Tell No One

Stone turned to Carlson. He made sure that his smile was off camera.

“Got him,” Stone said softly.

Carlson said nothing. He watched the technician bag the weapon. Then, thinking it all through, he began to frown.

23

The emergency call on my beeper involved TJ. He scraped his arm on a doorjamb. For most kids, that meant a stinging spray of Bactine; for TJ, it meant a night in the hospital. By the time I got there, they had already hooked him up to an IV. You treat hemophilia by administering blood products such as cryoprecipitate or frozen plasma. I had a nurse start him up right away.

As I mentioned earlier, I first met Tyrese six years ago when he was in handcuffs and screaming obscenities. An hour earlier, he had rushed his then nine-month-old son, TJ, into the emergency room. I was there, but I wasn’t working the acute side. The attending physician handled TJ.

TJ was unresponsive and lethargic. His breathing was shallow. Tyrese, who behaved, according to the chart, “erratically” (how, I wondered, was a father who rushes an infant to an emergency room supposed to act?), told the attending physician that the boy had been getting worse all day. The attending physician gave his nurse a knowing glance. The nurse nodded and went to make the call. Just in case.

A fundoscopic examination revealed that the infant had multiple retinal hemorrhages bilaterally—that is, the blood vessels in the back of both eyes had exploded. When the physician put the pieces together—retinal bleeding, heavy lethargy, and, well, the father—he made a diagnosis:

Shaken baby syndrome.

Armed security guards arrived in force. They handcuffed Tyrese, and that was when I heard the screamed obscenities. I rounded the corner to see what was up. Two uniformed members of the NYPD arrived. So did a weary woman from ACS—aka the Administration for Children Services. Tyrese tried to plead his case. Everybody shook their heads in that what’s-this-world-coming-to way.

I’d witnessed scenes like this a dozen times at the hospital. In fact, I’d seen a lot worse. I’d treated three-year-old girls with venereal diseases. I once ran a rape kit on a four-year-old boy with internal bleeding. In both cases—and in all similar abuse cases I’d been involved with—the perpetrator was either a family member or the mother’s most recent boyfriend.

The Bad Man isn’t lurking in playgrounds, kiddies. He lives in your house.

I also knew—and this statistic never failed to stagger me—that more than ninety-five percent of serious intracranial injuries in infants were due to child abuse. That made it pretty damn good—or bad, depending on your vantage point—odds that Tyrese had abused his son.

In this emergency room, we’ve heard all the excuses. The baby fell off the couch. The oven door landed on the baby’s head. His older brother dropped a toy on him. You work here long enough, you grow more cynical than the most weathered city cop. The truth is, healthy children tolerate those sorts of accidental blows well. It is very rare that, say, a fall off a couch alone causes retinal hemorrhaging.

I had no problem with the child abuse diagnosis. Not at first blush anyway.

But something about the way Tyrese pleaded his case struck me odd. It was not that I thought he was innocent. I’m not above making quick judgments based on appearance—or, to use a more politically current term, racial profiling. We all do it. If you cross the street to avoid a gang of black teens, you’re racial profiling; if you don’t cross because you’re afraid you’ll look like a racist, you’re racial profiling; if you see the gang and think nothing whatsoever, you’re from some planet I’ve never visited.

What made me pause here was the pure dichotomy. I had seen a frighteningly similar case during my recent rotation out in the wealthy suburb of Short Hills, New Jersey. A white mother and father, both impeccably dressed and driving a well-equipped Range Rover, rushed their six-month-old daughter into the emergency room. The daughter, their third child, presented the same as TJ.

Nobody shackled the father.

So I moved toward Tyrese. He gave me the ghetto glare. On the street, it fazed me; in here, it was like the big bad wolf blowing at the brick house. “Was your son born at this hospital?” I asked.

Tyrese didn’t reply.

“Was your son born here, yes or no?”

He calmed down enough to say “Yeah.”

“Is he circumcised?”

Tyrese relit the glare. “You some kind of faggot?”

“You mean there’s more than one kind?” I countered. “Was he circumcised here, yes or no?”

Grudgingly, Tyrese said, “Yeah.”

I found TJ’s social security number and plugged it into the computer. His records came up. I checked under the circumcision. Normal. Damn. But then I saw another entry. This was not TJ’s first visit to the hospital. At the age of two weeks, his father brought him in because of a bleeding umbilicus—bleeding from the umbilical cord.

Curious.

We ran some blood tests then, though the police insisted on keeping Tyrese in custody. Tyrese didn’t argue. He just wanted the tests done. I tried to have them rushed, but I have no power in this bureaucracy. Few do. Still the lab was able to ascertain through the blood samples that the partial thromboplastin time was prolonged, yet both the prothrombin time and platelet count were normal. Yeah, yeah, but bear with me.

The best—and worst—was confirmed. The boy had not been abused by his ghetto-garbed father. Hemophilia caused the retinal hemorrhages. They had also left the boy blind.

The security guards sighed and uncuffed Tyrese and walked away without a word. Tyrese rubbed his wrists. Nobody apologized or offered a word of sympathy to this man who had been falsely accused of abusing his now-blind son.

Imagine that in the wealthy ’burbs.

TJ has been my patient ever since.

Now, in his hospital room, I stroked TJ’s head and looked into his unseeing eyes. Kids usually look at me with undiluted awe, a heady cross between fear and worship. My colleagues believe that children have a deeper understanding than adults of what is happening to them. I think the answer is probably simpler. Children view their parents as both intrepid and omnipotent—yet here their parents are, gazing up at me, the doctor, with a fear-filled longing normally reserved for religious rapture.

What could be more terrifying to a small child?

A few minutes later, TJ’s eyes closed. He drifted off to sleep.

“He just bumped into the side of the door,” Tyrese said. “That was all. He’s blind. Gonna happen, right?”