Chapter Eight
The fracture clinic at the hospital on Monday morning was very busy with adults and children waiting to be seen. Many had a limb in plaster, others were heavily bandaged with their arms in splints and slings. Those with leg and ankle injuries were using crutches. I gave Kit’s name and hospital number to the receptionist and also told her of his change of address. She updated his file on the computer and then told us to take a seat and wait to be called. I’d packed books and small toys to keep the children amused, as well as drinks. I sat Kit on my lap and we looked at a book while Molly sat beside me and stared at those around us as children her age do. Gradually patients were called in to see a doctor and others arrived. As we waited, the woman sitting next to me struck up a conversation. I guessed her son was a similar age to Molly and he had a broken arm. She told me he’d broken it by falling from the top bunk bed, where he wasn’t supposed to be. He was the younger of two boys and slept in the bottom bunk bed, while his older brother had the top. She said she and her husband had told him repeatedly he wasn’t to climb up to the top, as he could fall and hurt himself, and that’s what had happened. ‘But that’s kids for you,’ she said. ‘Accidents do happen.’ And I wondered how many accidents a child could have before suspicions were raised. ‘How did your little boy break his arm?’ she asked.
‘He fell downstairs,’ Molly said before I could.
‘It’s impossible to keep your kids safe all the time,’ she said. ‘But I do feel guilty.’
I agreed and we continued chatting until she was called in to see a doctor. I don’t usually tell passing acquaintances that I am fostering the children. We were called in next and a healthcare assistant showed us into a consulting room, where a young doctor sat behind a desk, reading from a computer screen. He glanced up as we entered, said hello and told us to take a seat. I lifted Kit onto my lap as Molly sat on the chair beside me. The doctor read for a moment, then looked up and said, ‘How is Kit’s arm? No swelling or numbness?’
‘No, it seems fine as far as I can see.’
‘How is he coping with having a plaster cast?’ he asked.
‘He’s managing, although it is cumbersome. It stops him from doing some things and I think it’s uncomfortable for him at night when he turns over in his cot.’
‘Yes, it would be,’ he said. He read some more and looked at me again. ‘I’m not the doctor who treated him before. Are you his mother?’
‘No, his foster carer. The children were placed with me last Thursday.’ He obviously had to know.
He nodded, typed and then said, ‘I’ll have a look at Kit’s arm and then we’ll see about taking off the plaster cast, as it’s causing him a problem.’
‘Really?’ I asked, surprised. ‘It’s only been on a week. Will the bone have healed?’ Far be it from me to question a doctor, but I felt sure this couldn’t be right and perhaps he’d made a mistake with the dates.
‘It won’t completely heal for a few weeks,’ he said. ‘But it’s a straightforward buckle fracture, the most common type of fracture in young children. It’s caused when they put their hands out to save themselves. We used to plaster this type of fracture, but now we usually use a splint. They heal just as well, and in young children it’s far more comfortable. It has to be worn at night, but it can be removed for showering and washing.’
‘I see. So why was a plaster cast put on?’ I asked, puzzled.
‘Because the child’s mother insisted,’ the doctor said. ‘Apparently she was very anxious and wanted a plaster cast, so we obliged – to reassure her.’
‘I see.’ He stood and came round to where Kit was sitting on my lap and, smiling at him, gently lifted his arm. He examined his hand and told him to wiggle his fingers, wiggling his own fingers to demonstrate. Kit obliged. The doctor then compared both Kit’s hands. ‘I have no concerns,’ he said, and returned to his desk where he typed some more notes. ‘If you think Kit would be more comfortable with a splint instead of a cast, I will arrange to have it replaced.’
This was a little difficult. ‘If he was my son I would say yes straight away, but he’s in care. What would be your advice?’
‘To use a splint.’
‘Then please arrange it and I’ll tell his social worker.’
He nodded, made another note, then said, ‘If you would like to wait outside again, I’ll see if we can remove the cast today, otherwise we’ll make an appointment for tomorrow.’
‘Thank you,’ I said. We left the room and returned to sit in the waiting area, which was slowly emptying. I would need to update Tess as soon as possible, for I could see that if Kit arrived at contact with a splint instead of the plaster Aneta had insisted on, she was likely to be upset and angry. It wasn’t appropriate to phone her now from the hospital waiting area with Molly and Kit with me, so I’d phone her as soon as we returned home.
‘Doesn’t Kit need a plaster?’ Molly asked, clearly having understood much of the conversation I’d had with the doctor.
‘No. Apparently not,’ I said.
‘Why?’
‘Because his arm will heal just as well without it.’
