By I. L. Balkcom IV, M.D.
TAFP President 2012-2013
Her name was not important. This little 6-year-old girl I had been called to examine in the emergency room now sat silently, flanked by her mother and mother’s boyfriend.
I was in my third year of residency and was summoned to evaluate this patient who I’d been told had fallen in the bathtub at home. She had a large bruise around her left eye.
As I entered her exam room with my interns in tow, I was immediately struck by the defiant posture of the mother and apparent lack of concern by the boyfriend. Yes, physicians are often very suspicious. All questions were answered, not by the child, but by the adults. Her mother stated that the child had slipped and fallen in the bathtub, striking her eye on the cold water handle.
Why was the bruise so perfectly round? Why was it so large? Why wouldn’t the child talk to me? Was she frightened by the giant in the white coat? Under pretense of taking the child to X-ray, we did a complete exam and found the sickening evidence of large bruises across her back and buttocks and between her legs.
When I was able to speak to the child alone, I asked, “Who did this to you?” The small, blonde, fragile angel with a battered eye whispered softly, “Daddy.”
We have, in our country, a problem as serious as any cancer or drug addiction—child abuse and neglect—and yet many cases go unreported.
Child abuse includes any maltreatment of children or adolescents by parents, guardians, or other caretakers. The most common types of abuse and neglect are physical (80 percent), sexual (15 percent), and underfeeding (5 percent).
During childhood, 1 to 2 percent of all children in the U.S.A. are abused. Nearly 2,000 children die each year because of physical abuse. Especially frightening is the fact that the abuser in 90 percent of the cases is a relative. More than five children die every day as a result of child abuse and it occurs at every socioeconomic level, across ethnic and cultural lines, within all religions, and at all levels of education.
Physicians have three responsibilities in child abuse cases. They must be able to detect cases, report them, and prevent future cases. The law requires physicians to report abuse to the Department of Family and Protective Service within 48 hours of suspecting abuse or neglect, and protects them from liability if their suspicions are unfounded.
What can you do? If you suspect a child is being abused, bring this to the attention of DFPS. If deemed life threatening, contact your local law enforcement agency.
As I sat that night by the little girl’s bed rocking her to sleep, I felt all the rage and anger toward this man who had beaten this little girl. I did what any hardened physician, accused of having no feelings, dealing with life and death daily would do—I cried.
Good health to you!