by Cathy Glass
‘Don’t really need a medical,’ Aimee now said, finishing her breakfast. ‘I’m fit ’n’ healthy, living here with you. Wasn’t fit ’n’ healthy at me mum’s, though.’
I smiled. ‘That’s because I give you fresh fruit and vegetables,’ I said, seizing the opportunity to reinforce the importance of a good diet. ‘Fresh fruit and vegetables contain vitamins, which help keep you fit and healthy.’
‘Yeah, I know,’ Aimee said, sighing. ‘You told me already. Pity they don’t taste like sweets.’
We left the house at nine o’clock for Aimee’s medical and while I was driving to the clinic my mobile rang. I left it to go through to voicemail as I drove and then, once parked at the clinic, I listened to the message. It was from Jill, confirming she’d received the email I’d sent the night before, and that she’d forwarded it to Beth, Aimee’s temporary social worker. Jill asked if I thought Aimee would change her mind about being interviewed by DC Nicki Davies, as clearly her evidence would be crucial to any prosecution. She finished by saying she’d phone me later. I doubted Aimee would change her mind but now wasn’t the time to ask her. Since I’d parked the car at the front of the clinic Aimee had become very agitated.
‘Are you all right, love?’ I asked, turning in my seat before getting out of the car.
‘No I ain’t,’ Aimee said. ‘I’ve been to this clinic before, with me mum.’
‘It’s quite possible. Children come to this clinic for all sorts of reasons: to have their eyesight tested, their hearing tested, for vaccinations and medicals.’
‘I don’t want to go in,’ she said. ‘They called the police last time.’
‘Why?’ I asked, now fully turned in my seat to look at Aimee.
‘The doctor wanted me to take my clothes off and Mum said no. When the doctor said she couldn’t examine me unless I did, Mum got angry and pushed her.’
‘I’m not surprised the police were called,’ I said. ‘It was wrong of your mother to push the doctor. Of course the doctor had to examine you. Just as he or she will today. Why didn’t your mother want the doctor to examine you?’ I asked.
‘Because I had lots of bruises and Mum said they would think she did it.’
‘And did she?’
‘No!’ Aimee said, annoyed. ‘My mum doesn’t hit me. It was that other geezer.’
‘Who? Do you know his name?’
‘No,’ Aimee said too quickly, breaking eye contact. So I guessed she did know but wasn’t going to tell me.
‘Well, if you remember let me know his name,’ I said.
‘Maybe,’ she said with a shrug. And I had a nasty feeling that this abuser, just like Craig and the unnamed paedophile, would continue to walk free to abuse again for a long time.
Chapter Nineteen
Hatchet
‘Sit down, Mrs Glass,’ Dr Patel said as we entered her surgery. ‘Aimee, there’s a toy box for you to play with over there.’ Welcoming but forthright in her manner, Dr Patel was, I guessed, in her late thirties. Fortunately she wasn’t the same paediatrician Susan had pushed.
‘I don’t have any of Aimee’s medical records,’ Dr Patel declared as I sat down and she opened the file on her desk. ‘The social services have sent me the form I have to complete for the medical, together with a stamped addressed envelope, which was generous, but that’s all. Do you know where her medical records are?’
‘I assume they must be with her last GP,’ I said (referring to her general practitioner or doctor), silently annoyed but not surprised by this oversight. More often than not when I took a foster child for a medical, the paediatrician, who didn’t know the child, had not been sent the child’s medical records and therefore had no idea of the child’s medical history. It was a negligent and unnecessary oversight on the part of the social services, which I knew from experience would result in a half-complete medical assessment.
Dr Patel read out Aimee’s full name and date of birth and then asked for my address, which hadn’t been included on the form. I gave her this, together with my telephone number.
‘So Aimee is eight,’ Dr Patel confirmed.
‘Yes.’
‘Does she have any siblings?’
‘Five older half-siblings,’ I said.
‘Do you know their ages?’
‘Not exactly. They are all in their late teens and twenties.’
‘Do they live at home with the parents?’
