I totally have a soft spot for children who read. When I see children reading in the Emergency department rooms while waiting to be seen, I get so excited. I know reading helps kids build vocabulary and makes them smarter so I encourage them. I ask what their book is about and get a little detail of what they like to read. That usually makes my day, or at least ‘that moment of my day.’
I walked in to see the 10-year-old patient who had come in with his mother to be examined for a ‘cut’ to his finger. He was sitting comfortably on the bed, reading a book. Even though the television was playing a children’s movie, he wasn’t distracted by that. He didn’t seem to be in pain too. I concluded that either his book was interesting enough to be a good distraction for him or his injury was not that significant or he was straight up strong.
I introduced myself. His mother who was also reading a book, greeted me with a smile. The next statement I heard was “where are you from?”. I wasn’t surprised, I get that all the time. Although I’m not always sure if the question is asked because I’m black or because I have an accent
“I’m Nigerian” I replied, as i walked towards her son to check his cut (laceration). She responded back with a huge smile on her face, “happy to see a fellow West-African, we are from Senegal.” Nice to meet you!
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“Nice to meet you too! So, what brings you in today?” I asked, looking back and forth between my patient, Todd and his mother. I already knew from his triage note said he has a huge laceration, but from my experience, patient complaints can change from time to time and triage notes change too, so I always ask again.
I turned to Todd, to give me the details. He is 10 and I usually give kids a chance to tell their story. He answered “I was using a knife and I accidentally cut myself.” He had a long cut on his right thumb that extended from the tip of his finger, through the side of his nail (medial cuticle) about midway to the side of his thumb. He was lucky to have missed his nail
As a visual person, I always try to imagine the way injuries happen. Not only does it help me know how to advise families as regards preventing further injury but also helps me tell if a child is being abused; and in child abuse, the history doesn’t correlate with the injury pattern.
While examining and exploring his cut, I jokingly asked, “what were you cooking?” His mother yelled out ‘ he wasn’t cooking.” The room was silent for a few seconds and then she continued “tell the doctor you were trying to sharpen a pencil with a knife. A knife!! They have sharpeners all over the house and he chooses to use a knife. Who does that?”
Thinking and talking out loudly, I said “I wonder where he saw that. Kids usually act based on what they have seen before.” I hardly completed my thoughts and statement when Todd yelled back. “You mom! I saw you do the same thing last week, how was I to know I could get a cut.”
My jaw dropped as I looked at his mother. Defensively she said, “I did it once last week when I couldn’t find any of the sharpeners at home and I was in a hurry. I didn’t even see him looking.”
Well! my assessment here is done. His nail is pretty intact and wasn’t affected. All he needs is a small medication through a needle to make his finger numb and we will wash the finger really well and fix it up with some sutures. Our amazing suture technicians will be right back to close his wound and get him all set to go.
“No judgments here”, i said. They do what they see.
Kids are really smart, they learn from us, everyone and everything else around them.
So be careful what they get exposed to.
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