“Beep the trauma surgeon at mass,” Molly said to Marianne, “and page the supervisor stat and let her know we're probably getting multiple burn victims in, please.” Then she clicked the mike. “Thanks, four-five-one. We'll be standing by for further information.”
“His wife said he forgot it,” Marianne told her with relish.
Molly spun on her, furious. “Deal with it or learn the phrase, âWould you like fries with that?'” she snapped.
Marianne's heavy-lidded green eyes flashed with petulance. “When they fire you from this job, I'll be the one laughing.”
Molly just finished the call and ran for a dose of antacid. Which was where the young nurse Nancy and Dr. Wilmington, the pediatric resident on that evening, found her three minutes later.
“She won't let me call,” Nancy protested.
Molly took a second to chug about a quart of Mylanta. The twenty-two-year-old nurse was in high dudgeon, her round, soft face taut and anxious. Behind her, the pediatric resident, a doughy, impatient woman with bad posture and coarse black hair, came to a quick halt.
“I keep telling her it doesn't make any difference,” she said, plump hands in rumpled, stained white lab coat pockets, her pasty face bored. “We've called before. Nobody does anything. I don't want to have to do all that goddamn paperwork for nothing.”
Molly capped the antacid and tucked the mini-bottle in the pocket of her own pressed maroon lab coat. “And you're talking about?”
“The little boy in room twelve,” Nancy said. “The one whose mother said he fell off the bed.”
Uh-oh, Molly thought, her stomach sliding south. Just the presenting complaint was becoming a classic symptom.
“Injuries don't match the story?” she asked.
Nancy was all but quivering, hands on tiny hips, black eyes flashing. “He has a lot of bruises,” she accused.
“He's an eight-year-old who plays soccer,” the resident retorted. “Show me a kid like that without a bruise and I'll show you a miracle.”
“He's pale.”
“He's blond.”
“The mother says the boyfriend was baby-sittingâ”
Another bell-ringer. Boyfriends were more deadly than cancer, AIDS, and un-seat-belted autos combined.
“âthe boyfriend said he didn't see what happened.
I
thinkâ”
Molly walked far enough to see through the window into room twelve, where a washed-out blond mother stood alongside the cart that held her son. Her quiet, watchful, too-still son. A good charge nurse would simply dispense advice without actually getting involved. Molly had thirty-eight patients she was responsible for right now, with another twenty waiting to be seen and at least one on the way in. Without waiting for Nancy or the resident, she pushed the door open and walked into the room.
The little boy was small for his age, all bones and big eyes. He watched Molly's approach with disinterest as the mother rocked from foot to foot.
“Who have we here?” Molly asked the little boy, all smiles.
He ducked a little. “Nobody.”
“Don't be smart, David,” his mother chastised in high anxious tones, her eyes on Molly. “You taking him to X Ray now?” she asked. “We need to get home. I need to get to work.”
Molly pulled up a chair right next to the bed so she was eye level with the boy. “No,” she said in easy, casual tones. “Nancy's still kind of in training, so I double-check her cases. Is that okay, David? Do you mind?”
David didn't so much as blink. His eyes were soft green and nearly as colorless as his hair. His skin was sallow, his arms and legs too thin, with old scabs on his elbows and a Band-Aid over his left eye. But a lot of kids were too thin. A lot sallow-looking. And David was in perfectly clean, newlooking clothes, with his hair brushed and his face scrubbed.
“You fell out of a bed, huh?” Molly asked, a hand tentatively to his knee, her voice still soft and easy. “What'd you hurt?”
“His head,” the mother quickly said. “His ribs. It was a bunkbed. He was playing, weren't you, David?”
David just watched Molly as if she were an alien. Molly saw the purpling that was beginning to rise beneath his left eye, the faint mottling on his cheek no camera would pick up. She saw the emptiness at the back of that little boy's eyes that betrayed more than every bruise she might catalog.
It was time to play The Game.
Molly wished Sasha were here. Sasha had experience. She'd seen the worst of it, like Molly. Sasha could help Molly play The Game and come up with a reasonable outcome. But Nancy wasn't seasoned enough, so Molly played The Game all by herself. She asked the single question that mattered.
Can we save him?
Not can we save him physically? In a battered child, that almost didn't matter.
Can we save his soul? Can we catch him before whatever it is that makes him human is beaten and starved out of him.
There wasn't any question in her mind that this little boy was abused. There was nothing overt. No fingerprints, bristle marks, cigarette burns. It was instinct, honed over thirty years of nursing. This kid was just too careful, too quiet, and his mother too anxious to please. A little boy who couldn't even bother to be afraid of an ED had been at this for a while.
Molly knew that if she had the time she could probably pull up records from visits to half a dozen hospitals. All for falls, sports injuries, undiagnosable pains. Each and every one of them explained away. Because somebody was hurting this little boy, and somebody else was covering it up.
But that wasn't what The Game was about. The Game was about looking past bruises and suspicions and faulty stories. It was about predicting a child's future.
“Okay, Sash,” Molly asked in her head, as if her friend were actually standing there observing David. “The Game has begun. Up or down?”
If she'd been there, Sasha would have looked. Not at the careful behavior, the nervous mother, the obvious history. Sasha would look instead
at nothing but David's eyes, because that was where the verdict lay. The predictors, the betrayers, the reflectors. The gateways to a terrifying future.
Long years ago The Game had been a desperate question, one Molly had answered much more like Nancy. Not “could” we save him, but “couldn't” we save him. If we pulled him out right now, ran far and fast with him, handed him to helpful, faithful people who could nurture him, couldn't we bring him back from the brink?
