Thursday morning after Wednesday OPD chaos - the folders in the box are remnants of the previous afternoon, told to rather come back in the morning than sit on the uncomfortable passage bench, to be seen somewhere in the vicinity of midnight.None of my follow-ups have arrived yet so I pulled the first folder - green triage sticker, complaint - 'sores in the mouth'.
So typical of MOPD, the real reason for coming is not always well captured by the triage nurses, and in this case it was a complete red herring.
A very cute little 3 year old girl comes into the room with her mom. A pleasant little pair.
Her mom speaks a slightly broken, Eastern Cape version of English; her grammar giving it away more than her pronunciation. Her daughter is a sweet little poppet who barely says a word the whole consultation, just sits quietly next to her mom and wanders around the room with her eyes.
Sores in her mouth - not so much. Sores on her hands and feet - yes. More alarming is the blood in her urine and then very nonchalantly she tucks in this statement...
"The other thing doctor, I almost forgot... she was raped last year."
No, not how I like to start my Thursdays.
So we stumble through the story which is a good year old and sadly, probably the story of a thousand other little people.
Mom can't actually tell me what happened, at the time her daughter was too small to talk for herself. The only real clue may have been that she was suddenly reluctant to go play next door with the neighbors kids. The clinic had done a courtesy examination and said nothing was wrong and left it at that. The police had said a case wasn't necessary as there was already one opened by the first victim.
And so the system let her down.
For most of the examination she is a honey. She sits quietly, not a peep. Only right at the end when the consultant joins the examination do the tears come, and our promise that nothing is going to hurt fall on deaf ears. Surprisingly, we get through it with very little kicking and screaming and as a bit of a lackluster consolation prize the kids get to pick a take-home-teddy
What happens next is a moment I want to burn into my memory forever.
A little face, with big, sad, uncertain eyes slowly melts into a smile when the teddies are presented and she is allowed to choose one. She spots one in a pink dress, plucks it out of the bag without a moments hesitation and hugs it close to her little heart. By the time my notes are finished and social workers have been called, the teddy has been inspected from every angle, wrapped up in a blanket and rocked to sleep.
It is in those moments that she melts back into the shape of a normal three year old girl, and the reality of the morning is a deep contrast to this innocence.
