Authors: Heather Gudenkauf
Chapter 14
J
enny looked carefully over at Maudene as they made their way through the hospital parking lot toward the car. Maudene’s steps were slow as if she were hesitant to leave. The day had grown hotter somehow and Jenny felt the rubber bottoms of her flip-flops soften as heat rose from the asphalt. Jenny knew that Maudene wanted to stay with her daughter, but they wouldn’t let Jenny anywhere near the pediatric intensive care unit and Ellen wanted Maudene to go and get her other children. “I could sit in the waiting room,” Jenny offered once again. Jenny was good at waiting patiently. She waited whenever they visited one of his father’s friend-girls, whenever the truck broke down and whenever she had to wait for her father to come home after a night out with his friends. Jenny was the queen of waiting.
“That’s okay, Jenny,” Maudene assured her, unlocking the car door though her gaze returned to the hospital. “Besides, I can help by going and getting Lucas and Leah.”
“I really don’t mind,” Jenny said sunnily. “I won’t bug anyone. You could even just drop me off at your house if you want to come back. I won’t steal anything.”
Maudene gave a little chuckle and Jenny wasn’t sure why but was glad for it. “I’m not worried a bit about that.” They both slid into the car, the temperature of the vinyl seats causing them both to fidget uncomfortably. Jenny moved to roll down her window and Maudene put up a hand to stop her. “Wait just a minute,” she ordered, and Jenny’s finger froze on the button. The air in the small car was sodden and heavy. Immediately a thin layer of perspiration appeared above Maudene’s lip.
Jenny watched Maudene out of the corner of her eye as the older woman propped her hands firmly on the steering wheel and closed her eyes. Jenny liked to watch people when they didn’t know she was looking. She gathered faces like people gathered pretty stones or shells on the beach. Maudene had an interesting face, Jenny decided. Not beautiful, but maybe it was at one time. The skin beneath her chin sagged, and deep wrinkles had settled into the corners of her eyes and around her lips. She had a narrow, straight nose with faint freckles scattered across the bridge. Jenny had always wanted freckles, but to her dismay her skin was, in her opinion, colorless and boring like a cheap piece of manila drawing paper they had to use in art class. Maudene’s cloud-white hair was pulled back in a neat ponytail and Jenny peered more closely to see if she could get a hint as to what color it used to be. The heat within the confines of the car was becoming stifling and Jenny felt the tickle of droplets of sweat skimming down her back. Maudene remained still, eyes closed, chin tucked into her chest.
Jenny wondered if she could be sleeping but didn’t know how that could be possible in the rain forest that was overtaking the yellow VW. Jenny felt suddenly, overwhelmingly thirsty. Her tongue felt heavy and dry, her stomach vaguely sick. Slightly panicked, Jenny had reached over to shake Maudene out of whatever trance she was in when Maudene’s eyes opened. With a quick swipe of her fingers Maudene swept away the moisture on her cheeks that Jenny, uncomfortably, realized were probably tears.
“My daughter is a good mother,” Maudene said, eyes fixed on the windshield, and with an angry flick of her wrist she started the car and Jenny took this as permission to roll down her window. Even the hot air outside the windows was a welcome relief from the stagnant sauna of the car and Jenny gulped great breaths of air.
“I can sit in the waiting room,” Jenny said again. “I don’t mind.”
Maudene reached over and patted Jenny’s hand and smiled sadly. “No, no. We are going to go to the grocery store and pick up a few things. I’ve got company coming.” At Jenny’s confused look, she continued. “My grandchildren. They are going to stay with me for a few days so Ellen and Adam can be with Avery at the hospital as much as possible.”
“Boys or girls?” Jenny asked.
“One of each,” Maudene answered as she pulled out of the hospital parking lot. Jenny liked Maudene just fine, but the thought of meeting her grandchildren made her stomach bubble nervously.
