The day started on something of a low note with the news that my most regular and lively patient was not well enough to leave his bed. I started with him as usual, feeling my way a bit as he had had a very bad night. In fact he was in good form and enjoyed some play and story-making about the bus and Freddie (his puppet), who joined him in the cot. We decided the bus had headed for the stars, the patient played the moon briefly, we took on board a toy bird of his, and then, when we reached the moon Buzz Lightyear, another cot resident `climbed in`, adding a lot of humor to the proceedings as he could talk and kept interjecting surreal comments. We had a look at the puppet portal book and he heard what the other children had made and done the previous week, and helped stick in their and his own images. He was particularly taken with the idea of Shotgun, the hedgehog, getting kicked off the bus. He teased me when glueing, and took some more photos, and then set in to some serious cutting. His little `smile collections` sketchbook had gone awol but I gave him another as his own `visual diary` and had brought copes of his photos to glue in. He was too wrapped up in cutting however, and cut up the cover of this too. My attempts to steer this towards collage in the book were unsuccessful, as he was suddenly exhausted and dismissed me.

My next customer was a shy-seeming six year old who it was a treat to observe become slowly more and more animated and involved as we worked together. With encouragement from her dad she made quite a large puppet called Adam, who it gradually transpired was from Dublin, and loved the zoo. He has even been known to ride on a giraffe on occasion, and is fond of elephants and snakes as well. She photographed and her dad filmed him, and then she decided that the first film where I `interviewed` him could be improved on, and enacted a little `dialogue` where the puppet interviewed himself! She had a lot of art materials so I left her with some card to see would she like to draw the zoo, or somewhere else the bus might take Adam, and was working away when I left.

There were a few frustrations, and false starts today, a lot of patients sleeping or in theatre, doctors rounds etc. At one stage I approached a mother with a little boy and although she said wasn`t sure I could work with him as he cannot see, she was pleased that I came back to do so. However for infection control reasons, preparing for this took me some time and when I returned he had fallen asleep! I went back later however, and made him a puppet with bells for eyes - using bells had been the suggestion of another artist on the team when I had spoken of a patient who had difficulty speaking, and as this little boy was playing with musical toys I thought it might be good for him. I handed him each material before assembling and he felt most with hands and mouth. When the bell-eyes were attached to the head he played with it vigorously enjoying the sound. It wasn`t until towards the end though, with help from his mother`s questioning him that I really was sure from some smiles that the activity pleased him. 

I hoped to work with another little girl, also in isolation, but over the day a few attempts were thwarted and when I finally managed to talk to her dad he didn`t  think it was a good idea. Another 6 year old boy was surprisingly vociferously against the idea when I first approached him, although his mother tried to persuade him otherwise. Later in the day I went back to them and we spent some time together, he looked through the portal book and played with some of the materials but preferred to play tennis with a potential head and rod than make something. His mother said that as he has difficulties with co-ordination he doesn`t enjoy art work very much. I was sorry that conversation happened in front of him as it may have contributed to his frustration. I began to assemble a head a few different ways but he had really decided against it so I respected that (in the end!). One of the things I find hard about this job is that with patients with special needs you need a slower build to find how best to work with them and who they are. With a couple of other patients too, over the weeks I come away chewing over ideas, but when you go back the next week they are usually gone. I am learning a lot, I am sure, but on a person to person level it is frustrating. I could see from the way he was playing with his mum that he would be a great performer but didn`t find a way today of getting him there. A fifteen year old girl also declined taking part, saying she doesn`t enjoy making things, although I had hoped from the way she had seemed to be observing my work with the others that she might have had an interest.

Another boy, 3 years, had been in theatre in the morning and slept most of the afternoon, but by the end of the day was up on his mum`s knee. I had talked to mum earlier so sat for a chat with them, trying to see if he was well enough for something. He was talking in whispers and I was about to move on when I deciphered an announcement that he would like a puppet, "a horse puppet". He was very sore and needed to be held by his mum, but was happy to direct my making it for him, choosing colors and materials, and to my delight, promoting it to a unicorn half way through the process. He also took some photos afterwards, choosing to take the toast he was enjoying after his long fast, and his `tigger` who he had given sunglasses to with the `star patient` stickers the doctors had awarded him with. At my mentor session yesterday I was encouraged in my interest in what the children choose to photograph, and how telling it is about the hospital environment and their perspective on it. It is nice that it can happen quite organically as an addendum to the puppet making through inviting them to photograph their puppet and then inviting them to take some other shots. Like the little ones with the scissors, the camera as a tool is often kept out of their reach and so is exciting and inspiring for them.

Another enjoyable session for me was with the sister of the long term patient who has been eager to make a puppet for some weeks now. We went to the corridor as his mum was hoping her brother would nap. I asked her where in the world she would send the bus if she had a choice of anywhere and she thought a bit and decided "Clondalkin". We used the lost property clues to discover who she should make and getting the balloon she decided it was a magician on his way to a party. He became Mr Nobody, complete with cape, magic wand and hat and made a charming little film about changing me into a computer, then a princess, then a frog.

As I was packing up, the Alien maker from the week before was re-admitted "We`re back!...unfortunately" his mother greeted me. I dropped down some crayons and paper before I left and showed him his puppet`s picture in the book and heard he has been a big hit at home.

7 patient interactions, one sibling, but only 4 puppets. 8 parents. A lot of general staff interest.