Have you ever spotted a furry friend in the halls of Cook Children’s? Chances are, it is one of Cook Children’s many animal-assisted therapy dogs.

Skylar (Sky) Runnels, patient care technician and medical assistant at Cook Children's, has seen the significance of these special dogs both as a caregiver and as a patient. In 2018, at just 17 years old, Sky was recovering from a surgery to remove a hemorrhagic cyst. She has a rare bleeding disorder, Von Willebrand's Disorder, so hospital stays are not outside of the norm. During her recovery, Cheryl Farrell and one of her previous therapy dogs, Pixie, visited Sky. 

 “I was very depressed at that moment," shares Sky. “I’m already in the hospital for so much, then I didn’t feel good, and I was lonely." On this day, Cheryl and Pixie were doing their usual rounds when they stopped by Sky's room. Pixie was holding a carrot on her nose and jumped right up on Sky's bed to greet her. “Seeing Cheryl come in the room and bring Pixie just lightened my day,” continues Sky. "Though I was really, really sick, it gave me some motivation to see the better side of things.”

Sometimes it isn’t just the patients who benefit from visits from a therapy dog. “There are times that you’re not just there for the patients, but for the families too," says Cheryl. “Just having a fur friend lie on you and do some tricks for you is very comforting," agrees Sky. "It can release a lot of anxiety.” 

A Full-Circle Connection

Oftentimes, this duo never gets to know how their interaction impacts people. “I could tell you stories that would make you cry and Skylar was just probably one of many," says Cheryl. “Sometimes you throw a rock into water and you have those immediate rippling effects, and sometimes you never get to see what the rippling effects are.”

Luckily, Cheryl and Sky have recently found each other again. Cheryl and her current corgi, Beau, were doing their weekly patient visits when Sky came up and introduced herself to them. She then told Cheryl about her interaction with her and Pixie as a patient years ago. Sky then shared that one of the reasons she chose a career in the medical field was because of her interactions with Pixie and the care she received as a patient. “Like I said with Sky, it was so cool just to see the circle being complete," beamed Cheryl. Sky still has photos of her visit from Cheryl and Pixie, which she was so excited to show.

Volunteer with a Heart of Gold

Cheryl has been volunteering at Cook Children’s since 2008 and has had multiple four-legged partners during her time here. Her partners have included Pogo, Manny, Pixie, Halo, and now her current partner, Beau. Beau is a young Corgi who has been with Cheryl for almost two and a half years. She got Beau when he was four months old, and she immediately put him into puppy classes to get him familiar with being around other people. Beau then completed multiple levels of training and eventually passed the test to become certified. “They don’t just test the dog, they test you together as a team,” explains Cheryl.

Beau and Cheryl have a unique bond. After raising and training four previous Corgis, Beau continues Cheryl's Corgi family tradition of visiting Cook Children’s patients and families. Cheryl describes this program as a “comfort program.” “The role of an animal-assisted therapy dog is to be a resource that patients, families, and even health care providers can lean on when they need a break from everyday stresses,” says Cheryl. 

Cheryl is a gift to the entire system. “While her dogs tend to steal the spotlight, Cheryl is the one with the heart of gold,” beams Marie Howell, manager of volunteer services at Cook Children's. “Her compassion and empathy for the patients are what keep her coming. Cheryl also does staff visits whenever she can – how lucky we are to have her!” 

In 2022, Cheryl Farrell was honored as Patient Care Volunteer of the year for her countless hours of remarkable service. She has served over 500 hours as an incredible, impactful volunteer.

About Animal Assisted Therapy Teams

Animal Assisted Therapy Teams consist of the volunteer and their pet dog. The dog has to be complex certified by Pet Partners and be evaluated by our Animal Assisted Therapy Team Lead. At that point, they can apply to volunteer. “Though it is a rigorous process, we want to be absolutely secure about the team before they onboard and interact with patients and families,” explains Marie. If you are interested in becoming a member of the Animal Assisted Therapy Team, please reach out to Marie at Marie.Howell@cookchildrens.org.

When we were within close range, he read my badge, nodded, and said out loud, “Oh, Child Life.” It all made sense; this ridiculousness was Child Life. What he didn’t know was that I was on my way to help create joy for a patient who was at the end of his life, as requested by his grieving siblings. And nothing felt ridiculous about that. On the contrary, it felt painful and sad and very, very important.

Years later, in my current role as facility dog program coordinator (and handler of Ralph), I am often told I have the best job ever. And I agree with that to my core. In some ways it feels like I need to be pinched, because this cannot possibly be my job and my life.

