Wednesday, July 15, 2009

Eva...My last patient essay, now 2 months old

Midnight, the melancholic mood of the evening sets in. And I get called to her room, a wild little thing, thrashing like an animal. Hair unruly and tangled, face full of bruises and dirt. Feet and legs scratched and burned, a baby cub that ventured out of the lair too soon and whose bravado let a creature bigger than her take over.

But despite the fight and scrappiness of this little girl, she is a scared little puppy, and I know she didn’t try to take anything bigger than her on. I feel fatalistic, that this situation she has been raised in has turned her into a little animal, and wonder if she can ever really recover. Maybe in the future she can regain a semblance of normalcy, and perhaps even appear normal to the outside world, until some part of that inner animal, that was taught to fight at early age kicks in…I wonder how much of that you can undo.

The next morning, I go to her room. Her covered crib, it strikes me how much those cribs look like enclosed cages, kennels, when you have a child you are trying to control. I approach slowly, just like I would a scared animal. I speak to her softly from outside her cage, offer a hand through the bars and pat her head a little to show her that I am not going to hurt her. And as she acclimates to my presence in the room, I open her little cage. Before I can even get the bars all the way down, she outstretches her arms and tumbles onto me, her spindly arms and legs wrapping around me and holding tight. Wanting to be protected, wanting to be safe in someone’s arms, burying her little face with it’s wild hair into my shoulder. She even throws her wounded, infected, burned foot around me, without carefulness to avoid touching the tender parts. And I realize that despite the animal instinct in this child, she is still love, she is still wanting that basic need met. And like an animal fighting for survival despite a deadly injury, her instinct ignores the pain so that she can keep going to reach survival. Where she can be taken care of and someone else can take over. I walk around with her a little bit to give her a break from her crib. To my surprise she can talk, and can point things out to me. She takes my stethoscope off and puts it in her ears, putting then the bell to her own heart to listen.

Because I am not allowed to ignore the fact that I still have work to do, I sit her in my lap while I am making calls and writing notes. And within minutes of sitting, she is thrashing, screaming, and I don’t understand…Until I have to put her back in the crib, and she is hard to console. Today it was the same pattern.

And hours later, it strikes me. She latches her body around me, hoping I am going to be her vehicle, transport out…To survival…And like a little refugee, she is fighting, screaming, everything in her is trying to get that last seat on the convoy going out. Like it is her last chance.

This breaks my heart and brings tears to my eyes as I realize what she is trying to do. That at 19 months her instinct for survival is so strong, and she is so smart and intuitive, so resourceful, trying to use everything she can to escape this mess. And again I feel fatalistic, because I know that chances are that she is not going to have a happy ending. The goal of the foster system is to reunite children with their families and unless something drastic happens, she will likely be back in her mother’s house.

Despite my deep sadness about what this girl’s life is and what it will bring, and what she has already overcome, I see some beauty in her spirit. In who she is, and who this has already made her. And I wonder, how can I see so much beauty in the “human spirit” of another, when I am so apt to allow my own spirit to give up?

No comments: