Imagine, for a moment, that you are about to undergo life‑threatening heart surgery. You feel unwell—fatigued, breathless, and emotionally drained. You are hungry and weak from fasting since the night before. Pre-medications are beginning to take effect, leaving you drowsy. You are dressed in a hospital gown, wearing compression stockings, and quietly preparing yourself for what lies ahead. More than anything, you want the comfort of those closest to you.
Now imagine that, at this moment, a healthcare professional arrives with a superhero costume and encourages you to put it on and “fly” down the corridor to the theatre.
Most adults would find this deeply incongruous; an ill‑judged mismatch between the seriousness of their situation and the behaviour expected of them. It would likely feel dismissive of their fear and distress, offering little room for emotional authenticity or support.
Yet, this scenario is not far removed from what many children experience in hospital settings.
The Expectation of Bravery
Children undergoing serious medical treatment are often labelled as “brave,” “courageous,” or even “warriors.” They may be given “bravery stickers” for being a “good patient,” praised for staying still during painful procedures, or encouraged to embody heroic narratives by wearing costumes or celebrating milestones as victories in a battle.
These gestures are undoubtedly well-intentioned. They aim to comfort, motivate, and empower. However, they can also create a subtle but powerful expectation: that the child must cope quietly, without visible distress.
As someone who spent much of childhood navigating hospital care for congenital heart disease, I frequently heard these labels. I was described as brave, and I was rewarded for compliance, remaining still and silent during often painful and frightening invasive procedures. While these narratives sometimes instilled pride and resilience, they also carried an unspoken message: that bravery meant not expressing fear, pain, or anger.
In reality, I often did not feel brave. I simply felt I had no choice.
The Cost of Hero Narratives
Language matters. The metaphors we use shape experiences and influence behaviour. In healthcare, particularly in relation to long-term conditions, “battle” and “warrior” narratives are pervasive. Patients are encouraged to “fight” their illness, to “stay strong,” and to “keep going.” While such language can foster determination, it can also have unintended consequences. For children, in particular, these narratives can:
- Discourage emotional expression, as distress may feel incompatible with being “brave”
- Reinforce compliance at the expense of psychological processing
- Create pressure to meet adult expectations of resilience
- Contribute to feelings of shame or failure if they are unable to cope in the expected way
Research has also highlighted that war metaphors in illness can undermine adaptive health behaviours and negatively affect self-worth, especially if health outcomes worsen or are perceived as “losing the battle” (Hauser and Schwarz, 2015). A more constructive approach may involve acceptance, self-compassion, and learning to work with the body, rather than against it.
Making Space for Emotional Reality
Psychologically informed healthcare emphasises the importance of recognising and responding to emotional experiences. Illness, hospitalisation, and medical interventions are inherently stressful, often involving uncertainty, loss of control, and physical discomfort. Emotional responses such as fear, sadness, anger, or distress are not only understandable but expected (Morton, 2025).
Children, depending on their developmental stage, may express these feelings through behaviour or physical symptoms rather than words. Equally, some may appear calm or withdrawn, which can sometimes reflect shock or hypoarousal rather than an absence of distress. Families, too, are affected. Parents and caregivers may feel helpless, overwhelmed, and emotionally exhausted. Creating space for these experiences is essential. This means:
- Normalising emotional responses to medical stress
- Encouraging children to express feelings in ways that feel safe to them
- Reassuring them that distress does not equate to weakness
- Supporting families alongside the child
- Moving beyond reward systems that reinforce emotional suppression
Redefining Bravery
Bravery does not have to mean silence, compliance, or emotional restraint. True bravery can also look like:
- Crying when something hurts
- Expressing fear before a procedure
- Showing anger or frustration in response to injustice
- Feeling sad because we face loss
- Seeking comfort and reassurance
- Talking about difficult experiences afterward
If we broaden our understanding of bravery in healthcare, we can better support children, not just physically, but emotionally and psychologically.
A Call for Balance
This is not a call to eliminate positivity, encouragement, or creative engagement in paediatric care. These approaches can be powerful tools for comfort and distraction. Rather, it is a call for balance. We must ensure that in our efforts to uplift and motivate, we do not inadvertently silence or invalidate children’s emotional experiences. By doing so, we risk adding an additional burden to an already challenging journey. Children in the hospital do not need to be heroes. They need to be allowed to be children who are scared, upset, resilient, and human.
Adapted from Morton, L (2025). Beyond the Medical Gaze: Practicing Psychologically Informed Healthcare, Oxford University Press.