Patrick of Citium

Patrick is stoic.

Not when I am ruining his life by forcing him to stop building whatever he is building in order to go to school - you know, like he has done every single weekday since September and yet every day: unhappy surprise! - but when it comes to sheer physical discomfort he puts up with a lot before he says anything. That is my disclaimer.

Last Thursday Patrick and I were... huh. I think we were actually rolling around on the floor for some reason. Gosh we're playful. But as we rolled I noticed that he had a big old lump on the side of his neck, just under the ear. I'm not a rookie. I've played ohmygodnecklump before so I am able to recognize a swollen lymph when I see one. I said, yikes, Patrick, your neck. And he said, oh yeah, it's been like that for about two days. So I asked if his throat hurt (no) or his head hurt (no.) I took his temperature (99.nothing) and I checked his entire scalp for ticks. We have removed quite a few ticks from Patrick this season (some deer, some not) and there was a scab from one above the ear that was just above the lump. I concluded that his body had reacted to the two week old tick bite and the lymph was swollen in consequence. No big deal but I decided to take him to the doctor in the morning just to be on the safe side. I was about to try to analogize the lump for you but I just remembered I took a picture. See? Lumpy.

Our actual (beloved. oh how I belove him) pediatrician was not there on Friday so I had choice between New Partner Who Has Yet to Build Her Practice and Very Very Old Partner Who No One Wants to See Because He is Cranky. I went with the Newbie. I liked her. She checked Patrick out, went over his head looking for ticks, asked whether the lump hurts ("Well," Patrick replied carefully, "it hurts when my mom presses on it and I am not sure what you are going to do yet. So maybe") and then agreed with my initial assessment: his body was just dealing with some small scalp wound. I took Patrick to school.

Saturday, Sunday... Patrick was fine. A little warm at times but fine. I kept checking his lump and it seemed to be staying the same. Then on Monday night I woke up to the sound of sobbing. I am not the sharpest zester in the drawer at 4 am so I stumbled around upstairs trying to figure out who was crying and where they were. I finally located Patrick in the bathroom, moaning about how much it hurt to swallow. I felt his head, registered a moderate but not crazy fever on my maternal palm thermometer, gave him Motrin and took him to our bed. I tucked him in between Steve and me; waking Steve up to let him know Patrick was there, so be vigilant.

"Yarb," said Steve.

When Patrick woke up the next morning I discovered that his original lump was now the size of Idaho and all the surrounding lymph nodes on his neck were swollen and hard as well. His entire jaw had swelled and you could feel the glands there like a string of pebbles. Meanwhile, the lymph nodes on the other side of his neck were starting to increase. He was pale and his eyes were glassy. Strangely, his temperature was still around 99. Bodies are weird.

I called the doctor's office and their first available appointment was at 12:15.

"OK," I said.

You know, as I am writing this I am asking myself what I was thinking. And I know - I was thinking Patrick had a crappy normal kid virus - but in retrospect I want to slap myself for being so cavalier. Remember when I said that the only thing I recall from Biology is that the lysosome is the suicide bag of the cell? Well that is not true. I also remember that the lymphatic system is the body's highway. To para-sing: if a bacterial infection can make it therrrrrrrrre, it can make it an-y-wheeerrre. I should have taken him to the ER at four in the morning; is what I should have done. 

Back to reality: I accepted the 12:15 appointment, made Patrick a bed on the couch, gave him icy cranberry juice and very thin oatmeal. I let him watch anything he desired on Tivo.

"Can I watch America's Next Top Model?" he croaked.

"Um, sure."

"Ha," he gasped. "No. Thanks. Your. Stupid. Show."

[Aside: Patrick has been taught by his school that "stupid" is a swear word. Verboten. Not Done. Which is fine with us because calling someone stupid is very unkind. However, I think basic critical reasoning allows for a sliding scale of verbal assessment when it comes to things like Bravo TV programming so I gave Patrick permission to say that reality modeling shows are indeed stupid. It is a word he is allowed to use only at home so he does it at every possible opportunity.

Speaking of which, when I was in kindergarten I did something quite naughty. Stop me if I have told you this before. I told Kathy of the red rubber boots - awful girl; never liked her - that I knew how to write the mother of all swear words.

She said, "Show me."

I said, "OK but you have to promise not to tell. Cross your heart, hope to die, stick a needle in your eye. But," I added reasonably, "you don't really have to put a needle in your eye. Just your hand or something."              

