Hearts & hockey sticks
The phone call came into the desk from the en-route ambulance. A violent offender was coming to the pediatric emergency room.
The terse report was he had assaulted someone at his school. He was unstable, possibly injured, broken glass on scene. He would be placed in the padded room — we might need to use the Haldol.
“Be careful,” my mentor told me. “Get the nurse to show you the panic button, make sure you keep your distance during the assessment. I’m very busy, I’ll get to it as soon as I can, but it could be a while.” Psych cases often languished in busy Canadian ERs because they were triaged as less life-threatening than breathing difficulties or major traumas.
My attending of the day was a grizzled veteran of the pediatric hospital. Famous for something or another, with neat iron-grey hair and emerald scrubs that matched her eyes. Everyone bowed and scraped but I saw a kindred immediately and gave her a cheeky grin, which she grudgingly returned. I’d won her over early with some crisp, clean, assessments. Now, having proven my value, she was using me to lighten her workload. A true compliment from a staffer.
“Will do,” I said heading off immediately with a secret curiosity. I hadn’t worked with dangerous teens before.
I made friends with the appropriately burly psych nurse and entered the room cautiously.
The room was empty except for an industrial tan pleather couch with two occupants and a TV bolted too high on the wall to reach. The tableau was comically exaggerated. On the couch nearest me was the school principal, a middle-aged man with a portly belly and a carefully nondescript short-sleeved shirt. His arms were folded over his injured pride as he stared at the wall in grim masculine resolution, studiously ignoring his companion.
On the other side of the couch was my juvenile offender. Somehow unselfconsciously arrayed in mimicry of the exact same posture. Crossed arms and jutting jaw he also stared at the blank white wall in sullen silence. His legs stuck straight out from the couch, barely reaching the edge. A tiny child of no more than six years with the black spiky hair of an Indigenous youth.
I took one look at the two of them, their mirrored disgust. No reconciliations were forthcoming here.
“I’m separating the two of you,” I said with a crisp authority I really had no right to assume. I was only a visiting medical student, on my first pediatric emergency rotation. But they didn’t know that.
I asked the nurse to turn the television on for the boy and the principal followed me out, relieved to be able to recount his tale. Once ensconced in an interview room he waxed eloquent. The boy was violent, aggressive, and shouldn’t be in his school. He displayed a red mark on his arm, perhaps a small bruise, did we treat adults as well? He had been injured!
First, his duty, for the institutional record. I should take this down. Children ‘like that’ didn’t belong in the affluent and trendy neighborhood on the north end of the city, surely everyone knew. The boy should be attending school in the impoverished east-side suburb where he would be more comfortable.
The subtext was clear even to me, visiting from another city. The lower-income school had more Indigenous resources? I inquired casually…
Of course they did. They took care of foster children, and… problems. Well, they had security at least. The boy had assaulted him! The principal! All he had done was try to sit him down in the chair and the child had bitten him! Bitten him and hid under the desk. He was clearly violent. He needed to be medicated, probably… sedated, perhaps… something. Something was definitely needed.
The boy had arms the size of matchsticks I thought, while I estimated the principal was at least 250 pounds.
I remembered my mentor and her reputation held in my hands, my assumed mantle of authority, and studiously did not laugh.
Instead, I projected a cloud of sympathy. I’d learned I got better histories if people thought I agreed with them and back then I didn’t see any ethical dilemmas with it. We were both professionals, no? I just needed the facts, I’m sure we can help, I murmured, in my best soothing tone.
And the facts were these. Somehow simultaneously telling two different stories to the two of us. The story pouring from his lips evoked nearly opposite responses in my heart and his.
The boy had been raised in a closet back East. His stepfather had beat him often. But the authorities kept returning him to his mother, despite significant substance use, perhaps prostitution. Because he was raised in a closet he had never learned to speak. (“Children who can’t speak shouldn’t be at our school…”) Eventually, the stepfather had kicked the boy’s ribs through his liver, and because he nearly bled to death in the hospital ICU he had been sent to this city finally, to live with his father. His father had been trying to retrieve him, unsuccessfully, for several years.