‘They were all taken into care, although the older ones will probably be living independently by now.’ Aimee glanced up from the toy box. I hated talking about a child in front of them, as it’s disrespectful, but as Dr Patel didn’t have any of Aimee’s history and the form she was filling in requested this information there was no alternative.
‘Does Aimee see any of her half-siblings?’ Dr Patel now asked as she wrote.
‘No.’
‘Do you know why?’
‘No.’
‘And her father? Where is he?’
‘In prison,’ I mouthed quietly under my breath so Aimee couldn’t hear.
Dr Patel nodded. ‘I’ll write “absent”,’ she said, filling in the information that should have already been made available to her. ‘Are the siblings healthy?’ she asked.
‘As far as I know, but I don’t know really.’
‘Was Aimee’s birth normal?’ she said, reading the next question on the form.
‘As far as I know, but I don’t know really.’
‘Are there any congenital abnormalities in the family that you know of?’
‘Not that I’m aware of.’
‘Are Aimee’s grandparents still alive?’
‘I don’t know. They haven’t been mentioned, so maybe they’re not.’
Dr Patel gave a small sigh and continued, ‘Do you know if Aimee’s vaccinations are up to date?’
‘I don’t know. That will be on her medical record, won’t it?’
‘It should be.’ Dr Patel made a note and then asked: ‘What’s the social services’ care plan for Aimee? Do you know?’
I saw Aimee look over. ‘Yes, I know but I can’t really discuss it now,’ I said pointedly. ‘The social services will be able to advise you.’
‘I understand. But Aimee is happy with you?’
‘I think so. She has had to make a lot of adjustments since coming into care. But yes, I think she’s happy. Isn’t that right, Aimee?’ I added, including her in the conversation.
Aimee nodded. ‘But I’m not happy when I have to go to bed at night instead of watching television,’ she grumbled good-humouredly.
Dr Patel smiled. ‘Does Aimee sleep well?’ she asked.
‘Yes.’
‘I like my bed,’ Aimee put in.
‘Is she dry at night?’ Dr Patel continued.
‘Yes, although before coming into care she wasn’t.’
‘She was probably very anxious about what was going on at home. Why was she brought into care?’
‘Severe neglect.’
‘And abuse? Sexual abuse?’ Dr Patel asked quietly.
I nodded.
‘Poor child,’ she said quietly, and made a note. Then: ‘Does Aimee eat well?’
‘Yes, but before coming into care she was on a very poor diet with far too many sweet things. She seems almost to be addicted to sugar and I’m limiting the amount of sugary food she eats. I’m also concerned that she might be vitamin or mineral deficient. She never ate any fruit or veg.’
‘I do now!’ Aimee called from across the room where she was playing.
‘Good girl,’ Dr Patel said. Then to me: ‘I’ll check for any sign of vitamin deficiency when I examine her. But as long as she’s eating a good diet now, her body should recover quickly.’
‘I like sweets!’ Aimee added.
‘They’re bad for you!’ Dr Patel exclaimed, more forcefully than was necessary. I saw Aimee scowl at her and without Dr Patel seeing she stuck out her tongue. I frowned a warning at her.
‘Has Aimee ever been
tested for HIV?’ Dr Patel suddenly asked, looking up from the form and directly at me. ‘Both parents are intravenous drug users, so it would be sensible to know.’
I was taken aback. ‘I don’t know,’ I said. ‘It’s never been mentioned by the social services. Would Aimee have been tested for HIV at birth? She was on the child protection register.’
‘The mother would have been offered the HIV test. In this country all pregnant women are, but tests on babies are inconclusive because of the mother’s antibodies. A child has to be tested at about eighteen months before the results are conclusive.’
‘I’ve no idea if the test was done or not,’ I said.
‘Ask the social worker. Although the HIV virus is only transmitted in bodily fluids and is therefore relatively difficult to catch, you should know for your own safety and that of your family.’
‘We practise safer caring,’ I said, and thought back over the weeks Aimee had been with us. Had I always been careful, for example wearing disposable gloves when I’d treated her cut knee when she’d fallen over? I thought I had but I couldn’t be completely sure.
