The little boy, the one who screamed, “Please don’t kill me!” while we put a cast on his broken arm came back on July 6th. We put the cast on June 1st.
The doctor said, “Come back in 15 days so we can make sure it is taking well.” He wrote, “Rendez-vous dans 15 jours” in the chart. They made an appointment:” June 16th between 9am and 4pm Hopital Bon Samaritan.” They waited till today.
When my eyes took in his face, I asked myself, “Was it his arm that I held at 90 degrees while Dr. Belanger wrapped it in wet plaster? His defining feature, he lifts his right eyebrow when he smiles making it seem like he isn’t sure why he is happy, answered my question. My brain flashed: “How is his arm?” “Did he grow to like his terrifying cast?” “Why didn’t he come back sooner?” “Does he remember it?” Then, I scanned his body in a pattern that surprised me. I was looking at him to analyze his condition, not to take in the toddler pattering in circles or laugh at the sudden certainty of children movements, the way they stand still staring and then make a choppy motion as if their motor nerves fire the instant they think of something to do.
I wasn’t satisfied. His cast, if it is accurate to describe what looks like white rag used as a golden retriever’s chew toy that way, was soft and shorter. Sure, white things get dirty. The other day, I looked down at my arm after I ran my white sleeve across my forehead to keep hot drops from falling in my eyes, and it was gray. There is dust and dirt in the oven air here. The messy wasn’t what upset me. We had wrapped his arm from knuckles to armpit and now his cast barely reached past his elbow. I looked up at his Mamman. She was standing with both her eyebrows raised. They told me, “I’m either exhausted or bored.”
Dr. Belanger sent the little girl who had been sitting in front of him and her father to the pharmacy with a prescription for Calmine lotion to treat her sarcoptosis (Scabes) infection. Then the mother walked up to him.
“Doctor, can you take the cast off today?”
He looked up and squinted, obviously thinking, ‘Which patient is this?’
“Where is your chart?” He said. “And the X-ray from the day of the fracture?”
“I don’t know. No one gave me anything, but you saw him so can you just take it off?”
“Yes, but, I need to know when I put it on, and we need an X-ray to see if his bones took to the cast and healed.”
“Another X-ray?” She rolled her eyes.
Dr. Belanger was getting frustrated. “Yes.”
She left dragging her son by the hand. I watched them go and worried about his arm.
After lunch, I sat down with Dr. Felix at one of the three desks the doctors on service in pediatrics use to see patients. In the pediatric ward, there are no doors and no curtains. The physicians call a name from their stacks of charts and the children walk up with their parents. Each child sits on a stool in front of the desk and the doctor examines him. There is a bed at the end of the room that the doctors use if they need to examine a patient lying down. When Dr. Belanger, Dr. St. Fleure and Dr. Felix have patients in front of them, I can hear all three consultations at once. Most of the time, I am too absorbed in helping with the patient sitting nearest me, but when the visit ends and we wait for the next person, my eyes and ears stroll the room.
The Manman walked in with an X-ray in one hand and her eye-brow raising son’s fingers squeezing the other. I watched Dr. Belanger unfold it and attach it to the light board to examine it. I sucked my tongue against the roof of my mouth and breathed horror into my throat. It was the view of his arm that is taken when he places his forearm on the table with his palm up that made me cringe. In that position, the two bones of the forearm, the radius and ulna, should be almost parallel to each other and they shouldn’t touch. His were in a long, slender “X.” Even worse, there was still a black line breaking the white line of his radius bone on the X-ray. I looked at his now cast-free arm. The middle of his forearm was arced like a boomerang.
I heard Dr. Belanger say, “What did you do with his arm while it was healing? When did we place the cast?”
She said, “We came at the beginning of June.”
Dr. Belanger said, “You were supposed to come in 15 days! So we could make sure this,” he waved a hand in the direction of the boy’s arm “didn’t happen!”
I moved my gaze away from the crooked arm to the mother and she was staring at me. It was then that I realized what my face must have been doing. I had been too absorbed in frustration and shock to filter the conversion of my emotions into facial expressions. I had been gaping, at his arm, biting my lip, pushing my two eyebrows together and that told her things were bad.
She looked hurt and she started defending. “You said to come back July 15th. I’m early.”
He stood up and walked out of the room. She stood, I sat, and her son played with a shred of paper he found on the floor between us. Five minutes later, Dr. Belanger walked holding the yellow 5 by 7 index cards stapled together to make the boy’s file. I walked over to read them with him. The boy’s name was Jerome and he was 5-years old.
“Here, it says it!” Dr. Belanger told me. “I wrote that I made them an appointment to come back the 16th of June.” He showed the chart to the mother. She looked and said nothing.
I knew that between Dr. Belanger’s face and mine, there was enough information for her to realize that the 5-year old arm for which she had been responsible was worse than when we put the cast on it.
She sat down and started a type of pout. Mothers sitting in the benches waiting their turns to walk little ones to a doctor’s desk were staring judgement at her. I was looking at her, thinking, ‘Even if it is an honest mistake, it hurt him and how did his cast end up like that?’ She started to act like my little sister 14 years ago when our Mom made her sit in a chair for fifteen minutes because she slapped me in response to my teasing. She was ashamed and embarrassed. I started to look away, but little Jerome had started pulling her shirt. I thought, ‘Maybe he’s hungry since it is lunch time.’ She was squinting tears. “Stop!” she yelled. He kept pulling. She hit him 3 times saying “Stop it! Stop it! Stop it!" With that, I was indignant. She was hitting him because she was embarrassed, because she was sad. the way I hit a pillow when I was 11-years old and found out my parents were going to divorce. She was supposed to be the grownup, to protect him. He bit her hand. She raised her arm to hit him again and a mother waiting with her daughter in her lap said, “Pa fe sa,” (Don’t do that) in a commanding tone. Two other female voices added, “He’s probably tired” “Has he eaten yet?”
Dr. Belanger was writing a referral to the orthopedic specialist in Cap Haitian. The mother’s face was pale. I focused on the note to avoid watching her. After Dr. Belanger scribbled his signature, I felt her staring at me and I met her eyes. He handed her the note, she took it and walked out with her son.
