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‘Afternoon!’ Iosef introduced himself to Mark and his parents before running a cursory eye over the casualty card and the more obvious wounds, and then addressed his patient. ‘It says here that you fell.’
‘I did.’
‘Of course he didn’t fall,’ snapped Mr Taylor, but for the moment Iosef ignored him.
‘I am going to examine you if that’s OK, Mark.’ He turned to the parents. ‘Could I ask you to step outside?’
‘We’d rather stay here.’ Mrs Taylor gave a tight smile. ‘We’d like to see what’s going on for ourselves.’
‘At fifteen years old, it may be uncomfortable for Mark to have his parents present while he is examined.’
‘At fifteen years old,’ Mr Taylor responded tersely, ‘he’s still legally a child and we’d rather stay.’
‘OK.’ Surprisingly for Iosef he didn’t argue the point and Annie frowned just a touch as he pulled on a pair of gloves and performed a comprehensive examination. He did his best to keep Mark covered as he probed his chest and abdomen then rolled him over and checked some rather large bruises on his back, performed a neurological examination then carefully checked a nasty laceration on his scalp.
‘This will need suturing,’ Iosef said, though more to himself, then spoke to his patient. ‘Is there anywhere I haven’t examined that you’re hurting, anything else that happened when you fell?’
‘He didn’t fall,’ Mr Taylor snarled. ‘So can we all stop playing along with his lies? We want to know what’s going on with him. Today isn’t the first problem we’ve had. He’s hardly ever at school, has been coming home at all hours and when he is home is shut in his room. Heaven only knows what he’s on, whether it’s drugs or alcohol—’
‘OK,’ Iosef interrupted. ‘Clearly there are things that need to be discussed, so could I now ask again that you excuse us so that I can talk to your son?’
‘And I’m telling you again that we want to hear what he has to say!’ Mr Taylor barked. ‘You haven’t even asked him if he’s taken anything.’
‘Mark.’ Iosef turned briefly to his patient. ‘Have you taken anything?’
‘No.’
‘That’s not asking him.’ Mr Taylor’s face was twisted with rage and Annie watched as Mark just closed his eyes. ‘As if he’s going to just admit it!’
‘So what do you suggest I do?’ Iosef asked.
‘We have to get to the bottom of this,’ Mrs Taylor said.
‘I agree—but I don’t think that’s likely to happen with you in the room,’ Iosef answered, and his voice was still calm and easy. ‘I think there is more chance of Mark talking to me without you present.’
‘Well, if we do leave we want to know everything that’s said. Legally you can’t—’
‘Annie... ’ Iosef spoke over Mr Taylor. ‘Are there any beds in the obs ward?’
She shook her head. ‘Not for a couple of hours. Hopefully the tendon repair will be leaving around six.’
‘Do you know if there are beds on the children’s ward?’
‘I’ll check,’ Annie answered. Mark was at that difficult age where he really couldn’t be crammed in beside a three-year-old.
‘Thanks.’ He turned to Mr and Mrs Taylor. ‘He needs to be sutured, and given you are concerned there may be drugs or alcohol involved, and also that he has some renal tenderness, I’d like your son to be admitted overnight for observation. Annie, could we also check his urine for any blood, please?’
‘And drugs!’ Mr Taylor demanded, at which Iosef gave an ironic smile and spoke to Annie.
‘Forget the obs ward—I’ll go and ring the pediatricians.’
‘That’s it?’ Mr Taylor was incensed as Iosef turned to leave.
‘The pediatricians will discuss your son’s care with you and whether to do a drug screen—and naturally a social worker will—’
‘You’re just going to leave! We just said he could talk to you.’
‘Mr Taylor.’ Still his voice was calm, yet somehow it overrode the angry one. ‘I have worked with many teenagers and I have dealt with many who are in serious trouble. Confidentiality is a very difficult area. Now, I absolutely agree with your concerns about your son’s welfare and I understand that there are things you, no doubt, want and need to know. Your son presents to me as a young man who is in trouble, a young man, who like many, cannot, for whatever reason, talk openly with his parents. Me talking to Mark alone and having then to relayeverythingto you is, I believe, a pointless exercise. My speciality is emergency medicine—the pediatricians and the child psychologist are far more qualified to deal with family matters.’ He glanced at the casualty card. ‘In a few weeks your son will be old enough and hopefully well enough to get the confidential advice and care he needs.’
