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  • Grandmom Carol Wisnom and cousin Taylor visit the Deal Island...

    Sun photo by Monica Lopossay

    Grandmom Carol Wisnom and cousin Taylor visit the Deal Island cemetery where R.J. Voigt was buried as he wished.

  • R.J. Voigt and his mother, Michele, share their nighttime ritual...

    Sun photo by Monica Lopossay

    R.J. Voigt and his mother, Michele, share their nighttime ritual of cuddling in his hospital bed after prayers. R.J. holds his stuffed rabbit, Mr. Browney.

  • Carol Wisnom, R.J.'s beloved grandmom, who was able to be...

    Sun photo by Monica Lopossay

    Carol Wisnom, R.J.'s beloved grandmom, who was able to be present during his last moments, gives way to grief after his passing.

  • Upset with the Hopkins pain care team for increasing her...

    Sun photo by Monica Lopossay

    Upset with the Hopkins pain care team for increasing her son's morphine medication level and not telling her, Michele Voigt wants someone to answer for the mistake.

  • R.J. always gave thanks before eating any meal, including one...

    Sun photo by Monica Lopossay

    R.J. always gave thanks before eating any meal, including one of his favorites, powdered donuts.

  • As Elizabeth Reder, bereavement coordinator at the Johns Hopkins Children's...

    Sun photo by Monica Lopossay

    As Elizabeth Reder, bereavement coordinator at the Johns Hopkins Children's Center, calls the names, staff members light candles in memory of R.J. and the 125 other children who died there in 2003.

  • In the hours after R.J.'s death, his close friends Jamey...

    Sun photo by Monica Lopossay

    In the hours after R.J.'s death, his close friends Jamey Landon, Wayne Brisco and Marianne Rowan-Braun take down the personal touches that had made the hospital room something like a home.

  • Seeking one of her few fugitive moments of peace, Michele...

    Sun photo by Monica Lopossay

    Seeking one of her few fugitive moments of peace, Michele sits at the foot of the monumental statue of Jesus in the rotunda of Johns Hopkins Hospital.

  • Michele steps away from her son's room for a quiet...

    Sun photo by Monica Lopossay

    Michele steps away from her son's room for a quiet moment. "I wouldn't wish this on anybody," she told another mother. "I feel like I'm 60 years old."

  • Michele Voigt speaks softly to T-Rex, R.J.'s cockatiel, as the...

    Sun photo by Monica Lopossay

    Michele Voigt speaks softly to T-Rex, R.J.'s cockatiel, as the boy's cousin reaches for the bird. For Michele, the bird represents a part of R.J. that is still alive.

  • R.J., always an independent person, never wanting help from others,...

    Sun photo by Monica Lopossay

    R.J., always an independent person, never wanting help from others, is weakened to the point that it isn't an option for him anymore.

  • Unable to let go of treasured items belonging to R.J.,...

    Sun photo by Monica Lopossay

    Unable to let go of treasured items belonging to R.J., Michele has dedicated an entire room to the memory of her son.

  • Michele Voigt spends the days of her son's prolonged hospital...

    Sun photo by Monica Lopossay

    Michele Voigt spends the days of her son's prolonged hospital stays trying to comfort him and ease his pain. But sometimes R.J. comforts her.

  • Michele Voigt, her mother, Carol Wisnom, and niece Taylor visit...

    Sun photo by Monica Lopossay

    Michele Voigt, her mother, Carol Wisnom, and niece Taylor visit R.J.'s grave on Deal Island. At first, Michele hated to go. But over time, the graveyard has become a place his family likes to visit.

  • Michele struggles to get trapped water out of R.J's breathing...

    Sun photo by Monica Lopossay

    Michele struggles to get trapped water out of R.J's breathing tube.

  • With one eye swollen completely shut, R.J. lifts his cold...

    Sun photo by Monica Lopossay

    With one eye swollen completely shut, R.J. lifts his cold cloth from his face, as his nurse ask if he is feeling any pain and would he like try some medicine.

  • Michele gives way to grief at the prospect of R.J.'s...

    Sun photo by Monica Lopossay

    Michele gives way to grief at the prospect of R.J.'s approaching death as she talks with Elizabeth Reder, bereavement coordinator at Hopkins.

  • Michele breaks down as she is reunited with the doctor...

    Sun photo by Monica Lopossay

    Michele breaks down as she is reunited with the doctor who prenounced R.J.'s death to Michele.

