kate

You're back in the ER tonight. Even though it's a new city, it's the same routine. Libbie is next to you, leaning on you as her injured arm is being held in your lap. Judging by the way her wrist is looking, something is definitely broken or dislocated. This is the third broken bone in the past 2 years. In your head, you're starting to wonder if CPS will get involved again or if this will fly under the radar. Outwardly, you have a smile on your face as you try to keep your little sister calm.

"How much longer before we can go to John's?" Libbie asks with a slight whine in her voice. John's — or John's Pizza Palace — has become the Friday night staple after a week of work and school. But tonight, instead of eating pizza, you are at Pittsburgh Trauma Medical Center at 8:30 p.m. waiting to be seen.

You respond, "I don't know if we will be able to get John's tonight Lib, but I will take you tomorrow, how about that? Have you thought of what color cast you want in case you get one?"

This is not Libbie's first cast and likely not the last. Hopefully, this time she doesn't choose white again.

Right as you were shuttering, remembering the way the white ankle cast of last year turned a distant urine color with "princesses" drawn all up the sides of it, someone comes to the ER doors.

"Elizabeth?" The staff member shouts.

"That's us," you say to Libbie as you start collecting your purse filled with documents and ID cards. Libbie grabs her blanket and makes a sad whine as she holds her arm to start walking. The staff member leads you to a room, and Libbie hops up onto the bed as if this is a normal routine for her.

"Hello, I'm Emily. I'll be the nurse checking you guys in." She says as she starts hooking Libby up to the monitor to get a set of vitals.

She continues, “This one is going to give you-"

"-a big hug!" Libbie finishes her sentence as the blood pressure cuff starts going.

"Exactly. Aren't you a smart one?" the nurse responds while also glancing up at you with a question behind her eyes.

“Okay, I am going to leave this gown. She will likely need X-rays, so have her get dressed, and when she is done, open the curtain, and the doctor will come see you." With that, the nurse leaves the room.

Libbie, working quickly, already has her shoes and socks off by the time you get to her bed with the gown.

"Do you think this doctor will give me a sticker like the last one?" Libbie looks at you excitedly. You swear this child would do anything and go anywhere as long as there was a promise of a sticker. Currently, as you are taking off her shirt, you can count 3 stickers already, likely from the neighbor who babysits her after daycare while you finish your work shift.

"Maybe if you ask super nicely," you respond while tying the little gown in the back. Frankly, the doctor could give her a blank label, and she will be happy, but you keep that to yourself.

Once dressed, you open the curtain, go back to Libbie, and turn on the TV. You know the drill; this will take a while before the doctor gets to you.

About an hour later, Libbie still intensely watching Bluey, you've been drifting in and out of sleep in the uncomfortable chair, and you see movement out of the corner of your eye.

A handsome older gentleman with grey dusting his hair and a slight limp in his walk is opening the door with a small grin on his face.

"Good evening, my name is Dr. Abbot. I hear we have a potential broken arm in here." You nod affirmatively, a little nervous around doctors you do not know.

He walks until he reaches Libbie's bedside and speaks to her in a soft voice, "Hi honey, what's your name?"

Libbie, on the other hand, has no anxiety with people, exclaims, "My name is Elizabeth, but my friends call me Libbie. I'm five." She states with all the confidence in the world while holding up all five fingers.

"Can I be your friend and call you Libbie?" The doctor asks with a slight smile and a raised eyebrow.

"That depends. Do you have a sticker?"

With that said, Dr. Abbot looks towards you with a larger grin on his face. Meanwhile, you have a guilty expression and a hand on your forehead. This girl and her stickers.

Dr. Abbot reaches into his pocket and pulls out a pen. "How about this? I give you the pen, and find a piece of paper, and you draw something pretty. But next time I come back, I will have a sticker."

That seems to placate Libbie, and she immediately gets drawing.

Dr. Abbot then turns to you, his face becoming a little more serious and setting off some anxiety inside of you.

"Hi Mom, we do not have any history in our charts of Libbie. She seems pretty healthy besides the obvious arm injury, but any important medical history?"

This makes you pause. It is not the first time you have been mistaken for Mom, definitely will not be the last. But that is not what makes you pause. It's that you know, if you explain how much Libbie is in the hospital, it will end in child protective services talking to you. It happened last time when the ER doctor at Mercy Hospital didn't believe that a small fall could cause a femur fracture. Hopefully, Dr. Abbot believes you.

“Um, I am actually her older sister. I legally adopted her two years ago. But she has a little bit of a history," you start listing "epilepsy, ADHD, asthma, anaphylactic allergies, and osteogenesis imperfecta." You pause as Dr. Abbot starts typing into her chart. You start to get anxious, and when that happens, you begin to start over explaining.

