Three-year-old Harper is huddled close to physical therapy assistant Nick Hamilton on the therapy floor of the Johns Hopkins All Children’s Child Development and Rehabilitation Center, both in deep concentration. 

They’re preparing to perform a medical intervention — on her favorite baby doll. 

“Are you ready?” 

“Yes! Let’s do this.” 

Harper’s doll is getting a leg cast, and Harper is supervising because she is, clearly, a boss. 

Nick, with somber face, takes his time, executing with precision. He carefully applies white casting material around the doll’s leg. Next, a sticky pink fiberglass wrap goes on to harden the cast. 

“Let’s not touch the pink, OK?”  

“But why?” Harper says. 

Harper is all about quality control. 

She observes the therapist’s handiwork for a beat — until she feels the need to take charge.

She gestures to her mom for assistance.

“I need help with my gloves … so I can help him.”

Because if you want a job done right … 

Harper is a self-starter. She was born with spina bifida and has fought like a champion for every unlikely physical victory she has ever won … the kind the rest of us take for granted. Things like being able to sit up. To walk without a walker. To play and explore her world freely. 

Therapy at Johns Hopkins All Children’s is making a difference for her, but there’s always more to do. Recently, she has had to endure a temporary cast on her lower leg and foot to help with her range of motion. 

When the casting process was causing her some anxiety, her therapist thought he might know how to help. Would Harper’s baby doll like to have a cast too? She would. 

“If you can make things fun, that’s always a good thing.” Nick says. “Mainly, I want Harper to feel safe and empowered … because it’s her life.” 

When the casting is completed, therapist and patient lock eyes in mutual approval. Good collaboration. A job well done. A happy toddler. 

It’s the little things.