  • Having delayed it as long as he could, R.J. braces...

    Sun photo by Monica Lopossay

    Having delayed it as long as he could, R.J. braces himself for one of the procedures he dreads the most: the change of the permanent needle in the port in his chest.

  • Swollen with tumors caused by his cancer, R.J. props his...

    Sun photo by Monica Lopossay

    Swollen with tumors caused by his cancer, R.J. props his head up in hopes of relieving his pain.

  • Michele Voigt improvises using a wheelchair to get R.J. groceries...

    Sun photo by Monica Lopossay

    Michele Voigt improvises using a wheelchair to get R.J. groceries up to his hospital room.

  • With a painful gash under his chin caused by his...

    Sun photo by Monica Lopossay

    With a painful gash under his chin caused by his breathing tube, wound care doctors gather around R.J. to decide the best course of action.

  • Michele Voigt hugs Brigid Gilmore, R.J.'s favorite nurse, during her...

    Sun photo by Monica Lopossay

    Michele Voigt hugs Brigid Gilmore, R.J.'s favorite nurse, during her first visit back to the pediatric oncology unit after R.J.'s death. "I know you were there," Michele said. "Thank you."

  • R.J. lays quietly as his Mom, Michele, struggles to get...

    Sun photo by Monica Lopossay

    R.J. lays quietly as his Mom, Michele, struggles to get trapped water out of R.J's breathing tube.

  • R.J. and Michele join the Rev. Salvatore Livigni - Father...

    Sun photo by Monica Lopossay

    R.J. and Michele join the Rev. Salvatore Livigni - Father Sal, the family's favorite chaplain - in prayer as the priest anoints R.J.'s head. "He's an angel himself," the priest said.

  • On the day before R.J. died, Dr. David Loeb deemed...

    Sun photo by Monica Lopossay

    On the day before R.J. died, Dr. David Loeb deemed R.J. an honorary doctor of Johns Hopkins Hospital. R.J. was presented with a doctor's white lab coat and plaque, making one of his dreams of becoming a doctor come true.

  • R.J. rests with his stuffed bunny, Mr. Browney. Mr. Browney...

    Sun photo by Monica Lopossay

    R.J. rests with his stuffed bunny, Mr. Browney. Mr. Browney has been through almost every medical procedure with R.J.

  • At the end of a day in the hospital, R.J....

    Sun photo by Monica Lopossay

    At the end of a day in the hospital, R.J. Voigt prays for his family and friends, and for his own healing from the cancer that has invaded his body and subjected him to a long series of painful treatments.

  • The kitchen on the pediatric oncology floor is a place...

    Sun photo by Monica Lopossay

    The kitchen on the pediatric oncology floor is a place where moms like Michele Voigt and Marnice Sigur could spend time talking about their children's victories and losses.

  • Nothing has been the same since R.J.'s death. A grieving...

    Sun photo by Monica Lopossay

    Nothing has been the same since R.J.'s death. A grieving Michele left the house she and her mother had shared during R.J.'s childhood and moved with daughter, Kimberly, into an apartment in Pocomoke City.

  • Moments of peace could usually be found at Michele's favorite...

    Sun photo by Monica Lopossay

    Moments of peace could usually be found at Michele's favorite get away place, the Jesus Statue.

  • R.J. musters a laugh after smashing a creme pie in...

    Sun photo by Monica Lopossay

    R.J. musters a laugh after smashing a creme pie in his mother's face.

  • R.J. Voigt sits in his room at Johns Hopkins Children's...

    Sun photo by Monica Lopossay

    R.J. Voigt sits in his room at Johns Hopkins Children's Center. His mother, Michele, has personalized the place -- to make it more a boy's room -- with posters, Spiderman sheets, cookies and toys.

  • The time that Michele Voigt spends with her son's doctor,...

    Sun photo by Monica Lopossay

    The time that Michele Voigt spends with her son's doctor, Meghan Higman, is her most comforting.

  • Michele washes up in the bathroom as R.J. waits for...

    Sun photo by Monica Lopossay

    Michele washes up in the bathroom as R.J. waits for her to serve him a hot slice of pizza.

  • On a good day when the swelling in his eyes...

    Sun photo by Monica Lopossay

    On a good day when the swelling in his eyes wasn't so bad, R.J. could enjoy one of his favorite hobbies, reading.