“You know, I haven’t forgotten about you and your...situation,” Maudene added after a slight hesitation. Jenny busied herself by looking at her fingernails. She had always wanted long, pretty nails, but hers were short and stubby and ragged from constant gnawing. “If I’m going to help you, you’re going to have to give me some more information.” Jenny fiddled with the radio, trying to find a station that played something besides talking. “It’s just that there is so much happening,” Maudene continued, “with my granddaughter. Later, after we go and get Leah and Lucas, we have to talk. Decide what to do next. That social worker I told you about—” Maudene looked over as Jenny leaned her head slightly out the passenger-side window hoping for a slightly cooler slice of air. “It’s my daughter.” Jenny closed her eyes trying to calm her stomach, which was starting to feel wobbly again. “Jenny,” Maudene said more firmly. “Look at me.” Jenny swung her eyes toward the older woman in tired resignation and prepared herself for the word that she was soon to be dropped off at the police station or in front of the Department of Human Services. “It’s going to be okay,” Maudene said with finality. “I promise.”
They drove in silence through the streets of Cedar City. Jenny’s initial appraisal of the town as being somewhat dumpy was quickly changing. They wound through neighborhoods where the trees along the streets yawned over them in a great green canopy and where houses stood solid and upright. Nothing like the sagging structures in her neighborhood back home.
They pulled into the parking lot of a large, newly constructed grocery store.
“Hey, we have one of these,” Jenny exclaimed. “It’s just not so big.”
Together the two wound their way across the gleaming floors and aisles brimming with food, and when they were through, Jenny helpfully set the groceries on the conveyor belt. She loved to hear the rhythmic beep of each item being passed over the scanner.
Mine,
each beep seemed to say and her stomach began to grumble.
Jenny and Maudene loaded the groceries into the narrow, shallow storage space in the hood of the VW. “Can I have these?” Jenny asked, holding up the Bugles. “I can pay you for them,” she added.
“Help yourself,” Maudene waved her hand dismissively. “I think it’s gotten even hotter, if that’s possible.” She squinted up at the sun, which seemed too far away, too pale, to be emitting such heat.
Jenny tore open the bag of Bugles, sending a rainfall of chips into the air.
“Whoops.” Jenny automatically bent over to retrieve them and popped one in her mouth. She caught Maudene’s observant eye and let them fall to the concrete.
“I bet the birds will eat them,” Maudene said, climbing into the car.
Jenny settled into the passenger seat, arranged five of the cone-shaped Bugles onto each finger of her right hand and waggled them at Maudene. “This is the best way to eat them,” Jenny explained. She plucked each off with her lips, noisily chewed, and then replaced each Bugle. “What are you going to tell them?” Jenny asked, tilting the bag toward Maudene, who shook her head.
“Tell whom?” Maudene asked as she drove from the parking lot.
“Tell your grandkids. Who I am?” Jenny asked. “We could say I’m your neighbor’s grandkid or maybe someone from work needed you to babysit me. You could say someone’s mother died and they couldn’t afford two plane tickets and she asked if you could watch me for a little while.” Jenny sat back with a satisfied smile. “That will work.”
“I’m not going to lie to my grandchildren,” Maudene said firmly. “What I mean is, I don’t think we need to make up a story,” Maudene amended gently after seeing Jenny’s stung expression.
“Okay,” Jenny said, blushing furiously and sliding down in her seat.
They continued on in silence, Jenny staring out the window until a green street sign caught her attention.
Hickory,
it said. She sat up tall in her seat and began counting the number of streets they passed until Maudene signaled a right turn. Seven streets. She was only seven streets away from her grandmother’s street. She wanted out of the car but didn’t know how to get Maudene to stop. Three blocks later they turned into an older but well-tended neighborhood, with small houses, neatly mowed lawns littered with bicycles, baseball gloves and other detritus of childhood. Maudene pulled up to a tidy two-story where a young boy stood at the front door, hands pressed against the glass. When he spied Maudene’s yellow car he disappeared briefly and returned with a woman and three other children. Three blocks back that way and then seven more blocks to Hickory. Jenny had walked to places much farther away than that.
Maudene put the car into Park and stepped from the car, signaling Jenny to join her. “Nah,” Jenny said, opening the passenger-side door. “I’ll just wait here.”
Jenny watched as Maudene made her way up the front steps and as a heavily pregnant woman answered the door, followed closely by a boy and a girl just around Jenny’s age. Jenny waited until Maudene stepped into the house and then eased herself from the car, closing the door quietly behind her. First slowly and then more quickly she began walking. Three blocks back that way and then seven more to Hickory Street and her grandmother.
Chapter 15
A
fter saying goodbye to my mother and Jenny, Adam and I move quickly down the quiet corridor toward the pediatric intensive care unit past the nurses in brightly colored scrubs and doctors in white coats. We check in at the nurses’ desk and we are directed to Avery’s room.
