Skip to comments.The Marks of Childhood or the Marks of Abuse?
Posted on 05/14/2009 9:48:05 AM PDT by nickcarraway
I had just started out in practice when one day I examined a little boy, maybe 4 years old, and discovered around his neck the clear mark of a noose. I asked him what had happened; he said he didnt know. I asked his mother; she said she didnt know, but it was the fault of her ex-husband. I had to tell her I was filing a report with the Department of Social Services the child had clearly suffered an inflicted injury.
My training had included many slide shows about the stigmata of cigarette burns, belt marks and other suspicious injuries, but it was the first time I had been the person alone on the front line, looking at a mark on a child, knowing something was wrong.
My colleague Dr. Lori Legano is a pediatrician who specializes in child abuse at the Frances L. Loeb Child Protection and Development Center at Bellevue Hospital. Part of her job is to testify in court and to speak to judges and juries about a range of marks and bruises and what they indicate.
She has to integrate a pediatricians understanding of child development and behavior with a growing body of forensic information about child abuse. Bumps and bruises, after all, can be expected in any young child who is learning to walk. But some injuries are inconsistent with developmental stage: If you dont cruise, you dont bruise.
So a child who isnt mobile shouldnt have those marks, let alone broken bones. And then there are intrinsically suspicious marks, or marks in the wrong places.
(Excerpt) Read more at nytimes.com ...
My poor middle daughter was nicknamed Rocky from all the black eyes she got. Her brow bone inevitably hit any hard surface while learning to walk and that child got a black eye everytime. To top it off, while changing her diaper once, she rolled off the bed when I turned to grab my toddler who was climbing on the bed and broke a collar bone. Luckily I had three witnesses in the room and darn if they tried (unsuccessfully) to catch her.
It made me worry people would think I abused my child. She suffered two more broken bones, both occurred at afterschool daycare from my daredevil, a clumsy daredevil though.
That happened to my cousin. He was mortified.
It’s a horrible feeling!! Especially since I was grabbing the one child to prevent a fall and she just went roll roll roll in the other direction. Man, I still feel like crap and it’s been 10 years.
My daughter has a Mogolian Spot on her left butt check. It looks just like a purple bruise. Many asian and african children have them and they fade with age, but we made sure we had good documentation with the Pediatrician.
Nosy doctors creep me out.
My kids are covered with bruises, scratches, abrasions, sunburn, sometimes even black eyes.
If you compare them with a kid that sits on the couch all day playing video games, they might look a little beaten.
A friend of mine was at the pediatrician’s office when the doctor notices several bruises on her son. She tried to explain to the doctor that her son was rather exhuberant and always running and jumping all over the place. Her doctor was ready to call Child Services when her son took a flying leap off the examination table. The pediatrician finally believed her. Sometimes that’s not the case and some parents to abuse their children.
On the other hand, there are too many, way too many, “health professionals” that have read a book or an article, and consider themselves experts on the subject. These people can do serious harm.
About 5-6 years ago, I was having Christmas dinner at my house. I was carving up the rib roast, and my wife, who was doing something with the pots behind my back, bumped into me. Unfortunately, this knocked the roast off onto the floor.
Both my wife and I dived to catch it, me with the very sharp carving knife in my hand. It inflicted a serious injury to her ring finger.
We rushed her to the emergency room, but you would not believe the pressure the admitting nurse put on her to say it was something other than an accident. I could not believe the glares I got for her and a couple more nurses.
If she had been a child, I would have probably wound up in jail for the night. That is, until they checked out with the other 5 adult witness what had happened.
A little education is a dangerous thing, and incompetents rule most professions, IMO.
Then when I was 3, I fell down the front steps and broke my radius and ulna. The doctor did not set me arm so when the cast came off my arm was crooked and not healed properly.
SO, you guess it, I banged my arm and it re-broke. I remember being 3 and a half and having people questioning me in the emergency room about if my parents hurt me.
If a professional fails to report potential abuse, it’s on them, and it’s a CRIME. Thanks your legislators.
When I was a kid and misbehaved badly enough, Dad would take off his belt and smack me on my (covered) behind a few times, just enough to make it hurt and let me know that what I did should not be attempted again.
When I wouldn’t listen to reason, my Mom would go outside and get a ‘switch’ in which she would swat me with.
I suppose in this day and age Mom and Dad would have been sentenced to 20 years hard labor in prison for ‘mutilating’ me so badly.