  • R.J. uses a special computer that speaks for him.

    Sun photo by Monica Lopossay

    R.J. uses a special computer that speaks for him.

  • R.J. passes the time reading his favorite Yu-Gi-Oh! cartoon book.

    Sun photo by Monica Lopossay

    R.J. passes the time reading his favorite Yu-Gi-Oh! cartoon book.

  • Michele Voigt holds a treasured mold of her son's hand....

    Sun photo by Monica Lopossay

    Michele Voigt holds a treasured mold of her son's hand. Hopkins medical staff made it possible for R.J. to help in making the mold.

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Initiative for Pediatric Palliative Care
A non-profit partnership working
to enhance care for children with life-threatening conditions through
education and research, including a seven-hospital pilot project and
training of caregivers around the country. Phone: 617-618-2822

Children’s Hospice International
A non-profit advocacy, support and
education group and lead agency working with several states on developing
new models of care for critically ill children. Phone: 1-800-2-4-CHILD

National Institute of Nursing Research
The lead institute for end-of-life research within the National Institutes of Health. NINR is sponsoring a
research initiative in end-of-life care for children.

When Children Die
The National Institute of Medicine’s 2002 report on the
problems in end-of-life care and recommendations to do better.

Ronald McDonald House of Baltimore
A home away from home for seriously ill children, who are undergoing treatment at a Baltimore hospital, and their
families. Phone: 410-528-1010

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
A guide to pediatric oncology services at Hopkins.


Resources for seriously ill children:

The Starbright Foundation
A non-profit group led by Steven Spielberg
that creates projects to help children cope medically and emotionally with
illness. Uses entertainment, relaxation and other techniques to help kids
prepare for procedures. Includes Web-based program that allow sick kids to
connect with peers in other hospitals. Phone: 310-479-1212

Brave Kids
Support, message groups, games and other help for children with
chronic, serious or life-threatening illnesses or disabilities.


For Parents:

Harriet Lane Compassionate Care, Johns Hopkins Children’s Center
Support and services for critically ill children at Hopkins, also grief and
bereavement help. Phone: 410-955-0055.

Compassionate Friends
A support group for any parent who has lost a child, no matter what age.

Candlelighters Childhood Cancer Foundation
Support, education and
advocacy for families and children with cancer, also has message boards for
parents.

Parents’ Guide to Medical Research
An interactive Web site from the Children’s Hospital Boston, funded by the National Institutes of Health. The site helps parents make informed decisions about their child’s participation in medical research.


Books for parents:

Shelter from the Storm: Caring for a Child with a Life-Threatening
Condition
, by Dr. Joanne Hilden and Dr. Daniel Tobin, 2003.
A practical
guide full of emotion and wisdom that addresses parents’ worst fears.

Home Care for Seriously Ill Children, third edition, editors Stacy Orloff
and Susan M. Huff, 2003.
A manual for parents from Children’s Hospice
International.

Armfuls of Time: The Psychological Experience of the Child with a
Life-Threatening Illness
, by Barbara M. Sourkes, 1995.
A veteran therapist
gives a rare look into the world of dying children.

Hannah’s Gift, Lessons from a Life Fully Lived, by Maria Housden, 2002.
A
mother tells the story of her daughter Hannah, and what she learned from
her life and death.

The Bereaved Parent, by Harriet Sarnoff Schiff, 1978.
Schiff is a bereaved
parent and journalist. She gives practical advice on coping with a child’s
death and rebuilding the lives of the survivors.

What Forever Means: After the Death of a Child, by Kay Talbot, 2002.
A
bereaved parent who is a psychotherapist writes about the trauma of losing
a child, and how parents can find a way to live with this loss.


For siblings and other children who are grieving:

Support group, Johns Hopkins Children’s Center Phone: 410-955-0055

Camp Jamie, Hospice of Frederick County
A weekend camp for children ages 6 to 14 who have lost a loved one.

SuperSibs
A national support group for young brothers and sisters of children with cancer. Phone: 1-866-444-SIBS


For professionals

Palliative Care for Infants, Children and Adolescents, editors, Dr. Brian Carter and Dr. Marcia Levetown, 2004.

A practical
handbook

Hospice Care for Children, second edition, editors, Ann Armstrong-Dailey,
Sarah Zarbock, 2001.

The Private Worlds of Dying Children, by Myra Bluebond-Langner, 1978.