What I don’t often talk about, however, is that it is not in any sense an easy job. In fact, there are many days that it is extremely difficult. While I am exceedingly proud of the comfort and happiness Ralph brings to so many, the reality is that in just one eight hour day as Ralph’s partner, I bear witness to some of the highest highs and the lowest lows experienced by patients and families.

On any given day, I may sit in utter silence while Ralph snuggles a patient who landed in the hospital after attempting suicide, and then leave to attend a breakout party for a child going home from the bone marrow transplant unit; we may distract a child from a blood draw and then leave to be present at the bedside of a dying child.

Some days we work to show a child who has been abused what gentleness looks like, and some days we put his paw print on a canvas to congratulate a family on reaching the end of treatment. Together as a pair we act as cheerleaders, tear-catchers, and secret-keepers. And the truth of this work is our hearts break often. It is the great challenge of this work, in my opinion, to continually put our hearts back together so that we can be available to the next child and family that need us.

Lucky for us, we also get to play a role in helping kids find joy through circumstances that are sometimes unimaginable, we get to celebrate achievements and milestones, however big or small, and we get to have a front row seat to the miracle of human resilience.

When I come to work, I try to always remember the enormous opportunity in front of me and Ralph, which far outweighs any challenge we encounter. At least a couple of times every week, a parent or caregiver tells me that meeting Ralph was the first time they saw their child smile in days or even weeks. That is the reason we do what we do.

This past January, the facility dog program celebrated its fourth Cook Children’s anniversary. The program’s impact on patients, families and staff in that time is frankly incalculable. And though there is much more to it than meets the eye, the giggles, the security, the unconditional love and acceptance brought to the medical center each day by our five dogs is second to none. We will come back and do it again every day we possibly can.

References:

American Veterinary Medical Association. (2017). Animal-Assisted Interventions: Definitions. Retrieved from https://www.avma.org/KB/Policies/Pages/Animal-Assisted-Interventions-Definitions.aspx.

Braun, C., Stangler, T., Narveson, J., & Pettingel, S. (2009). Animal-assisted therapy as a pain relief intervention for children. Complementary Therapies in Clinical Practice, 15, 105-109.

Calcaterra, V., Veggiotti, P., Palestrini, C., DeGiorgis, V., Raschetti, R., Tumminelli, M., Albertini, R. (2015). Postoperative benefits of animal-assisted therapy in pediatric surgery: A randomized study. PLoS One, 10(6), e0125813.

Creagan, E. T., Bauer, B. A., Thomley, B. S., & Borg, J. M. (2015). Animal-assisted therapy at Mayo Clinic: The time is now. Complementary Therapies in Clinical Practice, 21(2), 101-104. doi:10.1016/j.ctcp.2015.03.002

Gilmer, M. J., Baudino, M. N., Goddard, A. T., Vicker, D. C., & Akard, T. F., (2016).

Animal-assisted therapy in pediatric palliative care. Nursing Clinics of North America. 51(3), 381-395.

Signal, T., Taylor, N., Prentice, K., Mcdade, M., & Burke, K. J. (2016). Going to the dogs: A quasi-experimental assessment of animal assisted therapy for children who have experienced abuse. Applied Developmental Science, 21(2), 81-93. doi:10.1080/10888691.2016.1165098

Vagnoli, L., Caprilli, S., Vernucci, C., Zangni, S., Mugnai, F., &Messeri, A. (2015). Can

presence of a dog reduce pain and distress in children during venipuncture? Pain Management

Nursing, 16(2), 89-95.

Cook Children’s has brought in visiting dogs for decades as a way to help patients and their families cope with their situations, but it was one of the first hospitals nationwide to realize the value in having dogs as badge-yielding staff members.

“People wouldn’t have pets the way they do and treat them like family members if there wasn’t something to that,” said Facility Dog Program Coordinator Kizzy Marco.

Just over three years ago, Ralph and Chanel became the first dogs to join Sit...Stay....PLAY, the facility dog program at Cook Children's.

“We are pioneering something really new,” said Marco. “The majority of hospitals in the country have animal-assisted therapy or dogs that visit routinely and that’s wonderful, but having them here as residents and as employees makes such a difference.”

As facility dog program coordinator, a large portion of Marco’s job involves handling Ralph, answering referrals and working one-on-one with patients and their families.

“I feel like people moved mountains to make these dogs available for our patients and families,” said Marco. “I’ve always loved working at Cook Children’s, but that was the moment I realized how much this place cares, probably beyond words, about the emotional well-being of its patients. Of course health care exists to take care of people physically, but we also have a responsibility to take care of people emotionally and these dogs are doing that.”

When Ralph comes in contact with a patient, the atmosphere changes immediately.

“I’ve seen kids at their very sickest,” said Marco. “I’ve seen kids at the end of their lives light up to see Ralph.”