When my 32 year old nephew was a child, he had asthma and was allergic to mosquito bites (my girls are too. they swell to the size of half dollars and have a white head on them)
We went to the drive in, the kid was playing on the swings for about an hour at dusk. He started having trouble breathing during the movie and we ran him into the emergency room.
The doctor looked at his mosquito bites and said, “These are cigarette burns”
Luckily, my sister was a nurse and said, “There are entry points on each of them if you look closely.” and there were.
I can’t imagine what would have happened if they had just called CPS!
The days are long gone when a family doctor was intimately knowledgeable of the families he or she was treating for years and years. So often, those doctors knew the daily habits and lifestyles of their patients and when a kid came in with out-of-the-ordinary injuries, it was fairly obvious someone had knocked the kid around. Now everyone must be assumed guilty of abusing their child until they prove otherwise so they can help those who are. Nevermind of course the invasion of privacy, false accusations, and social stigma that follows even a single false accusation.
>>If you compare them with a kid that sits on the couch all day playing video games, they might look a little beaten.<<
Then you abuse them if they are overweight.
We’ve stopped with Peds. At 9 and 11, they see regular doctors who aren’t as nosey.
I was at the doctor's for some routine reason a few years ago, when he asked me if my husband ever hit me. I laughed because it was completely out of the blue and had nothing to do with why I was there. There was also no evidence of abuse. He seemed very angry with me for my response, which seemed somewhat ironic to me.
“...Mom would go outside and get a switch ...”
She didn’t make you pick out the switch yourself? She was easy on you :)
I have a nephew who is very exuberant, strong and strong willed. When he chooses to go off somewhere it is hard to restrain him.
When he was only about 2 he would run full blast, and since he wasn’t yet very coordinated, he would run into things. Bruises all over. One time he was trying to get away from his mom who was holding his arm, and he dislocated his shoulder.
Fortunately, their doctor knows them well and knows how this child is, or they would be with cps constantly.
When he was little, my son was terribly allergic to mosquito bites. He would break out in hives, and his skin would really swell at the site of the bite. One time he was bit inside his ear canal. His ear swelled and he broke out in hives. We took him to an urgent care center because we feared the excessive swelling in the ear might cause more permanent damage.
Our family doctor later called me to tell me to never go to that place again. Unknown to me, the urgent care doctor reported us, assuming my husband boxed his ears. She stopped the investigation in it’s tracks by explaining my son’s history of hives and excessive swelling at the site of bug bites. The fact that my son had systemic hives helped. Also, within 24 hours, his ear was completely normal looking again, so the Urgent Care doctor looked pretty dumb.
My daughter loves to crouch with her feet on her bike seat as she coasts down a hill in our neighborhood. The first time she did that at 5 years old, I turned to my husband and said, “I guess we can take the training wheels off.”
Abuse allegations can be worrisome with this kind of child. I nannied for a family and the girl broke her arm and five meta-tarsels (foot bones) on two separate occassions. Luckily her brother witnessed the arm incident (she fell on ice) and the reaction from the parents on the foot was shock it took so long to break something. She had been on a furniture jumping spree for months.
Nosy doctors creep me out, too.
The last one was a pediatrician. I decided to try a new doctor, so I brought two of my children to her for a checkup. She had another doctor assisting her. As soon as she heard “homeschooled”, her facial expression revealed her bias. She and the other doctor seemed very suspicious of me. Right away, she asked my sons if they were involved in sports or activities, and they were silent because I’d recently told them we were taking a break for a few months. They’d never taken a break before.
Well, this doctor laid into me about “socialization” in front of them. I explained how heavily involved they’d been with co-ops, classes, meetings, sports, youth clubs, etc., for years. I said we were constantly running all week every week. But, now my father had just passed away after a difficult time, and we needed a break.
But, she listened to nothing and kept hammering on “socialization” and writing furiously in their files. Finally, she started talking with my older son, and she seemed impressed with him. But, she didn’t pay much attention to health/medical issues. I had to point those things out to her. Her big concern was “socialization”.
So, I’m back to looking for a pediatrician.
One time I did hurt my son, by accident. I was trying to get him and his baby sister ready for the pool; it was hot and I was tired; he was running around with his shorts around his knees, not co-operating at all, and I took him by his arms and sat him down hard.
He couldn’t bear weight on his ankle so we ended up not going to the pool but the doctor’s. An x-ray showed a sprain only. The doctor never reported me or showed any hint whatsoever of thinking about it - I suppose because I was a concerned white middle-class suburban mother with no suspicious history and made no attempt to hush my son’s tale.
