Idiocy

There he was, a tiny thing strapped onto a backboard four times his length, his head strapped securely and held in place with foam blocks. An endotracheal tube was taped to his blood-caked lips. His eyes fluttered every now and then as if he was trying to open them. Dried blood covered his face, trunk, arms, legs, every part of his baby skin.

As we worked on him, there was a grim air in the trauma bay - but then his eyes won their battle and opened, and large blue pupils looked at us. I imagined they conveyed bewilderness, especially as I grabbed the ophthalmoscope and shone a bright light into each of his eyes. They constricted. Sluggish, but they constricted. Maybe his brain had been spared after all.

The nurses started IVs on him, the pediatric surgeon's hands ran over his little body - his chest, pudgy little belly, his hips, legs. Then he started to rouse, this little boy - his hands clutched at the air, he kicked away the IV a nurse was trying to start in his foot. Good. Very good - he could move all his limbs. His spinal cord was likely intact. Was he starting to come around? He had been getting sleepier and sleepier on his way to us, the ambulance crew had said. But now he was waking up. A good sign.

"Sedate him," the pediatric intensivist said. "We need him to be still for the CT scan."

So we sedated him. Now that we knew he could move his limbs, open his eyes, we had to protect him by knocking him out. Otherwise, we would never be able to get him into the scanner, and he might even dislodge some of the equipment attached to his tiny body, some of which was keeping him safe.

I provided the in-line immobilisation of his cervical spine while the surgical resident looked in his ears. No fluid, no blood. A large piece of gauze covered his forehead and the resident removed it. A gash across his forehead running along the entire length from temple to temple to temple. Underneath the flap of skin, bone. He had almost been scalped. This was the reason he was covered in blood, then. But the bleeding had now been staunched.

He went to the CT scanner, a respiratory technician bagging him all the way. They CT'ed his entire little body - head, spine, thorax, abdomen, pelvis - all of it. Miracle of miracles - nothing terrible showing up. Imagine that - he might now live with just a big scar across his forehead.

That is, of course, provided his idiotic relatives didn't kill him first.

It had been a sunny day - the long weekend, Victoria Day. A relative of his - perhaps fuelled by too much booze - had decided to take him for a ride, complete without helmet. And it wasn't a ride on a bicycle, oh no - this relative had decided to take this three year old on an ATV. Not only that, this had occurred without his mother's knowledge.

So one moment, someone else was looking after the baby.

And then the next, a blood-soaked little child is returned.

He was lucky to have survived the accident, this boy. He was very, very fortunate. He may never again in his life be more lucky than today. I can only hope that he is never ever unlucky enough again to be exposed to idiocy on the magnitude of that which occured today.

Today was my first day of pediatric emergency medicine, and I learned something that is quite sad and yet quite true. Pediatrics is the world in which the most vulnerable people are sometimes called upon to pay for the stupidity, sins and crimes of others.

I can only hope that today, this little boy's family and his relative learned a lesson. Today, he escaped the consequences of another's unthinking actions. Life may not always be so forgiving.