Sunday, August 24, 2008


The surreal experience of Little man's enigmatic injury got a little bit worse before it got better. When we finally got to talk to his doctor at 10:30 pm. the day after the x-rays, she said they were inconclusive ("ossification on the patella -- injury to the knee can't be ruled out") and that we should go to a pediatric orthopedist for a bone scan. "Pediatric bone scan" -- not a reassuring phrase.

The next morning, she had her office staff call around everywhere to see where they could get us in that day, since it had already been so long since the fall, and her receptionist called and asked "So tell me, are you on skates?" This was 10:30, and we had to be in Wilmington, Delaware by noon, with the x-rays in hand. We zoomed out the door with uncharacteristic efficiency and were there half an hour early, starving but armed with the box of power bars my husband keeps in his office to stave off hunger pangs. (We each had one in the car on the way. Michael reading to me from the map quest printout: "Was that exit 8 or exit 9? Get into the right lane!" while L.M., chewing, musing: "Ack-chooly, I don't really like these. Can I have another one?")

Little Man got very interested in the huge fish tank in the colorful waiting room of the children's hospital ("Is that big orange one playing hide and seek? What's that big pink thing? Why is there bubbles? Did he just eat a rock? Why did he spit it out?") while Michael and I stood around chewing our nails. Finally we were called in to a "room" which was not so much a room as an area (it was instantly clear this was a hospital and not simply a doctor's office: the weird pastel-striped curtain hanging from the ceiling on little metal tracks was a dead giveaway, plus the shuddering flashbacks I was having to my appendectomy and also my ovarian cystectomy).

The first doctor who came in was very nice, despite looking alarmingly like Doogey Houser, M.D. -- too young and too earnest to actually know anything. He had us go in for more x-rays down the hall and then come back, and when we came back we waited and waited, and the only reason we figured out what we were waiting for was because little chipper L.M. (as far as he was concerned, we were on a mildly entertaining adventure of some kind) got bored and wanted me to carry him around for a walk, where we happened to run into Doogy, who mentioned as an aside that he had called in his boss and was waiting for a reply. Gee, thanks for letting us know!

When at last the long-awaited authority figure came in -- an older tall, thin man with a nearly cadaverous face and owlish wire-rimmed glasses, very grim-looking and expressionless -- I thought to myself, Uh-oh, let's make this quick and get out of here before he scares Little Man to death. But he didn't. He spoke with us quickly, efficiently, and then crouched on the floor to address Little Man directly where he sat on my lap. "So what stickers do you have there?" he asked him conversationally, matter-of-factly, as if he took it for granted that Nemo stickers constituted reasonable adult conversation. Little Man told him a little bit about the stickers the nurses had given him, and answered each question thoughtfully, seriously, backtracking as needed to correct his own statements: "I think this is Nemo. No, I haven't seen the movie but I know about him. He's orange and he's a fish. This other one has stars I think. I think they're stars. No, here's a butterfly. Butterflies can fly but they don't sting." The doctor looked calmly into L.M's eyes and peppered him with questions, and it took me a minute to notice that both of the doctor's hands were gently manipulating and exploring L.M.'s knees with efficient, practiced fingertips, as if he were reading Braille. L.M. did not react to the doctor's fingers except here and there, and the doctor seemingly paid no attention but kept his fingers moving while continually asking questions, "Does Nemo eat fruit? What do butterflies eat? Did you ever see a butterfly that was orange?" And L.M. answered him, responding comfortably to the doctor's conversational tone and respectful eye contact.

I was a little bit in awe. When Dr. Cadaver finally stood up and reported his findings to us ("he's not reacting to any discomfort except in one area of the left kneecap, and there's no swelling or any evidence of a fracture. I think it's a bad contusion, and he's being intuitively careful to let it heal..."), it became clear to me that he had been purposefully engaging L.M's conscious mind in order to gauge his bodily reactions. This is probably pretty standard stuff for a doctor, particularly one who works with kids all day, particularly one who works with kids with broken bones all day -- and it occurs to me that I've probably watched our regular pediatrician do it here and there, but still. What I liked about it was that I came expecting a bone scan with fancy machines and lots of lights and beeps and buttons, and what I got was a sixties-ish guy's skinny hands, massaging my kid's knees while speaking directly into his eyes.

It seemed a very old-fashioned kind of medicine, like a medieval midwife or a tribal healer, and I liked it. His recommendation was that we watch him: "Don't force him to stand, but don't stop him. If things don't improve in one week, bring him back to me." In other words, trust him and leave him alone. Geez, trust the 3-year-old patient? what is this, some kind of voodoo? Michael and I were grinning all the way home.

And L.M. straightened both legs by bedtime, and the next morning tentatively half-stood on both legs. "How does it feel?" I asked him. "A little weak," he said ruefully, and smiled at me. He's still not walking -- and tomorrow will be a week since he fell -- but I am entirely comfortable with it.

No comments: