Tales from the ER…

I have found it quite helpful talking about my work experiences; on one hand, it feels like I am sharing part of my joy, or burden… it depends… on the other, I’m portraying what kind of world we are living in… the good and the bad.

I am still devastated, and yet completely outraged from a case I saw yesterday in the paediatric ER.

A 2 year old infant was brought in by his mother because she realised he had bruises in his peri-anal area that weren’t there before.
To make the story short, this little child has been going to a ‘day nanny’, from 7am till 18h30, 5 days a week, since July 2016. His mom has noticed that, since then, he is coming back home with more bruises every day, but when she asked the nanny about them, she always had explanations on the lines of a certain fall or minor trauma.
2 weeks ago, that same child ‘fell’ from the stairs at the nanny’s place, and fractured his elbow. He had to undergo surgery for a proper fixation.
All this time, the mother was being warned by her family and surroundings, about the signs, and that she had to stop sending her son to that nanny.
She was torn between what she was being told by her family, and the fact that the nanny was reassuring her every time, and had good explanations for all the bruises he is having.
Everything came crashing down yesterday, when she was changing his diaper and saw the bruises around the anal area.

During my examination, I found bruises over the eyelids, the side of the face, both sides of the neck, all along the back down to the glutes, and the perianal area. The bruises were of different colours, meaning that each had a different age. It was quite obvious that this child was a victim of physical abuse.

Here comes the hard part… as though seeing a child suffering in that way is not enough…
As doctors, we have to remain neutral, and ensure the protection of that little boy. It is the police, and the child services’ job to open an investigation about these events, and find out who was truly behind them… the nanny, the mom, a family member… even if deep down, we have a certain incline as to who did this…
The child had to be taken away from his mother, awaiting further investigations…

Every time I was faced with a challenging situation at work, I always got the feeling that x time was the worst…
Yesterday’s case beat all the proceeding ones…by far…

Having to tell a mother that we have to take away her child for an unknown amount of time, till all the investigations have been started.. Trying to ease her pain when she realises that all the signs were present for so long, but that she was so blind…
And the cherry on top, performing the ‘CCB’, which is the term for opening a file about the aggressions, and documenting everything with photos.. Having to play around with the little guy in a way that taking photos of his bruises didn’t seem like an aggression by itself, and trying to hold back tears in the face of such horrendous actions against a small child was by far the most difficult thing I was ever faced with.

Mothers and fathers… be careful… I know it is difficult to acknowledge that your child is the victim of abuse… but it is happening… Keep your eyes wide open for the signs.

  • bruises of different colours and ages
  • bruises along the face, back, inner thighs
  • changes in the behaviour of the child
  • increasing number of nightmares

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