In the world of forensic pathology, we all see sadness and tragedy on a daily basis. While we can continue to talk about it, there is one situation with which we deal that I think we all have the most problem. The child. The baby who is beaten to death, the baby who looks perfect, but inside looks like they were run over by a car. The toddler, who wet his pants, and suffered death as a result. The so-called well meaning parents or caretakers, who look innocently at you and maintain that they can’t understand how that could have happened.

Those are obvious situations in which we have no question about the brutality to a child. There is another situation which we know occurs, watch it occur, and yet, do nothing about it.  That is allowing a child to suffer in ways that are indescribable, literally torture, and idly stand by and permit it to happen.  To withhold appropriate medical care from a child and allow it to suffer needlessly, is to me an act equivalent to, if not much worse than beating a child to death.

We all decry and respond in overt ways to that happening. But, what do we do for the child who is made to suffer, to undergo pain, to be allowed to struggle to breathe, and simply watch it with the knowledge that it will soon die without any assistance. Do we allow an animal to suffer in such a way? Whether this happens as a result of a religious belief, out of ignorance, or simply an uncaring, yet so called loving parent or caretaker is an act, even more reprehensible than the overt one of beating a child to death.  

Why, because we are allowing this to happen when we are able to prevent it through legal means, i.e. changing a law which allows a person to kill a child in this way. Call it what you will, it is nothing more than killing a child using a cloak of faith to cover the act.

A child is innocent, totally dependent on the person who is their caretaker and also to society who is ultimately responsible to see that each and every child is not placed in danger, and is given the means to survive. Has no one using this “cloak” ever heard the story about the Good Samaritan, and his willingness to help another regardless of who they might be? If not, then perhaps, they might read it.

When I see children who have died in a totally unnecessary setting, when they could possibly been treated medically, it is then that my primeval urges have to be quelled lest I become like the perpetrators in my desire for justice for those little ones that are being brutalized in the name of “love”. How can one possibly talk of love and caring while watching a child suffer to the point of death without lifting so much as a finger to help them?

Unfortunately, we all share some of that guilt for allowing it to happen. Can I forgive them?  Yes, I can forgive them, but I certainly don’t have to like them. And my forgiveness is given as the cell door shuts behind them, very tightly, so as not to allow them to perpetrate their “love” on any other child or human being.  

Seeing and experiencing all of these situations, happenings makes me begin to think about life in my own case, or my family, as it always does.  It seems that it is an everyday occurrence, that we are reminded of our humanity, frailty, and absence of permanence.  It seems that we watch life in all its various ways, the weaknesses, the strengths, and the love of people for one another.

It is so easy to view our own problems and think that they are the worst, but when we try to help others deal with theirs, many of which we can never imagine enduring, we realize how very fortunate we are.  It is like looking at the microcosm at ones feet, do we see it, do we appreciate it, and do we even know that it is there?

All too often, we develop the tunnel vision of the self-centered, and see our own problems and difficulties as much greater than they are. We realize that we need to recenter ourselves, to view ourselves in the total picture of mankind. Yes, our pain, real or imagined, is our pain, but is it in fact that great? The pain and discomfort that we feel fades very rapidly when we see another, reach out to another, and attempt to alleviate their pain, because the giving of ourselves is a potent medication for ourselves, and frequently a miracle drug for the one who receives what we have to give, if only in our love, compassion, understanding, and just listening.

We renew ourselves each day with the love, compassion, and caring for the “other person”.   That brings us full circle to the dying child, the child unattended and our responsibility to that child.  

I am constantly reminded that as a physician, I am privileged to be able to try and alleviate the pain and give whatever I can, in both knowledge and myself to that “other person” regardless of whom they may be. But, I, like so many others fail to do what is necessary for the child who is dying in an almost sacrificial way out of neglect and being denied the medical care they are both deserving of, and in so much need of.  

As a physician and a forensic pathologist, again, I am privileged to be able to take care of the living, but also be an advocate for those who cannot speak for themselves. It is amazing what words the victims can speak that I hear with my hands, my intellect, and my search for detail that could otherwise be missed.  

Many years ago, my mother wrote a birthday card to one of her grandaughters, in which she said,

“The beauty of a child's heart is food for the poets. Keep that joyous imagination and the magic of 'the truly you' to bring joy to ours and others hearts."  

A child is all loving and all trusting as depicted by my grandaughter of 3 months at her christening. She reaches out to the adult in total trust, expecting only that the trust which she has will be returned by the adult in total. She is, perhaps, a symbol of all children reaching out to the adult, the caretaker, in total trust. The residing question is what do they receive in return?  Only we can answer that question, and then ask ourselves how well do we respond?

     A Sagebrush Doc