At the end of March, Saimi was booked in for a four-night stay at the Isoniitty group home, from Monday to Friday. I, for my part, went to Barcelona for a short holiday to get some rest. Once again I took long walks on the hill at Parc del Guinardó and cycled around the Collserola mountains. Jana did the daycare runs as usual, and on Tuesday we managed to have a quick video call while they were waiting for a taxi. Unfortunately, Saimi fell ill that evening and couldn’t go to daycare for the rest of the week. We still video called after that, whenever Elli and Aimi visited her. It felt bad that Saimi had to spend her days at the group home. I missed her a lot too, and as soon as I was back in Finland, I went to Isoniitty to see her, as she was staying there for one more night.
Saimi came home on Friday, and on Saturday her breathing sounded heavy and her face went pale, so we set off for the emergency department at the New Children’s Hospital. After the initial examinations, she was admitted and moved to ward Star. Her haemoglobin was very low and her oxygen saturation kept dropping, especially while she was sleeping, so she was given extra oxygen.
As I had noticed before, things on Star seemed chaotic, and it was hard, for example, to get hold of the doctors in charge of Saimi’s care on the ward. This time, too, there was some confusion over her medication at first, but we had come prepared, bringing our own “starter pack” of the medicines and supplies Saimi needed, although we did not expect to be on the ward for very long. Hospital visits felt routine again, and I think this time, too, our attitude was that we’d be there for a couple of days and then go home, since the visits usually followed more or less the same pattern. Based on that, and on her very low haemoglobin, I said several times on our first day that Saimi most likely needed a red blood cell transfusion to start feeling better so that we could go home. Of course, it was only an educated guess based on our previous experience, and above all I wanted someone to make a call on it. But it was the weekend, and the hospital was staffed by busy on-call doctors.
Luckily, the next day Saimi’s gastroenterologist, Riikka, was on call. When she came into the room, she smiled and said, “Well, dad clearly knows what helps,” and ordered a red blood cell transfusion for Saimi. Perhaps the nurses had told her that I had been trying to play doctor. The unpleasant part was that it was hard work to get a cannula into a vein. It took four attempts and two anaesthetists before it finally went in properly. Once she’d had the transfusion, Saimi started to feel noticeably better.
We tried to make sure that one of us, or a familiar care worker from Tunne Hoiva, was with Saimi at all times. Her regular night care, however, was a service provided at home and couldn’t be moved to the hospital. But earlier that spring we had already asked Tunne Hoiva whether we could use the informal carer’s hours off to have a care worker stay with Saimi on the ward at night too. We had plenty of hours in reserve, as we had been saving them for the coming summer holiday, among other things. To our relief, it worked out, and Saimi had her own care worker, so Elli and I could go home for the night with peace of mind.
A few days later I fell sick too and couldn’t go to the ward, although luckily I recovered within a couple of days. Saimi was discharged on Wednesday and was well enough to go back to daycare as early as Thursday. I hadn’t slept properly that night and was very tired in the morning. After our morning routine, I sat on the sofa with Saimi on my lap, chest to chest, as we usually did while waiting to leave for daycare. This time, though, she seemed somehow uncomfortable and kept squirming restlessly, which made my grip start to slip. I tried to get us into a better position and swung her round so that she was sitting on my thigh with her back to me. Saimi let out a loud shriek and started crying. I had turned her carelessly and too quickly, and her right arm had apparently got caught at a bad angle and twisted.
I got a terrible fright and thought something really bad had happened. However, after a little soothing, Saimi calmed down. Elli and I examined her arm, but couldn’t see any sign of injury. Nor did it seem to hurt her, and she could move it as well. That morning, exceptionally, Elli took Saimi to daycare, because on the way they went to the laboratory at the New Children’s Hospital to have a blood sample taken, I think from that same arm. At daycare, Saimi’s day had gone fairly normally, but she had been tearful all day and hadn’t really wanted to nap. In the evening I looked her arm over again, but still couldn’t see any signs of injury, and while she was on my lap I also saw her move it, although just a little.
We decided to keep Saimi at home the next day and watch how things went. I hadn’t slept properly for many nights, so that evening I took a medicine called Atarax. It isn’t a sleeping pill, but it has a strong calming effect on me and makes me very sleepy. The downside was that after taking a pill I would be groggy for at least the whole morning, which is why I used it very rarely. Titta, who was on the night shift, woke us in the early hours and said the arm seemed really painful. I don’t think it really sank in, and we said we’d have a look in the morning. When I went to Saimi a few hours later and glanced at her arm, it looked so bad that we took a taxi to the emergency department straight away. Her upper arm was swollen and blue with bruising all over.
