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...

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.”

Chapter 38

I went to Matt’s side and felt his forehead and he did feel a little warm. “Where do you hurt son?”

He managed to lie on his back and show me. “Right where it did before Doctor Sanchez.”

I didn’t want to mask any symptoms but I didn’t like seeing the child suffering. I wrote orders for an IV then gave him some Tylenol for his fever. I also had him drink a liquid that would start working from the top down. After that was done, I gave him 2mg of morphine IV for his pain. About 30 minutes later, I gave him an enema. Matt didn’t complain once during the clean out procedure. He held the enema for a full 10 minutes. Once he started evacuating, the liquid I had him drink started kicking in. The poor kid was living in the bathroom for about 45 minutes. After his last trip, I felt his abdomen and it was finally soft. “How do you feel kiddo?”

He looked up at me and gave me a weak smile. “I feel like I don’t want to see a toilet for a while. My butt hole is sore too Doctor.”

After all the bowel he passed, I could imagine it was very sore. I got some KY with Lidocaine and put some on his rectum with a cotton-tipped swab. I no sooner put the ointment on than he hopped down and went back to the toilet. His mom started to follow him until he closed the door. “I’ve made arrangements for him to be admitted so we can watch him closely.”

She shook her head. “He’s going now. What’s the problem?”

“That’s right,” I nodded saying. “And I want to make sure he keeps going. I’ve contacted the dietician and he’s on a special diet for children with allergies. He will be fine.”

I could tell she didn’t like this one bit. “But he needs HIS diet.”

I put my hand up. “Ma’am, I’ve done this for almost 20 years. I know what I’m doing.”

Matt came out of the bathroom walking gingerly then got back on his bed. “Mom, I’ve had about enough of all this. I want to know what’s going on. It’s always something with me. Now, if Dr. Sanchez can help me fine, I’m all for it.”

She hovered over him like a doting mother. “But baby, Momma knows how to take care of you. Haven’t I done it all these years?”

I heard Matt sigh at his mother’s statement. “Yes Mom, you’ve taken care of me. But I’d just like to be a normal kid like everyone else.”

Martha leaned over and kissed Matt of the cheek. “Matt baby, you’re not like everyone else. You’re special, you’re my baby boy.”

“I want to stay Mom,” Matt said rolling onto his side away from her.

Just then there was a knock on the door. Paul came in and handed me some papers. “He’s in room 216 Miguel. It’s ready now and transport is on their way.”

I walked over to Matt and he looked up at me almost pleading to me with his eyes. “We’ll get you better son.”

Matt was taken up to his room and given lunch. Dietary sent up a soft bland diet for someone with food allergies. I kept him in the hospital for 36 hours and Matt did great. He ate his meals and used the bathroom normally. He was doing well so I had no reason to keep him. The morning he was to be discharged I went in to see him. “Well sport, you look better than you did a couple of days ago. You ready to go home?”

I could tell he was ready to get out. “Yeah Dr. Sanchez, I’m more than ready to go home. Thanks for everything you did.”

I wrote the discharge orders then watched him being wheeled towards the elevator with his mother right beside him. I went back to the nurse’s station and started doing my discharge summary. “Hi Dr. Sanchez, it’s nice to get the chance to put a face with the name I’ve heard so much about.”

I looked around and there stood a young doctor still in surgical scrubs. I looked at his ID and it read Dr. Michael Carver. I’d remembered Paul telling me about a new associate he’d hired but didn’t remember his name. “Hello Dr. Carver, it’s nice to meet you too. Dr. Combs told me he had brought a new associate into the group.”

He sat down and we chatted for a few minutes then I went back to work on my notes. I saw him looking at Matt’s chart. “Dr. Sanchez, I hope you won’t think I’m being forward here but if what I’m reading here is correct, this young man will be back.”

I shuddered when I heard Dr. Carver say Matt would be back but I wondered what made him think this. “Go on Doctor and I don’t think you’re being forward at all.”