I was unsurprised at this. I knew much about Aboriginal rights from three years working on an Indigenous wildfire crew. Twenty men, from twenty different reserves across the province, and all the stories of their wives, daughters, grandmothers, and institutionalized children woven in the air around the fire at night. An oral history of anguish and dispossession, and the living evidence of continued stewardship of the land.
A brotherhood that was somehow flexible enough to include me in its embered embrace.
The boy’s father was probably just unable to advocate for himself in the white man’s system like so many Indigenous parents of his generation. Now, unexpectedly a single-parent household he was working on a large construction project in the wealthy part of town, so the boy had been enrolled in the nearby school mid-year.
The wealthy school run by the man in front of me. (“I tried, I really did, I wanted to help…”) But the boy didn’t understand a word anyone was saying to him. He couldn’t speak at all. There were speech therapists, but the wait-list was too long. (“What are we supposed to do with him in the meantime I ask you…”) Indignation. Frustration. Spread hands.
So today’s story unfolded. His first week this. The boy hadn’t sat still in class, didn’t understand the teacher, and had been sent to the principal’s office. But when the principal tried to place him in the chair, grabbing both his arms firmly, the boy had erupted. (“He broke my photographs! The window! He bit me! And screamed! He is uncontrolled with rage!”)
Now the man in front of me shook with outrage — perhaps adrenaline. He must protect himself. His staff. His office. Surely this boy was someone else’s problem. Now it would be seen to. It had been documented!
Yes, I saw, he was my problem.
This boy was now my problem.
That’s the problem with being psychic. You see things sometimes and you know. Because you see them they are yours. And I saw the boy’s past clearly. So he was my problem.
His probable future was grim.
All of history and the system, his father’s poverty, the angry principal, his culture’s colonization with white-man’s addictions and white-man’s gangs, his own neurology and trauma… all arrayed against him at this point. A tiny scarred child in a web too massive for him to perhaps ever comprehend.
But I saw it. Psi unfolds in the mind like that, an aerial pattern, views across lifetimes, cultures, archetypes, the path souls tread.
Fate is a spider woman, weaving a delicate pattern. But she can be outmaneuvered.
“It sounds like the problem is he can’t speak,” I said hacking at the nearest strand of the web. We would start with the proper naming of things. The problem was not the boy himself.
Hesitation. “Well… yes.” Agreed the principal cautiously, “That’s part of it.”
“Do you think he thought you were going to hit him when you grabbed him?” I asked hacking at the next. “Seeing as how the last time a man grabbed him he almost died?”
“I would never!”
“Of course not. But do you think he might have panicked?”
“Well, he can’t do that again.”
“Of course not. So a speech therapist then?”
“You’ll never get it approved. They have a waitlist a mile long. It’s at least nine months.”
“But if I did?”
“If you did. I would consider it.” the man was suddenly somewhat mollified. Musing. Perhaps he wasn’t the hero of the story as he’d thought. I pressed the thought into his mind telepathically. A suggestion. Perhaps he was the ogre… Did he really want to be an ogre? Or did he want to be a champion?
A pause. Some surprise… his, not mine. We were still on the same team, but the goal had somehow unexpectedly shifted.
“Okay. Let me see what I can do for you.” I said, as though it had been his plan, then left the room, my task clear.
Now the boy. Would he join us?
The boy was my Helen Keller. I saw with the sight that doesn’t see. Before the water. Before the understanding. Locked in a world of screaming. A closed system.
Consent is everything in my world, in the apriori world I inhabit, before I inhabit a body, or the role of a medical student. It’s a free-will world, and my superpowers are constrained by your freedom. The boys as well. The principal and my mentor. I can only cut the strands of the web that I am allowed to.
The boy might be small, but he was alive, he must also agree.
How did I speak to a child who can’t speak? Could the child even be reached?
Some feral children are never reachable. The psychology textbooks are discouraging. Too much isolation, too much trauma, at the wrong developmental years, and human brains never develop properly. The wrong stimulus. They are forever cognitively bound, cannot be trusted. Must be institutionalized.