If I had tried to hush him I know just what he would have said: “Mommy said not to tell you but I want to tell you...”
Our first baby girl, only a couple months old and hardly very mobile (she turned over pretty late), unexpectedly rolled off our bed right in front of her horrified and frozen father and me. Young enough that we practically vomited thinking of what might have happened - she could have easily broken her neck or skull and died rather than just landing on her belly and wailing. Still makes me woozy just typing that out.
Mine too! My oldest's bites swell up like hives, only even bigger - more like silver dollars, poor kid.
I almost broke my hand punching my mean teenage son in the shoulder...I told the bone guy exactly what happened too...
It’s such a pain with it too. When they get too many at once, the entire limb will swell and they break out in hives!
My heart goes out to you.
My daughter was nothing but bumps and bruises when she was a toddler.
At one of her pediatrician visits, the nurse started looking at the marks and grilling us. When the doctor walked it, it was obvious the nurse had “warned” him out the bruises. He spent about ten minutes questioning us about her activities and the various bruises visble.
When he was finished with his questions, he looked over at her asked her to come over, she took about three running steps and hit the cabinet next to him leaving a small bleeding laceration above her eye. He almost freaked out, he jumped up and started turning circles looking for something to put on the wound. My wife calmly looked at the wound, cleaned it with some antiseptic from her purse and put a small bandaide on the wound.
He was all apologies about her getting hurt in his office. We reassured him that it wasn’t his fault, she had no slow speed, she ran into things in our house all the time. He ended up taking care of all three of our children as they came along and never questioned us about bumps or bruises again.
As a young child I was told I had to be harnessed to the bed and escaped at will. When memory serves I and my friends were doing stunt bike stuff sans helmets or pads at six and seven because we all loved Evel Knievel - mid 1960s before BMX. Then there was the pellet gun war games. And dares seeing ambulances on a regular basis.
All that came to a screeching halt for me when I borrowed a girl’s bike and she called out “I think the brake is bad!” Sure enough I came around a corner with a Cadillac bearing down, only little old lady blue hair visible above its wheel. “Break failure - speed through.” No, the old broad turned into my escape route and hit me around 35 mph, sending me flying some fifty feet and hitting the pavement on a curb.
According to the girl who rescued me the old lady kept on traveling. That brave and awesome girl dragged my crushed carcass to her parent’s door and dictated orders, saving my life. Fading in and out I recall that.
“Hey Mike, what does this have to do with child abuse?”
I was abusing myself via adventure while in a foster family that mayhaps didn’t exert enough control. While I got better my mishap had a lot to do with the divorce of the foster family taking care of me, so I was shuffled onto a family where the father believed everything his born daughters said while he never hesitated to translate his disappointment of my not becoming him with never-ending switchings, beltings and such.
Dude wouldn’t let up until the hickory was just chips amongst my blood or he just got tired. Thank God I’m not a scarring type. At 14 I was big enough, retaliated with a kitchen chair and camped on Lookout Mountain. He reported me a runaway and they snagged me coming down for supplies.
Sorry for all that dross. It started as a reply and found there is no justification for child abusers and the hate for what was done to me still burns.
Being better than the abuser without lowering oneself to their level is the goal. Convincing that to one’s soul is a different story.
You would be surprised how common this is. In fact, just about 2 hours ago, I spoke with a frantic mother whose 6 month old son fell off the bed onto a carpeted floor.
If the injuries are consistent with the story and the developmental stage of the child, you USUALLY have nothing to worry about. The only time you have to worry about sunburn is if you get a doctor who is a sunscreen Nazi; otherwise, they’ll probably just tell you to put sunscreen on in the future.
You can at least partially blame this aggressiveness in identifying potential abuse on JCAHO, which accredits healthcare organizations. They are systematically raising the bar in many areas, and abuse is one of them. I have nothing against screening for abuse, but the problem is that it needs to be done by someone TRAINED to do so.
At least you had witnesses, my Mom dropped me in my Crib accidently when I was three (early 90’s) and broke my arm, and the only person to agree with it, was my dad, and I don’t even think he was in the room. Said that she was questioned insanely like she had done it on purpose (If I remember correctly, she said they almost called CPS). When she told me years later, she still seemed a little freaked out.
Also considering the year before this happened, I also took a Tomohawk to my head, which she’s barely told me about (I had to ask why there was a scar above my eye) and seemed recient on giving any more details... I wonder if she got called out worse because of that...
