Thursday, August 02, 2007

Cry of My Heart

While a Pediatric Intensive Care (PICU) nurse for eleven years, I was especially drawn to abused children, even though their needs are usually difficult to meet. Often, holding them close to my heart comforted these children. By cuddling them, I attempted to show them the love of God, loving them as He loves. Through caring for these lovely, but broken, little ones I came to understand Christ’s call to “become as little children.”

Most of the time I felt I wasn't making any difference. We'd have kids come in having been battered in unimaginable ways, we'd patch them back up, then the Department of Children and Family Services (DCFS) would oftentimes send them back to the environment they came from (in an effort to "preserve the family" even though this was killing the kid). Sometimes I'd wonder what the point was to it all. (This came home to me dreadfully when I had a 3yo little boy who'd been beaten until he almost died by his mom. DCFS sent him to live with his maternal grandma “where he’ll be safe”. Unfortunately, his mother lived with the grandma! The grandma frequently came to visit this little guy and was sweet as honey when staff was in the room. Yet I’d caught her yelling at him more than once when she thought no one was around. He was in a PTSD state and would flinch and cringe when she approached him. I conveyed these concerns to DCFS but it didn’t matter. On discharge day he clung to me crying and had to be forcibly put in his grandma’s arms. It was heartbreaking!) Anyway, I grew terribly discouraged. In the past few years, though, I have come to understand that the love I gave, in all its simplicity, DID make a difference. Often, the love I had to give to abused children was more than they had experienced in their short, painful lives.

I’d like to tell the story of two children who changed my life forever, making me a better nurse and, more importantly, a better person. I’ll call them Hope and Grace, for that is what they taught me.

Hope was a two-year-old with a history of horrendous parental abuse, which led to removal from her mother’s home and placement in foster care with an aunt. One of her cousins was jealous of the attention Hope received, so he gave her a bottle filled with rubbing alcohol (she was somewhat developmentally delayed and still bottle-fed). When she gagged and wouldn’t drink it, he poured it down her throat. She arrived at our hospital in kidney failure and required multiple rounds of dialysis, as well as intubation and ventilation to manage her airway until she stabilized. After several days Hope was well enough to be transferred to the Intermediate Care Unit. It was my day to work in this unit and I was assigned to care for her.

When I walked into the room, I found her tied down by soft restraints, crying as if her heart would break. I removed the restraints but had to replace them immediately when she began screaming, pulling her hair and banging her head against the side-rail of the crib. When I changed her diaper I was horrified to find hideous burn scars on her bottom, where she’d obviously been placed in scalding hot water. When I gently lifted her gown to listen for bowel sounds, to my disgust I found multiple wounds from cigarettes being put out on her belly as well as other healed scars all over her torso.

I setup a tub of warm water to wash her since she’d only had sponge baths during her stay on the unit to this point. However, when I attempted to put Hope into the bathtub, she screamed at an inhuman pitch. The look of sheer terror on her face, as she pulled her legs up all the way to her chest, was heart-breaking. Since the burns on her perineum were old and well-healed, I had not expected her terrified reaction (although I should have). I put her down beside the tub and began to play in the water, splashing in it until she began to laugh, dimpling as she looked up into my face. She eventually wanted to join in the silliness and reached her hands in to splash me. I laughed back into her gamin face. Slowly and, oh so carefully, I was finally able to put her in the water to gently bathe her.

After her bath, I fixed her a bottle of formula and cuddled her in a rocking chair. I sang “Jesus Loves the Little Children” and “Jesus Loves Me” to her. As she went to sleep in my arms, tears slipped down my cheeks. I snuggled with her for a long time, weeping with sorrow for her suffering and with rage at a world that allows this to happen to “the least of these.”

Later, by God’s good grace, I realized the songs of love I sang that night brought as much comfort to me as they did to her. I believe I was able to show her that not everyone is bad and that it is safe to trust others, if only a little. Hope was transferred off the unit to the regular floor and was eventually discharged into another foster home. I never saw her again.

A few years later, little Grace came under my care. Grace was a twenty-month-old, blue-eyed beauty with curly brown hair and the lovely chubbiness of a well-fed and cared-for child. However, Grace’s mother (in one of the most frequent scenarios of child abuse) had met and fallen in love with a man who had no interest in Grace, except to make her life as hell-filled as possible. Since Grace was not his child, he decided that she didn’t deserve to live, except as a recipient of his sadistic tendencies. Grace’s mother valued her relationship with her boyfriend more than her relationship with her child and chose to ignore his horrifying, abusive behavior toward Grace.