‘Her parents are high risk,’ Dr Patel said. ‘So if a test has been done you should be told the result, not only for your own safety but for the good of the child. If she is HIV positive then her health can be monitored and with modern medication the outcome is usually very good.’
‘I’ll pass on what you’ve said to the social worker,’ I said. ‘Foster carers are only told information about the children they foster on a “need to know” basis. Often the social services take the view that the foster carer doesn’t need to know the result of an HIV test because if the carer is practising safer caring – as they should be – then they are not at risk.’
Dr Patel raised her eyebrows. ‘If I was in your position, I’d want to know,’ she said bluntly, before moving on to the next question on the form. ‘Do you have any concerns about Aimee’s eyesight or hearing?’
‘No,’ I said. Dr Patel made a note.
Once she’d worked through the remaining questions on the form Dr Patel stood and said to Aimee: ‘Now it’s your turn, Aimee, while Cathy has a rest. Come over here, good girl.’
Aimee responded to Dr Patel’s forthright but friendly manner by immediately standing, leaving the toy box, and coming to her side. The doctor took an otoscope from her pocket and first looked in Aimee’s ears. Then she shone a penlight in her eyes, and looked in her mouth. ‘Good girl,’ she said to Aimee. Then to me, ‘She’s seeing a dentist?’
‘Yes.’
‘Good. Let’s check your vision now, Aimee.’
The doctor positioned Aimee to stand some distance away from the Snellen eye chart that was fixed to the wall. She then asked Aimee to read the letters, which decreased in size, starting with the top line.
‘Aimee doesn’t know all her letters yet,’ I said, realizing that not recognizing the letter shapes could be mistaken for Aimee not being able to see them.
‘Don’t worry,’ Dr Patel said to Aimee. ‘Start at the top line and read as many as you can.’
Aimee read what she could from each row and recognized a sufficient number of letters for the doctor to be able to confirm her eyesight was good.
‘Excellent,’ Dr Patel said, making a note on the forms. ‘Now I want you to pop up on to the couch so I can examine you.’
Aimee did as she was asked and clambered on to the couch as the doctor took a stethoscope from her desk drawer. She then crossed to the couch, where Aimee lay flat on her back, and began by checking Aimee’s reflexes on her legs. Then she looked at the skin on her legs and her arms and finally lifted Aimee’s jumper and listened to her chest. ‘Good girl,’ she said. ‘Now let’s sit you up so I can listen to your back.’
Aimee sat forward and the doctor put the stethoscope on various places on Aimee’s back. ‘All fine,’ she said. ‘Lie flat again, please, and I’ll have a feel of your tummy.’
Aimee obligingly lay down and, using the palm of her hands, Dr Patel felt all over her abdomen. Aimee was very good throughout the process and lay still and watched the doctor.
‘Good girl, you can get down now,’ Dr Patel said, helping Aimee to sit up and then climb off the couch.
Aimee grinned. ‘Was I good?’
‘You were,’ the doctor and I said.
Aimee returned to the toy box as the doctor once again sat at her desk. ‘Everything is fine,’ she said to me, filling in the medical form. ‘There aren’t any obvious signs of vitamin deficiency, although Aimee is overweight for a child of her age and height. Keep doing what you have been doing and I am sure that will sort itself out.’
‘Thank you,’ I said, reassured. Then to Aimee, who I knew had been listening: ‘That’s good news, isn’t it?’
‘Does that mean I can have more sweets?’ Aimee asked, seizing the opportunity.
‘No,’ Dr Patel said firmly. ‘You’ve had too many sweets in the past. Do as Cathy says and you’ll stay healthy.’
It was 11.20 when Aimee and I left the clinic; we’d been inside for nearly two hours. ‘You’ll arrive at school just in time for your lunch,’ I said to Aimee as we got into the car.
‘Good. I’m hungry,’ Aimee said.
