Page 18 of Storm's Embrace

He listened to Jesse’s heart sounds and breathing, but also took the time to get a closer look at what Sallie had noticed while taking Jesse’s vitals and reported to LaDonna. They weren’t vivid. In fact, they were hardly discernible.

But they were there.

Faint bruising on Jesse’s upper arms and shoulders—the placement of the marks consistent with an adult’s hands.

“You’re such a good boy,” his mom told Jesse while Eli placed the bell across her son’s back. He didn’t notice any additional marks.

“Okay,” Eli said, putting the stethoscope pack in his coat pocket. “You did good. Can I get a high five?” Jesse laughed and slapped his tiny hand against Eli’s.

Next, Eli palpated around Jesse’s neck as he would in any exam, but then moved his hands to the little boys head to check for any swelling. There was none. Eli kept his one hand on Jesse and reached to his left for his plexor sitting in a wall rack. “Let’s check your knees. Okay?”

Jesse nodded and watched in fascination while Eli tapped the rubber mallet against each knee. The little boy laughed when his legs jerked.

“You liked that, didn’t you?”

“Gen!”

“You want me to do it again?”

Jesse nodded, so Eli tested his reflexes one more time—this time laughing along with the little boy.

“Okay, now open your mouth,” Eli said, taking his otoscope from his other pocket and turning it on. “Let’s see those teeth.” Jesse opened his mouth wide as he shone the light inside his mouth. “Good job, buddy. Do you brush your teeth?”

“I’m teaching him,” his mom said with a smile. “He likes the bubblegum flavor.”

“To be honest, I do too,” Eli said, and gave her a grin before focusing back on Jesse. “Now, let me look at those big blue eyes of yours.” Jesse’s pupils were equal and reactive to light, so normal. Relief filled him when he saw no signs of retinal hemorrhages. “Hey, buddy, watch my finger.” For a two-year-old, Jesse did a pretty good job of following Eli’s finger up and down and side to side, although he did grab at it a few times while laughing.

“Okay, young man, let’s check out your belly.” He maneuvered Jesse to a reclining position and pressed into his stomach and then did some abdominal palpations before checking his genitals—something Jesse wasn’t too happy with. “Are you using the big boy potty?” he asked him while pulling his training pants back up.

“I pee.”

“He’s started letting me know, so I’ve been working with him,” Mrs. Garrison interjected on a small laugh.

“Excellent,” he said while manipulating Jesse’s legs to assess his joints and mobility. “All right, let’s get you down on the floor, big guy.” Eli lifted Jesse up and said to his mom, “Can you stand across the room for me so I can see him walk to you?” She nodded and moved to the far wall and squatted with her arms out. “Okay, now,” he said, placing Jesse on his feet. “Walk to mommy.” He ran instead and threw his arms around his mom’s neck.

His gait looked good and he was holding his head up. All in all Jesse was a healthy child developing at a normal rate without any overt neurological defects.

But then there were the bruises.

Eli’s biggest concern before the exam, as had been LaDonna’s, was the placement of the bruising, leading them both to suspect Jesse had been shaken. From all accounts, it didn’t seem to be the case, but it still didn’t explain the bruising on him, or of that on his mother.

Eli picked up Jesse’s chart and made some notes before addressing Mrs. Garrison again. “My nurse, Sallie, is going to come in and take some blood and give Jesse his shots.” She nodded at him and stood up with her son still in her arms, a relieved look relaxing her features. “Afterward, he can get dressed, but I’d like to see you for a few minutes in my office.”

Brittany Garrison’s eyes widened and their depths filled with panic. “I don’t really have time. I have to get home and fix supper and—”

“Mrs. Garrison. Please. Let me talk to you. It’s important for both you and Jesse.” She slowly nodded and sat back in her chair with a resigned expression.

Eli left the exam room and shut the door to find LaDonna waiting outside the room for him. He pulled her further up the hall before speaking to her in a hushed tone. “I’ve got her waiting for Sallie to take blood and give Jesse his shots. I’d like you in there. Once Sallie’s done, I need you to bring Ms. Garrison to my office.” He checked his watch. “Damn.” He looked around to make sure no kids were close who might have heard him. “I’m running way behind again now.”

“No, you’re not,” LaDonna said, just as quietly with a soft smile. “I told Miriam the situation and she called in Serena a few minutes after you went in to start the exam.”

Thank you, Miriam.

Eli breathed out a sigh of relief, knowing their on-call nurse practitioner had come in to take up his slack. He hadn’t wanted to keep his other patients waiting, but he’d felt it was important to give as much time as he could to the Garrisons.

“What would I do without you?” he asked with a slight grin.

LaDonna’s face flushed, while she shook her head. “I have no idea.” She took in a deep breath, sobering. “So?”

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