The School Nurse Called Me About A Seven-Year-Old's Infected Jaw
The School Nurse Called Me About A Seven-Year-Old's Infected Jaw, But Pulling A Hardened Wad Of Chewing Gum From Her Mouth Revealed A Disturbing Secret.
I have worn a badge for nearly sixteen years.
For the last four of those years, I’ve served as the School Resource Officer for a quiet, upper-middle-class elementary school in the suburbs of Columbus, Ohio.
Most of my days are predictable. I break up minor scuffles on the playground. I give high-fives in the cafeteria. I deal with custodial disputes or the occasional irate parent in the pickup line.
It is a peaceful job. A safe job. It is the kind of assignment older cops take when they are tired of the night shifts and the endless adrenaline dumps of patrol work.
But nothing in my sixteen years of law enforcement, not the domestic disputes, not the highway collisions, not the narcotics raids, prepared me for the sterile, suffocating silence of the school clinic on a rainy Tuesday morning in November.
The call came over my shoulder radio at exactly 10:14 AM.
“Officer Miller,” the voice crackled. It was Martha, the school nurse.
Martha is a seasoned veteran of the public school system. She is a tough, no-nonsense woman in her late fifties who has seen every fake stomachache, every scraped knee, and every exaggerated playground injury known to man.
Martha does not panic. Martha does not overreact.
But when her voice came through that radio, it was thin. Frayed. It had a hollow tremor to it that made the hair on the back of my neck stand at attention.
“Miller. I need you in the clinic. Now. Please.”
She didn't ask if I was busy. She didn't use her standard ten-codes. She just begged me to come.
I dropped the coffee I was holding directly into the teachers' lounge trash can and began power-walking down the C-wing corridor.
The school was eerily quiet. It was the middle of second period. The cinderblock walls were plastered with colorful construction paper turkeys and cheerful handprint art, contrasting violently with the sudden, heavy knot tightening in my stomach.
I pushed open the heavy wooden door to the clinic.
The room smelled intensely of rubbing alcohol, stale cotton, and a faint, metallic odor that I couldn't immediately identify.
The fluorescent overhead lights buzzed with a low, irritating hum.
Martha was standing near the examination table. Her face was entirely drained of color. She was clutching a wooden tongue depressor in her right hand so tightly that her knuckles were entirely white.
Sitting on the examination table was a seven-year-old girl.
I recognized her instantly from the morning drop-off lines. Her name was Lily.
Lily was a quiet second-grader. She was small for her age, always wearing clothes that seemed a size too big and a pair of faded pink sneakers that had lost their glow a long time ago.
Right now, Lily was sitting perfectly still. She wasn't crying. She wasn't screaming.
But the left side of her face was a nightmare.
Her cheek was massively distended, swelling outward in an angry, deeply bruised purple-red dome. It distorted her entire face, pulling her left eye into a permanent, painful squint.
She looked like she had hidden a golf ball in her cheek, but the skin was taut, shiny, and radiating a terrible heat.
“Hey, Lily,” I said softly, keeping my voice low and steady. I kept my hands visible and non-threatening. “You having a rough morning, sweetheart?”
Lily didn’t look at me. Her pale blue eyes were fixed firmly on the beige linoleum floor. Her breathing was shallow and rapid through her nose.
I looked at Martha. "What are we looking at here, Martha? A bee sting? An allergic reaction?"
Martha shook her head slowly. She stepped away from the child, motioning for me to join her in the far corner of the small room, near the sink.
"Her teacher sent her down ten minutes ago," Martha whispered, keeping her voice entirely out of Lily's earshot. "Said the girl had been resting her head on her desk all morning, refusing to participate. When she finally looked up, her face was blown up like a balloon."
"An infection?" I guessed, keeping my eyes on the little girl sitting motionless on the crinkling paper of the exam table.
"That was my first thought," Martha said, her voice shaking slightly. "I assumed it was a severe dental abscess. An infected tooth root that had gone entirely septic. Kids this age, sometimes they don't brush, the parents don't take them to the dentist, and an infection can balloon overnight."
"Okay," I said, trying to process the information. "So we call EMS, or we call the parents to take her to the emergency room. Why did you call me?"
Martha looked at me, her eyes wide and deeply troubled.
"Because she wouldn't open her mouth, David," Martha said. "She fought me. I mean, she physically fought me. She clamped her hands over her mouth and started shaking violently when I tried to look inside."
