I modified a plushy doll by adding internal organs involved and to give a context for discussing upcoming surgeries and procedures.
Step 1: Choose Your Doll
I think it important that the doll has a happy appearance. Later when we present the doll to the child, we will do so as a 'play' and the doll will be in pain during the play when the symptoms are discussed, but we don't want a sad doll, we want the pain/discomfort to be temporary.
Step 2: Modify Your Doll
The type of illness will dictate the parts you need.
I was not obsessed over anatomical accuracy, the purpose is to provide the child a better understanding of the processes and possibly the surgeries the patient may face.
I sewed the pancreas by hand. It was a little bit like a thumb. I sewed the rough shape on three sides, turned it inside out, and stuffed it with some batting.
To the pancreas I attached essentially a cancer finger puppet I named Crummy. By attaching only the front part of the cancer puppet to the pancreas, I would be able to articulate the finger puppet by cutting a slit into the back of the doll just large enough to insert my finger through then into the cancer puppet.
I cut a slit into the front of the doll under the dress (the stomach area) and hot glued the pancreas into the doll.
Since my wife was facing surgery to help relieve digestion blockages, I also sewed a section of intestines. The intestines were constructed as three 'tubes' about as thick as my little finger and each about 4 inches long. I turned each tube inside out and stuffed it with batting. I attached two of these tubes to the doll's insides through the stomach hole. To the ends of these attached tubes I hand sewed a small button of velcro (sometimes called 'hooks and loops'). This allowed the intestines to be connected together. I knotted the third unattached tube, sewing the knot with black thread to keep it from unknotting. then to the tube ends I attached more velcro buttons so the the knotted section of intestine could be attached between the two attached intestines.
Step 3: Write the Play
In my particular case, the Play went something like this:
When my daughter, my wife, and I were in the hospital preparing for surgery the next day, I leaned on the hospital bed across from my child and presented the 'mommy doll'. I also had at the ready for later use a little rubber hammer which happened to be one of our dog's toys. Using my 'mommy voice' I told how bad I felt inside and we discussed going to the doctor to find out what's wrong. I used a different voice for pancreas telling how I help digestion and have done very well for many years until a terrible thing happened... and I presented Crummy the cancer. For Crummy I used my high pitch, shrill 'bad person' voice. Crummy says how he's 'messing with the tubes' and doesn't want to leave but wants to stay and make trouble. Here I present the intestines with the knotted section connected. I tell Crummy that he is doing a very bad thing messing with those tubes which my wife needs and he is hurting her, to which Crummy replies that he doesn't care. I explain and demonstrate how the surgery scheduled for the next day would remove the knotted section of intestine so my wife could digest her food. I returned the intestines to the stomach. I then tell Crummy that he has to go - but he won't, so I bring out 'Chemo', the rubber hammer. I hand the hammer to my daughter because i need her help... she has to use Chemo on Crummy... hitting Crummy again and again until Crummy promises to leave.
While I thought having my daughter participate by hitting Crummy would not only engage her but give her the opportunity to release stress by hitting the cancer, it had a different effect. After the play was over, she wanted an immediate repeat performance, which I obliged. On the second performance, when we came to the 'hammer time', my daughter asked if there were some other way to get rid of Crummy without hurting him. I said that Crummy would continue to do bad things unless we remove it. A tender hearted child wishing no harm come to anything meets Dad's unwavering wish for all cancers to die within everyone, everywhere, for all time. We each expressed our varied feelings without apology and we acknowledged the others' feelings without judgement. We each express grief in our own ways and we often can not predict how or where those expressions of grief will surface. With children, it is important to keep the lines of communication open and keep them engaged so they feel less isolated (IMHO).
Step 4: Present the Doll
The child can ask questions and gain a better understanding of the processes.
In our case, my daughter slept with the Mommy Doll and I believe it helped her during my wife's illness and after her passing.
If you are unfortunate to find yourself in a similar situation, and it is my wish you never do, I would like you to comment on your attempts to guide a child through their grief and the successes and failures you may have had. It is my hope that others may be helped by reading similar experiences.