He sat there and rifled through the papers. “I was reading some of the notes Paul made and then read your exam notes. When I did my physc rotation, I read about a mother who made one of her children sick then went about curing him. She did this a number of times but it caught up to her and the child had to be hospitalized. This just reminds me of that. They call it Munchausen’s Syndrome.”

I’d read about that myself but had never actually seen a case of it. In a few instances children had actually died. “You think she’s doing this deliberately?”

He nodded his head. “Yes sir, I do. Especially when I saw the long list of medications the boy is on and no two of them are written by the same physician.”

That did disturb me as well. “I didn’t want to involve the authorities because I really didn’t have much to go on. He was kept under watch by closed circuit television while he was here but there was nothing out of the ordinary and he made a full recovery.”

Michael nodded his head. “Yes, that sometimes will happen. The parent doesn’t want to risk being caught making her child sick. Now, if the child is here long enough, they will make them sick if they think they’re getting away with it.”

God how I hope he was wrong. “I could tell by watching the tapes that she didn’t know we were watching her. This sort of thing makes me sick Doctor. I do hope you’re wrong here but I’m certainly not discounting your theory either.”

I finished my summary then accompanied Dr. Carver on his afternoon rounds. I left the hospital and went home. After sorting through the mail, I sat in my recliner and thought about what Michael had said. My thoughts where broken by the sound of the garage door closing. “Hi Daddy, we’re home.”

I met Angel at the door then helped Steven with some shopping bags. “How was your day?”

Angel headed for the bedroom and Steven just shook his head. “I got some things for the house in Durham Daddy. I think the guys will like it.”

Angel showed me an assortment of knick knacks and I hopped I wasn’t going to be the one to deliver them. I did recognize a few items she bought. “Oh Angel, where did you find these Hummel’s?”

Steven looked at me like I was a traitor. “Son, these are classic collectables. I’ve seen some of these sell for thousands of dollars. The mantel over the fireplace would be perfect for some of these Angel”

Steven rolled his eyes and Angel smiled. “I know Daddy. A few were a little expensive but when I saw them I really wanted to buy them.”

It was late and dinner hadn’t been started so I took Steven and Angel out. After we returned, they went into their room and I once again started thinking about what Michael had said earlier that day.

The next few days, I was in the OR so I was too busy to give Matt much thought. One operation was on a 6 year old girl who was in an auto accident. Her liver was lacerated and her spleen was shattered. Paul, Michael and I worked on her for over 3 hours and she left the OR in critical but stable condition. I was on call so I stayed at the hospital and slept in the on call room. The next morning, she had improved enough so I upgraded her condition to serious.

I had three more days of marathon surgeries and on the one day off I managed to take, I was called. “Miguel, this is Paul. Sorry to bother you buddy but I need you.”

I had been up for a couple hours but I had visions of just relaxing with Steven and Angel. “What is it Paul?”

There was a long silence on the phone. “I’m not sure Miguel, to be honest. He’s coming in from the beach where he collapsed.”

Paul doesn’t get concerned but I could hear it in his voice. “I’m on my way Paul. I’ll meet you in the ER.”

It took me about 15 minutes to make it to Children’s. I quickly parked then trotted to the ER. I saw Paul talking with an ER attending. “I got here as quickly as I could, what’s up?

Paul handed me the paramedic’s report. My eyes got huge when I was the patient’s name. There in bold letters was Matt Davis. I shook my head and knew this was a child who really needed our help. “Paul, I want room 216 made available ASAP.”

The attending looked at me. “Dr. Sanchez, I haven’t transferred him to surgical services.”

I glared at him. “That’s fine. I’m also a Pediatric Attending. We had him the last time he was here so I want to make sure he has a continuity of care. I also believe we’re the on call group.”

