This has nothing to do with trying to conceive - because well, I'm still in a holding pattern. No period yet. This is about my really crappy day. My morning was crazy busy but not terribly unusual for a morning in the middle of winter. My afternoon was actually looking like it was going to be a little better. That's until my 1:45 appointment.
Without getting into too much detail, it was a young infant in whom I strongly suspected sexual and physical abuse based on my exam findings. I was so sickened that I wanted to cry and throw up right there in the room. The parents had no explanation for the findings. I called in one of my colleagues to take a look and he agreed that abuse was the likely explanation (actually it was pretty much the only explanation). I told the parents that I had to call a specialist because I was concerned about their child. Instead I called child protective services (CPS) and law enforcement. I kept stalling - telling the parents that I was still waiting to hear from the specialist.
I felt horrible for lying but I didn't want them to take the baby and run. They had no idea what was coming. CPS and the local sheriff showed up. They each spoke to the parents alone. The parents stuck to their story that the child woke up this way (impossible - trust me). After being in my exam room for over 3 hours, they were told that the baby would not be going home with them. She would be taken into protective custody. The mother cried - a similar cry to the wail of mother whose child you've just pronounced dead (that's the worst sound in the world).
I could not look these parents in the eye. Part of me is furious and sickened. How could they have done this. But another part of me wants to believe that this is something too horrible to do to an infant - there must be some other explanation (a rare 1 in 100 million bleeding disorder??? - don't worry, we'll test for that). I avoided the parents as they left. I did not know what to do or say. I actually avoided them after I walked back into the room with the "specialists" otherwise known as CPS and a cop.
This isn't the first time that I've seem something this horrible. In fact, I've seem much worse. However all of that was during residency. I did my residency in a major teaching hospital. It was also the county hospital (in a large city). Any child in the entire county (and also in several of the surrounding rural counties) who was removed from the home for suspicion of abuse was seen there. We also had a child abuse center that did forensic exams (took pictures of the bruises and injuries). As a resident, we all rotated through there and saw unspeakable horrors. I also took care of multiple "shaken babies" and other victims of abuse in the Pediatric ICU - some of whom died, others who probably should have. However, with all of these kids, they were already in custody of the authorities. I may have written reports confirming the abuse and recommending that they not be returned to their families but this is the first time that I have had a child removed from their home.
I know it was the right thing to do. I had no choice given the injuries noted. So why do I feel like an ass. Why do I care that right now the parents think I'm the scum of the earth for taking away their child. They brought her to me to help. They brought her to me because of vaginal bruising. I helped the baby but I did not help the parents. I hope they see it that way.
This day has truly sucked. Of course I then ran behind all afternoon. I had pissed off patients give me attitude. The patient who was right after the baby was really pissed. They had to wait an hour. My nurse informed them that I was running behind and would be with them shortly. Due to confidentiality laws, I could not say anything more detailed. I hope that they would have understood had I said, well the patient before you who was booked for a 10 minute appointment was sexually and physically abused. It took me more than 10 minutes to call CPS and law enforcement and file the reports. I think your 17 year old son's sore throat can wait a few minutes. Instead I just said I'm sorry for running late and they remained pissy, so pissy that they left without being seen just 2 minutes before I was finally able to see them.
I then had to work our evening urgent care. They day never seems to end. I came home to an empty house because R has a late class tonight. I came on to the computer to blog and noticed that an auction that R was bidding for on e-bay was 6 minutes from closing. I tried to win it and lost with 8 seconds to go - shit, fuck... can nothing go right for me. Today sucks... and still no period.
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9 comments:
That really is a horrendous day.
Clearly you did the right thing for the child, even if the parents are never able to see it that way because of the impact that the resulting circumstances have on their lives. No doubt they are going to have a very difficult time, but they are adults and will somehow have to find ways of dealing with it all, but you rescued a defenceless child from a situation in which further abuse could have occurred, which is by far the most important thing. You wouldn't be human if you didn't also care about the effect on the parents.
