For My Children

2008
Arora, Amritpal

Her hair is in a bun, she combs through it with her fingers trying to negate the effects of the Vancouver rain. She is wearing a pink salwar kameez with a grey hooded sweatshirt. Her dupatta, a long cotton scarf with an embroidered border, rests on her shoulders; they are stooped as if they can barely support its weight. The polish on her nails is a chipped and fading red, similar to the red blotting her tired eyes. She moves to settle her children. A young, unassuming girl sits to the right. She is dressed in sweatpants and a t-shirt. Her shoes are loosely tied and are clearly too big; perhaps passed down by her brother or purchased to outlast her spurts in growth. Her brother impatiently shifts in his chair; sounds of his nylon track suit interrupt the silence as I quickly review notes from their previous visits.

Although I only locum at this practice periodically, I have seen this family often. Their story is tragic. It is a story of a trauma; not of a physical nature that may heal with time. It is not amenable to clever mnemonics or ER protocols. This suffering runs much deeper; it pierces the skin and moves for the heart. It suffocates the heart and smothers the spirit. Its brushstrokes paint fear in the eyes of young children and defeat in the voices of their mothers.

I know of the violence that has plagued their home; but we have yet to discuss it. The mother frequently presents with chronic neck pain and her children the aches and pains of adolescence. They often troop in towards the end of the day seeking advice on minor issues; a cut, a bruise or a runny nose. More often than not, the mother has taken care of these issues appropriately; however I am always left with the feeling that she is seeking reassurance, validation that she is fit to raise her children.

"Veerji," - she uses the Punjabi term for older brother even though she must be ten years my senior - “Can you tell my children that things will be okay?" Her voice quivers as she asks the question. She stares at the floor and is unable to look me in the eye. Sensing that she may be on the verge of tears and seeing the discomfort in the children's faces, I escort the children to the waiting room. Upon my return, she is using her duppata as a tissue and wiping her tears.

I place a box of tissues in front of her and take a seat. She tells me her story ...

Her husband beat her frequently. He made it a point to beat her with her children as witnesses. Her son would run into his room and lock the door. Her daughter would often try to get between her parents and shield her mother from her father's blows. He would tell the children that their mother was useless, a worthless whore. She had held out hope that he would change as their children grew older. The beatings intensified. Surely, his parents would make him understand. Instead, they joined in the abuse. She could not leave. The shame she would bring her family, the embarrassment her children would feel and the prospects of them growing up without a father were facts she could not face, so she stayed and endured the beatings for years. The physical abuse was not the hardest part; it was the pure grief that permeated every aspect of her children's lives. "Even their laughter carried weight,” .. she tells me.

It was after her children begged her to call the police and take their father away, she decided to act "They cried with me," she says. "They felt every blow. They huddled with me in corners, held me as I licked my wounds. I could no longer subject them to that pain."

She stayed for the sake of her children; she left for the sake of her children.

She is exhausted and looks as if she can barely sit in her chair. Many emotions run through me; disgust, empathy and an almost overpowering anger. I feel helpless. I wish I could bring out my prescription pad and write something that would cure it all; her wavering voice, the heaviness in her breath and her inability to look me directly in the eye. But, I know it's not that easy.

Her children see a school counselor regularly and are on a waiting list for community counseling, she explains. They are doing well in school and have good friends. Their laughter isn't heavy. She takes them to the park everyday to ensure physical activity. She buys them nutritious food and emphasizes the importance of health. She throws them birthday parties and invites all their friends. As she updates me on everything she is doing to enrich the lives of her children, I begin to feel in awe of her courage and resilience. My sense of helplessness begins to fade and is replaced with a sense of hope. I feel that this woman will do anything and everything to make sure her children succeed. Their success is undoubtedly tied to hers as a mother.

We make a plan for her to return with her children and discuss things further. She throws her dupatta over her shoulder, straightens her kameez and walks out the room. I sit there for a few minutes and call for the next patient.

Theme: Family | Famille
Theme: Health Care Delivery | Prestation des soins de santé
Theme: Patients | Patients
Theme: Relationships | Relations

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --. 

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