Non-accidental

This month I am on my pediatric intensive care unit rotation. This is big time hospital work, this is where the sickest kids in the hospital are sent and where some of the brightest docs in the joint work insane hours to keep them all on a path to recovery. All the while I fumble along behind them trying to act as if I understand maybe a quarter of what they are doing. It has been awesome.

I have said to those that ask that one of the reasons I am attracted to peds (when I type that it is pronounced [pEEds], I will say otherwise if I am talking feet) is that 99% of the time the pediatric patient played no role in acquiring their affliction. This could be read two ways: I am either a compassionate soul striving to help the innocent fight something that is more often than not much larger than us all, or I am a judgmental cynical ass who just cannot seem to muster an ounce of sympathy for the slobs in adult medicine who are fighting every effort made on their behalf by health care every step of the way. I say it is a mix, you say what you want but keep it to yourself.

Anyways, you can't do this rotation and not come away with a sad story you want to tell everyone. A few days ago a girl came into the ER, went to surgery, and was sent to our unit. The report to us began as follows, "4 year old female with non-accidental trauma . . . . . . . . . ." I didn't hear anything after that because that was the first time I had heard the term and I had to decipher it for more than a few moments. Sounds innocent I suppose when spit out by the ER resident in amongst a rapid list of medical jargon. Then you think about it and realize this young girl was seriously injured and it was NOT an accident, it was on purpose. I won't go into the gruesome details but basically a sad sack of a mother left her daughter in the care of her "partner" who is in fact scum of the Earth and as my mother used to occasionally say, "A complete and utter waste of skin."

The girl was admitted with multiple abdominal bruises in various stages of healing and a large subdural hematoma, which is a bleed in the brain (think the mom in Irving's A Prayer for Owen Meany). She is downstairs now, with half of her cerebral tissue dead and necrosed the other half spotted with ischemia, with a large piece of her skull removed to prevent the swelling from increasing intracranial pressures and cutting off the circulation to the remaining dabs of living brain tissue she has. She is hooked up to a brain monitor that has been flat lined since the OR.

Her mother's partner has been arrested and trial awaits the likely cessation of this young girl's life, as the prognosis is abysmal at best. The astounding part is that the mother is still in the room, I see her walking up and down the hall ways and laughing with friends in the waiting room. She put up a sign on the room's door labeled "My angel!" with a photo of herself and her beautiful daughter.

I am sitting now in call room a few floors up awaiting the start of our night rounds. I don't have anything amazing figured out by witnessing all this. I know I spend a lot of time just staring in from outside that particular room, I know that this sort of thing is not as rare as we wish it was.