from The Patient Presents (available from The People's Press 4810 Norwood Avenue Baltomore MD 21207-6839) Community My neighbor, who keeps a little store nearby, was recently beaten and robbed of fifteen dollars by a woman needing drugs. The attacker held a toddler on her left hip and a brick in her right hand. Someone, listening, or watching, summoned the police. They took the thief away in a patrol car. The baby, sitting on the sidewalk, began to cry. My neighbor, two ribs broken, carried him inside. She found an old bottle, filled it with warm milk. She kept him six hours, until the Welfare people came. My neighbor asked me: how long does it take a broken rib to heal? Evening Hours The patient presents with a three week history of vomiting and sore throat; she is a 15 year old resident of a catholic group home; pregnancy testing is negative, throat culture results are positive for strep. The patient presents with an exacerbation of asthma; he is a 3 year old muslim male with nutritional rickets and brachial plexus palsy;* he sings the alphabet and announces, on leaving the clinic, "I a grown man." The patient presents with a three day history of clumsiness; she is a 4 year old female known to this practice since birth; on exam her smile is asymmetric; radiologic studies reveal an inoperable brainstem tumor. The patient presents for follow up examination of a gunshot wound to the left calf; he is a 13 year old male with a history of poor school attendance; on history he denies any knowledge as to the origin of his injury. The patient presents with her brothers, ages 15 months and 2 years for well child care; she is a smiling, sociable, well developed/well nourished, 5 month old female; the seventeen year old mother is expecting her fourth child in August. The patient presents with multiple healing bruises and abrasions; he is a 5 year old autistic male born to a 22 year old recovering alcoholic; the mother recently filed a recently restraining order against the father; her car windows had been smashed by a baseball bat. The patient presents with the complaint of eating from garbage cans; he is a 7 year old male with a history of bedwetting and night terrors; a notation in the chart states that he was found locked in a kitchen at age two; his parents bodies were in the next room, killed in a probable drug related dispute. The patient presents with six siblings for well child care; he is a 12 year old male resident of the Salvation Army shelter on Broad Street; he recently won state honors in the mathcounts competition. The patient presents for follow up of bilateral ear infections; she is a 2 1/2 year old female who was born at 6 months gestation, weight 22 ounces; growth and developmental parameters are appropriate for chronological age; she happily identifies a dog, two squirrels and a cat in the adjacent vacant lot. The patient presents for routine immunizations; she is a 5 year old female, second daughter and ninth of twelve children; her mother has brought me a book on Christ; she asks me to pray with them. She is my last scheduled patient. We kneel together on the linoleum. *nerve injury occurring at birth with resultant paralysis of the arm Belly I lay my face against the baby's belly. I close my eyes. She laughs. The warm brown skin calms my forehead. All stiffness melts. I smell fresh laundry and distant flowers. Tendrils twist my hair, sighing breath flows across my eyes. Everyone has gone home. I am a fallen tree trunk, bound by vines and the sweet, dark earth. . |