As much as I want to get to Avery, I’m afraid of what I will find and I let Adam step into the room first. A small cry escapes from his lips and I force myself to look. Avery looks so small lying on her back in the center of the high-railed crib; the strange IV still snakes from her knee, which is taped securely in place to a padded board.
“What is that?” I ask the nurse who has followed us into the room.
“It’s called an Intraosseous IV. It’s a device used to puncture an IV line directly into the bone marrow of the child. It’s important to get fluids right into her,” says the young nurse in pale blue scrubs dotted with grinning frogs and dragonflies. “We’ll have to watch her carefully to make sure she doesn’t pull out her IV. I’m Meredith—I’ll be taking care of Avery tonight.”
“I’m Avery’s mother, Ellen. And this is Adam, Avery’s father.” I nod toward my husband. I can see the fear on his face.
“Can we touch her?” I ask.
“Yes, please do.”
I reach through the crib bar for Avery’s hand. It is cool to the touch. “Can we stay with her tonight? Do we have to leave at a certain time?”
“One parent is welcome to stay the night in the room. Any siblings?” Meredith asks.
“Two,” I say. “An older brother and sister. Nine and seven.”
“Kids under twelve aren’t normally allowed on the PICU. Hopefully Avery will be here just a short while and we can get her to the general pediatric floor. Brothers and sisters can visit down on that floor.”
I lightly press my thumb into Avery’s palm. It is soft and cool. “She’s just sleeping?” I ask.
“Yes, she’s just resting right now.” Meredith lowers one side of the crib, leans over, checks the IV site and takes Avery’s temperature. “One hundred and one,” Meredith reports, writing it down on Avery’s chart. “Down another half a degree. That’s good.”
Adam stands close behind me, looking down at Avery from over my shoulder. “Is she in pain?” he asks, his voice shaking with emotion.
“She’s resting comfortably. We’ll watch her carefully. The doctor will be in a little bit later to check on her again and will talk to you.” She smiles encouragingly at us and leaves the room.
Stroking Avery’s hand, I marvel at her tiny fingernails. Her face looks thinner somehow, more gaunt. How can a one-year-old be gaunt? I wonder. “I wish I could hold her,” I say. “Do you think they’ll let me hold her?”
“Ellen,” Adam says softly.
“I mean, I think if they would just let me hold her for a few minutes...”
“Ellen,” Adam says again, setting his hands on my shoulders and turning me around. “We need to talk about what happened.”
I step backward, lightly bumping into the crib; a faint squawk comes from my child, a brief, pained protest. We both watch, holding our breath as she settles back into sleep. “It was an accident. A stupid accident, Adam. I didn’t hear you, I didn’t know.” I struggle to keep my voice low. “I promise you, I had no idea that Avery was in the van.”
Adam holds his hand out trying to placate me, his eyes darting back and forth from me, to Avery, to the doorway, back to me. “I know. I know it was an accident, Ellen. But it was a bad accident.”
“Not now, Adam,” I plead with him. “Please do not do this now. We do need to talk about this, but not right now.” I am crying openly now. I can’t stand to see him look at me the way he is, with disbelief, disappointment.
A retching sound comes from the crib and instantly we are both at Avery’s side. Her eyes are woeful slits, sunken into her head, trying to open but keep falling closed. Heaves wrack her little body and a surprisingly small amount of liquid spews from her mouth. Adam hurries out into the hall to summon help, while with one hand I use a tissue to wipe away the spittle that remains on Avery’s lips and the other to try to comfort her. She is shivering; goose bumps erupt beneath my fingers and her lower lip trembles in pain or fright. Probably both.
A doctor and Meredith, with Adam close behind, come into the room. “Vomiting is common with heatstroke. So is diarrhea,” the doctor explains. She is fit and wiry, somewhere in her late fifties, with ash-colored hair cut into a razor-sharp bob. “That’s one of the reasons we need to keep hydrating Avery.” We all look down at Avery, who has settled back into a fitful sleep, a wet thumb sliding from her slack mouth then being replaced. “I’m Dr. Grant, one of the pediatric physicians on staff. Dr. Campbell, the nephrologist who is overseeing Avery’s case will stop by shortly.” I am chilled by this statement. Avery has been reduced to a case that must be overseen. “Dr. Campbell specializes in kidney function. In assessing someone who comes to us with heatstroke we watch for kidney problems, rapid heartbeat, hyperventilation and seizures. All of which Avery has displayed.”
