Unicorn Day

Jewel Sheehan MD, Rita Agarwal MD, Alyssa Burgart MD and Romy Yun MD

Although this is not a traditional Pediatric Anesthesia Article of the Day (PAAD) entry, I am posting it because of its significance. As you know, the PAAD has become what I hope is an integral part of your daily professional routine, helping to keep you informed about issues that directly impact your clinical practice. The PAAD team reviews a substantial volume of literature each day to curate relevant and timely content. Despite these efforts, important topics are occasionally overlooked. This raises the question: why devote a PAAD to something that is not a formal article?

With a daily readership approaching 9,000 clinicians worldwide, the PAAD serves as a powerful platform for communication and engagement. On occasion, I think it is appropriate to use this platform to highlight initiatives of particular importance, even if they fall outside the traditional article-review format.

Today’s PAAD represents such an exception. I strongly encourage you to consider establishing “Unicorn Day” within your own institutions, regardless of where in the world you practice. Opportunities to witness—and participate in—the creation of a new professional tradition are rare, and this initiative offers precisely that.

Indeed, I am issuing a call to action. After reviewing today’s PAAD, I urge you to collaborate with colleagues, including our friends and colleagues at Stanford University, to develop and implement a Unicorn Day at your own institution. This is a unique opportunity to foster community, engagement, and shared purpose across our field. Myron Yaster, MD

In spring 2022, Dr Alyssa Burgart (@bioethics[AB1] ) was feeling a little down in the dumps. Covid was still a lingering and heavy presence . As a pediatric anesthesiologist and bioethicist, she was looking for a way to cheer herself up and thought a rainbow pack of unicorn headbands meant for a kids’ party might do the trick. They were made of a washable plastic, and so they seemed appropriate. At the very least, it might get a laugh.

Everyone in her busy ENT room that day was curious and opted in to wearing one. They tipped their horns to each other in the Time Out. Other anesthesiologists saw the team between cases and wondered how they could get a unicorn headband. Alyssa handed the rest out to whomever asked until the party pack was gone.

Later, her friend and colleague Dr. Romy Yun had a serious proposition: “We need to do this for everyone. Unicorns all day. It could be incredible.”

“You can’t make burned out people have a good time.”

With a twinkle in her eye, Dr. Yun responded: “I think we can.”

Unicorn Day was born. This new high holy day in the Stanford Lucile Packard Children’s Hospital Treatment Center only exists because Drs. Burgart and Yun thought that, as a group who spends their days caring for children facing surgery and serious illness, we could all use a little magic and whimsy.

Children understand the power of play instinctively. They know that a sticker can make a blood draw feel more survivable. They know that a silly joke can cut the tension before a procedure. They know that play is not decoration layered over the serious work; it is the foundation. It creates safety and builds trust. And while doing so it lifts spirits, improves well being and increases connectedness. It reminds us that, even when we are scared, we can use joy to maintain our humanity. At a time when everything around us felt upside down and chaotic, when we continued to work through all the trauma and disruptions of COVID, its aftermath, and the ongoing insecurity of the world around us our mental health made Unicorn Day a necessity. Drs. Burgart and Yun with the support of the division and nursing leadership organized and led the first Unicorn Day in 2023. It is now an annual tradition and looked forward to all year round.

Working in pediatric surgical care is a privilege and a weight carried simultaneously. We chose this; not everyone does. There is something quietly profound in the decision to show up, day after day, for children in some of the most vulnerable moments of their young lives, to be steady when they are frightened, to find the right words, to hold the hard things with skill and heart in equal measure. It asks a great deal of us, and the asking never really stops.

Unicorn Day is our answer to that asking.

When we see our colleagues with glittery temporary tattoos on their forearms, unicorn horns on their heads, and Alyssa and Romy leading the whimsical charge in their unicorn onesies, something in us lightens. Not because the work has become easier, nor because it’s almost impossible to be grumpy with a unicorn horn on, but because we have chosen, deliberately and joyfully, to tend to ourselves as human beings, just as we tend to our patients.

With care,

With intention

With the understanding that healing is not purely medical.

It is laughter

and

It is a ridiculous made-up holiday that no one outside pediatrics would quite understand.

Whimsy, it turns out, is not the opposite of seriousness. It is what makes sustained seriousness possible. So, on this day we put on our temporary tattoos. We eat the rainbow snacks. We don our unicorn horns. We celebrate with everyone in the perioperative area: anesthesiologists, trainees, anesthesia techs, nursing, staff, environmental services, surgeons, proceduralists, radiology and anyone else who wanders by. We feel, genuinely, that something important is happening. Not in spite of how silly it is, but precisely because of it.

And by sharing this with others who care for children, we hope that many more organizations or groups will be inspired to do something similar.

Make up your own silly holiday and share it with everyone you work with. Nurture the spirit of happiness, wellbeing, hope, deeply meaningful work, and overall good feelings. It is really hard to not smile when you see people doing some of the hardest work in the hospital walking around with unicorn hats on.

Why Unicorn Day matters: Quotes from a few participants

“Unicorn Day is an invitation to reclaim our inner joy, creativity and whimsy. By showing up for the child within, we rediscover our purpose and show up more authentically for the children we care for.” – Dr. Aruna Nathan, pediatric cardiac anesthesiologist

“…..Being a full-time clinician - a worker bee - in an academic setting ….may not bring the accolades or bonuses or promotions that traditional academic or leadership productivity does, but it’s at the core of what we do. ‘The asking never really stops,’ and it’s exhausting, and often thankless, yet it’s unbelievably personally rewarding.” – Dr. Grant McFayden, pediatric anesthesiologist

“Celebrating Unicorn Day reminds me of how magical our work is. Getting to improve the lives of children on a daily basis is a gift that puts everything into perspective. Unicorn day truly makes me feel like I’m part of a team of superheroes!” Dr. Marissa Schwab Pediatric Surgeon

“Unicorn Day is a time to celebrate the unique impact of every individual for their hard work and the care they give, uplifting both patients and those around them.” - Tracey V, Scrub Tech

“Unicorn Day is an absolutely magical day, even, the best day of the year. The whole perianeathesia team comes together to celebrate each other and the extraordinary care we provide to children and their families. There is this special feeling floating through the air which is only felt on Unicorn Day. 🦄 “ - Chris Lawrence, Perioperative RN

“Unicorn day celebrates the joy we get by caring for the kids and their families. Working with children and young adults spark a joy in myself and then the fun and lively conversations that come from that introduction brighten my day! It also allows me to let the family know that they, as well as their child, are the priority for the day. Caring for them gives me a deeper depth of commitment and reminds me why I came into nursing the first place. It’s a true gift” Laura Periop RN

“As a relatively new Stanford pediatric anesthesiology faculty member I am proud to say that I have not known a year without Unicorn Day—and what a beautiful culture to walk into!.....I especially love to see non-clinical staff members, patients and families also light up with the contagious spirit of the day……. I appreciate the time and effort it takes for just two pediatric anesthesiology faculty members to contribute their non-clinical time to gather the materials, purchase the treats and decorate the halls as a reminder that the work we do for children is not at all for the faint of heart, we are unicorns on earth, and we are appreciated.” Dr. Mgbechi Erondu, Pediatric Anesthesiologist and Palliative Care specialist .

“Unicorns bring joy — and so do kids! I love working with children and teens because their fresh perspectives, their silliness, their thoughtful questions and cool interests — it all brings joy and a smile to my face” Dr Stephanie Cizek, Adolescent Gynecology

Send your thoughts and comments to Myron (myasterster@gmail.com) and he will post in a Friday reader response.

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