"OK," she said.

So I did. I wrote F-U-C-K (I have an older brother, what can I say) and with a shocking lack of judgment I did so on the wall. In crayon.

Kathy of the boots promptly took a straight pin (where did she even get such a thing in the classroom? this part cannot be true and yet I remember it all so clearly) and put it painlessly through the very top layer of skin. Then she ran to the teacher and told on me. Snert.

Patrick got in trouble at the very beginning of the school year and he was devastated. Punished. At school. Oh the humanity. To cheer him up I told him the story of the writing on the wall, fudging the details a bit. It became more of a morality tale. I, too, was royally punished but I bounced back better and more law-abiding than ever.

"What was the bad word?" Patrick asked since I had glossed over that part. "Was it..." he lowered his voice, "stupid?"

"YES," I said. "YES it was. I wrote the word 'stupid' and I am very ashamed of that fact."]

Where was I? Oh. So Patrick began to watch a show about dinosaurs and then he just started to cry because he felt so terrible. Steve and I kinda freaked. The kid looked terrible. I grabbed him and a book and a blanket and threw him into the car. We went as a walk-in (technically a carry-in) to our pediatrician's office. While we waited Patrick just curled up on my lap with his head on my chest and groaned.

This time we saw Very Old Doctor Cranky.

I think in the past my problem with Dr V. O. Cranky has been that he has never taken my superspecial snowflake's symptoms as seriously as I have. I guess you see nine hundred million ear infections and the nine hundred million and first fails to inspire either pity or terror. This was not the case on Tuesday. It was obvious that he was actually concerned about Patrick and this fact made me triply/quadruply/infinitesimally more concerned. He did a strep test which came back negative, so he ordered blood work. Patrick sat on my lap and wept. 

White blood cell count came back high. They repeated the strep. Found an odd strain. Ordered two shots of antibiotic, one for each leg. Thought about sending him to Childrens. Left to consult with others. Kept us in the office to observe for an hour. Tried to decide if he had developed an abscess in the lymph. Decided not but dourly noted that it was still possible; maybe probable. Eventually put him on clindamycin, which is a hardcore antibiotic they use to treat broad spectrum infections. Said Patrick needed to return to the office the following day and if we had not seen significant improvement they would hospitalize him.

Scared the beejeezums out of me.

It's odd how everything can change in a moment. Not Patrick's condition - that had been getting gradually worse - but my interpretation of everything leading up to the visit changed in a split-second. Why on earth hadn't I taken him to the ER that morning? I remember this feeling from when a very small Caroline got hospitalized with a respiratory infection. It had seemed so harmless: oh the baby has a runny nose; oh the baby is a little stuffed up; she has a little cough... then fifteen people are running around struggling to get oxygen into her as the EMTs bundled her into their ambulance as gently as Tutankhamen's very last treasure.    

By the time the doctor saw Patrick his entire face was swollen and one half of his neck looked corrugated and reptilian. He was a terrible color and he couldn't stop crying. In retrospect I should have asked for a strep test on Friday. I should have taken him to the hospital when he said it hurt to swallow. It seems so horribly unfair that children are at the mercy of their parents - of this parent at any rate - when my ability to distinguish between sick and SICK is apparently nonexistent. I feel guilty.

But we were lucky. The infection responded quickly to the antibiotics. He finally developed a fever that night but by morning he felt terrific. He bounced into the doctor's office and the nurse who we had seen the day before said, "Wow, you look like a different kid."

"Guess those shots worked," said Patrick.

Our regular pediatrician said, "Old Doc Cranky doesn't scare easily. You must have looked pretty rough yesterday."    

"I did," said Patrick. "And then I got two shots and I couldn't even walk*."

"How is the medicine going? I know it tastes pretty bad."

"Yes," Patrick agreed. "And it... lingers? But," he shrugged "you have to do what you have to do, you know?"

Like I said, Patrick is stoic.

*Carrying 49 pounds of weepy Patrick out of the doctor's office through the parking lot and then around Walgreens to get his prescription filled with a pause mid aisle for chocolate-pudding-as-lactobacillus-delivery-system - the package for which I then had to clutch between my teeth - ranks as my own personal mother lifts volkwagen off child moment. I thought my arms were going to fall off. And, unlike Patrick, I whined about it afterwards.