She looked thoughtful but didn’t comment and the three of us then looked at a book. After about ten minutes a healthcare assistant came over to us with a new appointment card. ‘Sorry to keep you waiting,’ she said. ‘Monday is always busy, so I’ve booked in Kit for ten o’clock tomorrow to have the plaster removed and a splint fitted.’
‘Thank you very much,’ I said.
As I drove home I wondered why Aneta had gone against medical advice and insisted on a plaster cast when a splint would have done. The doctor had said she was anxious, which I’d already seen in her, especially in connection with her children’s health. I supposed she thought it was better for Kit; a cast was certainly more robust, but I trusted the doctor’s judgement and a splint would be far more comfortable for Kit.
It was 11.30 a.m. when we arrived home and, mindful that Kit and Molly had a medical booked for 1 p.m. and I needed to speak to Tess before contact, I made them an early lunch. As they ate I used the phone in the kitchen to call Tess so I could keep an eye on them but they wouldn’t be able to hear every word. It’s so much easier to hold a private conversation when I’m fostering an older child. They’re at school during the week and if I have to make or receive a private call when they’re home they can be left watching television or playing while I’m on the phone.
Tess was at her desk and had been about to phone me. ‘I’ve just finished talking to Aneta,’ she said. ‘How are Kit and Molly? What sort of weekend did they have?’
‘They are settling in slowly,’ I said. ‘Molly is talking more but misses her mother. We’re keeping her occupied, but at night she’s very tearful. Kit seems to be coping a bit better. I’ve just come from his hospital appointment at the fracture clinic.’ I then told her what the doctor had said.
‘I understand,’ she said, as though Aneta’s behaviour at the hospital wasn’t a complete surprise. ‘I’ll inform the parents that Kit’s plaster cast is being removed tomorrow and he will be fitted with a splint. I’ll need a copy of the doctor’s report,’ she added, thinking aloud. ‘I’ll request it.’
I had a number of matters I needed to discuss with Tess. ‘The Essential Information Form –’ I began, but before I got any further, she said:
‘Kit and Molly share a bedroom, don’t they?’
‘Yes.’ I’d shown her the room when she’d first placed the children.
‘They’ll need to be separated. Aneta is saying that Molly was responsible for Kit’s injuries.’
‘What?’ I gasped.
‘She said Molly pushed Kit downstairs and has hurt him before. Aneta is saying she took the blame to protect Molly, but she is innocent and Molly is responsible. Can you move Kit’s cot out before tonight, please?’
‘Yes. It will have to go in my bedroom, though,’ I said, shocked from what I’d heard.
‘That will be all right. He’s only eighteen months. He can go in your bedroom for now. Our policy is that an infant can sleep in the foster carer’s room until they’re two and a half, but not their bed.’ Which I knew. ‘From what I remember, you have space in your bedroom to accommodate his cot?’
‘Yes, I do.’
‘Have you witnessed any incidents of Molly hurting Kit?’
‘No. Not at all. She seems very close to him and protective. Last night when he woke she got out of bed to comfort him. At least, I assume that’s what she was doing. She had her hands between the slats of the cot. I’m sure she wouldn’t intentionally harm him.’
‘Monitor them and let me know if you see her intentionally trying to hurt him. There may be some truth in what Aneta is saying, although I doubt the child is responsible for all their visits to hospital.’
I was so thrown by the suggestion that Molly had intentionally harmed her younger brother that it took me a few moments to recover my thoughts. I knew sibling rivalry did occur and that a child could go through a phase of being quite spiteful to a sibling, but with the parents’ help they learn it is wrong and no real damage is done. I also knew that a child could unintentionally harm a sibling, not realizing the outcome their actions could have. But to suggest that Molly had intentionally pushed Kit downstairs and inflicted other injuries on him severe enough to require hospital treatment was rare and very worrying.
‘You mentioned the Essential Information Form,’ Tess prompted.
‘Yes,’ I said, reining in my thoughts. ‘In the section on health it says the children have seizures. It wasn’t mentioned when I met Aneta and Filip. Do they have epilepsy?’
‘Not as far as we know. Aneta claims the children have fitted, but it’s never been observed by a medic. The fit stopped before the ambulance arrived. I’m waiting to see their full medical records, but it’s likely if one of them did have a fit it was a febrile convulsion brought on by a sharp rise in temperature.’
I was partly reassured. While a febrile convulsion is alarming to watch, I knew they were quite common in young children and they passed quickly, and were not usually harmful to the child. The main treatment is to bring down the child’s temperature.
‘But obviously keep an eye on their health and give them their medicine,’ Tess said.