I saw the problem, but was there actually a solution?
I went back to the room. The nurse had turned the television to a hockey game. The boy was rapt. Riveted. Good, he could pay attention to something. I went into the room, but he didn’t even look at me. Refused to look away from the screen. No interaction whatsoever.
Hmmm. I remembered this from my childhood. Growing up off the grid we didn’t have television. When we went to our friend’s houses to play, we were truly hypnotized by the moving pictures — far more than our peers. Babysat by screens from a young age they could dip into and out of the digital streams, but for us, it was a cognitive tar-pit. One stray gaze and we were glued. Our friends said we wanted to watch the TV more than play with them — and they were right.
He acted like he hadn’t seen a TV before.
But I also sensed he didn’t trust me. He was huddled on the couch and I caught him watching me carefully from my peripheral vision. I reached out and read his emotions. He was still very consciously angry, indignant from the day. And I was looming over him with a clipboard.
But it wasn’t just his conscious mood that was the problem. His subconscious was much older than a child’s. A silent rage emanated around his baby body. Very red. Very old, growing in the dark in the closet over the years. Reinforced with hunger and terror. Defensive walls of molten metal.
I was the enemy, and he had an already-developed warrior’s soul.
I sat on the floor and tried waiting for his attention but he didn’t falter. Fifteen minutes is a long time for a child of that age to do anything, but he sat as still as a baby fawn in the grass. Curled and silent.
Suddenly inspiration struck. I stood and left.
Back in the pit, the central command station the nurses swarmed over a trauma in the bay. Tubes and IVs. My mentor’s jewel tones were easy to spot, she stood straight and petite barking commands in a deceptively calm voice. She was a serene as the bleeding child on the table in front of her, and the flat-lined monitor overhead. Meantime her junior colleagues and my scurrying peers manned the other eight exam rooms, and the TV overhead showed a croup-season waiting room list a mile long. My boy wasn’t even on the radar and the last thing my mentor needed was for me to investigate a bunch of croup cases to add to her caseload. I was safe to pursue my own illogical path.
I scoured the desks irritating the veteran medical receptionist. Finally, I had my prize, two plastic cups, a black felt-tipped marker, and a blank piece of paper.
Returning to the relative solace of the observation room I dropped my clipboard on the floor and started cutting the paper by folding it, soaking it in spit, and tearing it into rectangular strips. The boy’s stoicism began to crack as I ignored him. He craned his skinny neck.
I made a very small, spit-soaked disc, and colored it carefully black. Then I made two artfully folded hockey sticks and gave them racing stripes. The boy’s eyes gleamed. I felt his attention on the psi channel. He was watching me now, and only pretending to watch the TV.
Then I began to score petite, paper goals against myself into the plastic cups, winning by a mile. After establishing my clear dominance, I was definitely winning, with no goalie to defend the plastic cup. Finally, I looked up, and off-handedly offered the boy a hockey stick.
His future was suspended in the air in front of him, in the form of a slender paper hook, trailing gold dust to my second sight. (Sometimes I do that if I’m doing something important.)
He made eye contact for the first time. And took the stick with alacrity. I had myself a game. The iron door in his psyche opened.
I had initiated the war games properly. He would engage.
We spent the next twenty minutes in a hot and furious tourney. I lost badly. I was delighted. He began spewing war cries on the psi channel the first time I scored a goal. When I shouted back silently, he looked up in surprise. We spoke the same language.
I looked at him with surprise as well. I hadn’t thought his intellect was developed. But his intellect was fine. His silent thoughts were incisive, observant, and fully conversant.
Sometimes this happens. Children with no verbal capacity can be quite fluent telepathically, but with no one to listen or respond they don’t know they are broadcasting. They think it’s a private channel until your thoughts join theirs in happy communion. Like two velveteen puppies in a play fight.
This child was astonishingly bright. Psychic, not just driven onto the channel from trauma and isolation. He began playing happily. Then we exchanged a smile at a missed goal. And then instantly, love. A golden, electric current shot between us.