I was waiting for the nurse to being his chart back to the department. I quickly got a drink of water then I saw the nurse coming back with the chart. I met her and she turned it over. “Good luck Doctor. Her mother is something else.”

Just then I saw Matt’s mother making a bee line for his room. “Just a moment Ms. Davis, I’d like to have a word with you.”

She stopped dead in her track but began talking a mile a minute. “Doctor my son needs me. He was with friends and didn’t have HIS meals. I must be with him.”

“Your son is in good hands Ms. Davis,” I replied leading over to a chair. “Tell me what happened.”

Paul came over and quietly whispered, “216 is available any time you need it.”

I nodded my head. “Page Dr. Carver to the ER, please?”

I heard the page for Michael go out then I returned my attention back to Matt’s mother. “Well, he was out with some of his friends and then decided to stay at their place. It was late when he called so I decided to let him spend one night there. I got him home and fixed him his normal breakfast then he just collapsed.”

After hearing this, I saw Dr. Carver walk into the department. “Please wait here Ms. Davis. I want to examine Matt then order some tests.”

She started to follow. “But Doctor, he’s scared. He needs me.”

I went into his room as Michael intercepted her. “Please wait here ma’am. He’s in good hands.”

Matt was curled up in a fetal position on the gurney. I checked the IV then brushed the hair out of his eyes. When he felt me touch him, he opened his eyes. “Hi Doc. I know you didn’t plan on seeing me again.”

I smiled at him as Dr. Carver stood beside me. “Hi yourself kiddo and you’re right; I didn’t plan on seeing you again. This is Dr. Carver he’s one of my associates. We’re going to take good care of you. Now let me guess, you hurt the same place you did before?”

Matt looked up at the young doctor and smiled. “Yes sir, how’d you guess?”

I ruffled his hair then slid the sheet down a little. “Just lucky Matt. Now, tell me what happened this time to bring you back.”

Matt started telling me what had happened and while he was doing this, I started to examine him. He rolled onto his side and I was examining his rectum when an uninvited guest burst into the room. “Oh Matt, Mommy’s here now son and just what are you doing to him doctor?”

I rolled my eyes and slid my little finger out of his rectum. “I’m examining him Ms. Davis. I thought you were asked to wait outside.”

She ran around to Matt’s side and wrapped her arms around him. “My son needs me here.”

“Oh God,” Matt moaned.

“Shh now son,” she said softly but I still heard it. “Momma will help you.”

I wiped the lube off his butt and Matt rolled onto his back. “Mom, you don’t get it, do you?”

“Now Matt dear, don’t be difficult,” she said. “I know you don’t feel well.”

Matt leaned on his elbows. “I’m almost 12 years old. I don’t need you in with me every time I have to see a doctor.”

“Momma needs to be sure you’re not being hurt.”

I could tell Matt was about to lose it. “I’m a big boy! I have a mouth and I know how to talk. If someone is hurting me and can say OW. Now read my lips; GET OUT!”

I got that loud and clear. “Dr. . . . .”

“Matthew Davis don’t you talk to me like that.”

He stared back at his mother. “Mom, I said get out. I don’t need you in here while Dr. Sanchez is examining me. I’m almost 12 years old.”

“Ms. Davis, you’re son has made a very reasonable request.”

All of a sudden her attitude changed. “Very well Matthew, I’ll be waiting outside.”

She stormed out of the room slamming the door behind her. Dr. Carver’s eyebrows raised as the door slammed. “Does she act like that often son?”

Matt sighed and looked down. “Sometimes she does. It’s as if she has to have HER way all the time. A few days after I was home, I needed an enema again. I remember how you did it Dr. Sanchez and yours didn’t hurt. I can’t say that about hers. I thought I was gonna explode. When I said something about it, she said SHE knows better.”

After I finished talking with and examining Matt, I started writing my orders. I ordered a full blood work up, got him his liquid to drink then ordered an enema. “Once I get you cleaned out son, I’m admitting you again.”