Next to me, Adam is swallowing hard and breathing deeply and I’m worried that he might start hyperventilating. I reach for his hand, but he shoves them in his pockets, his face to the ceiling, eyes closed. The doctor must be worried, as well. “Let’s sit down for a minute and talk more,” she suggests. In the small room, even though it is set up to house two patients, Adam sits in a recliner covered in green, faux-leather material while Dr. Grant and I each pull up an institutional plastic chair. Once Adam’s breathing has calmed, Dr. Grant continues. “We’ve also ordered several tests—a chest X-ray to check for edema and acute respiratory distress, an electrocardiogram and an echocardiogram and a CT of the head to look for any brain swelling. We’ve already started running several lab tests. Organ failure, renal failure, especially, is often found in heatstroke patients.
“I also need to tell you that as a medical professional, I’m a mandatory reporter....” Dr. Grant says as Meredith busies herself with Avery’s IV tubing, avoiding eye contact with us. I know exactly what a mandatory reporter is. I’m one myself. Iowa law defines classes of people who must make a report of child abuse within twenty-four hours when they believe a child is a victim of abuse. These mandatory reporters are professionals who have frequent contact with children, including those in medicine, education, child care, law enforcement and, of course, social work.
“I understand,” I interrupt, holding up my hand to stop her. “I’m a social worker. I will call my supervisor right now. It was an accident, just an awful accident.”
The doctor nods. “I’m sure everything will get sorted out.” Dr. Grant stands and Adam and I do the same. “In the meantime, we will continue to watch Avery very closely. Do you have any questions?”
“Will she be okay?” Adam asks. “She’s not going to die, is she?” Each word is brittle, in danger of breaking. Without even looking at him, I know that Adam is trying to be strong, trying not to cry.
“Avery’s condition is very serious. The very young and the very old are much more susceptible to heatstroke and its lingering effects. The next several hours are critical, but she’s right where she needs to be.”
Dr. Grant exits and Adam and I watch silently as Meredith exchanges Avery’s empty IV bag with a full one. When she leaves, I step closely behind Adam, press my face to his back, encircling my arms around his midsection, inhaling his smell, a mixture of fresh-cut grass and sunshine. And something else, something unpleasant. Fear, I think. “I’m so sorry,” I whisper into the fabric of his t-shirt. He doesn’t answer, but carefully untangles himself from my grasp and walks out of the room, only pausing to touch Avery’s little hand as he leaves.
I pull up a chair as close as possible to Avery’s crib. I try to keep my hands on my lap, but they keep straying to stroke her forehead, now smooth in sleep, or to squeeze her hand. I know she needs to rest so that her little body will heal, so that her heart will return beating to its regular, strong cadence and her kidneys will resume carrying waste and water away from her blood, so that her temperature will fall to a tepid ninety-eight point six degrees. I can’t stop the tears—they fall freely down my face, rolling down my neck, dampening the collar of my blouse.
I don’t want to leave Avery’s side, will not leave her side. Adam’s disappointment in me is a physical ache and I wonder where he has run off to. I don’t know what I can say or do to convince him that I had no idea that Avery was in the car. That I am so sorry. I blow my nose and wash my hands vigorously in the small bathroom connected to Avery’s room.
I need to call Caren, my supervisor, right away, inform her about what has happened. My mind flashes to what my mother has said about the television reports. In a matter of hours, if it hasn’t happened already, the entire state is going to know that a social worker has left her child in a van, unattended, on the hottest day of the year. I will be crucified. Surprisingly, this doesn’t terrify me the way it should. I would offer out my palms to be nailed to a tree, gladly, if I could undo what I have done.
The door opens and I expect the nurse, but it is my husband. His face is gray, his eyes frantic. In two large steps he is in front of me and I quickly rise to my feet. “Did something happen?” I ask, fearfully looking down at Avery. She is sleeping so peacefully. Her chest is rising and falling. “Did the doctors find something out?”
