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By Linda Stahl
lstahl@courier-journal.com
The Courier-Journal

The tall cabinet on wheels is decorated with tropical plants, jungle cats and other exotic creatures.

Inevitably, when Bryan D. Carter rolls it down a hallway in Kosair Children's Hospital, people ask questions.

"Are there animals in there?" some young onlookers ask.

Carter, a pediatric psychologist with a quick smile, sometimes jokes that it's a "time-out" room for children who are acting up (a tongue-in-cheek suggestion from the nursing staff).

But what the big box on wheels is -- and what the sign on the front of the portable cabinet plainly states -- is the "Coping Cart," the culmination of an idea Carter had been kicking around for some time.

The cart is a one-of-a-kind mobile multimedia center used by children who are hospitalized to relieve stress, anxiety and boredom, distract themselves from pain and help other young patients cope.

Children find sophisticated cameras, computer programs, props and other tools in the cart. Some have used the technology to make DVDs about such things as:

• Giving other kids advice on swallowing pills (which is a problem for some children) or coping with pain during physical therapy.

• Telling family and friends about their medical condition and treatment.

• Portraying life in the cancer care and renal ward of the hospital.

• Getting through your teen years with cystic fibrosis.

• Seeing your doctors and nurses as more than medical caregivers.

In addition to the equipment for making a DVD, the cart contains a clinical biofeedback unit that teaches children to relax.

After sensors are attached to their fingers, children watch a program on a monitor that includes elaborate visuals accompanied by soothing voices and relaxing music. As they watch, they work to control their breathing and pulse rate to get a beautiful balloon to float across a mountain landscape or release an arrow from a bow and hit a target.

The use of the Coping Cart equipment is all about putting the child in the role of expert, said Carter. Also, children who make DVDs -- which they can share with other hospitalized children -- end up feeling like they are helping others. Children have a natural need "to help someone else," Carter explained.

Nine-year-old Jadon Cox of Elizabethtown, Ky., made two DVDs while recently hospitalized at Kosair Children's Hospital for a heart valve problem.

His first DVD, which he called "The Wacko Story of Jadon Cox," featured hand puppets operated by Jadon; his father, Daniel Cox; and Carter.

Carter said the exercise of making the video relieved the stress that Jadon was feeling at the time.

Turning the tables

Another film he made later on was more of a "day in the life of the hospital" type of story, Jadon explained. In it, he interviewed one of his doctors on a variety of topics -- about his pets, his decision to go into pediatrics and why he made Jadon use a breathing device every day -- something Jadon didn't much like to do.

"I wanted to see you suffer," the doctor joked, but then added, "It's good for you."

Jadon also persuaded some of his nurses to do a line dance for his DVD and then set it to music.

Children are good at using equipment, Carter said. They can download their own music to accompany video, make captions, use a cartooning program and other devices. There also are books and medical toys and games in the cart.

Children who are young can play with dolls and toy medical instruments. They can give a doll "shots" with a play hypodermic needle, and it makes them feel some sense of control and even releases some anger, Carter observed.

Carter has a colleague in Cincinnati who is intrigued with how Coping Cart activities might affect a child's ability to stick with a regimen required by his medical condition.

One 10-year-old child at Kosair who has cancer made a DVD about how he manages to swallow his pills. "I take them with applesauce on a spoon and just try to forget they're there," he tells the viewer.

Telling their story

About 20 Kosair patients have used the Coping Cart. It is a boon for children who are put in isolation because of a transplant and for those enduring long hospital stays. They can send DVDs to their extended family or school to help answer questions about where they are and why.

Tina Cox, Jadon's mother, said the filmmaking helped him come out of his shell and think of himself in a different way. "He asked for a video camera for Christmas," she said.

Carter thanks a brother in the television news business for familiarizing him with camera work and seeing its potential. Carter also has a natural interest in new technologies and has used them to train students. He is a professor and director of pediatric consultation at the University of Louisville School of Medicine.

Carter said that parents dealing with sick children at home might look for ways to help their child tell his story and feel some control over his life until he recovers.

The Coping Cart was funded by the Kentucky Psychological Association Foundation. In 2005, the association did a project in which artists created 41 fiberglass heads, which were displayed around town and later auctioned. Proceeds from the auction funded the $17,500 Coping Cart.