Toads-in-the-Hole

One afternoon when I was working in the emergency room as a third year medical student, a little family checked into our facility. The group consisted of a woman in her early thirties, a guy in his late thirties, and an elementary-school-age girl, who was in tears. This was during the summer, and everyone was dressed for fun at the waterfront.
"Burned by a barbecue?" I wondered to myself. We'd already had a kid with that earlier in the day. "Or maybe a bee sting."

The nurse approached with the girl's chart. I raised my eyebrows enquiringly. She said, with a dismissive toss of her head, "He ran over her with his boat."

The story I was given was something like the following. The guy was not the father. Rather, he was a newish boyfriend to the mother, and, as a way to get to know the daughter, took them out on the lake with his speedboat. Hooray for mom's cool boyfriend!

Unfortunately, the adults had allowed the little girl crawl out on the prow of the boat, and she'd fallen forward off the front of it and been run over. She was a good swimmer and had immediately bobbed, spluttering and crying, to the surface and been easily picked up. Still, they thought it would be best to bring her in to get checked.

I felt bad for everyone involved, but especially for the guy. He just didn't know how to act in the situation. I could clearly see his inner debate. Should he be really apologetic? Or actively comforting the still-sobbing child (who, it seemed to me, was putting a little effort into her sobs)? Or trying to jolly everyone through the situation? The mom just looked stricken.

I checked the girl over, and she seemed okay, just a little battered. The ER attending physician ordered X-rays. As we looked at them together I focused on the bones of her sinuses (And this is how I always am looking at X-rays: "Does that bit look funny? Or maybe that bit? Shoot, the whole thing's just a bunch of gray smudges."). The attending pointed out the silhouette of the little girl's face, "Look at her lower lip sticking out." (My mind raced. Was a protuberant lower lip a sign for something? Henoch-Schonline purpura? Kawasaki disease?) I wisely kept silent, so he continued, "She's totally pouting!" And then he pretended to be her, "Aw man, I got run over by a boat!" I remember this vividly because it was my first day working with him. He is a very good doctor.

When we went back to the room to tell everyone that the patient's X-ray looked fine, there was a cop there. Turns out it's against the law to let a child ride on the prow of a speedboat, and one of the nurses knew this and had called the police. (On the few occasions when the police were called to the ER, it was always the nurses who called them. I'm not saying this to be critical. It just seemed like that was part of their job: taking vitals, delivering medicine and bandages, and basic jurisprudence.)

The cop was very relaxed, smiling at the guy's painfully nervous jokes. The little girl had stopped sobbing and was staring at the cop open-mouthed. The mom still looked stricken. She didn't want to press charges. The cop nodded at her, but didn't seem to see her point (and I realize now that he was probably thinking she was just as exposed legally as the guy). After hearing from us, the cop told the group that they could go, and that he'd follow up with them later. I watched them leave, the mom and daughter clinging to each other, the guy walking well apart, shoulders slumped. Everyone involved was probably already thinking about exit strategies.

The guy's face flashed into my mind today as Adelaide and I hurtled over the snow ramp someone had built on our nearby sledding hill. She was sitting in front of me, well-secured by my legs on our purple plastic toboggan. I hadn't meant to go over the ramp, and had done my best to actively steer away from it. Our toboggan doesn't really steer, however, and as we descended the ramp seemed to pull us in. Going over it quickly began to feel inevitable. We were airborne for almost a second, which was plenty of time for me to wonder if we'd land okay, and, if we didn't land okay, would it be like the time that guy ran over the little girl with his speedboat. He, too, was just trying to show a little girl a good time and maybe went a little... overboard.

We landed with a bone-jarring thump that forced the air out of my lungs with a "Hoo!" As we skidded across the ice at the bottom of the hill I caught my breath and said, "You okay, Lady?" She didn't say anything for a second, and I became even more nervous. Then I realized she didn't reply because she was shaking with silent laughter. "Whoo-hoo, Papa!" she yelled, then laughed and laughed as we slid to a halt. "Let's go again!" she said, so we did, a dozen more times.

I never want to have to take Adelaide to the ER because she was injured while we were playing together. But, on the other hand, life is to be lived. Maybe we'll just stay away from boats. Or anyway, their prows. (photo courtesy of Sephanie Lallet)