"We moved recently from South Carolina, and it takes forever to get a primary care doctor, and the wait lists are 6 months long. But I still follow up with her old doctor to stay on medications. Her epilepsy has been under control now since I have adopted her. She has broken bones before due to the OI, but we've been working on being gentle with our bodies, but she always wants to play with the neighbors. That's what happened today. I was at work, and our neighbor called saying she fell while playing soccer in the backyard. I came home as soon as I could and took her here. She has fragile bones, and we are working on supplements to help, but I heard it can take a long time before we see results. I can give you the number and name of her doctor from South Carolina that proved she has it. Wait here, let me pull it up on my phone.“

“Breathe." Dr. Abbot cuts you off.

You stutter to a stop and try to avoid looking at Dr. Abbot in the eyes, but they are calling to you like a beacon.

"She's okay. You did good bringing her here," he says in a gentle voice.

You take another breath before avoiding his eye contact once again by looking towards Libbie. She is still zoned in on the television, totally unaware of a conversation happening around her.

Most days are hard for you. Gaining custody at 22 years old meant dropping out of college months before graduating to take care of your 3-year-old sister. Your mom, finally succumbing to addiction, left you with a chronically ill sister, a mortgage debt, and a broken heart. Even if she was a drug addict and made your childhood absolute turmoil, she was still your mother. You had your grandmother still to help with selling all of your mom's things and to help raise Libbie. But around 6 months ago, she passed away. Leaving you once again alone. This time truly alone, but you had your sister. So you moved to Pittsburgh for an opportunity to finish college while working full time. Most days are hard, but there is a goal to be able to give Libbie a good life with opportunities. But due to your mother's addiction issues, she used while pregnant, leaving Libbie with chronic (and expensive) problems.

It started with the withdrawal as a baby. Which lead to seizures that seemed to never stop. At 19 years old, you were rushing Libbie to hospital after hospital to find someone to help with these seizures while your mother continued to abuse substances. Eventually, a doctor was able to figure out the right meds and doses to control the seizures. At that point, Libbie was walking, and then the first broken bone happened. You and the doctor did not think much of it until it happened again. And again. Eventually, gaining the diagnosis of OI. Then, finally, when things calmed down, grandma gave her peanut butter for the first time. We were back in the ER for anaphylaxis and sent home with Epi Pens and an instruction manual. Since then, we have added tree nuts, soy, and kiwi to Libbie's allergy list.

Noticing that you are staring at Libbie, Dr. Abbot turns his attention towards your sister.

"I am going to order an X-ray, and we will go from there." Dr. Abbot says offhandedly.

Libbie, taking the time to realize there was a conversation happening, asks, "And then can I get pizza?"

Once again, you are embarrassed, cheeks starting to redden as Dr. Abbot looks towards you again with a small grin.

"Sorry, we ran right to the ED. I didn't think about grabbing her a snack." You try to explain.

Abbot, looking back at Libbie, says, "As soon as I see the x-ray pictures, I will see if I can grab you a snack."

He gives you one last look as he stands from the chair and leaves the room. Even minutes after he has left, you still feel his presence and can't stop remembering the way his eyes seemed to stare into you.

__

X-ray came by eventually, and Libbie is getting antsy and starting to wiggle around more. Bluey is not holding her attention as it did when you first got here.

Just as she began to try and hop out of the bed, there is a knock at the door.

In walks Dr. Abbot. With a delicious aroma coming in with him.

"PIZZA!" Libbie shouts, practically jumping on the bed.

Abbot is holding a whole box of fresh cafeteria pizza.

"Good news. Libbie's arm will not need surgery, meaning it's pizza time." Dr abbot states as he sets the box on the bed. You notice he has a bunch of supplies hanging out of his pant pockets.

“Okay, honey. First things first, we are putting a cast on, and then you can eat the pizza. Just make sure to give your sister a piece. She’s earned it and looks famished." Abbot sends a wink your way, and you swear your heart jumped a beat.

"What color cast are you thinking, Miss Libbie?"

“PINK!" Libbie practically yells.

Internally, you are thanking the heavens she did not choose white again.

"How did I know?" Dr. Abbot replies, taking a pink fiberglass package out of his back pocket.

He makes quick work of the cast, and Libbie is mowing down her pizza in minutes.

As she's distracted and eating, you lean towards Dr. Abbot as he is cleaning his supplies up.

You speak in a hushed tone, "Thank you for helping her and calming her, and of course, the pizza. You really didn't have to do it. I appreciate it. You really made our night."

Once again, you lock eyes and you both are in a breath-holding trance. After a pause, he finally responds slightly out of breath, "No problem at all. I'm glad to help. She's a good kid."

He seems to shake his head a little, retreats his eyes, and begins to stand.

“Alright, Libbie, no more soccer until your arm is all better. We will see you guys in 6 weeks to take the cast off."

With that, Abbot hustles out of the room.

Huh.

And as you start packing up, you notice a roll of princess stickers left on the bed. It brings a smile to your face and a longing look towards the door.

The whole way home, you swear you can still smell his cologne. And every time you closed your eyes, you could still see intense eyes looking your way.

The next day, you end up at John's Pizza Palace as promised and couldn't help but remember the doctor's kindness. You couldn’t help but remember how handsome the doctor was too.