BITING OFF THE BRACELET: A Study of Children in Hospitals

Taking Erving Goffman's ""total institution"" as her model, Beuf finds that children's hospitals have the same depersonalizing characteristics that he found in Asylums (1961). She acknowledges that like conditions exist for adult patients but notes that they are harder on children because, first, children are already in a situation of enforced helplessness which hospitalization compounds and, second, their sense of self-esteem is still forming and thus more fragile. The structure of this book derives entirely from Beuf's comparison of what she observed in two children's hospitals with Goffman's model and with Talcott Parson's ""notion"" of the ""sick role,"" which she finds inaccurate in this setting. Beuf points out the discrepancy between the hospital's ostensible function, to help sick children, and its hidden one--to work efficiently and regulate its inmates. She draws up some broad composite-impressions of patient types (the wild kid, the gregarious host, the junior medical student) to illustrate the ""coping strategies"" she has observed. Her recommendations are unsurprising: professionals should have courses in child psychology, and other staff members should be trained to deal with patients' emotional needs; for all, jobs and promotions should depend on sensitivity. The problem with Beuf's argument is not that it is invalid but that it is ponderously belabored. The study grew out of her own experiences as a mother of hospitalized children; perhaps if she had drawn more from those experiences the book would read less like an unimaginative master's thesis.