Julio – The Growing Years

 by: Miguel Sanchez

© 2006-2008 by the author

The author retains all rights. No reproductions are allowed without the author's consent. Comments are appreciated at...

Steven and Angel decided to come home so they could have some quiet time to themselves. I also had a feeling she was going to want to check on the state of the Orphanage and the Hotel.

Chapter 37

Steven, Angel and I packed our clothes and hugged everyone goodbye. I told Marco, that if anyone called, I’d give them the number here. We got on the road and by 2 we were pulling into the driveway. I looked behind me and Steven wasn’t behind me. I figured he had been caught at a traffic light. Finally 30 minutes later he and Angel came pulling up. I opened the front door and asked, “What happened kids?”

Angel got out of the car holding a large pizza so now I knew what really happened. “Steven’s stomach started going off so we had to get something to eat.”

I had to admit mine was going off too. I held the front door open and followed them inside.  “What’s the matter, don’t they have phones in Blacksburg?  You guys had me really worried.  I didn’t know what had happened to you and I was expecting the worst?”

Steven had that ‘deer in the headlights’ look.  “Ummm ahhh gee Dad, I’m sorry.  I guess I just wasn’t thinking.  I really didn’t mean to worry you.  We’ll try to do better in the future.”

Angel also had that ‘Oops, we really messed up’ look on her face.  She came over and hugged me and gave me a kiss on the cheek. “I’m sorry, too, Daddy.”

Well Steven is really lucky that I can’t stay mad at my Angel for very long but I would find a way to pay them back.

I’m not really a junk food eater but the three of us demolished that entire pizza. Angel put the box in the trash while I helped Steven bring in their bags. I went out the mailbox and brought in 3 days of mail. I sorted it into piles by owner and noticed a letter to Marco from the Government. After out last encounter, I wasn’t ready for another. I thought about calling Marco first but if it was garbage, he didn’t need to know about it. I removed the letter and smiled as I read it.

Dear Mr. Cortez,

It gives me great pleasure to inform you that you have passed your Citizenship Test. There will be an oath administered on July 3^rd at 10am in front of the US District Courthouse. You are required to attend.

I guess I let my enthusiasm get loud because Steven and Angel were standing there looking at me. “Marco passed his Citizenship Test!”

Angel hugged me in excitement. I got on the phone and called Marco. I gave him the news and he almost took my eardrum out with his yelling. “That’s great news Pop. I’m going to call Dad and let him know. Maybe he’ll be able to get up for it.”

I shook my head trying to get the ringing out of my ear. “That sounds good son. Let me know if he can make it. Tell him if he needs transportation, I’ll send the plane after him.”

I heard Marco telling Jay that he’d passed his test in the background. “Thanks Pop. I’ll call you as soon as I know something.”

I hung the phone up then went through my mail. ‘Bill, bill, junk, junk, bill, humm, what’s this?’

I looked at this letter and noticed it had a Receife postmark on it. I opened it and there was a letter from the contractor who was doing the addition on the Children’s Home.

Dear Mr. Sanchez,

Since our initial meeting regarding the renovation to the Children’s Home and looking at the facility I’ve come up with a better plan for putting on the addition. I’ve decided on putting a second floor that would stretch between the ends of each wing. Enclosed please look at the drawing I’ve included. As you can see, I’ve also moved the kitchen and dining area off the common room. This will allow for better use of the facility without losing any of the playground.

If you have any questions, please feel free to contact me. Construction time should still be as we’ve previously discussed.

I hope this idea is acceptable to you.

Sincerely,

Dean Bartell

‘An elevated wing between the ends of the ground floor wings,’ I thought.

I liked that idea because it won’t take away from the children’s play area. The one downside to it would mean we’d need the stoves and refrigerators moved or new ones purchased.

It looked like a trip to Receife was now on the agenda. All I had to do was figure when I could go. There were 3 weeks before Marco took his oath but I didn’t want to have something happen there then have to leave before it was solved. I was really hoping Paulo could come up to see Marco become an American citizen.

I finished going through the mail and I started smelling something coming from the kitchen. I went in and saw Angel fixing dinner. “Hi Daddy, hope it tastes as good as it smells.”

I looked in the pan and she was braising a pot roast. “It looks great love. I’ll get out of your way.”

I saw Steven carry some dirty laundry towards the laundry room. “Do you have room for some of my things son?”

Steven goes into the laundry room then returns. “Sure Dad, how much do you have?”

I go into my room and look into my hamper. I empty it on the floor then sort through it splitting it out by colors into piles. “Looks like I have more than I thought.”

Steven takes the light colors with him. “I’ll get your whites for the next load Dad.”

I was about to answer when the phone rings. “Hey Dad, guess what? Dad can make it. He has to be in Miami so he said he’d book a flight to the Beach.”

I was happy for Marco. Paulo was spending a lot of time away from home so this time together for them was something Marco really needed. “That’s great son. I’m glad he’s not going to miss this.”