But Molly, now looking into David's flat, emotionless eyes, knew what Sasha's answer would be.
Already by the age of eight, David was a statistic waiting to happen. A spousal abuser, a felon, a serial killer. Whatever made David a human being was so lost to rage and defense and fear that the chances of digging it out were virtually nonexistent. And Molly and Nancy were too late even now to stop it. That indefinable light that illuminated a human's eyes had already winked out of David's and left nothing behind but emptiness.
“Thumbs down,” Sasha would say in her deceptively cool voice and walk away.
And Molly standing with her hand on young David's knee, agreed.
David was eight, and they were probably already too late.
So Molly checked him over with gentle hands and did her best to make him smile, at least once.
“Soccer, huh?” she asked. “I used to play soccer when I was a kid. You pretty good?”
“No.” Such a passive voice. Too colorless, as if reaction could spark retribution. Trying to be invisible so he'd be safe.
“What position do you play?”
“Forward. Sometimes.”
“Well, I'll tell you a secret. I really liked soccer. For about twenty minutes, until I realized that I had to run all the time. I hate running.”
He was sore in fifteen places and breathing fast beneath that careful blank facade. Molly wondered what he felt. Fear? Fury? Futility? Eight years old, and he probably already knew far better than Nancy how pointless all this was. Even so, Molly tweaked his nose and smiled for him.
“If you're a soccer player, you've been X-rayed before, I bet. Same thing tonight, okay?”
A nod. The tiniest flicker of reaction. For the briefest moment Molly
desperately wished she could do more. But the way the social service system was these days, more usually wasn't available to children like David.
“Will it take long?” his mother asked, almost beneath her breath.
Molly smiled for her, too, because she knew how very wary a mother like this was. “I hope not. It is busy tonight, though.”
Where David wouldn't allow emotion, the mother did. A hot flash of impatience. Resentment. “Ya know, we've been waiting here a long time,” she protested. “We need to get going. You gonna drop us in somebody else's lap now?”
Angry at Molly, because Molly was safe. “Nope,” Molly answered equably, because it didn't cost her anything. “Just X rays. See you when you get back, David.”
And then she fled the field of battle.
“Call DFS,” she told Nancy when she walked back out of the room. “I got him to wince when I palpated his legs and arms, so you might want to order limb films to check for old fractures, Dr. Wilmington. His ribs were sore, too, weren't they?”
“Jesus,” the resident bristled. “Are you kidding? That's going to keep me here another three hours, and it won't end up doing a fucking bit of good.”
Now would probably not be the time to ask the resident just why she'd chosen pediatrics if that was the way she felt. Instead, Molly shrugged. “Oh, what the hell? The streets are probably too bad to drive home right now anyway.”
The resident glared. “It's not going to make a goddamn bit of difference.”
“It probably won't,” Molly admitted, her attention now back on that little boy who didn't turn his mother's way, even though she was three feet away. “But it's not going to hurt to try.”
“It
will
make a difference,” Nancy informed Molly in arch tones. “I'll make it make a difference.”
Molly didn't say a word. She did think of all those times when she'd been Nancy's age she'd thought the same thing. She remembered hiding kids in the back rooms where parents couldn't get to them before she had a chance to save them. She remembered making call after call, hounding social workers and police and physicians, knowing perfectly well that if just
one person listened to her, if just one of them saw that small, broken, frightened child she was protecting, he'd see the light and get that baby to safety.
That had been before she'd begun playing The Game. Before she'd realized that it was harder to save one child than an entire nation with oil reserves.
And here she'd been promising Sasha she'd stay away from the kids.
Nancy spent a second staring at Molly with disillusioned eyes. Then she walked on into room twelve to fight the good fight. Left behind, Molly did her best to scrounge up enough enthusiasm to finish the shift.
“Charge nurse to the radio,” Marianne paged over the intercom. “Multiple victims en route.”
Molly trotted for the station. “Did I page the supervisor for more help yet?” she asked nobody in particular.
“You must have,” Nancy said. “Because we have three people from housekeeping here to help tech.”
A gaggle of misshapen humans huddled along the supply cart. Molly recognized one, the guy with the scar on his neck. When he flashed her the kind of hesitant smile that made her think of beaten puppies, she groaned. “This just isn't my day.”
Molly picked up the microphone to find that they were getting four victims from the house fire. She called to advise the burn unit, paged the burn docs stat, and begged for even more help. She juggled patients and soothed tempers and did her time in with one of the gangbangers she knew from previous visits and tried to supervise the housekeeping cross-trainees who were much more comfortable emptying laundry bins than doing blood pressures. And just when she thought she might just have things in hand, she walked out of a room to find Winnie Harrison standing at the X-ray view box.
Molly shuddered to a complete halt. She noticed that a goodly percent of the staff had stopped to stare, too. Everybody knew of the legendary Dr. Harrison. Few, though, had actually seen the Medical Examiner cross the sliding ED doors.
Clad in a winter white suit and heels, her hair swept back and up, her ears dangling exotic wood and brass, Winnie was a vision.
“Winnie?” Molly greeted her, hands full of charts and chest suddenly tight.
Winnie simply looked in the direction of the nurses' lounge. Dropping the charts on Marianne's desk, Molly followed her back.
One of the night nurses was sprawled on the couch snacking on a TV dinner before her shift. She took one look at the Medical Examiner and found a reason to be across the hall instead.