I frowned. It wasn't entirely unusual for a child in severe pain to avoid being touched, but Martha was an expert at coaxing cooperation out of frightened kids.
"I finally got her to let me look," Martha continued, her voice dropping to a barely audible whisper. "I used a penlight. David... it is not an abscess."
"What is it?"
"I need you to look," Martha said. "I need a witness before I touch it. I don't know what I'm looking at, but it isn't natural."
I walked slowly back over to the examination table. I knelt down so that my eyes were perfectly level with Lily's.
"Lily," I said gently. "My name is Officer David. I have a little girl at home who is exactly your age. Her name is Sarah. And whenever she gets a terrible toothache, we have to look at it to make the pain go away. Can you do me a huge favor and let me see?"
Lily’s small, frail shoulders began to shake. A single tear escaped her right eye, cutting a clean path down her dusty face.
Slowly, agonizingly, she parted her lips.
Martha stepped in instantly with her penlight, clicking the bright yellow beam to life and illuminating the inside of the child's mouth.
I leaned in closely.
The smell hit me first. It was a suffocating, sour stench of old saliva, decay, and dirty pennies.
I squinted against the glare of the flashlight, peering past her front teeth, deep into the pocket of her left cheek.
Martha was right. There was no swollen, infected gum line. There was no ruptured tooth.
Wedged deep in the very back of her mouth, completely packing the space between her rear molars and the soft tissue of her cheek, was a massive, hardened lump.
It was a giant wad of chewing gum.
But it wasn't fresh. It was discolored—a sickening mixture of grey, dark green, and black. It had been wedged back there for days, maybe even weeks. The saliva had hardened it into a concrete-like mass, stretching the delicate tissue of her cheek to its absolute tearing point.
The tissue surrounding the gum was violently inflamed, bleeding slightly at the edges where the hardened mass was digging into her flesh.
"Who put that in there, Lily?" I asked, my heart hammering against my ribs.
Lily squeezed her eyes shut and refused to speak.
"We have to get it out," Martha whispered to me. "It's choking off the circulation in her jaw. If it shifts, she could swallow it and it will block her airway entirely."
"Do it," I said, positioning myself to gently hold Lily's shoulders steady. "Lily, this is going to be uncomfortable, but you have to hold incredibly still, okay? Martha is going to help you."
Martha retrieved a long pair of sterile medical forceps from a stainless steel drawer. Her hands were remarkably steady now that she had a task to execute.
"Open wide, sweetie," Martha murmured.
Lily opened her mouth again.
Martha carefully slid the metal forceps into the child's mouth, gripping the edge of the hardened, calcified wad of gum.
"One, two, three," Martha counted softly.
She pulled.
Lily let out a muffled, agonizing whimper, her hands grabbing desperately at the fabric of my uniform.
The mass didn't want to come loose. It had practically cemented itself to the back of her teeth.
Martha applied more pressure, twisting her wrist slightly. The sound of wet, tearing suction echoed loudly in the silent room.
Suddenly, the mass broke free.
Martha pulled the forceps out rapidly, holding the massive, foul-smelling gray lump in the air before dropping it into a metal kidney tray resting on the counter.
It landed with a sound that froze all the blood in my veins.
It didn't sound like a piece of hardened candy. It didn't sound like old chewing gum.
It landed with a heavy, distinct, metallic CLACK.
Martha and I stared at the tray.
The mass of gum was roughly the size of a large walnut. But as the impact of the metal tray fractured the hardened, calcified exterior shell of the gum, a piece of the grey exterior cracked and fell away.
Peeking out from the center of the foul, chewed mass was something dark. Something solid.
"Get me some warm water and a scalpel," I told Martha, my voice suddenly devoid of all emotion.
Martha rushed to the sink, filling a small plastic cup with hot water, and handed me a sterile surgical blade.
May you like
I put on a fresh pair of latex gloves. I picked up the heavy mass from the metal tray and submerged it into the hot water, using the edge of the scalpel to carefully pry away the thick, disgusting layers of hardened gum.
Layer by layer, the grey sludge peeled back.
And as the final layer of gum fell away into the water, I finally saw exactly what had been shoved into the mouth of this seven-year-old girl.
I dropped the scalpel. It clattered loudly onto the floor.
I looked at Martha, and then I looked at the terrified little girl shivering on the table.
