Dr Carlisle Cullen's POV
The little girl lay on the hospital bed, her small frame dwarfed by the white sheets and pillows surrounding her and keeping her propped up. Her breaths were shallow, labored, and every now and then, her small face would scrunch up in discomfort, as if the weight of the world were pressing down on her fragile chest.
I approached her bed, trying to mask my concern with a gentle smile. "Good afternoon, sleepyhead," I whispered softly. Her eyes, heavy with the weight of both sleep and pain, slowly fluttered open. She squinted up at me. I could see the fear and disorientation in her gaze as she tried to make sense of her surroundings.
"I'm Carlisle," I introduced myself gently, crouching down to her level. "I'm one of the doctors here at Forks Hospital. We met yesterday morning." Her eyes searched mine, trying to grasp the fleeting memories of the previous day. I could see the fog of the pain medication clouding her thoughts.
"We've given you a lot of medicine to help with the pain," I continued, speaking quietly. "It might make your head feel a little fuzzy, but that's normal. It will pass."
At the foot of the bed, Josh was reviewing her medical file, his expression tense. He glanced up at the monitors, his brow creasing with concern. The numbers weren't where they should be, and we both knew it.
As she began to wake fully, the reality of her situation became more apparent to her. Her eyes widened as she took in the tubes and wires connected to her tiny body, the beeping machines, the sterile smell of the room. Panic set in, and I could see her chest rising and falling faster, her breaths becoming more erratic.
"That funny feeling in your throat?" I said gently, trying to distract her. "That's just a special tube to help you eat until you're strong enough to have real food again. It's doing a very important job, even though it might feel a bit strange." She didn't seem entirely convinced and screwed up her face, sniffling and coughing away as if trying to budge it. Nasogastric feeding tubes were uncomfortable, and it was just another indignity and element of loss of control for the poor thing.
Her eyes darted to the IV lines in her arms, her face turning pale. "Get them out… please… mister," she whispered, her voice quivering. Before I could react, she reached for one of the lines, her fingers shaking as she tried to pull it free. Blood quickly spotted the sheet, a stark contrast against the white linen. It was frustrating given how much effort it had taken for us to get venous access with how tiny her veins were.
"Sweetheart, please," I said firmly, yet gently, as I moved forward to hold her hands in mine. "We need to keep those in so you can get better. It's very important." The girl continued to cry, trying to wiggle her hands out of my grip. "What a-are they?" she asked in a sob, her voice filled with fear and confusion. Josh crouched down next to her. "They're little straws that deliver medicine to you, so they do a really important job in helping take away the pain and healing your wounds. They leave a little bug bite when they go in though, so sometimes feel like they can sting or pinch a bit." She eventually appeared to settle after his explanation, and gave a slow nod. I released her hands, hoping she had understood, but almost immediately, she reached up to tug at the feeding tube in her nose. My heart sank as I gently stopped her before she could pull it out completely. She had managed to dislodge it slightly, and I knew it would need repositioning, but that could wait. Right now, all that mattered was calming her down.
Josh and I both exchanged glances, as if picking our battles of which to face first.
Josh knelt back down at her level. "What's your favourite food, huh? Carlisle and I can sort that out for you a bit later, if you'd like. I'd imagine you must be pretty hungry." He said, clearly trying to regain some trust with her and settle her tears.
She gave a little shrug, clearly not wanting to engage in small talk.
"Do you like ice cream?" he asked. She shrugged again, her tiny shoulders barely moving.
"No ice cream?!" Josh exclaimed in mock surprise. "You don't like chocolate chip?"
The girl's voice was barely a whisper. "It hurts me. Sometimes."
Josh's expression softened further. "Oh, that's not fair. Where does it hurt you?" She pointed a shaking finger towards her mouth and pointed to her lips, her eyes downcast.
"Ouch, sensitive teeth? Do you like hot puddings instead? Sticky toffee pudding and custard?" he asked, his tone still light but his concern evident. She stayed quiet for a moment, then gave a timid nod.
"Should I get some of that for you later? I heard the kitchen does a fantastic sticky toffee pudding," Josh said, his voice full of encouragement. The corners of her mouth twitched into the faintest hint of a smile, and I heard the subtle sound of her stomach rumbling at just the mention of food.
Josh glanced over at me, and I saw the relief in his eyes as he gave a little wink. "Can Carlisle just adjust your tube to make sure we're giving you enough food until I sort your pudding out? It won't hurt," he explained gently, trying to keep her focused on the promise of something sweet. The girl gave a nod of permission.
"Thank you, sweetheart. Can you face me?" I asked, reaching out for the NG tube which had sagged on her cheek. My hand brushed across her cheek, and she immediately pulled away from me.
"Sorry, cold hands. I should have warned you." I whispered, reaching out again to reposition the tube. The same happened again, although this time, she yet again went to bite me. She recoiled, looking sad, embarrassed and disappointed in herself.
I turned to Josh, my voice barely above a whisper. "I think that might be a no-go right now," I said, knowing we were losing the battle to keep her calm. "10mg of diazepam?" I requested from Josh. He gave a nod of agreement. "IV." I suggested. It would reach her bloodstream within seconds, unlike a tablet. He went to the back of the room and drew up the fluid and passed the syringe to me discretely.
"I'm going to give your body a little drink of water," I explained. "it's going to feel a bit cold," I warned her, pushing the sedative into the one remaining cannula she had. She clearly didn't like it and tried to pull her arm away from me, but I held it gently still. The tension in her small frame eased, and her movements became sluggish. Her eyes, once wide with fear, slowly began to close as the drug took effect.