“So am I Pop,” Marco replies. “He’ll have about a week that he can spend here.”

That would be great timing. They can spend some time together before Marco has to leave for California. “Excellent son; now call him back and have him get a one way ticket. I need to go to Receife so he can come with me on the plane.”

“Sounds great Pop, I’ll call him now.”

I hung up the phone then finished sorting through the mail. I helped Steven with the laundry and by the time that was done, Angel had dinner ready. After dinner the 3 of us cleared the table and got the kitchen cleaned up then spent a quite evening relaxing.

I spent the next 2½ weeks back at my practice. The first day back, I went to the ER to see which group was on call and one of the first people I saw was Paul. “Well hello stranger.”

I had to blush because I had been away so long. “Alright, I had that coming. I take it we’re on call?”

Paul nodded his head and handed me the chart he was looking at. An 11 year old boy was rushed to the ER by ambulance complaining of severe abdominal pains. His mother told the paramedics they come on suddenly causing him to double over breaking out into tears. Paul and I went into the exam room where the ER physician was talking to the mother. “Ma’am, how long did you say he was having these pains?”

“Today was the fist he’d said anything to me about them.”

Paul looked at the doctor then the three of us stepped outside. “Have you examined the child yet?”

The young doctor shook his head. “He’s in so much pain I’m afraid to touch him. I was about to get him something for it, then examine him.”

My eyes opened real wide at this. “How long have you been in the ER doctor?”

“I’m a 3^rd year Resident,” he replied.

I shook my head. “You still have a lot to learn. Come with us please.”

I handed the young Resident the chart then went right to the child. “I’m Dr. Sanchez and I’m going to try and help you get your tummy to stop hurting. Can you tell me your name?”

He opened his eyes and I smiled at him. “Hi Doctor. My name is Matt, Matt Davis.”

“Can you tell me what caused your tummy to start hurting?”

I saw him wince is pain and I gently rubbed his forehead. “I dunno, it just started hurting.”

“Can you point to where it hurts the most?”

He put his hand in the middle of his abdomen. I lowered the sheet to just below his waist then raised his gown. I put my hand gently in the middle of his abdomen and just let it stay there looking for a response. When I didn’t see any sign of pain I pushed down a little. He closed his eyes and winced. “Alright Matt, I’m going to have to push down all around your abdomen. I know it might hurt but please bear with me.”

I first felt his lower right quadrant thinking it might be his appendix. He winced a little when I pushed down and when I released it, he didn’t cry out but instead a look of relief came across his face. I next palpated his intestines and they were hard as a rock. “Matt, when was the last time you went to the bathroom?”

He looked at me then thought for a moment. “Ah I dunno sir.”

At that point, I decided to do a rectal exam to see if I could feel bowel. I put on a pair of rubber gloves then had Matt roll on to his side. I moved the sheet and gown then got some lubricant. His mother stood and looked at me. “Doctor, what are you going to do?”

I started to put a small dollop on my little finger. “I need to feel if there is bowel in his rectum.”

The mother was looking distressed as I answered her question. “Why do you need to do this?”

I couldn’t really understand why she was so uncomfortable with me doing this. “If there is bowel in there, it will show that he is constipated. This in all likelihood is what’s causing your son’s pain.”

I put the lube on my little finger then leaned down so I could see his rectum. I looked at it and I froze in my tracks. I motioned for Paul to take a look and his eyes got big. Matt’s rectum was red and inflamed. I didn’t see any signs of tearing but there were signs that he had been penetrated. I wiped my finger off then looked at the mother. “Will you excuse us for a moment please?”

Paul and I stepped out of the room. “What do you think?”

Paul shook his head then glanced in at the mother and back to me. “I don’t know Miguel. He’s been penetrated but by what, I don’t know.”

I thought for a moment about how to proceed. “Let’s separate them. I’d like you to talk with the mother. See if you can find out if Dad is in the picture here. I’m going to try to talk with Matt and see if he’ll tell me anything”

If Matt was playing around with himself back there, that would explain things but at 11 years of age, I found that a little unusual. Paul stuck his head back into the room. “May I have a word with you out here please ma’am?”

The mother came out and Paul led her to one of the conference rooms. While they were heading there, I went back inside. “Hi Matt, I think I might know what is causing your belly to hurt but I need to ask you some questions. Now, these might seem embarrassing but what ever you tell me stays right here between you and me. I also need for you to be honest with me. Can you do that?”

I saw a worried look come over his face. “Um yes sir, I’ll try.”

I smiled at him and brushed the hair out of his eyes. “That’s good sport. Now, can you try and remember when you last took a poop?”

He thought for a minute. “Umm, the day before yesterday, I think.”

Some boys don’t move their bowels every day so that didn’t really concern me. “OK. Now here comes a question that might be a little embarrassing for you. When I looked at your bottom, I see it’s quite red back there. How did that happen?”

