A Silent Sentinel

As I did my first newborn exam today, it hit me–how you were supposed to be. A healthy baby, likely colicky, but nevertheless loved by your family. You should have been interactive with your primitive reflexes still intact, maybe even making a student chuckle with your Moro reflex just like this little one did for me today.Your clavicles and ribs should have been growing, not healing multiple fractures. Your skin should have only displayed the benign lesions we expect, not the numerous ecchymoses we only discovered well into your hospital stay because you came to us in a medical papoose instead of swaddled like your successor.

You haunt me. You’ve been following me, largely without notice, around the halls of Primary’s and even venture home with me. Yet you must always be in my periphery, for you slip into my thoughts frequently now, always leaving melancholy in your wake. I know how much skill this takes, because I, too, do my own slipping in.

I slipped into the trauma bay for the first time that day and shadowed the hoard of doctors into the CT reading room to watch Neurosurgery quickly scroll through your scans whispering phrases like globally hypoxic, diastatic fractures, and finally non-operable before brusquely leaving. I slipped behind my fellow as he was leaving the ED and listened as his only reply to police questioning was “his [your] injuries are not consistent with the mechanism from the history.” Joining you in the elevator was too obvious, so I slipped through the back stairwells and hallways into your PICU room behind the procession of intensivists, surgeons, and support staff.

I was the silent sentinel to everything that happened to you that day. I watched them take blood and transfuse blood. I witnessed a fellow futilely try to place a central line for two hours before the attending took over, only to take another. I listened as your mother told the police that it was her first day back to work from maternity leave and she had called your father to ensure he was up to drive your brother to school but discovered he had overslept. Everything was running late. It wasn’t your fault. I do not know what triggered your father’s final episode of abuse, but I hope it was mercifully fast. You did not deserve this.

You became my own private sadness when you slipped in, because the rest of the team quietly continued on, expressing anger with words, but not tone, for those that commit these atrocities against children. But I obsessed about you. I read your chart innumerable times, hitting refresh hoping to see new updates.

I eavesdropped on conversations with specialists hoping for mention of you. I compulsively scrolled through your imaging and retinal scans for hours, mentally cataloging every abnormality. Primary’s is supposed to serve as a presidio, protecting children like you from disease and death. Our system failed you; someone here had to bear witness to your life.

The closest to true enrage I saw on our service was your attending aggressively lecturing me a few days later on another suspected non-accidental trauma case, “Don’t belittle it into something more palatable. It’s like calling rape ‘non-consensual sex.’ It’s absurd. Call it what it is–child abuse.” I wonder, will all your future unfortunate comrades join you until I have a small phalanx as my shadow urging me to call it by its true name?

Maybe you’re not always in my periphery, little one; perhaps you’re a part of a brigade that follows him, slipping occasionally into his thoughts as well.

Dannen is a member of the University of Utah School of Medicine class of 2019. She holds a B.S. in Biology with minors in Psychology and Art History, which she will employ as a psychiatry resident at the University of North Carolina-Chapel Hill beginning in summer 2019. In her spare time, you can find her devouring books or emulating the Barefoot Contessa by making dinner (with dessert!) for her friends. 

Rubor Participation:
2019 Poem, "To Astra in Clinic 6"
2018 Essay, "A Silent Sentinel"