A Sad and Frustrating Case
The chief complaint was possible sexual abuse of a child. I was just coming on shift, and neither the physician I was relieving nor the swing shifter had picked up the chart yet despite the patient's relatively long wait in the department (or room). Nobody wants these cases because they are usually sad, frustrating, and time-consuming. This one was no exception.
As I entered the room, I found a happy playful 3 year old girl accompanied by her grandmother and a few slightly older siblings and cousins. The grandmother alleged that the girl had reported that her mother's boyfriend had touched her inappropriately. The incident supposedly had occurred sometime during the previous month.
There was no evidence of external injury, so my main concerns were to make sure the girl was not in danger of further abuse and to file a report with Child Protective Services (as required by law). A careful evaluation of the victim's living situation was required, which in this case was quite complicated. It was a Friday night and fortunately we weren't too busy yet, at least when I began my assessment.
The girl's mother has custody of the patient because the father has been in jail for several months. The mother's boyfriend was the alleged assailant. Fortunately the grandmother had the name and address of the mother but no phone number. She knew only the "street name" of the boyfriend, who is called Pookie. Apparently the girl also stays at Pookie's mother's and auntie's houses sometimes, but their names and addresses were unknown. The girl is often left alone with Pookie while the mother is at work. Grandma has custody of the child every other weekend, and she also cares for several other young relatives in her home due to a dizzying variety of unfortunate family social circumstances.
That concise description perhaps fails to convey the difficulty that was required to obtain it. Though grandma may have a heart of gold, she certainly was a poor historian. After waiting on hold for 10 minutes with the CPS Abuse Hotline while I typed my notes, I gave up and entered the information via the internet. The CPS Abuse Hotline sucks.
One hour after I started my shift, I saw my second patient. Now we were busy, and it stayed that way for the rest of the night.
As I entered the room, I found a happy playful 3 year old girl accompanied by her grandmother and a few slightly older siblings and cousins. The grandmother alleged that the girl had reported that her mother's boyfriend had touched her inappropriately. The incident supposedly had occurred sometime during the previous month.
There was no evidence of external injury, so my main concerns were to make sure the girl was not in danger of further abuse and to file a report with Child Protective Services (as required by law). A careful evaluation of the victim's living situation was required, which in this case was quite complicated. It was a Friday night and fortunately we weren't too busy yet, at least when I began my assessment.
The girl's mother has custody of the patient because the father has been in jail for several months. The mother's boyfriend was the alleged assailant. Fortunately the grandmother had the name and address of the mother but no phone number. She knew only the "street name" of the boyfriend, who is called Pookie. Apparently the girl also stays at Pookie's mother's and auntie's houses sometimes, but their names and addresses were unknown. The girl is often left alone with Pookie while the mother is at work. Grandma has custody of the child every other weekend, and she also cares for several other young relatives in her home due to a dizzying variety of unfortunate family social circumstances.
That concise description perhaps fails to convey the difficulty that was required to obtain it. Though grandma may have a heart of gold, she certainly was a poor historian. After waiting on hold for 10 minutes with the CPS Abuse Hotline while I typed my notes, I gave up and entered the information via the internet. The CPS Abuse Hotline sucks.
One hour after I started my shift, I saw my second patient. Now we were busy, and it stayed that way for the rest of the night.
posted by scalpel at 8:08 AM
8 Comments:
That is terrible. I have to say that the BEST thing about working in the state that I do now is that we have a 24 hour State Attorney General-hired RN who comes to the hospital with the whole evidence collection kit, a social worker, and police. It is WONDERFUL. All we have to do is make sure there is not imminently dangerous situation and we are done. This compares to the 2-3 hour misery we all endured (the patient as well) in the state where I did my residency. BEST expenditure of tax payer money spent I think.
Seriously, I don't know how ER doctors can handle these type of cases without going crazy. I know your heart hurts when you see a child that has been abused.
MJ
I don't know about Scalpel, but when I've seen this I've turned off and gone on autopilot. You get used to asking the questions and doing the careful exam, because that's your job and it's what you're trained to do. Otherwise yeah, I think you'd lose it...
That totally stinks!
I work in Labor and Delivery and Peds too. It is horrible to get those kind of complaints from the parents, grandparents etc... You really want to believe it is not true. I can not tell you how many times we have been wrong. I feel your anger and heart-break!
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These cases are heartbreaking.
No normal human being would intentionally harm a child...particularly that way. :(
Seaspray is right. Unfortunately we don't deal with normal people much of the time, do we?
And the rapist, if guilty, will get out of prison at a reasonably young age and continue this behavior.
Some of the abused children will grow up to abuse others. All will probably experience complications of this abuse.
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