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Deciding to care for Amanda first, as she was the actual patient, Melissa placed the chart on the countertop and washed her hands. After she’d dried them, she sat down on her stool so she wouldn’t tower over the little girl.
Quickly, she assessed all Amanda’s mostly healed bicycle crash wounds. No signs of infection and the edges of the lacerations approximated well, with no gaps or dehiscence. A few sutures were completely covered with a thin layer of skin growth because of how long they’d been in, but with care Melissa could remove them without hurting Amanda too much.
“The stitches have to come out or your knee won’t heal properly.” Melissa put her hand on Amanda’s. “The good thing is that taking the stitches out doesn’t usually hurt. Because of how long these have been in, you may feel a little pinch, but it shouldn’t be too bad.”
“I don’t want them out.” Amanda started crying loudly, more for her mother’s attention than fear. “Don’t let her take them out.”
Melissa frowned at Amanda’s behavior. She’d understood the girl’s screams when she’d been sutured, but this wasn’t normal behavior for Amanda.
“Amanda, they have to come out. Be good for Dr Melissa,” Jamie’s tired voice pleaded.
“My daddy wouldn’t let her hurt me.” The little girl crossed her arms, big tears rolling down her cheeks. She looked duly pitiful. “He’d never let anyone hurt me.”
Unbelievably, considering how pale she already was, Jamie’s face became even more ashen. “Dr Melissa isn’t going to hurt you.”
Melissa and Jamie both attempted to soothe Amanda, but the little girl wasn’t having any of it. Melissa got Debbie to place Amanda in her lap, pinned her arms, and tucked Amanda’s lower legs between hers in a big hug.
“Shh, it’s going to be OK,” Debbie cooed, trying to comfort the squirming but trapped child. “Dr Melissa is going to help your knee get better.”
“My knee is better. Stop. Stop. Daddy!” Amanda screamed.
Melissa worked quickly to glove up and painstakingly remove each suture with her pickups and suture scissors. Only one bled and, considering how overgrown with skin they’d become, Melissa wasn’t complaining.
&
nbsp; “Almost done,” she assured her unhappy and uncooperative patient.
She cleaned the wound and covered it with a large square sticky plaster.
“Debbie, could you take Amanda to the treasure chest and let her pick a prize for being so brave?”
The nurse gave her a “Brave? Yeah, right” look, but smiled sweetly at Amanda. “Let’s go see if we can find you a pretty ring to match your shirt.”
Amanda recovered with miraculous speed. Skipping, she followed Debbie. “I want a yoyo.”
“I’m sorry she gave you such a hard time,” Jamie apologized the second they were alone. “She stays upset all the time. I can’t make her happy.”
“It’s not your job to make her happy twenty-four hours a day, Jamie. It’s OK if she gets upset from time to time. We all do. It’s how we learn, grow emotionally.”
Jamie’s head lowered. “But I can’t seem to ever make her happy. Or Cindy either.”
“I know better than that.”
“You don’t understand.” Tears streamed down Jamie’s bloated face. “She told me she hates me and wishes I’d been the one to die.”
“She didn’t mean it, Jamie.” Melissa’s heart ached. “Children say things they shouldn’t. I’m not excusing what she said, but she’s a child and doesn’t fully understand the ramifications of what she says.”
“Cindy says the same thing.” Thirteen was a little harder to excuse than five. “If my own kids hate me so much, what do I have to live for?”
How could Jamie’s children be so cruel? They were just children, but couldn’t they see how sick their mother was? How much their words hurt? No, they were kids, even Cindy at thirteen. They only saw that their mother was no longer able to jump through hoops. Hoops Jamie had done her best to leap through since their father died.
“They’re confused. And scared.” Melissa knew her words were the truth even if the girls’ hurtful actions angered her. “Their father died and now they see you getting sick. They’re afraid they might lose you, too, and they’re taking out those fears on you.”
Jamie gave a weak nod. “Maybe you’re right, but I’m just so tired. I asked Cindy to help me, but she won’t. I don’t have the energy to argue with her, and she knows it. She does what she wants to.”
“It’s normal that she’s going to test her boundaries. All kids do.” Melissa squeezed Jamie’s hand. “It’ll be difficult, but you have to stick with what you tell the girls. If they don’t do their chores, take away a favored plaything. If they argue, put them in their room.”
“But they already hate me.”
