On the Vulnerability of Children: The Tiger's Bad Tumble

On Wednesday, my six-year-old son, the Tiger, “lost a battle with gravity,” as my friend who witnessed the situation described it. He fell from the monkey bars on the school playground, to the great detriment of his left elbow. You could see that there was an actual bend in his arm just above the elbow.

We transferred up to Columbus after our local ER determined he’d probably need surgery. His dad deposited us at Children’s Hospital, then went home to take care of the Bear. The Tiger was almost heartbreakingly brave through all of this, even when he got an IV in his uninjured arm.

The good news is that the orthopedic resident at Children’s determined that the Tiger’s fracture could probably be treated without surgery. She set it under deep sedation and we were discharged before the night was over. There’s a lot more to that part of the story, which I’ll write about as I’m able. Right now, I’m still dizzy with exhaustion from the past few days, busy pampering the Tiger, and reeling from the night’s emotional trauma.

The Tiger is feeling pretty good today following a miserable first 36 hours. He’s off pain meds, which is a mixed blessing because he was extremely charming while on Vicodin, and now he’s rather cranky – but his pain is blessedly subsiding. He’s learning how to maneuver in the world with his left arm in a sling. Unfortunately, he’s a lefty, so eating is tricky, and schoolwork will be well-nigh impossible.

We’ll return for a recheck on Wednesday, at which time we’ll learn if the Tiger still needs surgery. He has a supracondylar fracture – a break in the humerus just above the elbow. It’s a common injury for kids his age. It’s also “serious,” if the intertubes are to be believed, with the short-term potential for harming arteries and nerves. The Tiger appears to be fine on that score, but the main possible long-term complication is failure of the bone to grow properly, since the fracture runs through a growth plate. His odds of unimpaired growth are pretty good if the bone is positioned properly. If not, well, that’s why he might still require surgery. Supracondylar fractures are rated on a 1 to 3 scale, with 1 meaning the bone is still in alignment, and 3 always needing surgery. The Tiger’s break is between a 2 and a 3, which basically means the bone was substantially displaced but still hanging together by a thread.

Oddly, his cousin – my sister’s daughter – who’s two months older had a very similar fracture just two months ago. She did end up with surgery (and a pin – ugh), and she broke her left radius just below the elbow. Like the Tiger, she too faces a risk of impaired growth. My sister has been a wonderful source of support and advice. The whole family is stunned that the cousins would go through such similar experiences – at the same age, almost to the day.

Ever since my niece’s accident I’ve been ruminating on how impossible it is for us to perfectly protect our kids. Throughout most of human history, it was common for parents to bury one or more of their babies. Gustav Mahler’s Kindertotenlieder have been echoing through my head – especially the fifth one, where the protagonist regrets letting his child go out in a storm. The text (by Friedrich Rückert) begins:

In diesem Wetter, in diesem Braus,
Nie hätt’ ich gesendet die Kinder hinaus

In this weather, in this windy storm,
I would never have sent the children outside

Four years after Mahler finished these songs, one of his daughters died at age four of scarlet fever. He later wrote:

I placed myself in the situation that a child of mine had died. When I really lost my daughter, I could not have written these songs any more.

These days, we don’t often face the specter of child death, and as a society we repress the fact that it still occurs. As a society, we try to convince ourselves we can always keep our kids safe, if only we buy the right products and hover over them incessantly. Moments like this – when a child’s little body suffers damage that could be permanent – break through our thick carapace of denial.

The storm never subsides completely. It ebbs and whispers, only to rage anew. We can’t always keep our children inside, nor should we. Therein lies our kids’ vulnerability – and our own.