When I told him that, it was as if I’d lifted a load off his back. “Thanks Doctor. After I’m feeling a little better, maybe you and I can talk a little.”

The nurse came in with Matt’s liquid and he quickly drank that right down after making a few faces. “I’d like that Matt. One of the problems I see is being able to do it without your mother around.”

Matt made another face. “Ugh that stuff tastes gross! As for my mother, don’t worry about her. I’ll just tell her to get out so we can talk. She’s really starting to get on my nerves.”

Just then the door opened and she came back in all smiles and being quite contrite. “I’m sorry for my outburst before. I’m just so worried about him Doctors. Dr. Sanchez, you have children so you of all people should understand what I’m going through.”

The honey was dripping off her so thick I was starting to get sick. “I do understand ma’am but we do know what we’re doing here. Now, I’m going to get Matt cleaned out then he’s being admitted.”

I could tell she wasn’t pleased but she didn’t start yelling. “Doctor, can Matt have his own fruit? We use nothing but organic fruits and vegetables at our house.”

I thought about that for a moment then looked over to Dr. Carver. I really didn’t see a problem with that request. “That’s fine Ms. Davis. Just check it in with the nurses. They’ll bag it and put his name on it so it won’t get mixed up with the other snacks.”

Matt was cleaned out then taken up to room 216. The nurses remembered him from the last time. They had to have one nurse constantly watch the closed circuit television 24 hours a day so we would know what was going on.

Over the next 2 days, Matt was back to his old self again. I was really at a loss here and if Dr. Carver was right about Ms. Davis, I’d yet to see any unusual behavior in her.

On the third day, she brought in a half dozen oranges in a plastic bag with his name on them and handed them to his nurse. “Dr. Sanchez said it would be alright is he had these. These are organic oranges. We only use organic fruits and vegetables in our house.”

The nurse took them and put them in the fridge. “I’ve seen the order written by Dr. Sanchez. Just have him ring when he wants one and we’ll bring it to him.”

Ms. Davis nodded her head. “I see he’s just had lunch, might he have one now for desert?”

The nurse didn’t see a problem with that so he handed her one of the oranges. She brought it into his room then peeled it for him. The nurse went over and watched everything on the TV. Matt ate the orange then she poured him a glass of water from the pitcher. She’d used all that was in there then went into the bathroom to refill it. A few minutes later, she returned and poured him another glass and Matt quickly gulped it down.

I was busy in the OR and only got to spend a few minutes with him at a time. I had just come up to the floor when I saw his nurse hand her an orange. I followed the nurse to the CCTV and watched as she carefully peeled it. Matt quickly ate it then drank several glasses of water. “Is this how she is with him?”

His nurse nodded her head. “Yes Doctor. No one has seen anything out of the ordinary. Matt loves his fruit. He’s eating at least 6 oranges a day.”

I guess with him being on that diet, having something special was really a treat. I decided to try putting him on modified solid foods to see what happened. I had about 90 minutes before I was due back in the OR so I figured this would be a good time to try and talk with Matt alone. I wrote the order for the change in diet then went into his room. “Hi Matt, how are you feeling today?”

He got a smile from ear to ear when I walked in. “Hi Doc, I’m going great. When do you think I can get out of here?”

I still had his chart. I wanted to see more of the lab results and so far, nothing really jumped out at me so I was still no better in coming up with a diagnosis than I was before. “I have a couple of more tests to run but hopefully that will tell us something. I was wondering if we could talk.”

Matt looked over at his mother then back to me. “Um, sure doc. Mom, would you mind giving us some privacy?”

She smiled and tried to inject herself. “On Matt, you two can talk around me. You know we have no secrets from each other.”

Matt’s eyes squinted. “Mother, I did ask politely.”

I heard her sigh because he was defeated. “Very well Matthew. I’ll just run home and get you some more oranges since you’ve already eaten the 6 I brought you.”

