The Intern Blues(68)

The woman said she and her daughter slept in the same bed at night but during the day the mother went to school and she had to leave the girl with anybody who happened to be around. She admitted it was possible for anyone, especially her teenage cousins, to have sexually abused the girl while she was out of the house.

At this point the mother started crying and I had to leave the room for a minute. I was ready to cry myself.

I went over to talk to the attending and told him the story and he asked me one question: Why was the mother being so honest? I hadn’t even thought about it before that, but he was right; having your child sexually abused by one of your relatives is not something anyone would be especially proud of. The only thing I could think of was maybe the mother wanted to get something out of this. I mean, here she is living with all these people in this chaotic apartment. Maybe she figured the BCW would do their investigation and decide that the girl should stay with the mother but that they should be placed in their own apartment. It was a pretty disgusting thought but completely possible.

I had to go back and tell the mother what was going to happen, and I had to do the rape kit. The attending told me I should draw some blood for HIV testing, just as a baseline. [People who are exposed to the human immunodeficiency virus will test positive for antibodies to the virus a few weeks after the exposure. As such, Amy’s patient should have been negative but may later convert to positivity if she had been exposed to the virus.] I hadn’t even thought about that, but it certainly was a possibility. Not only did this little girl get raped, but also the rapist might have given her AIDS! I didn’t even want to think about it.

After I finished the rape kit, I started to make all the phone calls. I first called the social worker, and she said that I’d have to make it a joint response. [Joint response: When a child’s life is considered to be in danger, a report must be made simultaneously to the Bureau of Child Welfare and the New York City Police Department. The BCW’s investigation does not get started immediately. Therefore, an immediate investigation by the police must be done to determine whether the child can return home.] So I called the BCW and the police. The whole thing, from start to finish, took about four hours. By the time I was done it was after one o’clock in the morning and there were still a bunch of charts in the box. What finally happened was the mother and the girl were placed in a shelter for the night. I think they’ll ultimately get placed in their own apartment.

I’ve been thinking about that little girl constantly since I finished with her. All through the rest of the night, all during the cab ride home, while I was trying to fall asleep and since I woke up, that little girl didn’t leave my mind. It’s really terrible. I’m sure I’ll see her face in front of me for years and years to come.





Mark


NOVEMBER 1985

Friday, November 1, 1985

Yesterday was Halloween. I was on last night in the Jonas Bronck ER, and I learned an important lesson: If you want people to trust you, it’s probably not a good idea to dress up like Bozo the Clown. I know that because I did dress up like Bozo the Clown yesterday and none of the parents of my patients wanted to have anything to do with me. I guess I can’t really blame them; it’s one thing to come to the ER and wait four hours to be seen by a competent, or at least a semicompetent, doctor. It’s another thing to wait four hours and finally get called in to find out your kid’s going to be treated by Bozo the Clown.

But, hey, it was Halloween, and we’re supposed to be taking care of kids, aren’t we? We all decided the day before to come in dressed in costumes. Peter Carson, who’s about six feet three and weighs at least 250 pounds, came dressed as a ballerina, the chief residents were dressed as killer bees, Terry Tanner (a junior resident) was dressed as a witch, and I was Bozo the Clown. The kids seemed to like it even though their parents weren’t ecstatic about it. And everything would have been fine if I hadn’t had to tell a mother that her kid was dead.

It was about eight o’clock, right in the middle of the busiest time of the evening, of course. All bad things seem to happen when we’re really busy. We got a call from the EMS [Emergency Medical Service] saying they were bringing in a traumatic arrest [a patient who, as a result of some accident, was not breathing and whose heart was not beating]. So Bozo the Clown; the six-foot, three-inch prima ballerina; the witch; and one of the killer bees stood around the trauma area waiting for the disaster to show up. It took maybe two minutes and they brought in this eight-year-old. He had run out into the street and had gotten flattened by a van. The van then stopped and the kid got pinned under the back wheels. They started CPR out on the street, but you could tell it wasn’t doing him much good. He was pulseless and breathless, and when they hooked him up to a monitor, he was flatline [he had no electrical activity in his heart].