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The Unexpected Trip

You never forget your kid’s first ER visit. I mean real visit. Not the times you take them in because of colds, coughs, asthma, rashes, or weird bumps. Those you see coming, a bad cough that isn’t getting better or a fever that is getting too high. I’m talking about the ones where you’re having a perfectly reasonable day when suddenly BAM something happens and the next thing you know you’re on your way. We’ve had three good ones courtesy of our oldest kid.

Our first trip came because of something that parents do every day and never think twice about it. You’ve seen it countless times on TV and in movies, and I’m guessing it makes up a considerable portion of stock photo sites, the image of parents (or a parent) holding hands with their little one and walking. If there are two adults then perhaps each will have a hand and even give their kid a swing. This image sounds innocent enough. Look! They’re all laughing. Their life seems wonderful. Don’t you wish you were these people? Wait, what’s wrong? The little kid doesn’t seem to be enjoying the swinging or holding hands anymore. In fact, the kid looks like he can’t do anything with that one arm. Ah, crap.

The first time I heard the term “Nursemaid’s Elbow” was when our ER doc mentioned it within 15 seconds of seeing us. It’s what happens when the tendon on the elbow gets pulled or yanked too hard and partially dislocates. Nursemaid's elbow sounds way cuter than a dislocated elbow. A dislocated elbow makes me want to barf. Nursemaid’s Elbow sounds like a lovely British children’s book about a nursemaid with magical elbows.

We had all the signs though, confused worried guilty parents that were silently blaming themselves (and their kid) and a sad but guilty looking kid that didn’t know why he was guilty but subconsciously knew that he was partly at fault here too. Nursemaid’s elbow goes back to a time when having a nursemaid, or nanny, was a pretty common thing. They were the primary caretaker of the children and were most likely also the ones playing/disciplining them. Meaning they were most likely the ones swinging them by the hands and arms, yanking them up off the ground if they were pitching a fit, or pulling them to walk faster when they were dragging their feet. Today, if they renamed the condition, they would call it something like, “babysitter’s elbow,” or “nana’s elbow,” or “no we’re not getting Auntie Anne’s Pretzels we’re only at the mall to return something, and we have to go pick up your brother in 30 minutes – elbow.”

As you can guess, our kid got it by flopping to the floor of our mall like a thirty-pound sack of potatoes because we wouldn’t get him a pretzel stuffed with mini hot dogs. One minute we’re walking along, holding hands like one of those stock photo families, the next it’s like gravity reversed on him and he dropped to the floor, except you’re still holding his hand. And he fell with such force it’s only instinctual to grip his hand even tighter and hold on. It’s as if your vice-like grip is the only thing keeping your precious little guy from being sucked through the child size black hole that just opened on the mall floor.

Only there is no black hole, just your kid freaking out on the floor of your mall because you won’t buy them little pretzels with hot dogs in them. I mean, who doesn’t love a pig in a blanket (especially a cup of them) but that line was dang long, and we had things to do and places to be. The problem with your kid throwing a temper tantrum is that you’re not going to notice when he suddenly starts complaining about his arm, um not working. ‘Notice’ is the wrong word; more like you’re going to ignore it because you think it’s just a ploy to get those delicious golden brown piggies. It’s only when you get back to the car and begin strapping him into his car seat that you notice that he can’t lift his arm and you’re a terrible parent.

Luckily, nursemaid’s elbow is super common and easily fixed. The ER doc did a couple of quick movements of my kid’s arm, and the tendon flopped back into place, he was as good as new, and I didn't pass out when the doc did that. So I was pretty proud of both of us. We were in an out of the ER pretty quick and no worse for wear. Unfortunately, that isn't the case on our next couple visits.

The second one happened when my wife left me alone with both our sons for the first time. It was the first time she’d been away from them both at the same time, ever. She was meeting friends for dinner and drinks. She hadn’t been out to eat without either of the kids in nearly 23 months. My oldest (2 at the time) was bouncing on our bed while I was feeding his baby brother. What my oldest lacks in listening skills he makes up for in enthusiasm. Tonight was no exception, and the excitement was radiating off of him because he knew he was home alone with dad. He ran. He screamed. He ran and screamed. He bounced on his bed. He jumped on our bed. He continued to bounce on our bed when I told him to stop. He giggled at me when I said him I meant it this time. He jumped higher. And higher. And higher and then he went headfirst into the corner of our nightstand.

Shocked. I did what any dad in this situation would do. 1) Check to see if he poked his eye out. 2) Check for any open wounds. 3) Check for any broken bones. Then I went and got some ice for his head and a popsicle for the pain. After 10 minutes I took the ice off and realized that it wasn’t so much a bruise as I had first assumed but a divot. The corner of the nightstand dug a little chunk of skin out, just to the right of his eye. Like when a golfer shanks a swing and a piece of earth goes flying. Only I couldn’t go searching for the skin divot and press it back on his face. It was just a teeny tiny itty bitty little divot. It’d almost be cute if it weren’t on my son’s beautiful face.

