Early Friday morning, Dolores is awakened by the squalling of The Baby. (Never mind that The Baby is no longer truly a baby; rather, he is a solid, adventurous, smiling toddler, who loves to go outside, and eats hot dogs and chicken nuggets and chocolate milk, and tries to keep up with his two big brothers. But he is still her baby, her littlest one, her chubby little munchable child.) Unlike his brothers, he wakes up at the ungodly hour of six a.m., and today he has awoken screaming, almost inconsolable, and yanking on both his ears.
She scoops him up and takes him back to bed with her, patting and shhhshing, but he isn’t interested in sleeping anymore. She grumbles but she rolls out of bed and gathers him up in her arms – he fits into her arms like he was made for them - to take him downstairs and feed him a nice bottle of warm milk. He wails impatiently while the milk is microwaving, but as soon as she hands him the bottle he pops it in his mouth. She settles into the big armchair and then she doesn’t want to move. She’s warm and cozy and the baby is content, cuddled in her lap and drinking his milk.
Two hours later, Dolores is wrangling the two older boys for school. Len grumps and whines, he hasn’t been in preschool all week due to a particularly violent stomach bug and he doesn’t want to go today either, but the speech therapist comes on Fridays and Dolores doesn’t like him to miss the speech therapist. His K sounds are coming along so nicely, and he has his Fs nailed. Sam doesn’t want to stop reading the sports page, and finally Dolores rips it out from under his arms and throws his jacket at him to put on. She only – only! - has to verbally chivvy the two older boys along: “Brush your teeth,” “Put on your shoes,” “Put your lunch in your backpack.” But The Baby still requires physical manipulation – diaper changing, wrestling him into his clothes, then his jacket and hat and mittens and boots, and this morning he is not happy about any of it. He starts to holler when she switches off the TV at the end of “Little Einsteins”, and the screaming escalates to head-banging and feet-kicking when she tries to put on his boots. His hands are firmly clenched around his ears, and Dolores sighs. She had better call the doctor – it’s a Friday and if it is an ear infection and he needs care over the weekend, that will mean a trip to the ER instead of an easier, cheaper, office visit. Best to go in today and get it over with.
The doctor’s office can offer an appointment only at precisely the time she needs to pick up Len from preschool. Dolores calls the babysitter. Fortunately the sitter’s available and they arrange for her to pick Len up at 11:30.
Everyone is on Dolores’s last nerve today. Well, really? Honestly? That’s not that different from every normal day – she is hardly the most patient of people. But there’s a giant SUV blocking the reserved-for-pediatrics-patients parking spaces in the doctor’s office parking lot; she fumes as some couple with a largish baby takes their time loading themselves into the car and digging out their parking token and getting THE FUCK OUT OF HER WAY. And when she walks into the waiting room and some hippie-slacker-type mom with short dirty hair twisted into two stupid ponytails glances at The Baby and asks without preamble, “Is he sick? Because she’s NOT,” gesturing to her offspring, a cute little girl toddler whose hairstyle is years more sophisticated than her mother’s, well, Dolores snaps, “Yes, he is but I’ll keep him away from her,” without even caring that she has already recognized the woman as someone she met at the pool last summer and whom she had hoped to cultivate as a mommy-friend. But not any more, thank you very much, damn germophobic, over-protective diva.
The Baby is calm, even happy, until the nurse shows them to the examining room and, after his brief foray into the milk crate full of tattered books, Dolores refuses to let him rummage through the biohazard waste container. Mean Mama! The Baby screams and stamps his feet and throws himself around and then settles onto the floor for his tantrum, rolling around, drumming his little feet and banging his head into the floor. Dolores tries distraction: tongue depressor? cup of water? that little rubber hammer used for checking reflexes? Nothing works. She tries soothing and holding, but when The Baby bucks backwards and smashes his head into her teeth, endangering several thousand dollars’ worth of orthodontic work, she lowers him to the floor and lets him do his thing. The doctor has previously assured her that The Baby is perfectly cognizant of what he’s doing, and he will not hurt himself – not intentionally, anyway.
Fifteen minutes later, The Baby is still screaming, lying on the floor and clutching his ears, and the door opens tentatively. The nurse pokes her head around: “Can I get him anything? I brought him some Tylenol.” Valiantly Dolores and the nurse pour the medicine down The Baby’s throat; Dolores knows it will have no effect and is indeed not necessary but she appreciates the nurse’s need to do SOMETHING in the face of the nonstop screaming.