Matt smiled when she said that. “Thanks Mom. I love them and it is better than the hospital food.”

I knew he was right. That diet was pureed nothing. No taste or no flavor but it was nutritional. After she left the room, I sat down beside him. “So how are you really doing kiddo?”

“No too bad Doc,” he replied looking forlorn. “I just don’t have any privacy. I can’t even use the bathroom by myself.”

Can’t you close the door?”

Matt nodded his head. “I do but after a couple of minutes, she’s knocking on it asking if I’m alright. I can’t have some ME time.”

I was confused here. “ME time son?”

“Um yeah Doc,” he replied turning a little red. “You know, there are some things a guy just has to do.”

Suddenly I got the picture. “Oh, you mean time to masturbate?”

Matt pulled at the covers and got bright red. “Um well yeah Doc. You were my age once. This thing has a mind of it’s own at times.”

I saw him reach under the covers and pull on it. “Is something wrong son?”

He was about to lower the covers then I remembered the CCTV. “Um just a minute Matt, I’ll be right back.”

I went to the CCTV room and had them turn it off so Matt’s privacy would not be compromised while I was there. I quickly returned then said, “OK, now what were you going to show me?”

He shed the covers and showed me his uncut tool. “It really itches too Doc.”

I looked at it carefully retracting the foreskin. “I see you’re not circumcised. You need to wash it a little better. This dirt and stuff is what’s causing it to itch.”

“I’ve tried telling her that,” Matt said getting angry. “Every time I get ready to pull the skin back she yells her head off saying I’m playing with it and it’s nasty. Once she caught me jacking off and called me a fag.”

Matt was getting upset now and about to cry. I sat beside him on the bed and drew him into my arms. He almost threw himself at me when I opened my arms out to him. “I’ll have a talk with her about that son.”

Matt cried for a good 10 minutes. Maybe what Michael was saying about his mother was true. I would keep him here until she showed her hand or I had no choice but to discharge him. “Doc, am I really bad for jacking off?”

He still had his head buried against my chest. “No son, you’re not. There is absolutely nothing wrong with masturbating.”

I was about to continue when Matt’s mother walked in. She saw Matt crying and ran over to him. “What’s wrong baby, tell momma.”

I picked the phone up and called the nurses station. I let them know I was finished and to resume monitoring the room. “Mom, I was talking to Dr. Sanchez. Yes, I cried but I feel better about it and NO, I’m not telling you what it was about. It was between him and me.”

I looked at his mother and I could tell she was pissed Matt hadn’t told her what we’d talked about. “By the way Ms. Davis, Matt did inform me that you’re not allowing him to properly clean himself.”

“Excuse me Doctor?” she replied in a huff.

I nodded my head. “That’s correct ma’am, he told me he is not permitted to properly wash his genitals.”

“That’s disgusting,” she huffed. “I’m his mother,”

I interrupted her when she started her little tirade. “Ms. Davis, if not cleaned properly an infection can and in almost all cases, will occur. It is very painful and the patient might even require a circumcision.”

“Mom, I do know how to take care of myself and starting right now, that’s what I intend on doing,” Matt jumped in.

All of a sudden her attitude changed. “Yes of course Matthew, you’re quite right. You are old enough to take proper care of your body.”

I had lost track of the time and I heard my name paged over the loudspeaker. I called the operator and told her I was on my way. After surgery I stopped at the nurse’s station and asked how Matt was doing. The nurses informed me that he’d had 3 more oranges and consumed several pitchers of water. I checked the CCTV and Matt appeared to be taking a little nap. I wrote and order for an abdominal CT with contrast then headed home.

I was on call that night and I had a couple of calls about my surgical patients. I checked with Matt’s nurse before turning in for the night and everything was fine. About 3 in the morning I was awakened by the phone. “Dr. Sanchez, Matt’s curled up in severe pain.”

To be continued...

Posted: 07/04/08