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A resident on our team has just paged me. I'm in emerg, she says. I'm already doing an admission, but there's another one here. Do you want to do it?
Sure, I say. I'll be right down.
Great, she says. I don't know much about it, but I think it's a boy with SCID.
SCID? I think. Oh God. Is he in a bubble or something? It's a long, slow walk down to the emergency department. I flip through my pocket reference, trying to learn something about immunodeficiency.
I exhale with relief when I arrive and look over the emerg sheet. SCAN, it says, not SCID. Except, what the heck is SCAN? I ask someone.
Oh, the emerg doc says, that's Suspected Child Abuse or Neglect.
That's much worse, I think. Can I have the kid in the bubble back?
A rag. That's what his mother's boyfriend has been stuffing in his mouth. To keep him quiet. Charming, I think. He's got a hematoma the size of a strawberry crowding his tiny mouth. He's miserable.
Things happen fast. He's admitted. He's fed through a tube in his nose. He gets better. He's apprehended. He gets a foster parent.
I go to see him just before he's discharged. Usually he's glad to see me, but I interrupt his eating and he's cranky.
Don't let anybody push you around, I tell him. Push back. I show him how to make a fist. I show him how to punch me in the jaw. He's six months old. He's going out there, where everything is so much bigger than he is.
Maybe he'd be better off in a bubble, I think.