The Grape Picker

By Lucia Cristinoiu

The story with the title The Grape Picker was the main reason that I wrote this book. It is the story of an accidental trauma of a small child, misdiagnosed as child abuse. Witnessing the painful experience that the child's parents had to go through (the accident itself, the accusations against them, ACS involvement with subsequent placement of the child in foster care, the need to go in court), I came out with some conclusions. The doctors that are dealing with situations like that must have certain qualities: they have to be less opinionated, more flexible, on top of being very knowledgeable. If they remember the Hippocratic Oath, it will also be very helpful (particularly the part of not to be ashamed when you don't know how to solve a case and call for other colleagues help when their skills are needed). It also affected me very much because the child was my patient. My hope is that mistakes like the one described in my story will not happen anymore. For me, practicing pediatrics was like a bonus to my life. Working in this field has been interesting, challenging, and rewarding. It is occasionally sad, but more often, there were funny moments as this one. One day, a two-year-old boy needed to receive a vaccine. To distract him, I started to ask him questions: what his name was (Michael), his mother's name (Mama), his father's name (Mama calls him John), and my name (no answer). In the meantime, I had already administered the vaccine without him realizing it. Two days later, coming back to pick up a medical form, the moment he entered the office, he started to spell my entire name correctly and said it out loud. And then he added, "No shots!" Can you not laugh? He was only two years and two months old.

• Language: English
• Publisher: Page Publishing, Inc.
• Release date: Apr 9, 2020
• ISBN: 9781645846246

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The Grape Picker

Lucia Cristinoiu

Copyright © 2020 Lucia Cristinoiu

All rights reserved

First Edition

PAGE PUBLISHING, INC.

Conneaut Lake, PA

First originally published by Page Publishing 2020

cover photo: Mihai Potcoavā

ISBN 978-1-64584-623-9 (pbk)

ISBN 978-1-64584-624-6 (digital)

Printed in the United States of America

Table of Contents

Foreword

The Grape Picker

Another Type of Doctor’s Training

An Extended Family

The Letter

Miracles Still Happen

Friendship

Short History Lesson: Where Am I Coming From?

Foreword

During the late ’90s, I attended a series of workshops about child abuse at New York Hospital.

One of the sessions was about the legal aspects of such cases. That particular session was conducted by Judge Jeanine Pirro. It was interesting and dense and also included some cases that had unusual findings—unsuspected initially—at the beginning of the case.

At the end, the judge emphasized quite seriously: God forbid you to make a mistake, because then, you, the doctor, become the abuser. Frightening warning. We all understood what she was trying to say. If we were superficial in our examinations and underdiagnosed or completely missed signs suggestive of abuse, then we would just allow the abuse to continue.

On the other hand, overdiagnosing cases, we would become the abusers of the caretakers (parents) of the child. Something like that will affect innocent people (usually the parents) for life.

Very deep statement from the judge. It came very close to Hippocrates’s famous statement: First, do no harm. The story that I am writing about is of that second kind of mistake—overdiagnosing.

The Grape Picker

Why This Title?

Iconsider the title of a book to be the essence of the story, the one thought or feeling that you remain with, after reading it. If the story is good, you remember that title for a lifetime.

Recently, after Charles Krauthamer’s death, I heard about his book Things That Matter. The title was intriguing. I needed to read the book. I had a lot of respect for that man, not only because he was very intelligent and versatile but also for the way he went through life after the terrible accident that left him paralyzed at a very young age.

It was quite difficult to find the book. None of the bookstores had it, not even Barnes and Noble stores that still survived. I ordered the book at Amazon, but the delivery time was in two months’ time, so I reached the conclusion that they didn’t have it either. Needed to be printed again. I thought of my town’s public library as the last resort, and as it proved, they saved me. They had only one copy, and that was already lent out, and there was a waiting list for it. Nonetheless, they promised to try to get the book for me that week. I never thought that the librarians could be so nice and understanding.

They promised to obtain the book from another’s town public library, and they did so. In three days, I was called to come and pick up the book.

The meaning of that title was extremely powerful for me. I read the book with a lot of interest. I had some problems with his use of the English language—too sophisticated and refined for me—but I managed, although I used the dictionary a lot.

Since I mentioned this subject, the level of sophistication (or lack of) of my English, I have to explain something. I do not expect, neither do I want that my story be a literary triumph. I only want the story to be known. Except for some possible grammatical errors, everything in this story is true. In a nutshell, it is a case of a mishandling of an accidental skull fracture of a child—as child abuse. In my entire professional life, this was the most outrageous injustice done to a family by some of the people that you expect the least to inflict harm—other doctors.

Now, I return to explain why my English is not so refined. I came to this country at age thirty-four not knowing how to speak English. The first year, I lived among a group of conationals, so my English did not flourish at all. One year later, I had to pass an equivalency exam to recognize my medical degree. There were hundreds of questions—multiple-choice type—from all material studied in medical school. I understood the medical terms, of course, but most of the time, I had no idea what they were asking me about them. But I passed the exam (the medical part, not the English test that all foreign graduates must also take). The passing score was 75 percent. I scored only a few points above that, but what was important was that I passed. Up to this day, I cannot explain how I managed to do that—divine intervention, maybe.

Preparing for my equivalency exam to recognize my medical degree in America. Most of the things around me are dictionaries and notebooks with translations English-Romanian.

The Hardest Exam

The equivalency exam was hard for me, but it was not the hardest exam that I had to take in my life. The most difficult was back home (Romania): a competition exam, the aim of which was to gain a medical position in the capital city of the country (Bucharest). I don’t know how it is now, but in those times, in order to obtain a place of work in a big town, you had to compete for it with a number of candidates that sometimes reached several hundreds. These exam needs to be explained; you will see why. It was the determinant factor in my decision to leave my country or not.

We were several hundred candidates when eleven positions for pediatricians became available for Bucharest and other big cities of the country. It was said during those years that those competitions/exams were in Russian style. Even though that was just gossip, I believe to this day, the way the exam was structured looked very much like it had a KGB imprint on it. The exam was brutally hard. The medical subjects were not the problem; rather, it was the way the exam was administered.

The exam consisted of a written test and an oral exam with a medical case. Each part had its own examiners. For the written test, you received a number of twenty sheets of paper stapled together; on each one of them, at the top, was written a subject that you were supposed to answer. You could use both sides of the paper for one answer, but you could not go on the next paper to complete your response. The problem was that the first five questions were covering very big subjects—almost a chapter of a textbook (like chronic cough in children, acute abdominal pain in children). It was not enough just to make a list of the medical problems involved; you were supposed to also describe the clinical presentation, the most appropriate tests, the complications, and the treatment for each one of them. You knew all that, but to concentrate everything on one sheet of paper, believe me, was very hard. I had one advantage: my writing was calligraphic, small and very easy to read.

The hardest part was the oral exam. You had one hour for the oral test, divided in three parts of twenty minutes each. The first part was draconian, with a difficulty that was dementia-inducing. You were given only a few pieces of information: age of the child, symptoms at admission, and what day the child was admitted. Having the day of admission, you could figure out by the length of the hospital stay that the case was something complicated that required a lengthy treatment. To reach the diagnosis was not very difficult, although they never gave cases with only one diagnosis; usually you came out with a list of seven to eight diagnoses. The difficulty consisted of the fact that in those twenty minutes, you were supposed to ask all questions that would lead you to the diagnosis, to ask for all the laboratory tests to support your diagnosis plus the tests necessary for a differential diagnosis. In addition, you were supposed to examine the child, who was also present in the room. The part involving the laboratory tests was very time consuming. You were asking for