Matt blushed when I asked him the question. “I don’t know doctor. Sometimes I have to push hard when I take a dump.”

******

Over in a small conference room, Paul was talking with Mrs. Davis. “Ma’am, is Matt’s father in the picture? I saw where you said you’re divorced.”

She shook her head no. “He left shortly after Matt was born. It’s been just him and I ever since.”

Paul was still wondering why her son’s rectum was red. He’d read a few reports where mother’s would sexually abuse children but he didn’t really want to think this was the case. “Does your son have trouble using the bathroom?”

She nodded her had. “Yes, at times he does. His system is so very sensitive. He’s allergic to so much I have him on a strict diet.”

Paul’s ears perked up to that comment. “I didn’t see any of that on the chart. Is he seeing an allergist or has he been tested?”

She plopped her purse up on the table and pulled out a huge bag on medicines. “Yes, I’m afraid he is. He’s been seen by some of the best doctors. But none of them can really get a handle on things. They just keep giving him medicines so I’m the one having to make sure he’s keeping healthy.”

Paul took the bag and started going through the pharmacy she set before him. There were inhalers, several diet supplements, several different tranquilizers and three different types of oral pain medications. The one thing he noticed was they were all written by different physicians. “When Matt has trouble using the bathroom, what do you do?”

Normally a mother hesitates when answering a question such as this because he knew giving an enema was something a child would balk at but not her. “I do what I need to doctor. I gave him an enema. He needs to keep things moving. It also flushes toxins out of his system.”

This woman was beginning to scare Paul. People, especially children, can become dependant on them and that can cause more problems. “How often is this needed?”

“Not all that often,” she replied as she started reaching for the bag of medicine.

Paul felt she was being evasive but didn’t want to push the issue. Paul was busy writing the names of the medication Matt was taking on a legal pad. Ms. Davis stood and gathered up the pills. “I need to be with my son.”

******

I put a pair of rubber gloves on and picked the KY back up. “I’m going to gently insert my little finger into your bottom Matt. I need to feel how much bowel is in there.”

Matt rolled onto his side and I slid my finger in. I got about ¾ of an inch into his rectum and sure enough, I felt bowel. My next concern was that he wasn’t impacted. I removed my finger and cleaned his rectum just as Paul and Matt’s mother returned. “How are you feeling Matt?”

I looked at Paul and he motioned for me to step outside. “I have some answers Mrs. Davis. I’ll be right back.”

I stepped out of the room and closed the door. Paul shoved the pad at me with a distressed look on his face. “Miguel, something definitely isn’t right here. The stuff this kid is on could plug a tank if he’s taking it all the time.”

I looked at the list and I couldn’t believe my eyes. “One doctor has prescribed all this?”

Paul shook his head. “That’s just it pal, they’re all written by different doctors, some of which are on the peninsula.”

I knew of people who doctor shopped but they were usually looking for narcotics. A mother who doctor shopped for her child was either very desperate trying to find a reason for her child’s illness or was just plain crazy. I just have to figure out which. “I did a rectal on Matt and he is really full. I just hope he’s not impacted.”

“Miguel, she told me she’s given Matt enemas in the past. She said they weren’t that frequent so maybe 1 will get him cleaned out. My next question is this. Do we let her leave with the child? I would really like to admit him for observation after he’s cleaned out and see how he does.”

Paul had a point. I didn’t want to think of the possibility of a mother hurting her child but it’s been known to happen. If this was the case here, we would need to have him in a room with a hidden video camera so we could record it. “Can you see if there is a room with hidden closed circuit television available?”

Paul went to take care of this while I went back in with Matt and his mother. “All right now. The first thing we’re going to need to do is get Matt cleaned out.”

Ms. Davis interrupted me at that point. “If that’s the problem Doctor, I can take him home and do that. It’s almost lunch time and he needs his special diet.”

This took me by surprise. “First things first ma’am. His abdomen is hard as a rock and my concern is that he’s not impacted. We’ll get him cleaned out here and then I want to observe him to make sure he’s not in pain. If that starts, it’s a good sign he is impacted and then he will need surgery.”

I could see the look on his mother’s face change when I mentioned the possibility of surgery. “Um are you sure Doctor? I mean that’s a drastic step, don’t you think?”

I shook my head and was about to speak when she interrupted me again. “I think I’m going to take him home. I can better take care of him.”

I didn’t want to push the issue with her nor did I want to have to involve Children’s Services at this point in time because I didn’t really have proof he was abused. I needed to know just what the hell was going on. I was about to speak when Matt rolled onto his side into a fetal position and moaned loudly in pain. “I’m sorry Ms. Davis but I can’t in good conscience allow you to take him home in this condition.”

She went to Matt’s side and rubbed his head. “I guess you’re right doctor. Please take care of him.”

To be continued...

Posted: 07/04/08