Free Ask Me Why I Hurt by M.D. Randy Christensen Page B

to look at me through the good lens. I could see from their thickness that he had very poor eyesight. I thought he looked like a walking target, a boy so demoralized he was open to attack.
    “What happened to your glasses?” I asked in a friendly voice.
    “I got jumped. I was trying to fight them off.”
    I examined his teeth. The ones up front were OK, but there were huge gaping holes in his back molars, the result of years of untreated cavities. He would need intensive dental work.
    “What can I help you with?” I asked.
    “My feet. They hurt.”
    I looked down. He was wearing heavy boots.
    “OK, how about we take them off for a look?”
    He hesitated. “It’s OK,” I told him.
    When he unlaced his boots and pulled them off, the smell was profound, putrid. I struggled to keep my face even. I carefully lifted one foot. Humiliated, he put his head down. His once-white socks were stuck to the soles of his feet. I could see damp blood and pus through the thin fabric. Parts of the socks were embedded in the rotten flesh. He probably hadn’t changed the socks in weeks. Months even. How could he change them? He was homeless. He didn’t have access to a bath. The lack of shelters meant the kids had no way to get clean.
    He began slowly peeling one of the socks off his foot. A layer of skin and pus came with it. I could tell immediately his feet had a bacterial superinfection from an untreated fungus. I examined the soles. Along with raw infected flesh there were deep holes thatlooked to be a good quarter inch deep. Of more concern were his toes. The tips of two were black and spongy. It had to be incredibly painful just to walk. He kept his head turned down, his eyes at his knees. The smell filled the room. He was embarrassed. How hard this must be on him, I thought. He was at a time in his life that he should be feeling ready to take on the world. Instead he was at rock bottom.
    “I can take care of this,” I said, trying to reassure him, to take away the humiliation.
    “Really?”
    “Sure. These kinds of foot infections go crazy in the heat, especially in monsoon weather like this. First I’m going to get rid of these socks,” I said, picking them up with my gloved hands and dropping them in the trash. “I’m going to get you some new socks and shoes. We’ve got extras up front. But before that I am going to treat your feet. I need to spray them with medicine. Then we’ll get some clotrimazole cream. I’m also going to put you on Keflex, since the infection is bad. It’s an oral antibiotic. You’re going to get the triple whammy.”
    After I had treated his feet, I finished the rest of his exam. What I’d thought was asthma turned out to be a mild case of bronchitis. On his arms I noticed a series of unusual symmetric scars. They were neat, almost orderly, as if his forearms had been caught in some form of machinery. I turned his arm gently and examined the scars further. They weren’t identical. They had a hand-hewn look, something I had seen as a pediatrician, though usually in girls.
    “Do you cut yourself sometimes?” I asked.
    “Yeah.”
    “What with?”
    He took out a folding knife from his back pocket. “With this.”
    I took the blood-flecked knife. “It’s hard to hurt so much, isn’t it?” I asked him. “You must hurt an awful lot to do this to yourself.”
    He nodded, his eyes watering behind the broken glasses.
    “When kids hurt this much, there is usually a reason,” I said. “You know, this is a clinic just like any other doctor’s office. We arereal doctors and nurses. That means we maintain confidentiality. But I’m also what they call a mandated reporter. That means if you tell me you are going to hurt someone or hurt yourself, I have to report that.”
    “What if someone hurt me?” he asked.
    “That depends on when it happened.”
    He nodded.
    I touched his arm very briefly. “Why don’t you tell me, and we will figure it out together?”
    “I’m scared a