Little Chocolate Baby. 7-24-11

Consult: Rule out OI. That's medical genetic/dysmorphology short hand that says many things. First, it's a consult; we will need to see someone at the hospital. There has been an acute event. Rule out is a differential diagnosis. It means that we have a hypothesis about what they have. Usually, you want to rule out the most severe or critical condition first. Then, OI. That's Osteogenesis Imperfecta, commonly called 'brittle bone disease'. It has a range of severity depending on type. For some, bones will break from the slightest provocation. For other types, folks can go through their whole lives and only have a few breaks.

Her skin was the color of a Hershey’s chocolate bar, and she was quiet and sweet. I looked through her chart. Mother brought the baby to the ER, claimed that her older daughter had jumped on the baby and that was what caused the bone breaks. Mother had left the ER to get a snack and never returned. She was all alone and covered in casts. Although I was new to doing consults, something told me that I wouldn't be able to rule out OI. I made my initial assessments and looked at the Xrays with my attending, Dr. W. I kept asking questions and would get gentle but frank answers. We have a magical way of looking at Xrays and ruling out OI. We could rule out OI for her; she did not have OI. And do you think we bought the story about the older sister jumping on her?

And so I left her all alone. I wanted to bring her home with me. I was single, of course, and had to occasionally skip lunch to make ends meet. There were a million reasons I couldn't. I can still see her laying there all alone in her little bed/gurney. Later, Dr. W told me that if a woman should ever want to adopt a special needs child, that she should let the MDs in the clinic know, that they could help. I guess I wear my heart on my sleeve when it comes to little ones. It's like my great aunt D says, "I don't know how anyone could hurt a child." So, now, I get more and more information that Boop is healthy, thank goodness. But I wonder what ever happened to that little chocolate baby that I wanted to bring home with me.