Photos by Kyle Green | The Roanoke Times

Jill Hamilton, a child life specialist at Carilion Clinic Children's Hospital, helps bring laughter into the lives of young patients such as Libby Jamison, a 5-year-old with leukemia. Hamilton has been the driving force behind the expansion of Carilion's child life program.

Libby Jamison (left) and child life specialist Jill Hamilton draw good blood cells and bad blood cells at the hospital in Roanoke. Hamilton says that while there are four child life programs in the state, Carilion Clinic offers the only one in Southwest Virginia.

Jill Hamilton started her daily afternoon visit with Libby Jamison, a spunky 5-year-old leukemia patient, as she normally does.

"What do you want to do today?" Hamilton asked. "You want to do something special?"

Hamilton, 29, helps children cope with severe childhood illness as a child life specialist at Carilion Clinic Children's Hospital. She is slim with blond hair and has a loud, captivating laugh.

"Remember, a blue butterfly with sparkles," Libby said excitedly.

Hamilton describes Libby, a bright orange-haired girl with light-blue eyes, as one of the happiest, most imaginative children she knows.

Libby loves having her face painted, and Hamilton paints it almost daily. That done, Libby will get into character, hopping down the hospital halls as a bunny or scaring doctors as a dragon.

As the lead child life specialist, Hamilton has been the driving force behind the expansion of Carilion's child life program, which this year has grown from one to three specialists.

Started in 1997, the program seeks to help children deal with the potentially traumatic effects hospitalization can have on them. Carilion's is one of only four such programs in the state, and it's the only program in Southwest Virginia, according to Hamilton.

As she painted Libby's face, an IV dripped chemotherapy medication into a catheter port on Libby's right side. Hamilton explained how the chemo would kill the sick cells in her body.

"And they'll fall in the trash can?" Libby asked.

"No they don't really fall in the trash can," Hamilton said. "They just kind of disappear. Yeah, the chemo just sort of zaps them."

"Why does it do that?" Libby asked.

"Well, we don't want those cancer cells in our body anymore, do we?" Hamilton asked.

"No," Libby said.

Hamilton finished painting Libby's face -- two bright blue wings on her cheeks and a red butterfly body down her nose. She put on the final touch -- sprinkles -- and gave her a mirror to look at herself. Libby stared at her transformation as a huge smile took over her face.

Child life specialists

Hamilton was the youngest child in her immediate family. Growing up, she related well to children and says she always knew she wanted to work with them. She just wasn't sure in what capacity.

The Mississippi native studied therapeutic recreation and psychology at the University of Southern Mississippi. She graduated in 2001 and then did an internship in child life at the University of Florida, which is where she became hooked on the profession.

Working alongside physicians and nurses, child life specialists hold a unique position within the hospital.

Unlike other staff, they focus their time almost exclusively on patient care without having to deal with paperwork related to medicine or health insurance. They demystify medical procedures through education and medical play, provide support to decrease children's anxiety and help families through bereavement.

Before Carilion, Hamilton worked as a child life specialist at Children's Hospital in New Orleans for two and a half years.

Then, in late August 2005, Hurricane Katrina hit, putting Hamilton's job in jeopardy and leaving her feeling uprooted.

She interviewed to be a child life specialist with Carilion in October and said she felt somewhat torn when she was offered the job.

She said she felt guilty about leaving New Orleans and her friends and family to go to a place where she didn't know anyone. But, she also knew she needed to take a leap.

Now, three years later, Hamilton has found a new home in Roanoke. She's also now engaged to Ben Davis, a Carilion internist who serendipitously lived next door.

At Carilion, Hamilton spends most of her time visiting youngsters in the pediatric intensive care, general pediatric, hematology and oncology wards. She sees an average of 16 children a day.

Hamilton admits that it can be very hard when she gets close to patients who die. But she believes in providing children with quality of life while they're in the hospital.

She uses her humor to make kids feel comfortable and will often break into song, make a fish face or say silly words to do so.

"I'm trying to provide them with joyful things to do, to let them be happy, let them have fun, just to let them be a kid," she said.

Her job also takes her beyond the hospital and into the lives of her patients.

She visits schools to explain children's medical conditions so classmates don't bombard a patient when they return to class. She also reassures students who may worry that a classmate has died.

She leads a support group for teenagers with cancer (which includes their siblings), organizes an annual weekend getaway for children with terminal or chronic diseases and takes patients on special trips such as to New Orleans for Mardi Gras last year.

Hamilton also helps with program planning; that included adding two new child life positions this year. She helped hire Tara Lynch to work in the operating room in March and Jacqueline Sessa to work in the pediatric emergency room in September.

Dr. Lisa Uherich, director of the emergency room, also pushed to have a child life specialist in the ER because she says they have a significant impact in reducing kids' stress levels. That makes the jobs of other hospital staff easier.

"It's an extra expense that Carilion doesn't get back ... but we know it leads to better patient care," Uherich said.

Libby and "Miss Jill"

Hamilton says she loves developing deep relationships with children such as Libby and their families.

Hamilton first met Libby and her mom, Jennifer Jamison, in March.

Jamison and her husband, Troy, are from Roanoke but have been living in Denmark for more than two years. They were in Roanoke visiting family when Jennifer Jamison noticed that her daughter had some strange bruises and decided to take her to a pediatrician.

The next day, Libby was diagnosed with acute promyelocytic leukemia, a form of leukemia characterized by too many immature blood-forming cells in the blood and bone marrow.

"It was a complete and total shock," Jennifer Jamison said. "Our life has really just been turned upside down since then."

Advances in treatment since the 1990s have greatly increased the odds for patients with the disease. According to the American Cancer Society, the cure rate is now greater than 80 percent.

Hamilton met Libby and her mom in the oncology clinic 10 minutes after Libby's diagnosis. She talked Libby through every process that day, showing her dolls and animals with IVs and explaining her medical condition in ways she could understand, Jennifer Jamison said.

Once uprooted herself, Hamilton helped Libby to feel at home. Hamilton taught Libby American slang after she talked to the hospital staff in Danish for a good month. She gave Libby a reason to want to come to the hospital and became her best friend after she left all of her friends in Denmark, Jennifer Jamison said.

She's been there when Libby first started powerful chemotherapy treatment in April that left her listless and unable to eat or drink for almost a month. She's answered her questions when she's scared and taught her relaxation techniques such as guided imagery and deep breathing to help her through any pain.

On Libby's better days, Hamilton is there to goof around. She's even taught the girl to ride down a hall in the hospital on her wheeled IV pole when she feels like a typical playful kid -- provided an adult is around.

She will continue to be there as Libby undergoes three years of maintenance treatment.

Before her daughter's diagnosis, Jennifer Jamison had never heard of a child life specialist and didn't know about Carilion's program.

"We have been so blessed to have something like this here at this hospital," she said. "It's one of the only reasons we're making it through this."