It’s Mustard It is early afternoon, around two pm. The ER staff is shuffling about tending to patients and other duties. Triage has a straight back coming in. No stop at registration, just pass, and go directly to a front room. A woman is frantically carrying a young child, two years of age, who is burned throughout, beginning with the top of his head, to his face, torso, arms, and legs. She’s the child’s mother and is hysterically shouting, “Mi hijo! Mi hijo! Ayudenlo!” A yellow paste is spread throughout his little body and seared inside and around the open flesh wounds. The child is screaming a siren of excruciating shrieks. His face is not the face of a two year old boy, bubbling blisters surround his forehead, eyelids, nose, lips, cheeks, and ears. His little toasted body doesn’t want to move, but the pain is unbearable and he flails uncontrollably. He is taken into room 4 where the examination begins. I am called in to interpret, and to help calm the mother. “What’s this yellow stuff?” the nurse speedily asks, and I in turn ask the mother. “It’s mustard!” “Mustard! What the hell are they thinking! What happened?” “?Que ocurio?” I ask. The mother, visibly confused, crying, and afraid, begins to describe the occurrence in Spanish, “I was going to give him a bath, and I just stepped out of the bathroom for a second to get a clean towel, and that is when I heard the scream. I run into the bathroom and see that he turned the hot water knob on and burned himself! Please help my son!” she is sobbing. “Why did she put mustard on him?” asks the nurse. She heard it is a remedy for burns, I respond. “Tell her never do that again, it is far from a remedy, and probably exasperated the burns.” The nurse covers his bodily burns with cooling medicated patches, while another nurse attempts to secure an IV line. His chest, stomach, and small limbs are covered with second and third degree burns, and huge blisters, even the top of his feet and little toes did not escape the hot water. The attending physician steps into the room and is updated. He begins to call out necessary orders to staff. The mother is standing to the side leaning over the back supplies counter against the wall in the room. She is hysterically crying, covering her face, and trying to catch her breath. I approach, put my arm around her, and softly say, “I need for you to take a deep breath, and try to calm down. Your baby needs you right now and should not see you like this, it will only frighten him more, and you must be brave for him. Come (as I walk her toward the gurney), its ok, stand next to your son, he needs to see and hear your comfort.” She steps closer to him and touches his hand, “todo esta bien mijo, no llores, tranquilo, tranquilo, eres muy valiente mijo” mother begins, as she holds back her panic and tears. The social worker is called in, at the request of the doctor. Because the incident occurred at home, he wants her to provide a brief overview of the family home structure and dynamics. Lynn, the social worker, calls the mother out of the room and into the ER quiet room. She request that I be present and interpret. Lynn is a kind Asian lady, very petite in stature, but a giant in her knowledge working over thirty-five years of the profession. The mother sits on a small sofa and I sit next to her as Lynn positions herself on a seat directly in front of her. “What happened?” she asks. The mother looks at me, then she looks down. She is silent for a moment, and then she begins to hyperventilate. “Stop!” Lynn firmly whispers. “Tell her to take her time, I am not in a hurry, she is not in any trouble.” I convey the message. After a short patient period of sitting in silence, the mother begins. “I was boiling a pot of water on the kitchen stove for cooking. I stepped out of the kitchen, and didn’t realize my son stayed in there, I thought he was following me, like he always does. Then I heard him yell like something I’ve never heard before. I think he reached for the pot handle. (She pauses, her eyes are closed as she attempts to take a deep inhale, gasping for breath through her tears). When I ran back to the kitchen, he was on the floor scorched in hot water.” At this moment, my stomach sinks low, the story has changed. Oh my God, this is not good. Lynn looks at me as we visually communicate to each other “I know, I know” I’m thinking, I know what needs to be done. “Why did you say he burned himself in the bathtub?” Lynn asks. “Because I thought it sounded better. If I left a hot pot of boiling water on the stove it is my fault! But that is the truth, I swear it, I swear it!” She stares at the floor, with a look of defeated despair. I know it is too late, even though my gut feeling believes her, law enforcement must be notified. “Explain to her that because her story has changed, we are required by law to call the police department for the child’s safety.” “But it is the truth! It is! I don’t know why I said what I said, I was just scared! I love my son. Please do not do this!” She cannot hold back the tears, and her body is trembling. “I love my son! He is my life, and I would never hurt my baby! Understand please!” “I understand” I say, “but as mandated reporters, and because you changed your story, we are required by law to notify the police. This is necessary for your son’s protection. If what you say is true, I’m sure it will work itself out. I am so sorry.” She’s mumbling and swaying, “No, no, no.” Lynn steps out of the room and proceeds to call the local police department.” “Can I please see my son?” she desperately asks. “Yes, of course.” I walk her back into the son’s room. He is in excruciating pain. The constant probes and procedures do not comfort the situation. I place a chair next to his bed, and she touches his little fingertip, “Perdoname, te amo mijito.” He lays there scorched and bubbled, full of pain and fear, and just the beginning of many agonizing procedures to follow for his little body. Mom is disheartened, hunched over, looking shameful. She wants desperately to take his pain away, but she cannot, she can only watch his agony. It isn’t long before two police officers arrive. They ask to speak with the mother, and I escort them all to the quiet room where they begin to ask her questions. As I interpret for her she starts to explain, “We were home and I was cooking in the kitchen. I had a pot of water boiling on the stove, and when I stepped out of the kitchen, my son somehow spilled it on himself.” “Why did you say he was in the bathtub when you were first asked?” “Because I was scared, I don’t know, I was scared.” “Why did you put mustard all over the burns?” “I heard it was a burn remedy.” She is crying and looking down. “It was an accident, it really was. I love my son, and I don’t know why I said that.” A nurse walks in, “He is being transferred to a burn trauma center as soon as possible.” “Can I go? I need to go with him, please!” says mom. The officers finalize the preliminary documentation of the incident, and a family member arrives and picks her up. She is told that further investigation may pursue, and she is permitted, for now, to follow the ambulance and go with her son. The Patient Advocate.
Posted on: Sun, 29 Jun 2014 19:51:37 +0000
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