problem would be straightforward so I could make up time. I called him in. Mid-Âtwenties. High cheekbones, tanned skin. It took a second to see he wasnât ill. I could sort this quickly.
âHow can I help?â
âBack pain, runs in the family.â A Welsh accent. His hand, strong and weathered, lay close to mine on the table. I put my hands in my lap.
âWhat do you think brought this on?â
âCarrying my kid sister around.â A defensive note crept into his voice. âShe likes to sit on my shoulders, but sheâs getting heavy.â
âCarrying children doesnât help.â Itâs tempting, though. I used to carry Naomi everywhere, long after she could walk on her own. I liked the weight of her, her face against mine. âBest to let her walk on her own.â
I caught a flicker of anger in his eyes, but in seven minutes advice was more important than sympathy and I had to look at his back. The long erector spinae muscles on either side of his spine were as smooth and thick as a pair of snakes, but when he lay on his back he winced as I raised his legs. Sciatica. His reflexes and sensation were normal. When I told him what exercises he needed to do and prescribed some analgesia, he smiled and shook my hand. The laying on of hands had worked its magic: his hostility evaporated completely. He left with a leaflet of advice and his script, his foot accidentally tipping a toy as he went. It spun across the room and crashed into the wall. I picked it up as the door closed. It was the little plastic duck with the faded orange beak that had been chewed so often it was frayed into soft spikes, and the wing had come cleanly off, leaving a sharp edge. There was a muffled clang as it hit the bottom of the metal garbage can. I called the next patient in.
I knew Jade was ten, though she looked much younger. She stood motionless as her mother took off her parka, her school sweater, her skirt. There were bruises on her face, her arms, and her legs. She seemed perfect apart from the bruises, but her pretty face was blank. She watched me closely as she clutched a tattered velvet giraffe. I had seen her at least four times this year; there had been tiredness, ill-Âdefined abdominal pain, poor appetite, and now coughing. Nothing had jumped out at me before, though I had noticed her dirty clothes and the matted hair that hung in silvery ropes. I had simply given advice, and tried to reassure her anxious mother. This time it was different. The bruises were new. I smiled at Jade, but the room seemed to turn darker around her.
Her mother, in bulging fake fur, talked quickly and loudly, leaving no gaps between her words. Gaps held clues, but her words fell out in a tight line.
âStill keeping us awake with the bloody coughing.â
The womanâs hard green eyes tracked mine.
âSomething else as well.â
The caked face pushed in close and little blobs of hardened mascara trembled when she blinked. Her fingers with long pointed nails gripped her daughterâs shoulders tightly.
âShe comes home covered in bruises. She says she trips over a lot. We think itâs the other kids. Picking on her.â
âWhy are they doing that?â
âI donât know, do I?â
I uncurled Jadeâs fingers and put the steel disk of my stethoscope into the small palm so its coldness on her chest wouldnât shock her.
âCan I listen to your tummy?â
The bright head made a small movement up and down.
I put my stethoscope on top of her undershirt first to gain her confidence; her hair fell over my hand and I saw something black scuttle up a strand toward her scalp. When she stopped holding her breath, I lifted the undershirt to listen and saw that the bumpy little rib cage was bruised; there were more bruises on her backbone. I could hear the motherâs voice become louder and faster as she watched me, but I stopped listening to the words. I kept my face
Booker T Huffman, Andrew William Wright