Sunday, February 8, 2009

A pain in the neck

It was a Tuesday evening when our son began complaining that he felt achy and feverish. He was sniffling a little and picked at his dinner. Wednesday, he had a fever and a headache and we kept him home from school. Thursday, his head hurt so much, he couldn't sit upright. His temperature was 102.7. His face was visibly swollen. His neck hurt. It looked thicker than normal and was hard for him to move. When you're dealing with fever and a stiff neck, you don't mess around. I made a doctor's appointment for that very afternoon.

The pediatrician was not reassuring. She said the boy needed blood tests immediately and we didn't have the option to send them out to a lab and wait several days. We had to get to the hospital, pronto. My son begged: Can we wait 'til tomorrow? Not a good idea. The doctor didn't think it was meningitis because our son was lucid and not nauseous, but the fact that he couldn't touch his chin to his chest was worrisome. And there were other serious possibilities which she didn't go into. We went home and walked the dog, grabbed the kid's tooth brush and some reading material, and headed for Oakland Children's Hospital.

Children's is an urban hospital. The families are poor, their lives are hard and no doubt, getting harder. A lot of the kids are brought in with minor ailments because they don't have a pediatrician and rely on medicaid. We checked in at 7pm, but by the time we were ushered into a room it was almost midnight. The young doctor on call wanted to do multiple blood tests and a spinal tap, and went to his supervisor for permission. She nixed the spinal tap: Meningitis presents with nausea and vomiting, and those symptoms were absent. One less thing to worry about.

At 1 pm, they took our son upstairs for a catscan. Then, in the absence of available rooms, they dumped him back into the examining room, where he'd have to spend the night. Yet another doctor came in to convey the results of the catscan. According to the radiologist on call, the kid had something called a retropharyngeal abscess, a rogue sore throat that develops behind the pharynx (voice box). He would have to immediately cease all eating and drinking in case he needed surgery to drain the abcess. In the mean time, they started him on an IV antibiotic. Had I not been bone tired by the time we got home, I would have googled the boy's condition, thereby preempting the possibility of getting any sleep whatsoever. It seems this infection, due to its location, can wreck ungodly havoc. Blood clots in the jugular vein. Pneumonia. Respiratory blockage. Sepsis. In short, an early appointment with one's maker.

My husband and I slept for a few hours and were back at the hospital at 10:30, only to find the poor kid still curled up on a gurney in the same examining room. The good news was, they had just asked the A team to take a second look at the cat scan films, and whoever had been on the graveyard shift had misread them. The alleged retropharyngeal abscess was just a shadow on the film. Our son had good old-fashioned blood poisoning, probably from popping his zits with dirty fingernails. He still needed two days of intravenous antibiotics before they would discharge him. On the upside, I now had a plenty of ammunition to tell him to wash his hair and stop picking his pimples.

Like all hospital experiences, this one was unpleasant. The waiting room periodically got too crowded to seat everyone. The floors and bathrooms were filthy, and there were no foot pedals for the sink, so you got to re-contaminate your newly washed hands when you turned off the faucet. And of course, it's always tough to see so many sick little ones and worried parents. My husband kept complaining that we should have gone to a nice suburban hospital, but the pediatrician had warned that our son would likely be moved and end up at Children's anyway. Besides, Children's Hospital proved to be a consciousness raising experience about American society, as illustrated by the following examples:

• We were admitted right after an African American teen whose mom wheeled him in on a gurney. He had the vacant look and curled hands that come with years of living in a vegetative state. I don't know what he was brought in for, but his mother explained to the admissions clerk that he had been like this since getting shot at age two.

• My daughter and I rode the elevator with a burly white guy and his three year old son, whose nickname appeared to be "Stud". After the man got off, we wondered whether Stud had a little sister, and what her nickname might be. We hoped it wasn't Hot Lips.

• We shared the examining room with an Asian immigrant woman and her newborn, who couldn't stop spitting up. The baby had been sick for a week, so her mom fed her a crushed adult motrin mixed in with breast milk. The vomiting was the poor child's reaction to motrin poisoning. We listened in disbelief as the doctor explained that you don't give adult medicine to infants.

• When my son finally got a room, his roommate was a 4 year old Hispanic boy on a respirator. The child had apparently been in a car accident, and hadn't been wearing a car seat. His arm was in traction, he couldn't stop crying and he was completely alone for the entire day. The nurse explained that nobody in his family could get time off work to sit with him. His mother and brother finally arrived around 6 pm.

The presidential election stimulated a lot of talk about race in America, and that's a fine thing. But while few would argue that racism in America is over, it seems to me that the overarching problem here isn't race: it's class. It's lack of opportunity that forces people to live in neighborhoods where young men work out their differences with guns, and toddlers catch the stray bullets. It's lack of education that keeps people from understanding that it's not appropriate to sexualize one's children. It's lack of medical care that forces people to improvise and give babies adult medications because they don't have insurance or a regular pediatrician. It's lack of resources that causes people to skimp on essentials like car seats for infants. And it's lack of compassion that allows employers to tell parents they can't take the day off to sit with a traumatized, injured four year old who's all alone in the hospital.

Former Presidential candidate John Edwards turned out to be a world class creep. But when it comes to his campaign theme of "The Two Americas", the guy had a point.

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