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1,000 Paper Cranes Can Bring Our Patients One Step Closer to Healing

— We must remind our patients to hold on to hope

MedpageToday
 A photo of Hezaran Dorna paper cranes laying on a table.
Jalilian-Khave is a general physician and a postdoctoral psychiatry fellow.

Japanese folklore says folding can make a wish come true and restore health after an illness. The legendary tale of paper cranes was mostly unknown to the world until became famous: a 2-year-old girl who survived the bombing of Hiroshima, but went on to develop leukemia (so-called the "A-bomb disease" at the time) after the disaster; she is said to have believed so firmly in the magical power of folding 1,000 paper cranes that she started and kept folding throughout her illness course, ultimately folding before she died at the age of 12. She inspired many, including her friends and classmates, with her commitment to stay hopeful. In May 1958, a few years after her death, Sadako's friends and family raised money to build a monument in her honor. It is now known as the , located close to the spot where the atomic bomb had once dropped.

Decades later and thousands of miles away, I first saw paper cranes in a children's cancer ward in Tehran, Iran. I was an intern at the time. As I was finishing up a few tasks at the end of a long night shift, I heard intense crying from the hematology patients' room. However, the crying had stopped by the time I reached the room. There, I saw a toddler in his mother's arms, pointing to colorful cranes hanging from the ceiling and following their imaginary flight. The mother whispered to her child, "See, you're gonna get better, just like what they were saying." Not knowing the meaning of the cranes, I admired the color and sense of cheerfulness they added to the plain white walls of the ward. Those decorative details were scarce in a resource-limited setting.

This memory stuck with me: the scene, the baby's smile, and the mother's message to her child all made me curious about the cranes. Who had put them there and why?

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A child with cancer gazes up at donated paper cranes from his hospital bed in Iran.

The next morning, I learned that they had been put there by a volunteer group called (which means "One Thousand Cranes" in Farsi). The group frequently organizes people to make 1,000 cranes at a time and donate them to children's hospital wards all over the country. They did this in order to make big changes in hospital environments through the small steps of folding origami papers to deliver the message of hope for healing and support. Steps that everyone, anywhere and at any time, can learn and take.

"When installing the cranes in the wards, we tell parents that hundreds of people outside these walls have wished for your child's health and folded these papers. We tell the children of the crane's legend and Sadako folding papers, believing in better days after healing," one member told me when I reached out to the group. "We believe that childhood cancer shouldn't be considered life-limiting, and the ward should feel like a part of their journey. Therefore, it must be beautiful and promising, just like the life out there and ahead of them," he continues.

What sticks with me is how they describe active participation in spreading hope rather than a passive, abstract wish for wellness.

"It's not about the scale of the step, but rather showing the actual effort to the children and their families. When we can show them that people they don't even know have carved out time and gathered, thinking of them. We are presenting the unconscious message of how thousands of people truly believe in them getting better."

The organization conceptualizes the power of the effort this way: simple activities can foster "patients and families' sense of belonging to a supportive community, and potentially turn individual's solitary healing into a collective journey." They have also involved different groups of people with disabilities and rare conditions -- such as children with Down syndrome, hemophilia, hearing loss, multiple sclerosis, and other conditions -- in making the paper cranes for their peers with cancer, emphasizing that anyone with any capability and skill level can be a part of shaping supportive resources for others.

Even years after seeing the cranes for the first time, and working in settings with much more limited resources, I remained inspired by how the community can help compensate for the lack of resources in healthcare systems. The various colors of the threads the cranes hung from showed how diverse projects can add color to patients' healing, from volunteer groups to an and accommodations for sick children and their families traveling to neighboring cities and countries to receive healthcare.

Some types of cranes migrate when the weather changes. They remind us that there can be warmth after the harsh cold. Patients too can find healing and happiness after being dealt a harsh diagnosis -- and we all, especially us doctors, nurses, and other healthcare professionals, can play a role in reminding our patients that there is always hope. This does not need to be an extraordinary act. Every step, as easy, small, and inexpensive as it might be, counts, just the same way every fold brings the crane one step closer to flying.

is a general physician from Iran, a postdoctoral fellow in the Department of Psychiatry at Yale School of Medicine in New Haven, Connecticut, and a public voices fellow of the OpEd Project.