It’s hard to describe what that means, and in this context, it will seem too easy. Too instant. Like magic.
But it is.
Real love is magic. Instant and permanent. Spit, paper, a plastic cup, then… a lifetime, the universe. He trusted me now, he couldn’t not. But everyone trusts love. It’s an open conduit.
I had expected to score a goal or two, perhaps get a read on his mind. But now I unexpectedly held his fragile, hidden, traumatized, child’s heart in my hands. Fluttering with its four delicate valves, beating butterfly wings against my mind.
That’s the hard part. Love gives you an infinitely valuable gift in an instant. And then you must bear it forever, always, a conduit to someone’s innermost being that can never be exploited or fucked up. Because you can hurt them so much more than anyone else.
Better to be an enemy, than beloved and harmful. I had opened a door I could not close.
I had his consent. The only consent that mattered. He could love, would love if someone could reach him.
Now, my battle. The real one. I retrieved the nurse and taught him how to play paper hockey. The boy let me, cautiously trusting my telepathic recommendation of a better tournament. The nurse did not disappoint, he proved surprisingly flexible toward child incarceration. (I think he was also a hockey fan and there was no game outside the room.) I left them on the floor, the nurse’s large ass and the child’s bony one raised in the air as they knelt over their respective cups.
I found my mentor. She was sitting with her feet up on my chair looking exhausted. “I hope you have a report for me,” she said.
I gave a succinct history, stating the history of extreme physical abuse, the likelihood that the child had misinterpreted the principles actions as threatening, and my observation that the child had normal intelligence but needed speech therapy.
“I think the principal would be amenable to him returning to the school with some extra funding. Can you get him a special-needs classification? A speech therapist?” I asked.
My mentor gave me a steely assessing gaze. “I can,” she said reservedly. “I can pull some strings. You get me a physical exam?”
“I wanted your permission,” I said. “Can he leave the room?”
“You can try,” she said. “But if he freaks out he goes back in the room. If he can sit still for an assessment I’ll make the call.”
I returned to the room. My charge looked up. “He’s winning.” the nurse said ruefully. I brandished cookies and water. My charge stood up, happy to see me. I showed him the door. He obediently walked out, took the food, and followed me down the hall. He trailed crumbs with miniature slapping delinquent feet.
I showed him the table and he climbed up expertly. I looked at him and he looked at me. Touch was going to be a problem. I remember an ex-boyfriend of mine who had been severely beaten in childhood. He could hardly bear to be touched — never by surprise. I was worried the boy would react violently again if I touched him.
I reached for my stethoscope. Put it on, and listened to my own heart. It beat with a steady thump. He watched me, chewing quietly. I cleaned the earpieces with an alcohol wipe. Then handed him the earphones. He listened carefully. Looking at me quizzically. I took the end from my heart and put it on his shirt. He heard his own heart and looked at me in surprise. A sudden grin flashed across his face. I gently took the earpiece back and listened to the precise thah-thump under his skinny ribs.
After that it was easy. He played with the stethoscope and let me remove his shirt for a well-child exam. Slender white scars crisscrossed his body. Little brown cigarette burns, and some jutting ribs where they had been broken. An oddly angled long bone or two. Small scars on his head. His diminutive frame was a Frankenstein map of abuse.
The heartbreaking aspect of working with abused children is how carefree they can be. They really don’t know any better. The boy was more interested in the cookies I handed him formally as we completed each stage of the exam, and using the stethoscope to listen to my lungs the way I had listened to his, than he was in his own old injuries or my nearness.
Exam completed I took him back to the nurse. He was transformed, obedient and interactive. Even a bit friendly. I was sure this wasn’t the end of his behavioral journey, but he would present well to the child psychiatric team when they arrived. My charge was going to be his own best witness now.
I found my mentor. “The child was perfectly compliant and nondisruptive and exactly mimicked the pulmonary exam on me after I performed it.,” I said. “He’s obviously quite bright and observant, see for yourself. I suspect his behavioral problems are partly due to frustration with the inability to communicate. Perhaps even giftedness…”
I didn’t know if that was exactly true, but gifted kids are known for having behavioral problems and the kid had enough labels to last a lifetime. Might as well throw a wrench into the works and make them rule out intelligence, with some carefully worded clinical notes. I didn’t mind evening the scales with some undeserved praise.