Ten minutes, later, The Baby is still going.
Great, thinks Dolores, I have given birth to the Energizer Baby.
There is a soft knock on the door, and the doctor comes in.
Dr. R is a quiet, mild-mannered little man, but he exudes confidence, and Dolores has learned to appreciate his careful consideration and need to concentrate on a patient. He is given to crisply starched, monogrammed, short-sleeved dress shirts, beautifully polished classic wingtips, and the colorful ties one has come to expect from pediatricians the world over. He greets her with his usual firm handshake and “Nice to see you” before he turns to The Baby, who has momentarily stopped screaming and is just sort of “uh-uh-uh-ing” and watching the adults out of the sides of his eyes.
The Baby stares up at Dr. R. He has stopped even the uh-ing, but is clearly unsure of how to proceed; again, Dolores notices his fingers wrapped around each ear, and Dr. R of course immediately notices as well.
“How long has he been holding his ears like that?”
Dolores mentally slumps gratefully into Dr. R’s capable hands, and answers that question, and a torrent of others. The doctor listens carefully; The Baby has begun half-heartedly screaming again, but Dr. R ignores him for the moment and focuses on gathering his background information.
The physical exam, careful and gentle as it is, sets The Baby off again. (It could be the doctor’s tuneless crooning of “Twinkle, Twinkle, Little Star” but more likely it’s the energetic probing of his ears.) Once Dr. R finishes his thorough exam, Dolores lays the writhing child on the floor, and she and the doctor settle in for the show.
The Baby screams and screams; he is practically purple in the face, and his head-banging has taken on a new ferocity. Dolores begins to fear for his skull, or at the very least, his pert little nose. The doctor watches, and carefully explains to Dolores, his quiet voice somehow cutting through the earsplitting crying, the various ailments and chronic conditions which could engender such displays of emotion in The Baby. He reassures her that The Baby’s ears are perfectly healthy and in fact, beautiful: little pink opalescent shells of eardrums. There is no congestion, no wheezing, no fluid in the lungs. He deduces through his many questions that there are no stomach ailments: no constipation, diarrhea, intestinal blockage, intussusception. He assures Dolores that the Baby is most certainly NOT autistic.
They spend several minutes discussing the possibility of headache; Dolores offers up her own history of migraine headaches, and the doctor explains how very difficult it is to diagnose headache in a not-yet-verbal child but describes the behaviors and symptoms to watch for. They decide together that a headache is not what’s causing this behavior.
The Baby continues to wail and flail, but he is beginning to flag, and even Dolores can see now that he is watching the adults, casting sidelong glances at them to be sure they are still paying attention to him.
A total of twenty minutes of this, and Dr. R has covered all real possibilities and addressed all the worst-case scenarios tentatively suggested by Dolores. He asks about triggers, and verbal skills, and how well The Baby can communicate and how well his parents understand him. Dolores lists The Baby’s words: cat, uh-oh, Kix, baby, truck. She feels she understands him relatively well, certainly better than anyone else. After all, she is the one who knows that “Ma!” means milk, and “bana” means banana, and that he doesn’t like to use baby spoons but prefers the full-sized teaspoons. He likes to sit at the table like a big boy and can very carefully drink out of a big boy cup. And she understands his frustration, but some days she feels like she is trying to decipher the Rosetta Stone.
Almost on the verge of tears, she tells the doctor this. You’d think she was a first-time mother. Honest to God. She angrily wipes her eyes with the back of her hand.
Dr. R gently tells her that she is a fine mother, that her three boys are robust and healthy and clearly well cared for, that there is nothing to worry about. It’s a little hard for her to believe him with The Baby wailing and flailing on the floor, but she tries. She’s been sitting in the exam room for close to an hour at this point; the doctor has been with her for the past twenty-five minutes. The Baby has been screaming this entire time.
The doctor points out that The Baby is winding down now, and he’ll probably pass out in the car on the way home. This, along with the fact that there is an identifiable trigger, that the child is apparently aware of his surroundings and reacts to such, and that there are no physical signs of anything else at all wrong with him, leads the doctor to deliver the following diagnosis:
Dolores has spent two hours of her life, thirty bucks on babysitting, twenty bucks on a co-pay, and an inestimable amount of her daily stamina and patience, not to mention her dignity, for this.
She has taken her child to the pediatrician