It was at this point that I decided it was time to ruin my wife’s first night out and looped her in on the happenings. In the middle of my skin divot golfing analogy, she left the restaurant and returned home. Our first family trip to the ER soon occurred. They checked him for a concussion, gave him another popsicle, and they sealed the divot with glue. Which I thought was a good thing because no stitches (Yay!) but to this day my wife glares at me whenever he mentions the tiny mark to the right of his eye. I was able to expel some excellent dad advice though; I offered to draw a little teardrop where the hole was for Halloween. I routinely remind him that “chicks dig scars.” And we’re continuously revising the scar origin story from him crashing into the nightstand, to shark bit his face, to cobra bit his face, and my personal favorite Voldemort.

The third unexpected trip to the ER occurred a couple of years later but with many of the same characters and themes only better (meaning more terrible). It’s like those rare occasions when the sequel to a movie is better than the original (Godfather II, Empire Strikes Back, Gremlins 2) with a dash of instant karma that makes you stop and wonder if there is a higher power at work.

The same two boys as before but this time they are both older. It’s the beginning of summer, and they are doing what boys do; running, screaming, not listening, and more screaming. It’s Virginia, in the summer, so that means humidity. Gross sweaty moisture that weighs you down like an old wet fur coat. We’re all inside enjoying the AC, and I can hear the boys goofing around upstairs. My wife shoos them from the upstairs, and they take off down the stairs grabbing and pushing each other the whole way down. Sensing their recklessness my wife called down to them both to stop goofing off on the stairs before they break something. Sensible instructions that my boys realized were meant to protect them, and they immediately quit horsing around. 


No, of course not, they both turned to my wife and repeated what she said but in a mocking singsong sort of way. Like they were trying to mimic her voice, only higher pitched. They turned their hands into puppets to go along with their impersonation. It was like they were trying to goad her into chasing them. Both cackled with glee and ran down the rest of the stairs. My oldest, realizing he was trailing his little brother leaped from four stairs from the bottom and landed right behind him. He turned to take the inside lane then let out a scream and collapsed to the ground holding his leg. He was still on the floor whimpering when we got to the bottom of the stairs. His little brother, not fully understanding the situation, was running circles around him still laughing.

When determining the severity of an injury to one of our boys (who we think might be hamming it up) we deploy the "Cookie Test." It’s called the cookie test because it involves offering them a cookie. We ask them if a cookie would make them feel better. When they say yes (and they always say yes) we know that they’re okay and tell them to shake it off. And no, we don't give them a cookie because we don’t give cookies to fakers. If we wanted them to get rewarded for faking injuries, they would play way more soccer. And I know what you're thinking. If the boys know they won’t get a cookie if they say they want a cookie, wouldn’t they do the opposite and say they didn’t want the cookie? I counter that sound logic with, “have you ever had a four-year-old turn down a cookie?”  That’s why when our four-year-old, moaning on the stairs, said he didn’t want a cookie I knew this wasn’t some game theory trick; he's hurt. My wife and I became very serious, and I gently scooped him up and placed him into the minivan, propped up his leg so it didn’t dangle and we were off on our second ER visit as a family.

A toddler fracture (another cute sounding name to keep the parents from passing out) is when a toddler plants his leg then twists in a way that the leg breaks. It’s an innocent-sounding name for a horrible injury. Toddler fracture sounds like something Doc McStuffin could fix in ten minutes; a broken femur sounds like my oldest's summer just got ruined. It was an emotional rollercoaster watching him go from a wild screaming four-year-old to a bedridden screaming four-year-old, to a four-year-old with a cast up to his hip. Kids are amazing at adapting. And you’d think (hoped) having a full leg cast would have slowed him down, and it did to a point, but it wasn’t long before he was scooting his way around the house swinging his cast at his little brother like a club, who was always just out of reach. It was a glorious few weeks for his little brother who, for the first time in his life, had the upper hand (and two good legs.) He was now faster, more mobile, and just needed to stay out of reach to take and keep whatever he wanted from his brother. It was a great few weeks for him, but it all came to an end a few months later when they removed the cast, and his older brother began limping after him like a vengeful newborn baby deer.

One funny aftereffect of the toddler fracture was the amount of attention my oldest received from strangers after they removed the cast. It took him about a month to get the muscles in his leg strong again to not walk with a noticeable limp. But, during that time people would see this determined skinny little kid walking, running, climbing and they would smile at him and then my wife and I, sometimes they'd ruffle his hair and give him a "bless your heart." On our family beach trip, other beachgoers would see him limping across the sand trying to keep up with brother and cousins, and I could hear them saying things like, “Oh look at that brave little boy trying to keep up. So determined.”  It took every part of me not to yell, “He broke his leg being a jackass on the stairs!”

Notice in this last one I said it was our “third’ visit and not our “final” visit because emergency room visits are part of any parents life. Especially if you have crazy active boys like mine. And for the most part that's a good thing. It means you're paying attention. I never went to the ER as a kid. One, because I was an overly cautious child, but also I think parents back then only took you if something was missing, hanging off, or pointing in the wrong direction. But, you should never hesitate to take your kid to the ER. No one knows your kid better than you. As for those out of nowhere ER visits, think of it as kids doing what kids do; Exploring, testing their limits, being impulsive, and (hopefully) learning. With any luck, they'll only walk out with a bump on the head or a couple of stitches. And one day you'll be able to look back on all these unexpected ER visits as funny stories you can wait to retell, whenever they bring home a date.

Ray Tolbert