Cruel to Be Kind: Saying no can save a child’s life

‘I don’t think so,’ Mrs Marshall said. ‘Max gets out of breath after exertion, but I think that’s because of his weight. His mother has been committed to him having an inhaler for a long time and it seems the doctor has finally agreed. Many children in the school have inhalers now. Personally I think they’re over-prescribed. One of my children had asthma – he still does – so I know the signs and symptoms. Max has used his inhaler once since he got it and that was after his sister, Summer, made him rush in, as she was going to be late for her school. He was out of breath but more panting rather than wheezing, which is what you hear when a child has asthma. But obviously I’m no doctor and we have to let him use it if necessary.’

‘He’s used it once with me, when he first arrived,’ I said. ‘He’ll be having a medical before too long, so I’ll raise it with the paediatrician.’

‘I’d be interested to know what they say. And also what is said about his weight and going on a diet. Caz says it’s their genes, and it’s true they are all chronically overweight apart from the father. But when you hear what they eat, coupled with an inactive lifestyle, it’s hardly surprising. As part of our “staying healthy” project in school all the children kept a food diary for a week and it was quite an eye-opener.’

‘I’m limiting the amount of sweet foods Max has,’ I said.

‘Good. But we can’t do that here in school unless we have the parent’s permission and the child is following a special diet. We have a child with a nut allergy, another who has gluten intolerance, and the girl I mentioned earlier in the class who is trying to lose weight has a diet plan. The kitchen staff are aware of what these children can and can’t have, but they can’t stop a child having a second helping of pudding unless they’re told to do so. And the puddings here are delicious.’ She licked her lips.

‘So I understand,’ I said with a smile. ‘Max said it was sticky toffee pudding yesterday.’

‘It was tasty.’ She paused thoughtfully. ‘I wish I could do more for Max. He’s bright and has huge potential but isn’t given the support he could be at home. There are no books in his house and reading isn’t encouraged, so he borrows books from the school library and reads them in his bedroom. He has a lot to contend with. He’d love a proper relationship with his father, but he has little time for him and refers to him as “Mistake”. There’s a gap of seven years between Summer and Max, and according to Caz, Max was a mistake. But it’s not fair to make the child aware of it, and in some ways he is very different to them.’ Mrs Marshall paused and a smile crossed her face. ‘He reminds me of Matilda in the Roald Dahl children’s story. Do you know it?’ I nodded. ‘Matilda is bright and loves reading and learning just like Max, but her parents don’t and are so wound up in their own lives that they don’t recognize her worth. Eventually she is saved by her teacher, Miss Honey. Perhaps you will be Max’s Miss Honey?’

I returned her smile. ‘I will certainly do my best while he is with me.’

‘I know you will. And if Max ever mentions being bullied let me know straight away, please. We have a strict anti-bullying policy in this school and we keep a close eye on our most vulnerable children, but we can’t monitor them every second, especially in the school playground. I have a quiet chat with Max every so often, but I’m not sure he would tell me if someone was being unkind to him.’

‘I’ll keep a lookout for it,’ I said. ‘Thank you for all you are doing for Max.’

‘It’s a pleasure. Pop in any time if you have any concerns. Academically, Max is doing very well.’

We said goodbye and I left the classroom and went to reception, where I bought a spare PE T-shirt and shorts for Max – size age 12. I returned to my car and collected Paula from my friend’s house. She’d given Paula lunch, so, thanking her, I then took the opportunity while I had the time to pop into town to buy Max the Toy Story posters I’d promised him for his bedroom wall. I also bought a poster each for Adrian and Paula so they wouldn’t feel left out, although they already had plenty on their bedroom walls, built up over the years. From town I drove straight to Adrian’s school, collected him, then we returned home briefly for a drink before leaving again to collect Max.

Max came out of school carrying his PE kit for washing and a school bag weighed down with books. ‘That looks heavy,’ I said, taking the bag from him to carry.

‘Mrs Marshall always gives me extra books to read over the weekend so I don’t run out,’ he said.

‘Great. Although you are going to spend some time playing as well. We’re going to put up the tent,’ I reminded him. Having heard what Mrs Marshall had said about Max’s social isolation and using books as a means of escape, both at home and in the playground, I thought it was even more important that he spent some time playing and interacting with Adrian and Paula. Reading is a lovely pastime, but children need to play with other children to develop their social skills, and hopefully have fun.

Once home I showed Max the posters I’d bought and he was delighted with them. Adrian and Paula liked theirs too. I said I’d put them up later after we returned from the hospital, as there wasn’t time before. I served the meal I’d previously prepared and as soon as we’d finished we set off for the hospital and arrived just before 5.30 p.m. As with the evening before, I left Adrian and Paula to wait just inside the ward while I saw Max to his mother. Had Caz and her daughters been more friendly I would have introduced Adrian and Paula to them. Parents of children in care often like to meet the carer’s family, but Caz and her daughters didn’t want anything to do with me, so I doubted they’d be interested in meeting my family. Caz was propped on the pillows as she had been the night before and her daughters were draped around her bed, popping sweets from the various bags open on the bed. They all looked bored stiff.