Stephanie Myers witnessed the power of dog therapy first-hand when her 4-year-old daughter Baylee was introduced to Ralph after being diagnosed with stage 4 neuroblastoma.

“She hadn’t walked or gotten out of bed in about a week,” said Myers. “Kizzy brought Ralph in and I saw a light in Baylee’s eyes I hadn’t seen in a while. She instantly wanted to sit up and then stand so she could pet him.”

Ralph brought normalcy and softness to the situation with Baylee, as he does with so many others.

“Anytime Baylee has needed a little push, Ralph has been there to guide her through it,” said Myers. “He is such an amazing therapy dog and has given our daughter strength and a smile when we thought she might be out.”

“What our dogs do for patients is deep. A patient once vulnerably told me that he loved Ralph because he knew Ralph would never judge him. That says it all right there,” said Marco.

Because of the large number of both inpatient and outpatient cases, therapy dogs are not able to sit on every child’s bed or walk the halls with them or get ready for surgery with them.

However, many patients, families and staff members get the experience of seeing one of the dogs in passing walking down the hallway or in the cafeteria, which Marco considers a therapeutic encounter.

“You don’t know what people are carrying emotionally when they’re walking through the hallways,” said Marco, “so adding this goofy, smiling, prancing, fluffy, handsome Golden Retriever to the environment is so important. If you never knew a single patient story, if you never knew how much of an impact these dogs make, just knowing that is huge.”

When Ralph does have the opportunity to work one-on-one with a patient, they form a bond so strong that every child thinks Ralph is their best friend. When they see him and start calling his name, his tail starts to wag, he squints his eyes and starts shaking around with excitement.

“It’s almost like he remembers every kid he’s ever met,” said Marco.

While the dogs are a friendly face for children at the medical center, they really do serve an important role in the physical and emotional well-being of these patients.

Whether giving a dog a syringe of water mixed with juice to get a child to take medicine or taking him for a walk to get kids up and moving, these animals are trained to relate to the patients and their difficult experiences in a way that normalizes their environment and gives them something else to focus on.

Using dogs as a means of reducing anxiety in patients is especially true for Child Advocacy Resources and Evaluation (CARE) Team, which assesses cases of child abuse.

“When you’re talking about abuse and really difficult subjects with these kids, having a dog there can really ease their anxiety and help them voice what happened to them,” said Jamye Coffman, M.D., a child abuse pediatrician at Cook Children’s. “When you reduce the anxiety in a child, it reduces all the stress hormones so you don’t have any of the effects of stress on the child that can contribute to illness.”

Dr. Coffman has handled Kitty since she came to Cook Children’s nearly a year and a-half ago. Kitty stays with the CARE Team and is trained to jump up on the couch with patients when they are being interviewed to help relax them and their parents, making the environment feel less like a doctor’s office and more like a home.

But there is also an art to the things that dogs can do innately, the things that cannot be taught.

Not long after Marco and Ralph began working as a team, they were asked to visit a patient with a severe developmental delay. Marco was admittedly nervous because this patient was unpredictable in her movements and she was not sure how Ralph would react.

Without hesitation, Ralph walked up to the patient, looked her in the eyes and put his head on her lap while he sat there and let her do whatever she wanted.

“That’s the true gift of our dogs is that they don’t see any differences,” said Marco. “We know patients whose illness or treatments make them look or behave in a certain way. We know the ones that have especially great challenges, and hopefully it doesn’t alter how we interact with them, but Ralph doesn’t even know those things.”

For that child and her family, interacting with Ralph was a completely normal experience and there was nothing atypical about the situation.

“That’s an innate art that is something that we as a health system found a way to provide. It had never been provided to our patients and their families before,” said Marco. “It is very humbling to know that our dogs can make moments like that happen for families.”

It's important to remember that Ralph is only one dog out of five at Cook Children’s, making up only one-fifth of the program. Our most recent addition is a 2 year old Golden named Lulu who started working in inpatient psychiatry and partial hospitalization program just about a month ago.

Every day these dogs have encounters like this one, and every day they are doing something to make the hospital a better place for patients and their families.

The impact that these dogs have made and the moments they have shared with people in the time they have been at Cook Children’s is remarkable.

“It is profound that they know and have the ability to mourn with people who are mourning, to celebrate with people who are celebrating and to play with people who are playing,” said Marco. “I think there is a bond or intuition that connects them to people exactly where they are, and to watch that is amazing."

How to Help

The generosity of donors helps make it possible for Cook Children's to bring programs like Sit ... Stay ... PLAY to our patients. To support our dog therapy program and other programs like it, please call 682-885-4105 or donate online by clicking here. Learn more about Sit ... Stay ... PLAY by clicking here.