The First of What Will Be Many

Yesterday and today on the pediatrics inpatient unit, I have had my first --- of sadly, what will be many --- official, very personal encounter with the Department of Human Services. My team admitted a toddler boy after two prudent orthopedics nurses suggested we take a closer look at his history and resultant injury, both of which didn't quite add up. As mandatory reporters, medical professionals are required by law (and protected through good samaritan provisions in all 50 states) to notify the proper authorities when we suspect neglect or non-accidental trauma in children, elders, and everyone in between. Such was the case with my little patient.

A suspicious fracture, a shifting story, and a young mother with a great deal more history than she chose to reveal set our reporting protocol in motion. A urine drug screen, ophthalmology consult, full body skeletal survey, and a hair analysis later, I witnessed DHS intervene and remove the child from her custody amidst sobbing anger and flying words. Hospital security guarded the hallway, and our unit was on lock-down until 9 a.m. this morning. Meanwhile, the sandy-haired, doe-eyed little boy cried in confusion, fearful of all the nurses and doctors entering and leaving his room, and eventually lulled himself to sleep in his crib.

The unit was much calmer today. The staff, hospital volunteers, and my fellow student and I took turns wheeling him around the floor in a red wagon, feeding him graham crackers and milk, and coaxing him to smile. I even managed a laugh or two from him when I tickled his feet and played peek-a-boo from behind a blanket. Despite our best efforts, he sat alone most of the day behind crib bars, waiting for his foster family to arrive. I sat with him in the toy room for a half hour or so before he left, watching quietly as he compensated for his heavy, casted right arm and curiously pushed buttons and knocked over blocks with his left hand, adapting very quickly to his new handicap. I wonder what he, in so very few months of life, has already seen, what he's understood, and what experiences, if any, have faded from his memory. I hope he is able to forget.

I introduced myself to his foster mother when she came, a very enthusiastic, caring woman with two of her own sons in tow. She has three children of her own and two foster daughters, so my little patient will have a great deal to observe the next few days as he adjusts to his new home. The boys helped him eat dinner, and the mother and nurse rummaged in the donated clothes box for something for him to wear. I returned to my office and began to pack up my things to catch my bus home.

As the family began to leave, several staff members looked up from their work or stepped out of other patients' rooms to say goodbye and wish them luck. I walked around the corner, called his name, and waved. He watched me from his foster mother's shoulder until she reached the end of the long hallway and turned toward the parking lot.

It was more than enough to put a lump in my throat.