‘Hello,’ I said brightly as Max joined the throng.

‘Kiss,’ Caz said, pointing to her cheek. He went up and kissed her cheek, then, helping himself to a sweet, joined his sisters in lolling against the bed. I wondered what he would find to do for an hour and a half apart from eat sweets, and it crossed my mind that perhaps he should bring in a book to read. It was a long time for a young child to spend on a hospital ward, even if it was with his family.

No one had responded to my hello so I said a general, ‘Have a nice time, see you later.’

‘Bye, Cathy,’ Max said. I smiled and left.

Following the same routine as the evening before, Adrian, Paula and I went up to the café and children’s play area, where Adrian completed some of his homework – the rest could be done over the weekend – and I read to Paula, and then they both spent some time playing. There was another boy Adrian’s age there and they had a few games of draughts. At seven o’clock we packed away and returned to the ward. Again, Caz’s youngest daughter, Summer, was the only one still there, sitting in the chair, staring into space and twiddling her hair. For whatever reason, clearly the older two girls could go but Summer had to stay.

I smiled politely at them both, remembered not to ask Max if he’d had a nice time and said, ‘OK? Ready to go then?’

‘Bye, Mum,’ Max said. ‘See you tomorrow.’ Kissing her cheek, he left her bed.

‘See you tomorrow,’ I said. Caz nodded and Summer just stared at me.

The ward was hot and stuffy and Max yawned repeatedly on the way out of the building, but once outside in the fresh air he perked up. ‘Have we got time to put up my posters tonight?’ he asked.

‘Yes.’

‘And tomorrow we’re going to play in the tent?’

‘We are.’

‘I’m hungry. Can I have a snack when we get home?’

‘Yes.’

And his face lit up at the prospect of eating, the thought of food giving him as much – if not more – pleasure as his posters or playing in a tent, which I thought, for a child of his age, was sad.

That night, as Max climbed into bed, with the Toy Story posters on his bedroom walls and Buzz Lightyear sitting on the bed, he said wistfully, ‘I wish I was Andy, then all the toys could be my friends.’ For anyone who doesn’t know the film Toy Story, it is a computer-animated adventure story where the toys owned by six-year-old Andy come to life and have amazing adventures.

‘It’s a nice idea,’ I said.

He nodded. ‘I don’t really have friends at school.’

‘I’m sure you do,’ I said, sitting on the edge of the bed. ‘Mrs Marshall said what a lovely boy you are.’ I’d already told Max in the car coming home from school that she’d said he was doing very well in lessons.

‘If my toys were alive, I could play games with them. I don’t play with anyone at school.’

‘Why is that?’ I asked gently. I was pretty sure I knew the reason, as Mrs Marshall had, but I wanted to hear what Max had to say.

‘The kids play running games and I can’t keep up with them,’ he explained. ‘They don’t want me to play with them, really.’

‘How do you know that?’ I asked, inching the conversation towards the possibility of Max being bullied. ‘Do they say something?’

He shrugged. ‘Not really. They’re not allowed to. It’s the way they look at each other. I can tell from their faces they don’t want me in their team.’

‘I understand,’ I said. It wasn’t overt bullying but the result was the same, and clearly you can’t force children to play with a particular child. In PE Mrs Marshall was in control and included and encouraged Max to participate, as she did the other overweight child in the class. The playground was very different and a free-for-all.

‘I can’t run like they can,’ Max added quietly, picking up Buzz Lightyear for comfort. ‘I’m very slow and I can’t keep up. I get hot and out of breath and go red in the face.’

I nodded sympathetically. ‘But perhaps you could join in with their games in a way that doesn’t involve you running fast.’

‘Like what?’ he asked. ‘All their games involve running.’ Which was probably true, as children of this age are usually very active, especially after having to sit quietly during lessons.

‘Well, let me see,’ I said, thinking. ‘What about this for an idea? If they play football you could offer to be the goalkeeper, or the linesman, or referee. You wouldn’t need to run much in those positions.’

‘That’s true,’ he said, ‘but they play a lot of tag and other chasing games like stuck in the mud and shipwrecked.’

‘OK. So you could be “home” or the “safe place”?’ This was the person or place the child being chased could go to so they couldn’t be caught.

Max looked thoughtful. ‘That might work.’

‘Have a think about it and I’m sure you can come up with ways of joining in. You read a lot of books and have a good imagination.’ He nodded. Max hadn’t mentioned his actual weight as being the problem. He hadn’t said, ‘I’m fat and I can’t run fast enough.’ His concern had been about joining in and I thought it best to deal with that issue. If he began talking about his weight and the need to lose some then I would do all I could to help him. But of course losing the weight would be a long-term goal and would require encouragement, willpower and the full commitment of his mother.

Chapter Eight