. POSTAGE
    CHILDREN’S HOSPITAL
                                                                                                                                                                      PAID
                                                                                                                                                                 LEBANON, NH
                                                                                                                                                                PERMIT NO. 211
                  One Medical Center Drive
                  Lebanon, New Hampshire 03756




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