“Sometimes I just feel a burst of hatred. How can people be so cruel? How can they let this happen to their kids? How can they cause this?”

Never in my life have I seen such rampant abuse. Not a single emotional or physical need was met. They had to wash his skin 10 times before they could get an IV in. He hadn’t eaten in months, gorging himself to the point of vomit when given access to food for the first time. He could barely speak. The only phrase he could say with certainty was “fuck you.” It was clear he’d heard it before. He delivered it with the same vitriolic intonation I imagine he heard it used with over and over again.

With clerical focus and rampant professionalism, we monitored CBCs, cut up his food to modulate its intake, and looked up and down his GI tract to ensure that there were no structural abnormalities. With the narrowest of gazes, we tracked, and we monitored, and we tried not to think about how he got here.

People saw the wear and tear though. Suddenly the chief residents were popping their head in at the workstation. “How is it going? Is the patient load too much? How are you all holding up? Let us know if you need any help.”

And then, the day of reckoning. The goggles came off and in a rush of humanity we all got to sit down and take a moment to reflect. How had this affected us? What were our thoughts and fear and worries outside of the minutiae of healthcare?

In a moment of intense vulnerability, a mentor and friend spoke with incredible honesty without considering what might be the “correct” thing to say. She hated his parents. She hated what they had done and the consequences it would create for years to home. She hated that we had to shove down the emotions to get a job done.

And then, she stopped. She asked, what could be wrong with those parents? What type of difficulties had they faced? What type of abuse had they endured? What deficits had persisted to create an environment where they committed such actions

I thought then that she had an incredible amount of empathy. Her she was, questioning her own thought lines and motivations in a situation where no one would’ve expected her to do so. Am I fully convinced these parents deserved such consideration? No. Yet still here we were, grappling with the constant need to question the validity of our own thoughts. Even in the most “black and white” situation, there was room for grey, room for questioning, contemplation, and understanding.

I still wonder how these parents could inflict such harm on him. I still hope he gets justice. But I also hope to question how such things ever came to be and not be complicit in a system that allows such things to happen again.