ABSTRACT
I examined 10-year-old Elke within the framework of a research project on coping mechanisms shown by children aged between 8 and 12 during bone marrow transplantation (Günter, Werning, Karle & Klingebiel, 1997; Günter, 2000; Günter, 2002; Günter, 2003). In Chapter 14 I describe some of the results of this work in more detail. In order to give a better understanding of the situation in which Elke found herself, I will briefly describe the process of a bone marrow transplant. Again, a more detailed account can be found in Chapter 14. Elke had developed severe aplastic anaemia a few months before, which meant that she required regular blood transfusions; without a successful bone marrow or stem cell transplant, the condition is fatal. She was now undergoing further extensive diagnostic examinations in the clinic after the indication for the bone marrow transplant had been confirmed. My first squiggle interview with Elke took place in my office at the clinic in the week before her admission for the planned bone marrow transplant. A week later Elke was admitted, and the first procedure she underwent was conditioning, that is to say the removal of the remaining bone marrow through the administration of large doses of cytostatic drugs. About a week after her admission, the transplant was carried out in the form of an intravenous infusion of bone marrow via a Hickman catheter. During this time and for the following three weeks, Elke, like other children in the same situation, 141had to be treated in a germ-free environment, in a single room under isolation conditions. With the removal of the bone marrow, the body’s immune defences were largely eliminated and there was a risk of lethal infection until the new bone marrow had grafted in. Our second interview took place in this isolation room on the 18th day after the transplant. The third interview was roughly three years after her first transplant. I visited Elke at her home after agreeing on an appointment with her. It was not until the end of this interview that I learnt from her that in the meantime she had suffered a relapse and had to receive a second transplant. She said she had forgotten when this second transplant had taken place. If she should suffer a second relapse, she told me she would not agree to undergo another transplant.
