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The little ones bounce...

Posted Sep 12 2008 11:33am

I'll call him Chase. Chase was eighteen months old, and I first met him as I prepared to accompany him to CT so his primary nurse could finally take care of her three other patients, ones she hadn't had the chance to see yet. You see, Chase was occupying quite a bit of time, hers as well as that of other nurses from the ER and PICU who were trying in vain to get some kind of access on the kid, to draw labs and medicate if necessary. As I entered the Peds ER at the request of Charge, I saw a bunch of scrubs clustered around the gurney, a youngish mom outside the room crying, and a youngish male standing uncomfortably by her side. It could've been any tough pediatric stick, nobody takes it lightly when we have to poke a kid more than eight times. The doctor was reluctant to use an IO (intraosseous access, a spike that pops into the top part of the shin and works gloriously in all ages of people but especially kids), and it wasn't until the sea of scrubs parted that I realized why.

Chase had seen the dark underbelly of humanity, and wore the badges to prove it. Nickel-sized bruises dotted his pale face and head, bigger bruises on his tiny torso and abdomen (and it takes a significant amount of force to bruise a resilient little tummy like that). His arms and legs were bruised up too, none of the patterns matching what you'd expect to see with the reported fall into a coffee table and fall down two stairs the family was claiming. But the one that really got me was the 4-inch or so straight indentation across Chase's temple, the one that looked oddly shaped like a broom handle, and was darkening by the minute. And genital bruising, too. For the love of all that's holy, what can an eighteen month old child do to incur that kind of wrath? They'd brought him to the ER because his 'bruises were spreading.' Funny, they have a tendency to do that with continued beatings.

And through it all, his dark eyes watched us. He trusted us as only a child can do, as surely as he trusted whoever it was that had done this to him. Quietly, with barely a whimper each time a needle pierced his soft skin - I had to push out of my mind the fact that this sweet angel was used to pain worse than our IV pokes. He trusted us. Through the painful procedures and the wheeling all over the hospital for xrays and ultrasounds and more xrays, too many strangers' hearts breaking with a single glance and a "who would do this?" shake of the head.

When the other nurse went home and I took over her assignment, Chase became mine, and his eyes still won't let go of my soul. Through all of the chaos that night, between allowed and disallowed visitors and police officers and investigators and frantic calls for security, I'd slip into the room to check his monitor and lines, and sit on the bed and stroke his cheek and tell him worthless little things like "you're such a good boy," "you're so handsome," "It's gonna be okay, sweet boy," when in fact I knew no such thing. I can do everything in my power when he's my patient, keep visitors away, station guards outside his room, run the show - but while I'm doing that, realize that my pen had better be stronger than my heart, because my documentation could realistically make or break the case. And trying my best to shelve my distrust of a system that may put the kid back in the hands of harm.

Through the night, as we prepared to admit the child for blunt abdominal trauma and an old arm fracture (blessedly, his head CT was okay), the looks in the watery eyes of my co-workers mirrored my own, as we all agreed this was one of the worst cases of NAT (non-accidental trauma) we'd ever seen. But the eyes that keep haunting me are the accepting, trusting, innocent eyes of that poor little angel. And I hope he never has to feel that kind of pain again. It's gonna be okay, sweet boy.
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