As I drove to school my thoughts returned to Dr Patel’s comments about the possibility of Susan and therefore Aimee carrying the HIV virus. Susan was dreadfully thin and I’d often thought she looked ill; in fact if I was honest she looked as though she could actually have AIDS. I would ask the social services if Aimee or her mother had been tested for HIV as Dr Patel had advised, but whatever the outcome I would still look after Aimee. What Dr Patel perhaps didn’t realize was that over half the children coming into care came from backgrounds where one or both parents had been drug users, so most children could be considered ‘high risk’. The social services often didn’t know if the parents or the child had had an HIV test, and if they did know they rarely told the foster carer. Informing foster carers of these test results remains a contentious issue and is usually avoided by the social services, so the foster carer just gets on with looking after the child and tries to remember to practise safer caring.
I took Aimee into school and returned to my car with the intention of stopping off at the social services’ offices on the way home to deliver in person the consent form I needed signing for Aimee’s dental treatment. The social services’ offices were only five minutes out of my way and if I hand-delivered the form it would be signed sooner than if I sent it through the post. Aimee needed to have the fillings as soon as possible. I’d put the form in an envelope before I’d left home and it was in my handbag.
I pulled into the council office car park and parked in one of the visitor bays at the front of the building. I cut the engine and was about to open my car door and get out when I heard a loud bark which sent a shiver down my spine. Was I being paranoid or had I heard something familiar in the bark? I looked through the windscreen, over to where the bark had come from, and saw Susan coming out of the main entrance of the building and go to the cycle rack, where Hatchet was tethered. The dog barked loudly, pleased to see her, but not half as pleased as I was that I was still in the car and hadn’t met her or the dog on the way in. I stayed in my car until she and Hatchet had left the area and were out of sight before I went inside. I assumed Susan had had some business with one of the departments in the council building – the social services or housing, for example.
At the reception desk I showed the receptionist my foster carer ID badge and explained that I wanted to leave a letter for the social worker of the child I was fostering. ‘Her name is Beth,’ I said, showing her the envelope on which I’d written ‘Beth’. ‘But I don’t know her surname,’ I said. ‘She’s an agency social worker.’
The receptionist checked on a printed list beside her keyboard. ‘Beth Ridgeway,’ she said.
‘Thank you.’ Using the pen on the desk, I wrote ‘Ridgeway’ on the envelope after ‘Beth’, and passed the envelope to the
receptionist.
‘I’ll make sure she gets it,’ the receptionist said.
‘Thank you.’
I came out and returned to my car.
The reason Susan had been in the council officers was about to become clear, for as I climbed into my car my mobile rang and it was Beth phoning from inside the building. ‘Susan has just been in to see me,’ Beth said, sounding stressed, and not aware I was outside. ‘She’s very upset that you didn’t let Aimee phone her last night. She’s told her solicitor and she’s threatening court action.’
Ridiculous! I thought but didn’t say. ‘I didn’t stop Aimee from phoning,’ I said. ‘I forgot. We’d been to the dentist and then Aimee disclosed sexual abuse. There was such a lot going on I forgot.’
‘Oh, I see,’ Beth said as though she had believed I’d intentionally not let Aimee phone her mother. ‘I’ll tell Susan it was an oversight on your part, but can you try not to forget to phone her in future?’ Which was clearly a daft request, for I hadn’t intentionally forgotten.
‘I won’t forget again,’ I said, giving Beth the reassurance she needed to hear. ‘I’ve just come out of your building. I’m in the car park. I’ve left the consent form for Aimee’s dental treatment at reception. Could you sign it now and I’ll come back in and collect it?’
There was a pause. ‘I think I need to ask Susan first if she would like to sign it.’ Which I knew was considered good social work practice but would cause delay.
‘The sooner Aimee has the treatment the better,’ I said. ‘The fillings she needs are in her second teeth, so they don’t want to decay any longer.’
‘I understand,’ Beth said. ‘I received your email in respect of what Aimee said about the man who supposedly sexually abused her. I told Susan when she came in and she denies it ever happened. She says Aimee is lying.’