My mentor spent the obligatory fifteen minutes with my charge required by law. She carried enough clout to decide his future with a tersely-worded sentence to her colleague, but the child-psychiatrist would be the one determining care.
I hovered anxiously in the background, projecting patience when the hellfire began to light in the boy’s eyes again. “Pleeeease trust her,” I asked him on the psi channel, and he reluctantly did.
She was brisk, incisive, and thorough. Also a bit surprised.
“He does seem quite intelligent she said. And I can’t see any obvious misbehavior… Those scars are awful. I’ve seen it before though.” her eyes were swiftly sympathetic toward me. Most med students don’t handle severe child abuse well. I didn’t say anything and she went on.
“This is a complex case you know, it won’t be as simple as an ER assessment. He needs a whole team.”
“But you can jump the queue.” I said ”For the team? For speech therapy?”
“I can get him into an expedited program,” she admitted. “The ER has a fast track. We don’t use it often, it’s only valuable because it’s not used all the time…” Then looking at my hopeful face.
“Fine, fine. I’ll make the call. It doesn’t fix everything but you’ve convinced me. It’s clear you’re passionate about this.”
It was. I was.
Love always goes both ways.
On the way out of the hospital at the end of the shift, I stopped by to say goodbye. The boy’s father had arrived.
He was younger than me. A slender man. Quiet. A little hopeless, the weight of the world newly hung on his slender shoulders. I read his thoughts. It was hard for Aboriginal men to get good construction jobs, he had been fighting his own battles to get on the well-funded government project he was working on. Long hours, the junior man working harder than everyone else, microaggressions. Then a sudden child, a bewildering grade school, white-people paperwork — not easy. He was overwhelmed, sleepless nights filled with worry for the traumatized boy who arrived cut into jigsaw pieces. A family system skeletonized from urbanized Indigenous translocation, addictions, and ancestral trauma. Crowded housing.
I saw that he had showered after work and before coming to the ER. I felt a surge of tendernesss. It was something my old crewmembers would do, cleaning up for the white doctors. So they treated you better. He wore a plaid shirt, new jeans, and clean leather workboots with new laces. He looked up with silent trepidation.
I saw that the boy and he really didn’t know each other that well yet, they had only recently met after all. They sat together on the couch. But this time the boy was on his end, looking up at him starstruck. The boy was clearly capable of bonding after all. I was not the only one with a newly-opened door to his butterfly heart. The man looked at me expectantly, emanating nonverbal respect, alert, needing to know about this child, his son.
Stories matter. They are everything sometimes.
“The doctor will be in soon to speak with you directly,” I said. “She is my boss. She will arrange things, people to help you….”
I paused, choosing my words carefully. Venturing past strict empiricism for the sake of the boy, the rewritten story. “I think your son just got confused at school today. Lots of new people, a strange setting. I don’t think he meant to cause trouble. He just needs some teachers who understand him better, he can definitely learn to talk with some patience. He’s very bright. I’m glad I met him. I think he is smarter than anyone knows and he has normal emotions for a child his age. ..Also, he’s also very good at hockey.” I smiled, the boy smiled back shyly, ducking his head.
His father looked relieved. I was holding a clipboard. I was a white doctor, and I thought his son was smart. The white people saw his son the way he did. We agreed with him. The boy was special. He gently clasped his child’s leg in reassurance. The boy snuggled under his arm and he hugged the child to his side. A cloud of silent love erupted from him, dark velvet gold, enveloping the boy. All that the child would ever need. A bubble on the end of the couch, in the empty room. The two of them sheltered from the world.
He nodded at me and they looked up at the screen again. Two dark heads with spiky hair watching the game in silent companionship. That was the last I saw of them.
Hearts and hockey sticks can be arranged, folded. Spit, a tear, a crease in the right place, and some racing stripes.
It just takes a bit of creativity and some Magic.