I wish I could introduce you to mine!
She’s nice about the fact that I homeschool, and is not pushy, nosy, or overbearing.
I have to drive 30 minutes to get to her office, but it’s worth it to keep the one pediatrician in San Antonio who’s not a control freak.
“We’re not raising socialists...”
Seriously, THIS is what most folks who complain about “socialization” are complaining about - your kids are not being indoctrinated properly.
Had my 2 year old’s hand firmly in one hand & my 3 year old’s hand firmly in my other hand while waiting in line at the bank one Saturday morning. (I was visibly pregnant w/ #3 at the time.
The 3 year old gets tired of standing & decides to sit down on the floor with out telling me. And since I was holding on to them pretty tightly (I was tired and didn’t want to have to chase them around the bank in my extended form), his elbow popped out of its socket. But he didn’t cry. So I didn’t think there was anything wrong till we picked my now ex up from work an hour later and the 3 year ld said his arm hurt & he couldn’t lift it up.
I cringed when the Dr matter-of-factly popped it back in & showed us how to do it if the elbow popped out again.
That was 25 years ago and I still feel just awful.
I’m sorry for the abuse and the pain it still causes.
That said - you’re quite the storyteller. After enjoying the ambling, modern Mark Twain-esque air of your post (for example “that brave and awesome girl dragged my crushed carcass to her parents door and dictated orders, saving my life” and “until the hickory was just chips amongst my blood”), I read your profile page and found a bit more of the same. You should write your memoirs while you have all this extra time, and in that same bemused, reflective, descriptive style.
I’d read it. :)
They hospitalized my six month old daughter because she was ‘undersized’ according to their charts. They fed her gravy and white bread for a week, realized that she was just a small kid, and discharged her...But not before instructing me to stuff her full of peanut butter which they should have known is a huge allergen.
So where do they get off treating my wife like a child, and me as a leper?
The law is one thing, but before they start tossing innuendo and accusations around, they need to know what they are doing. Which means more than reading an article in Psychology Today and thinking they are ready to do God's work.
Listen, every mom’s been there. One of my kids bumped her front teeth on a coffee table, and she got huge and theatrical black eyes and strange bruises around her mouth. It isn’t just docs who look at you dirty, it’s everyone in the grocery store. But if the docs aren’t careful, they’ll be criminally liable.
I went to Urgent Care in Feb. because of a severe cold. One of the questions the intake nurse or P.A. or whatever she was asked me was, “Is there anyone at home that you are afraid of?”
I laughed and said, “No, but there’s someone at home who annoys me quite often.”
And I AM grateful there’s no one here I’m afraid of.
Annoyances I can deal with.
Thanks for sharing all that.
So the blue-haired little old lady kept on going? Did she ever know she’d hit someone?
I was at the grocery one day when one lady questioned me about the marks on my boys’ faces. I had no idea what she was talking about. Turns out they had lipstick marks from me kissing their faces (they still ask me to kiss their faces when I put on lipstick) and she thought they were bruises of some sort.
WHen socialization comes up remember my daddy always said, “I didn’t send you to school to socialize.”
I had a similar question asked at my last checkup.
“Are you secure in your home relationships?”
I said “My cat is trying to kill me.”
LOL. Perfect answer.
>>Oooooh, don’t even get me started on their ridiculous obsession with weight.
They hospitalized my six month old daughter because she was undersized according to their charts. They fed her gravy and white bread for a week, realized that she was just a small kid, and discharged her...But not before instructing me to stuff her full of peanut butter which they should have known is a huge allergen. <<
Oh that is too cute!
Thanks much but the stories on this thread...I cried, laughed and cried again. And that’s not cliche’.
For a long time I bought into the idea that “real men” never cry. I’ve traveled a very long path from a very macho persona that was a necessary shield to now. My journey regaining humanity should never have happened when I think of the (very few) opportunities.
Child abuse is a unique torture that can shape a forming human being into a tool, an automaton or a monster fueled by hatred to wreak Hell on his tormentors...nothing good comes from it.
I’ve finally forgiven mine. Mostly. I wonder if I’m shouldering the karma of bad people or just unlucky. But hey, I’ve gotten to where I cry over an actor’s cue. I’m finally regaining humanity.
BTW: Thanks for the encouragement to write but what I have in the drawer has all been done to death by other writers. The only original story I have (my personal life) is far too depressing to sell no matter how I tell it. I’m striving to make it a success story. The light of hope remains as a beacon.