At the emergency department, it turned out that the upper arm was broken, and I found myself being properly interrogated. The doctor looked at me angrily and grilled me again and again about how the injury had happened. I fully understood that it’s important to find out whether a parent has caused an injury, but being on the receiving end of almost hostile questioning felt awful all the same. After the X-rays and an assessment by an orthopaedic surgeon, however, the doctor’s expression softened, and we were able to talk normally. It is unlikely that a healthy child´s arm would have broken in that situation. In addition to my mistake, it came down to the fragility of Saimi’s bones. My guess is that when her arm twisted, it suffered some kind of fracture, which then got worse over the following day as the arm was moved and, for example, when she was being dressed.
At the time, neither I nor anyone else knew, or could even have imagined, what the fracture might lead to in Saimi’s case. Since then, I have gone over that moment and that day in my mind countless times, and even though it was an accident, I will beat myself up about it for the rest of my life and never forgive myself.
Saimi’s arm was put in a cast bent at the elbow, reaching from her hand to her upper arm, and a sling. After we were ready, I called an accessible taxi and we headed home. I sat next to Saimi and comforted her as best I could. The driver must have noticed that I was feeling very sad. He looked me in the eye in the rear-view mirror and said, with a slight accent, “I admire you.” At first I didn’t understand what he meant, and I probably looked baffled. He went on, “You’ve got a big heart,” and then I realised he meant that I was looking after a sick child. It was only a few words from a complete stranger, but they moved me deeply. I really had to fight back the tears. As he helped Saimi out of the taxi, he wished me strength and all the best for what lay ahead. My voice shaking, I barely managed to thank him for the kind words I didn’t deserve.
At home, Saimi seemed to be in pain, and we were wondering whether the cast was sitting right, as its upper edge appeared to be close to the fracture. On Sunday, Elli took Saimi back to the emergency department, where they did adjust the cast. Saimi was also prescribed stronger painkillers, Tramal drops, which helped her settle. That weekend we would also have had the Ravut swimming session, which the whole family had been eagerly looking forward to, but it was clear that swimming would be out of the question for a long time still.
On Monday, Elli went to work and I stayed at home with Aimi. Saimi first had a day carer in the morning, and then Jana came for the afternoon. Saimi was unusually quiet all day and mostly dozed in their arms. I thought that was probably normal under the circumstances, but in the afternoon her breathing sounded heavy again, and her face went so pale that we rushed to the emergency department.
The doctors suspected a respiratory infection, and radiographers came into the room to take a chest X-ray. Her arm, in the cast and sling, lay partly across her chest, so it had to be moved for the X-ray. I told the radiographers that they had to be extremely careful with the broken arm, and that I didn’t want to move it myself, so as not to cause her pain or do any damage. I asked them to call a nurse to reposition it, and someone popped in and very quickly turned the arm so that it wouldn’t get in the way. At that point, moving the arm didn’t cause Saimi any pain. As is standard practice, I had to leave the room while the X-ray machine was in use.
While I was outside the door, Saimi started screaming in pain and crying. I went straight back in and saw a radiographer holding her arm in a really awful-looking position. When I had left the room, the broken arm had been resting on the bed with her elbow next to her side and her fist pointing straight up at the ceiling. Now the radiographer was turning her arm out sideways, away from her body, which put pressure on her upper arm, right where the fracture was.
I crossed the room in a few quick strides and moved Saimi’s arm into a better position. I told the radiographer that she was handling the arm wrongly, but got no reaction whatsoever. The radiographer seemed completely unconcerned. When I asked, more firmly, whether she understood that she had hurt my child, the reply was an indifferent “Oh right, well, sorry.” Afterwards, I mentioned the arm being twisted to the emergency department nurse and doctor who were looking after Saimi. The person responsible for casts in the emergency department also came by briefly to talk to me and confirmed that the arm must not be rotated out to the side.
The incident wasn’t looked into at all, and nobody seemed to take me seriously or even really listen to what I was saying. Afterwards I noticed that nothing about it had been written in Saimi’s medical records, even though I brought it up many times over the following days too, as I was worried about the arm. It was only a week later that an entry was made, when I insisted in front of several doctors that it be recorded in Saimi’s records so that I could refer back to it later.
I also submitted a formal complaint to the hospital about the incident. The response I received was mostly a general description of how things are supposed to work, rather than focusing on what had actually happened. The responses from the care staff didn’t really address my points, apart from a few. On the lack of any entries in the medical records, one senior physician stated: “In my assessment, the doctor in the emergency department would have made an entry if the matter had been raised with them.” The response from the ward manager of the radiology unit, in turn, got the incident wrong in every respect. According to it, for example, the mother had been present, and they concluded that the radiographers had acted appropriately, but considered that the emergency department nurse had not been aware of the restrictions on moving the arm. So in a way it did admit what had happened, although the blame was pushed onto others. But none of that mattered, nor did the errors in the responses. The complaint was dismissed as unfounded, and no further action was considered necessary.
After the X-ray, we moved from the emergency department to ward Star once again, to room number 15. It was the start of the most terrible time of our lives.