One evening, Grace was left alone with the boyfriend for the night. Shortly thereafter, an ambulance was called and the baby was brought to the hospital with a severe head-injury. Upon arrival in the emergency room, she was thought to be brain dead. She was placed on a ventilator, while the doctors tried to convince the family that there was no hope. Finally, it was decided to do a perfusion study to determine whether her brain was receiving oxygen, and she was transferred to the PICU.

I requested to care for Grace but had no idea what I was getting myself into. The ER nurse gave me Grace’s horrifying medical history, which included the head injury, burns, broken bones, and bite marks. Then she quietly explained that the baby had been brutally sexually assaulted, as well. Because the baby was so desperately ill, I had a great deal of work to do, so, I tried to focus on the task at hand and not on the broken bit of humanity before me.

Once the scan was completed, the specialist decided to withdraw life support and let her die. Normally, the parents are a big part of this process, since it’s their last chance to say goodbye, but Grace’s mother was reluctant to watch her die. Eventually, she agreed to be in the room but stood three feet away from the foot of the crib. She repeated the same words over and over, “Is she dead yet?” She wouldn’t touch the baby, so I placed my hand under the sheet, stroking Grace’s leg, as she lay dying. Her mother left the room before Grace’s heart stopped beating, so I was able to pick her up in my arms and hold her until her life had ebbed away. Cuddling Grace, I whispered, “I love you and God loves you. You are precious and beautiful.”

As I held her, I felt the Lord’s presence in the room as she passed from my arms into the arms of her heavenly Father. I felt comforted knowing that she was now in the presence of an all-encompassing love and would never again experience suffering. I also felt the Lord’s nearness and love for me as I began one last act of love, preparing her poor, broken body for burial.

As I tried to sleep that night, I couldn’t get her beautiful burned face out of my mind. I was terrified of returning to work and that awful suffering. I sat in my car the next morning, afraid to go in and desperately praying that I would never again see such pain and suffering. I knew this wasn’t a rational fear. Child abuse usually doesn’t involve the utter destruction of a child’s body, thus the chances of my having to witness anything similar to Grace’s case was infinitesimally small.

However, rationality doesn’t always win. I felt terrified. This was the hardest thing I had ever experienced. I had never seen so many gruesome injuries concentrated on one small body. A week later, after going through this panic-filled prayer on a daily basis, I quit my job and my profession. I couldn’t face the fear and the helpless knowledge that nothing I could do would prevent another Grace.

After several months of menial jobs, I was able to talk to a friend, Melissa, about Grace. Until then, I couldn’t voice the horror I’d felt. Even though I relived it daily in my memories, I just couldn’t let it out. God, in His grace, gave me the courage to finally speak of it, and Melissa’s response comforted me. She believed that Grace would remember she was loved in the final moments of her life, and that Grace would recognize me in eternity. Melissa said, “She’ll come running up to you and lift her arms to be cuddled once again by the one who gave her love in the last moments of life.”

With these words, I began healing. In a few more months, I returned to nursing. Although I struggled for months, I sensed God’s presence. His love would not let me go. My nursing abilities are the greatest gifts God has given me. Through the Lord’s love and mercy, He has given me the grace and the strength to continue nursing, although in a different area.

Telling these stories is difficult; reading them must also be so. Although the extreme abuse I saw in Hope and Grace does not occur daily for a pediatric nurse, working with abuse victims is always emotionally draining. Most nurses are socialized to be clinical and emotionally detached. While some emotional distance is necessary to enable us to be objective, I believe that victims of abuse experience healing when we love them enough to allow ourselves to feel their suffering. This doesn’t mean taking on their suffering, because that is not what God would have us do, but we need to help lighten their load.

Holding and loving Hope and Grace made a difference in their lives. Had I not held them, the tragedy of their existence would have been compounded. While it caused me greater pain than I had ever experienced in my life and, indeed, almost cost me my profession, I am thankful that God gave me the strength and courage to do this work. How grateful I am to Him for making these children the cry of my heart.


Since this story was published in the Journal of Christian Nursing, Fall 2002, I’ve again left the nursing profession, this time permanently, I think. I love kids and love pediatric nursing and long to be back in it, but just cannot meet the physical demands of the job due to the terrible pain I have each day. Perhaps someday the Lord will bring in healing and I will be able to return to this important and well-loved work that has been my life.

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