Adam grabs my hands in his, holds them tightly, almost painfully. “I should have made sure that you heard me.” His voice is barely a whisper. I have to lean in more closely to hear him. “I should have come out to the van to tell you that I put Avery in the backseat. I’m sorry.”
My shoulders sag in relief. “We’ll get through this, okay?” he assures me. I nod, my face pressed against his chest and I begin to cry. Great, heaving sobs that I try to bite back so that I don’t disturb Avery, but I can’t. I hold on to Adam for a moment longer and then extract myself from his arms and escape to the tiny bathroom in the corner of Avery’s hospital room. I turn on the faucet to try and drown out the sound of my weeping. Adam’s words are a gift that I am at once grateful for and undeserving of. When I look up into the mirror over the sink I look wretched. My hair is standing on end, my eyes are puffy and bloodshot, my skin blotchy and the tip of my nose bright red. I look down and my knees are skinned and dotted with dried blood from where I had knelt down next to Avery after she was pulled from the van. The hem of my dress is edged with dirt and grass stains, and dry earth has wedged beneath my fingernails. I look back into the mirror and try to see what I’ve seen in the eyes of countless other mothers I have met over the years. The ones who have dipped their children into scalding hot water, knocked them to the ground, beaten them with belts. I lean in more closely to the mirror until my nose is nearly touching the glass. I search for the manic glint or the deadened gaze in the green depths of my eyes. But it’s just me. I can’t be like them, those women.
There’s a rap at the door. “You, okay?” Adam asks.
“Fine,” I answer. My voice shrill and high. Not my voice at all. “I’m fine.” I wash my face and scrub the dirt from beneath my nails. My dress is hopeless and a sweaty, acrid odor rises from me. I need a shower but don’t want to leave Avery to go home to retrieve a change of clothes.
I step from the bathroom and see that another doctor has come into Avery’s room. He is a tall, slope-shouldered man of about sixty. Reading glasses sit atop his gray head.
“Mr. and Mrs. Moore,” the doctor greets us with a nod. “I’m Dr. Campbell, the nephrologist. I’d like to update you on Avery’s condition.”
Once again we take a seat and anxiously look at the expert who can save our child. “We have Avery’s core temperature normalized. We continue to watch her closely for delayed end-organ dysfunction. This means that even though her temperature is normal and she is stabilized, she remains at high risk for multiple organ failure, the breakdown of muscles, high potassium levels, low calcium levels and abnormally elevated phosphorus levels, all which can lead to kidney injury and renal failure.”
Dr. Campbell scans our faces as if trying to glean whether or not we understood what he was saying. We both nod. “We will monitor Avery until we are sure these levels are within normal ranges and she is seizure-free.”
“How long do you think that will be?” Adam asks.
Dr. Campbell shakes his head. “It could take twenty-four hours or weeks. It just depends on how quickly Avery responds to treatment.”
Before leaving us, head bowed, Dr. Campbell rests one capable hand on each of our shoulders and I’m reminded of the faith healers who, just by touch, supposedly can send currents of curative volts of electricity through your system. I feel nothing. Adam and I sit next to Avery in her hospital room for the next four hours, speaking only out of necessity. He flicks through a stack of old newspapers, periodically sending text updates to well-wishers. Waves of tears come and go. I try to cry soundlessly, keeping my eyes on my daughter who is sleeping fitfully. Every squawk she makes sends me to my feet.
I hear a small commotion outside the room and look up to find Caren Regis, my supervisor at DHS as well as Richard Prieto, the county attorney that I’ve worked with many times. I am relieved to see Caren, but I’m puzzled about Prieto’s presence. I’m not here today to visit a neglected, abused child or here to chronicle the many indignities they have endured. The sight of Richard Prieto is alarming.
I put a finger to my lips to signal that Avery is sleeping and lead them to the hallway just outside the PICU entrance. “Hi, Caren, Richard.” I nod briefly at each of them. “What’s going on?” I ask, panic clawing at my chest. Wordlessly, Prieto hands me a piece of paper. A piece of paper that I have handed to parents countless number of times. A piece of paper that has the power to snap a mother’s heart into two jagged pieces. “Caren?” I say, looking at her in disbelief. Her gaze remains steady, unemotional, just as mine would have been if we had reversed roles.
Prieto clears his throat. “I wanted to inform you in person. We’re discussing the possibility of assembling a grand jury to determine if we will move forward with formal charges.”