That poor, poor baby. I just cannot comprehend how anyone can do such awful things to a child.
I am really sorry you had such an awful day. I can kind of sympathise because I work in a gaol. I hope you are able to vent your anger, sadness and frustrations further- it's a lot to carry, even tho you are a 'person of trust' within your community. You did the right thing.
That. Bites.
It seems like if the parents were responsible for the abuse they wouldn't have brought the child in to be seen? So it must have been someone trusted in their lives? Or do you think the parents thought you were that dumb?
In any case, it sounds like an awful situation in which you did the best thing possible in just about the worst world possible.
i am so so sorry. i've been in similar situations while a drug counselor for women (addicts) with children. i went to court often to testify, sometimes in their presence that they were unfit to have their child(ren) returned. it ripped me a part each time but i new that it was the only option for the child. keep on fighting the good fight!!
i hope you'll update us on the blood test results, especially if it turns out to actually be some sort of disorder so you can restore our faith in humanity, if that's even possible!
oh my god that is so fucking horrendous. what a trainwreck of a day. too bad you couldnt say to later patients something about how you were busy dealing with an extremely unpleasant situation and the delay was unavoidable. then maybe they could snap out of their complete self-absorption.
i had to report suspected abuse one time in a much, much, much less clear situation and i was tormented by it until a fellow student reminded me that it wasn't my decision to make and that i had an obligation to report the situation. it was out of my hands so to speak. it doesn't sound like you are tormented by making the decision but i thought i'd offer that i ncase it is helpful. you had no choice. not that that makes it any less horrific to deal with what you dealt with. can't imagine what that was like. if the parents weren't doing the abusing then they will surely be highly motivated to figure out who the hell was doing it. man oh man do you need a good glass of wine or two after a day like that.
What a fucked up day! It's so not right that people who shouldn't have kids actually have them. There are so many people, like yourself, who deserve a child, and would be a terrific parent. There is karma in this world. You get what you give. You will one day be blessed for the amazing and wonderful things you do on daily basis as a pediatrician.
I just started lurking here a week ago and usually I stay a lurker for a while before jumping in but your post hurt my heart and I felt the need to say I'm sorry that you had to deal with what you did. I can't begin to imagine the horrors that people can do to their children (and when I try to I get sick to my stomach). I just don't understand how anyone could hurt a baby. I'm glad that there are people like you who step up and take the heat to do the right thing to protect these innocent little beings.
I'm really sorry though - I'm sure it does make for a sucky day. :(
Being a mandated reporter sucks ASS. There is nothing worse. I rarely have to see the gory details though (and have never seen something like what you saw today), and the kids I see are older, but still. It just jolts you to your core doesn't it? And for me it isn't just about feeling sad/angry for the kid. It is a complex train wreck...fear and hatred, a crazy sense of shame at being involved at all, simultaneously hating/feeling bad for the parents (or other abuser or caregiver that did not report or notice the abuse) and generally just wanting to fucking puke.
It doesn't get easier, does it?
And I can comprehend (because I'm a therapist and I have to) how people can do this. It is so ugly. Witnessing that ugliness just makes your whole day ugly. I hope your week gets better and that you bleed already. Oh, and although it is hardly a consolation, you so completely and totally did the right thing and you might have even saved that girl's life.
I hate being a mandated reporter. I only had to do it once, for a situation that wasn't clear but was too likely for me to ignore. Luckily, in my case, the principal handles most of it. I would report it if suspected anyway, but sometimes it removes the ability to give the benefit of the doubt (which belongs to the child anyway).
I've been nervous before, with all the bruises Charlie has, that someone would think we hurt him. The first time he was admitted to the hospital I was SO thankful that we had a heavily documented medical history for him, instead of just walking in with a child who looked like he had been lit on fire.
You now have my email address. I will explain more, privately, if you desire. Our communication about the issue is not exactly going through clearly.
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