Am I the Bad Guy?

Abstract

Am I the Bad Guy? Tavishi Chopra What do you do when the 6-year-old patient you have vowed to protect suddenly deems you the bad guy? The afternoon started out like any typical afternoon during my inpatient pediatric rotation. We had finished rounding, grabbed lunch, and began to see our new admits. My residents told me to go see a 6-year-old, Ela, in the ED. All I knew was that she had a burn injury. As I walked to her ED room, my heart sank. Burns from cigarette stumps covered her torso and back. She was holding her shirt off her chest to prevent the excruciating pain caused by her t-shirt rubbing against her skin. As soon as Ela made eye contact with me, she immediately started crying and exclaiming, "Mommy didn't mean to!" confirming exactly what I thought. These burns were inflicted from someone she loved. Ela was eventually admitted into the hospital, and the Department of Child Services was contacted. Little did I know that I would be so conflicted by this decision. DCS launched an investigation on Ela's mom, but during the investigation, Ela's mom was permitted at her bedside. It was very clear that Ela felt protected and loved by her mom. Often it was only her mom who could get her to stop crying during the painful dressing changes. I felt torn allowing Ela's mom to have such a strong presence in Ela's hospital stay. To me, nothing in the world can justify hurting a child so cruelly, and inflicting that pain so many times. However, my job was to help Ela heal. That meant that because Ela turned to her mom for support, I also needed to include Ela's mom in our medical decisions. I buried away any negative feelings I had, and I proceeded to interact with Ela's mom in a professional manner. It was this that allowed me to get to understand Ela's mom a little bit more. She was a single mom [End Page E8] working multiple jobs to help keep her family afloat. She often lived her day on three to four hours of sleep, so she was very tired. The sleep deprivation made her frustrated more easily, and she didn't have a healthy outlet to release her emotions. Unfortunately, Ela was on the receiving end of that frustration. Hearing her story made me even more angry, confused, and upset that a child suffered. I strongly believed that as adults, we should have better control of our emotions, and sleep deprivation and frustration weren't an excuse. I couldn't find it in me to respect Ela's mom, who I shamefully began to avoid. I still wanted to bond with Ela and show her unconditional love. When Ela's mom was at work, I would use that opportunity to go and spend time with her. We would play "princesses," blow bubbles together, and turn dressing changes into a game. We formed a special bond, and I always made it a goal to go and spend some time with her every day. DCS, meanwhile, was actively conducting an investigation. They interviewed Ela's mom, Ela's siblings, and Ela. The findings of their investigation revealed that Ela's mom often would lose her temper, and the kids feared their mom. Hearing this further proved to me that I did not need to interact with Ela's mom. Embarrassingly, it was just as much a priority for me to avoid Ela's mom as it was to spend time with Ela. DCS eventually concluded that Ela's mom would lose custody of Ela for the time being. Because of the connection that Ela and I had, I took it upon myself to deliver the news to her. Our bond was shattered right then and there. She immediately began to cry, told me she hated me, and asked me to leave the room. Anytime I would go into her room after that, she would start screaming and refused to talk to me. In a span of five minutes, Ela's mom made a decision that destroyed their family...