This as-told-to essay is based on a conversation with Leandro Brandão Guimarães. It has been edited for length and clarity.
When I first started operating on children as a pediatric ear, nose, and throat doctor 15 years ago, I remember personally struggling watching children enter the operating room with me. They were scared and often crying. Sometimes, they were screaming.
It was policy that parents couldn’t enter the operating room with us, which added to the children’s distress.
It bothered me a lot, especially once I had my own two children, and I started considering how I could make it easier for kids.
I wanted parents to be there for their kids
The first thing I did was refuse to operate if parents weren’t allowed to enter the operating room prior to the child being anesthetized. Being separated from a parent at such a vulnerable time is both horrible for the child and for the parent.
I then spoke with a friend in San Diego who helps children with their nerves before surgery by letting them drive a small electric car into the operating room. It was a very cool idea, but too expensive for me.
I wanted to give kids power — to help them feel they were strong and could face their fears. I wanted them to feel like superheroes. This gave me an idea — to give every child the option of choosing a superhero costume to wear into the operating room.
I bought my patients superhero costumes
After an online search for costumes, I found a seller in Brazil who made costumes. I bought, out of my own money, Superman, Batman, Spider-Man, Princesses, and Wonder Woman costumes.
That first time a child walked through the hallway in a costume, I knew this would work. The child wasn’t apprehensive or nervous — he was laughing and having a fun moment. He forgot the fears he’d had.
That was six years ago, and I’ve never stopped giving kids this option, always making sure I’ve bought costumes (from the same seller as I started with — a single mom who appreciates the work and added income) to provide them with before surgery.
I don’t lie to kids about their surgeries
Prior to surgery, together with their parents, I clearly explain that I will be doing something in their nose or throat that is going to help them breathe or sleep better. I don’t lie to the children about what will be happening.
In appointments prior to the surgery, I have toys for the children to play with in my office, and I often try to joke around to make them laugh and feel comfortable with me as their doctor.
Once they are dressed in their superhero or princess costume on the day of the surgery, I give them the option to either run or fly through the hallway (with me carrying them on my shoulder).
They love going through that corridor in their costumes, laughing and smiling, which in turn makes the parents and the rest of the staff do the same. It’s a magical moment.
Following surgery, the family takes the costume home, a reminder to the child of their bravery.
Although I always ask if the patient wants a costume, the older children nearly always decline. To empower them and relieve their anxiety, I treat them with respect and answer any questions they might have. We will have a chat and laugh on the way to surgery — an attempt to distract them in a different way than I do with the younger children.
This shift has clearly been positive for children, but has also contributed to greater love for my work, as I rarely have children who feel distressed before surgery anymore. They now have their parents or guardians with them until they’ve been anesthetized (a comfort blanket for children) and are distracted by costumes, humor, and lighthearted conversation on the way to surgery.
My job isn’t just about making children physically well, but ensuring that the entire surgical process is easier for the child. I’m treating the whole person, not just the problem I’m operating on.