‘Which medicine?’ I asked, alarmed.
‘You were given a bag at contact on Friday containing the children’s medicines.’
‘Yes, but there’s nothing in there to be taken regularly. I checked. It contains things like antihistamine, Calpol, cough syrup, eye and ear drops, medicine for stomach upset. They are all medicines to be given if the child is ill. There’s also an inhaler I was going to ask you about. I went through the bag carefully – there’s a lot of medicine, but none of it is to be taken regularly.’
‘You’re sure?’ Tess asked.
‘Yes, positive. I’ll look again, but all the instructions are to take when symptoms first appear or as and when required. I assumed the inhaler was to be given if one of them had difficulty breathing after an allergic reaction, as asthma hadn’t been mentioned.’
‘I’ll check with Aneta and get back to you,’ she said. ‘Have the children been ill at all over the weekend?’
‘Molly was sick when she came out of contact on Friday, but I put it down to upset. She soon recovered. It was quite traumatic when it was time for them to say goodbye.’
‘In what way?’ Tess asked. ‘I haven’t got the contact supervisor’s report yet.’
‘Aneta was very upset and couldn’t bring herself to say goodbye, which of course upset Molly and Kit. Once we were outside Molly vomited but recovered after I comforted her and gave her some water. Then on Saturday night she said she felt sick and tried to be sick but wasn’t. She was talking about her mother a lot. She didn’t have any other symptoms, and again she quickly recovered after being reassured. I think she spends too much time worrying about being sick.’
‘So does her mother,’ Tess said bluntly. ‘You’re keeping a note of all of this and a food diary?’
‘Yes.’
‘Aneta should be calmer this afternoon at contact. Filip took her to the doctor and he’s prescribed a light sedative.’ I felt for Aneta. The poor woman was so distraught at her children going into care that she was now being sedated to get through it. Surely this wasn’t the reaction of an abusive parent? For a split second I wondered if Molly could have been responsible for Kit falling downstairs.
‘Tess,’ I said, moving on, ‘the allergic reactions the children have that result in vomiting, diarrhoea, rashes, bruising and difficulty in breathing, could it be an inherited condition? It’s strange that both children have them.’
‘It was mentioned, but nothing has been identified. Neither of the parents have these symptoms, although it’s something the doctors may need to investigate further. I’ll know more when I’ve seen the medical reports.’
While I accepted this, I had the feeling that Tess knew a little more than she was willing to say at present. Information-sharing with foster carers has improved tremendously since I first started fostering twenty-five years ago, but we are still told on a ‘need-to-know’ basis. Perhaps I didn’t need to know this – if indeed Tess was holding something back at all.
I was watching the children eat their lunch as I talked to Tess. Kit was doing well feeding himself, although some of the sandwich had slid from his plate and onto the table. As Tess spoke I went over and put it back on his plate, smiling encouragingly at them both.
‘Aneta has asked me to tell you’, Tess continued, ‘that because the children are sensitive to germs, she disinfects everything they come into contact with every day. That includes their toys, cutlery, plates, mugs, the dining table and the furniture in their bedroom. She also washes their clothes, bed linen and towels every day.’
My mouth dropped open in amazement as the children continued to eat at a table that, while clean, hadn’t been washed with disinfectant. The same applied to their plates, cutlery, the chairs they sat on and the rest of the house. ‘Are you asking me to do that?’ I asked in dismay. There weren’t enough hours in the day.
‘It seems a bit excessive,’ Tess conceded. ‘So use common sense. Follow good hygiene practice and make a note of any reactions the children may have.’ I breathed a sigh of relief. Clearly if something was identified I’d have to take more precautions, but for now I could continue as I had been. ‘What are the children doing now?’ Tess asked.
‘Having their lunch. I’ve already entered what they’re eating in the food diary.’
‘Good. I’ll phone Aneta now and get back to you about the medicines.’
‘I’ll be on my mobile after twelve-thirty as we have their medical at one o’clock and then contact at three. Tess, just something that’s crossed my mind as we’ve been talking, do Kit and Molly share a bedroom at home?’
‘Yes.’
‘Why? If Aneta thinks that Molly has been hurting Kit?’
‘They live in a two-bedroom flat and there isn’t room for the cot in their bedroom.’
‘But surely they would make space for his cot in another room – the living room, for example – if there’s a possibility Molly could be harming Kit?’
‘I agree,’ Tess said, and that was all she said. And again, I had the feeling that there was more to it. It didn’t make sense. If Aneta truly believed that Molly had been hurting Kit, she’d have found a way to separate them at night – presumably the only time they weren’t being watched. Why risk it?