Yvette's voice on the phone was so calm. That's what threw me off. If she was calling I knew something was wrong, but she was so calm that it couldn't be serious. "Someone has to come and pick up Elliot," she said, as though Elliot were at the Cineplex snacking on Twizzlers.
He had three poops today, I thought, which to them meant diarrhea, and meant that he wouldn't be able to come to daycare tomorrow. Immediately the future started yarning out before me. I would have to take care of him all day on Thursday. Which meant I wouldn't be able to work on my article, which meant I would have to spend twice as much time on it Friday....
"He's not moving his left arm," Yvette said, for the second time. This time I heard it. "What?" He's not moving his left arm." She started again at the beginning. He had fallen. He cried every time they moved his left arm.
It suddenly hit me that this was serious. My son had something wrong with him. I looked around at the cars and vans and business suits moving through the Financial District. Was I going to remember this moment forever?
I got on my bike and started over the Brooklyn Bridge, heading for the daycare. Should I go home and get stuff first? What might I need? Insurance card, immunization record? Was I wasting time on this bike? Should I just park it and take a cab? I was so focused that I nearly hit a few pedestrians on the narrow bridge walkway.
When I got to the other side, I remembered to stop and call Hannah. She would meet me in the ER, we agreed. Then I kept biking.
When I got to the daycare, they took me in back. He was fine, sitting there with a toy in front of him. He wasn't crying, wasn't in pain. I picked him up and they showed me where it happened. They said he had been standing against a "saucer" which made me wonder what a saucer was. They pointed and I realized that they were referring to, in our lanugage, a jumperoo.
"He just fell to the side," Laura said. "He cried a little, but not much."
Yvette picked up the narrative. "We didn't notice anything was wrong until later, when we were giving him his bottle. Normally he takes it with both hands and holds it, but today he wouldn't move his left arm."
At this point I started examining his left arm. It seemed completely normal. He was using his right hand to poke at my chin whiskers, so I took his left wrist and bent the arm gently. No reaction. I bent it all the way.
He screamed.
I quickly straightened the arm out, and he, just as quickly, stopped screaming.
Okay, time to stop playing doctor. I knew when I was over my head.
I tried to load him into our frontpack. Holding him against my chest, I asked Laura to hand me the shoulder straps. She handed me one, but it was for the wrong shoulder. I said Not that one, that's the wrong one, I need the left shoulder. And she was down there around my knees hunting for the other strap, when Yvette said You already have the left shoulder strap on.
I called a car service. Yvette and Laura came up to the front and waited with me. I told them to go back and take care of the kids but they stayed until the car came. I sat in back worrying about not having a car seat. When I said we were going to the ER, the driver said "What's wrong with the kid?" in a way that made me want to put my hands around his neck and squeeze.
This, I realized, was irrational.
As I got out of the car, I saw the hospital and my heart filled with dread. The ER suddenly became real to me. The memories from every crazy crowded ER shift I'd ever worked came flooding back. And I was arriving at 6pm, by far the worst possible time to go to the emergency room. Given how healthy Elliot looked, people would think we were abusing the ER, using it as our primary care clinic. I was expecting a long wait and lots of dismissive looks.
Maybe it was Elliot's cuteness that saved us. I had arrived before Hannah, so the two of us walked in alone. The receptionist did that head tilt-fractured smile thing that women often do when they see me holding him. Within thirty seconds we were inside the ER with our own crib.
The first person who approached me was a PA student, and I told her the story. Then I repeated it to the PGY-3 resident. Somehow word got out, and within ten minutes there were five people huddled around us, nurses and residents and med students, squeezing his fat and commenting on his eyelashes. He acted shy but was secretly happy to be center of attention.
Hannah arrived, to Elliot's great delight. And finally we were seen by the very nice attending Dr. Kelly, who had a neatly trimmed red beard and was upbeat and reassuring. (Hannah noticed that he wore no wedding ring and pondered trying to set him up--- I refused to go along with this.)
Dr. Kelly told us that this was most likely something called Nursemaid's Elbow--- the official medical term is "radial head subluxation." Infants of Elliot's age don't actually have a ligament connecting the humerus to the radius, which means that it's pretty easy for the radius to pop out of the joint.
The treatment is a reduction maneuver. "Supinate and flex" was how my doctor friend Justin put it in a text message. And that's exactly what Dr. Kelly did, twisted Elliot's arm around and flexed it.
Elliot screamed. His little face went sweaty red, and his mouth opened all the way. He had just munched on a pretzel that I'd bought at CVS, and I sat there trying to hold back tears, looking at a little wet crumb on the back of his tongue.
The maneuver didn't work. If it had, the bone would've popped back into place and he would've started using the arm immediately. But we sat there and watched him continue not to use it.
The saddest part was how Not Sick Elliot was. He sat on his hospital mattress and smiled at us and munched his pretzel and played with toys. But only with his right arm. I put my cell phone next to his left leg, and he reached across his body with his right arm to grab it and play with it.
To him it was no big deal: the left arm hurts when I move it, so I just won't move it. But to me it was heartbreaking. I was convinced that this experience was screwing him up. Even these few hours without his left arm was deforming his little brain forever. If he ended up right-handed, this would be the reason.
Dr. Kelly came back half an hour later and tried a different reduction maneuver. The immediate effect was the same, screaming and misery. The doctor said that this time he felt a little pop, which meant the bone was sliding back into place. But fifteen minutes later there was still no improvement in his arm.
Nonetheless, we were reassured that Elliot's symptoms were "classic" for Nursemaid's Elbow. We were told to give him Ibuprofen solution every six hours. We were given the phone numbers of two orthopedic surgeons and told to call if he didn't get better. And then we were discharged.
We got home about 9:30. That may sound late, but to get in and out of the emergency room in 3.5 hours was, to me, unbelievably good luck.
Elliot fell asleep in the carrier: long day. We laid him on the changing table and pulled off his dirty diaper and his clothes. He still wore a tiny plastic wristband, the one with his name and medical record number on it, which had irritated him immensely when they first put it on. I removed it by yanking it over his hand; only later did scissors occur to me.
We laid him down in his crib. He slept. We sat on the couch and tried to take comfort in the fact that Dr. Kelly had laughed at us when we asked if he might never regain function in his arm.
Eventually, we went to sleep.
