Child Abuse: What if...

child abuse doctor dealing with
What if things had turned out differently?
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Beep, beep, beep, the pager lit up. It was sometime in December of my third year.  Since we had lost a resident, senior residents had to take first call too. Ordinarily a junior resident would stay in the hospital and call the senior (third or fourth year), for back up, when necessary. 

I checked the pager. The pediatric floor wanted an Oral Surgery consult on a six-month-old baby, an unusual call.  At that age I imagined getting called for a laceration or an infection.  But, normally those acute issues came through the emergency room, yet this call was from the floor.  I threw my lab coat on and instinctively stuck my hands in its pockets to feel for the necessary items: drug book, flashlight, pen.  Then fumbled to fix my collar just before the elevator stopped on the fourth floor.  At the nurse’s station, I found the chart and flipped to the yellow consult form.  In a typical doctors’ chicken scratch, it said, “Please evaluate bite marks on L foot.” L was circled indicating left. They wanted me to determine if the marks on the baby’s foot originated from an adult or a child.  Bite marks?

I sat down to review the chart.  He had been brought to the ER multiple times before.  During one episode he had presented with burn marks.  Parents claimed it happened from a fall on a heater.  Only later it was discovered how his eighteen-year-old father had burnt him.  I kept reading.  He had been “stuffed in a sofa” and left there. He had been burnt with cigarettes. He had been broken. Radiographs revealed multiple healed fractures.  It went on and on.  I fidgeted as I read, shaking a foot, running fingers through my hair, taking deep breaths, all to release the stifling tension.  It felt like a giant fist was crushing my whole being.  Still, you can’t skip over a patient’s history.  You must learn every detail.

Reason for this admission:  fractured ribs and clavicle. Other findings: oral thrush, bite marks on left foot.

I closed the chart and braced myself for the physical exam. It’s almost impossible to prepare for such a scene. There he was. Gabriel, a beautiful baby boy, his tiny body wrapped in a full body cast. He lay all alone in that lifeless hospital room under florescent lights, no family by his side. One of his few visible body parts, his little foot, was red with an oval of teeth marks probably from a child.

My mind replayed the words in the boy’s chart over and over. It didn’t matter that I hadn’t been there. I couldn’t stop imagining it. In his short life on earth he had only known pain. Not surprisingly, anytime an adult, a nurse or doctor approached him, he’d let out shrieks of fright. 

I rounded on him until the bite marks slowly faded away, but not because the department required it. It actually didn’t, but because I wanted to. I wanted to do something, to take his pain away, protect him, perhaps give him a different life.  I wanted to be the someone who’d hold him and tell him, “Don’t worry, you’re safe now.  I’m here.”

The night after the call, I spoke to my husband.  “What if we adopted him? After all he’s been through, the state will probably take him away from his parents. No way they’d send him back to get hurt again. Why not give him a chance at a better life?” We could proceed however the state deemed appropriate, as foster parents, as adopted parents, anything, until the official adoption.

It took some time before my husband relented. He did so only because we had been entertaining the idea of having our own children. By then Gabriel was discharged.

I sought out the social worker assigned to his case. “You remember Gabriel, the abused baby boy?” The boy I fell in love with?  “Where is he now?  What happened to him? Who is tending to his wounded body?”

“Oh he’s in foster care,” she said.  “The court ordered some parenting classes for his mother. He will go back to his parents after his mom completes the courses.”

That’s it?

I wanted to scream, “Don’t you see?  His parents don’t want him. They didn’t welcome him to the world the way my mother always describes a baby should be welcomed.”  “A child should come into the world with everyone waiting for him in joyful anticipation, welcoming him with open arms, celebrating him.”  No one celebrated this child.

But I didn’t share any of those thoughts. Instead I said, “Oh.  So it’s all done then?”

“Yes his case is all set.”

Every year since that call, come December, I think of Gabriel. I wonder if his life got any better, if his mom learned, or his dad changed.   Every year I also wonder what if…

We’d be celebrating his ninth birthday this December.



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