"Good job, you're doing so well," I whispered, my heart aching at the sight of her vulnerability.
With her body now more relaxed, Josh turned his attention to finding a new site for the IV. Her veins had been traumatized from previous multiple attempts, and her veins were thin and fragile due to her malnourishment. He carefully selected the smallest needle he could find. He spent a few minutes picking up each of her arms and examining the veins in her hands, wrists and elbow creases. He shook his head, clearly not convinced.
He looked towards me with eyes full of concern. He wanted my help. "Dorsal venous arch?" I whispered, gesturing discretely to her foot. He sighed, giving me a slightly pained expression. Cannulas placed in the foot were often painful to insert, and we always tried to avoid doing them unless it was a last resort, especially in kids.
"You're gonna feel me scratching your foot, kiddo. My nails are going to be a bit sharper than Carlisle's, I'm afraid. Can you keep really still for me?" he warned. I kept a firm hold of her hands to stop her from doing anything sudden, though it appeared that the sedative was working well and she was fairly powerless against us both.
Josh carefully swabbed the area with antiseptic, his face set in determination to make this as quick and easy for her as possible. He inserted the needle and the vein collapsed almost immediately, and I could see the frustration in Josh's eyes. The girl was whimpering and wiggling her legs around, trying to get away from his firm hold on her. He tried again, this time with a neonatal needle. I held my breath as the needle slid in, and this time, it found the vein. He secured it in place and flushed it to check it was working.
"All done," Josh said softly, his voice full of relief.
"Was it… was it really?" She asked, her voice exhausted and she was struggling to finish her sentence.
"Yes, all done, sweetheart." Josh reassured her. She shook her head, her forehead screwing up as if we hadn't understood her.
"Your nail? Scratching?" she finished her question, clearly skeptical.
Josh and I exchanged a glance, knowing it wasn't fair to deceive her.
"It stung. Lots." She continued, looking betrayed.
Josh sighed a little. "No, it wasn't my fingernail." He admitted. "It was a small, sharp needle—a bit like a tiny, pointed straw. It might have felt like a scratch, and I wanted to make it sound less scary. It's all done now, and it might feel a bit like a mosquito bite—possibly a little stingy or itchy, but it will settle soon."
"You're so brave. I'm so proud of you," I praised her, giving her a moment to settle before attempting to reposition the NG tube again. But as soon as I moved to touch her face, she used all the strength in her small body to push me away, her fear and pain overwhelming any sense of trust she might have had. She didn't want anyone near her, didn't want to be touched, and it was clear that we weren't going to be able to care for her the way we needed to until she was fully asleep. Even during her sleep, she had whimpered and squirmed as we worked to place the feeding tube and stitch her facial wound. I began to wonder if her face was particularly sensitive or if it held some deeper significance for her.
The girls blood tests indicated signs of infection—elevated white blood cell counts and markers suggesting inflammation. The X-rays showed bruising and damage consistent with physical abuse, with both old and recent injuries. Most concerning of all was the presence of toxic substances in her system. We'd found extremely high doses of a drug called Lisinopril which was used to treat hypertension. It had caused her blood pressure to tank, exacerbating her pre-existing infection. We suspected she had been poisoned, though I had encouraged Josh to hold back on reporting it to the police until we had time to prepare the girl for those conversations.
She tugged on my white coat, just as she had done yesterday, to get my attention.
"Can I h-have the medicine from y-yesterday?" She asked.
"Sweetie, morphine is a very strong drug," I said gently, trying to explain. "You've already had a fair amount of it today." My voice was filled with understanding, but I felt a deep sadness knowing how much relief she was seeking, how much she wanted to escape the pain. "It made me feel good… made me feel calm," she mumbled, her voice small and full of yearning.
"You have a pretty powerful sedative in you right now. If you closed your eyes and counted down from ten, you'd be out of it in seconds," I said, trying to soothe her as I began tucking her back into bed.
"It's completely normal to feel scared. You've been through a lot," I continued, adjusting her pillows with care. "But treating those fears with a drug isn't the best solution. The best thing to do is talk about them."
She looked up at me, her voice barely more than a whisper. "I don't want to be here," she said, her words filled with a sadness that cut straight to my heart.
I sighed, giving her hand a gentle squeeze. "I know this isn't fun," I said softly, trying to keep my own emotions in check. "But we're doing everything we can to make you feel better."
"I want it to go away," she whispered again, her voice cracking with desperation.
Her eyes were glassy with unshed tears, her tiny frame shaking as she tried to hold them back.
"Sweetheart, I know it's really hard right now," I said, my voice gentle but firm. "You're going through a lot, more than any kid should have to. But I need you to know that things can get better. We're here to help you, okay? You're not alone." She looked back up at me, sighing and shaking her head a little in resignation, as if I hadn't understood her at all. I wished I could, if only she let us in. We didn't even know her name.
Josh knelt down beside her, his expression softening as he took her hand in his. "Hey, kiddo," he said softly. "You've got a whole team here who cares about you. We're going to get you through this, one step at a time. And I promise, there's a whole lot of good stuff waiting for you on the other side of all this."
I could see her struggling to believe us, but there was a tiny flicker of hope in her eyes. It was faint, but it was there.
"Close your eyes and rest," I murmured, tucking the blanket around her. "We're right here with you."