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So, it was all the harder to encounter the next case that took me from the staff room.
A young boy in a coma, victim of child abuse, his little body battered. He was brought in by EMS just before nine in the evening. Parents had called 9-1-1 with claims that the boy had fallen down stairs and was unresponsive.
When I saw his little body, I knew different.
He was maybe four years old and when we scanned him for trauma, we saw old broken bones that had never been set. He had been abused repeatedly.
"Oh, God." The three of us on the team looking after the boy sat in front of the monitor and studied the damage, imagining the abuse inflicted on such a small child.
"It makes me want to puke," Pete said from the chair beside me. "It's really too bad that any fucking moron can have kids while so many really great people can't."
"I know," I said, a choke in my throat, glad that if this poor child survived, he would be taken from his abusive family and put in foster care, with strangers or maybe other family members. Even if it were for the best that his abusive parents lose custody, it was the only one he had known and it would be hard for the boy to grow up knowing that his parents almost killed him.
If I was skilled enough, the boy would survive.
"You have some pediatrics background, right?" Clint said, turning to me. "This is yours."
"Yes," I said. "This one's mine. I better go scrub in." I stood up and made my way to the OR where they were prepping him for surgery.
Several hours later, after doing everything I could to save the boy's life, I left the OR and went to speak to the family – such as they were. The mother and father had been taken into custody and now, a grandmother sat with another daughter and waited for me. I had to break the news that the boy might not survive the night, despite my best efforts.
I sat down with them in the small waiting room and removed my surgical cap.
"He's very sick," I said, making eye contact with them both. "He has a serious brain injury plus multiple broken bones. He had some internal hemorrhaging and we had to remove his spleen. If he survives the next few hours, he has a chance but we won't know until we do some more tests."
The grandmother covered her mouth with a hand and she and the other woman embraced.
"His scans suggest that he's been abused over a long period of time," I said. "We saw old fractures that suggest he's been abused repeatedly. Were you aware of him being treated for broken bones?"
"I had no idea. I knew that something was wrong between my daughter and her boyfriend," she said. "But we had a falling out over it and I haven't been by for months."
"I'd say this has been several years, by the way the bones have healed."
"Oh, God," she said and closed her eyes. "I had no idea..."
"I'll keep you updated on any change in his status," I said and stood up, feeling bad for the woman who was obviously traumatized by the thought her grandchild had been abused under her nose and she had done nothing about it. I knew enough about the issue to understand that most people learned abuse in their families. If the father had been the culprit, he was likely abused in his childhood and so on. Child abuse was largely a multi-generational issue.
I knew that the child welfare system was overworked and underfunded and never seemed to be able to keep completely on top of some cases. I hoped little Nathan wasn't one of those cases, but I had a bad feeling that he had never come to the attention of the authorities and so the abuse had gone on for years and had accelerated recently, probably due to some stress in the family system.
I spoke with Dora, the social worker on shift, who stayed late so she could meet with the family to discuss the child's future – if he survived.
"We'll check on the grandmother and see if she can safely care for him if and when he is discharged. If there are adequate supports, it's best he goes with his family than being placed in foster care."
"As long as his grandmother's safe," I said, uncertain myself if she was.
"We'll make sure," Dora said and nodded. "This one is hard to deal with."
"I know," I said softly. "I have a son a few years older than him," I said and thought about Liam. "I can't imagine anyone harming a child. It's unthinkable."
"Sadly, it's all too common," Dora said with a sigh. "Talk to you later. I'll let you know what happens with him."
"Thanks."
When I finally left the hospital and arrived home, I popped my head into the bedroom to see that Sophie and Kate were asleep in our bed, Sophie snuggled up to Kate, her pacifier in her mouth.
I had a quick shower and then slipped into bed, trying my best not to wake them, a choke in my throat at the memory of the small boy whose life I saved, wondering what kind of life he'd have. It made me even more determined to get joint custody of Liam so I could make sure that he had a father there all the time – a father who loved him. I did love Liam with a fierce love I was surprised to feel considering that he had lived most of his life not even aware of my existence.
But I did. I lay beside Kate and Sophie, my arm draped around them, thinking of little Nathan. Then, I thought of Liam, and how his life would change with his mother gone to Indonesia for six months. I had to cover my eyes and bite back tears.
