When it comes to mending broken bones, ER doc Jan Luhmann is a great believer in bubble gum. "Do you like bubble gum?" she asks 15-year-old Noel Brockett, who has arrived at Children's Hospital in St. Louis after breaking her arm in a bike accident. Clearly upset, Brockett says yes, and Luhmann quickly smears bubble gum scent on a gas mask and presses it to the teenager's face. As the nitrous oxide (laughing gas) starts to flow, Brockett relaxes. She and the doctor chat away-while two orthopedists wrench the bone back into place, a procedure that often provokes a cry of agony. But not from Brockett. "There were a couple of times when I felt something," she says later, "but it didn't hurt."
Welcome to Children's ouchless ER. Unlike doctors who use needles and IV tubes to put young trauma patients to sleep, Luhmann, 38, and her colleagues at the St. Louis hospital are in the forefront of a movement to manage pain and soothe frightened children with laughing gas. According to Luhmann, the gas works faster than traditional IVs, is equally effective and eliminates the use of scary needles. It's even a comfort to parents as they hold their child's hand. "When I started here 13 years ago," says Luhmann, "you would walk up and down the halls and hear children screaming."
Not anymore. At Children's, kids with cuts, small wounds and even objects lodged in their ears are now routinely sedated with laughing gas. For the few among the 60,000 patients a year who absolutely require IV sedation, doctors first apply a local anesthetic to numb the skin with a needle so tiny that many small children don't even notice it. As Luhmann and her partner Dr. Robert Kennedy expand their pediatric pain-management methods, other hospitals around the country are taking notice. Dr. William Zempsky, a convert to laughing gas at Connecticut Children's Hospital in Hartford, says the new method marks a subtle but revolutionary change for doctors who have traditionally tuned out the cries of their littlest patients. "Physicians used to make a diagnosis before doing anything about treating pain for fear of masking the cause of the pain," he says, although that theory has now been discounted. According to Luhmann, until recently, pain medications were not even tested on children. "The common response a decade ago was that children are supposed to cry," she says.
That is now changing, although laughing gas is not always the answer. Children occasionally become dizzy and 1 in 10 will vomit under the gas. But Luhmann, an Illinois native—who had an operation at Children's to correct a hip dislocation when she was in sixth grade—insists the method is "extremely safe." She credits much of her expertise to caring for her own offspring, Zachary, 3, and Meredith, 2,with husband Scott Luhmann, 40, a pediatric surgeon she met at the hospital after medical school at Loyola School of Medicine in Maywood, 111. Initially, relations were strictly professional, says Scott, until he chatted up Jan one day at a grocery store. "It was the first time she saw me that I was not wearing my white coat," he says. They married four years later, in 1995.
Since then, the two doctors have come to know firsthand what if s like to be on the other side of the ER. Last year Zachary needed stitches in his forehead after cutting himself aboard a plane during landing. Naturally, Luhmann insisted the ER docs give him laughing gas. "I am one of the biggest needlephoic people in the world," she confesses. "I think that's why I'm so passionate about what I do."
Kyle Smith. Giovanna Breu in St. Louis
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