2. Enzo
2
ENZO
T he tension was thick as I walked back into the exam room. My mind was racing, but I couldn’t let it show. Ava was sitting on the table, swinging her legs back and forth, her face glowing with the kind of innocence that didn’t belong in situations like this. Summer sat beside her, her shoulders rigid, her lips pressed tightly together.
“Hi again, Ava,” I said, keeping my voice as light as possible. “How’s the knee feeling now?”
“It’s okay,” she said, her small fingers fidgeting with the edge of her dress. “It doesn’t hurt much anymore.”
“That’s good,” I said, stepping closer. “But you know what? I want to make sure there’s nothing else we missed, just to be extra careful. Would that be okay?”
Ava nodded, her wide eyes trusting.
I glanced at Summer. She gave me a hesitant nod, but her expression was guarded, like she was waiting for the other shoe to drop.
“All right,” I said, pulling over a stool and sitting down. “Ava, I’m going to ask you a few questions, okay? It’s like a little game where you tell me if anything feels funny.”
“Okay,” she said softly.
I asked her about pain in her other joints, whether she ever felt tired during playtime, and if her knee had hurt before today. Each question was met with a shake of her head or a quiet “No.”
Summer sat silently, her eyes darting between Ava and me. When I asked about bruises, though, Ava tilted her head, thinking.
“Sometimes,” she said.
I leaned in slightly. “Sometimes? Can you tell me more about that?”
“Um… when I bump into things, I get big bruises,” she said, holding her hands out wide to demonstrate.
My stomach tightened. “Does it happen a lot?”
“Not a lot,” she said, her voice small.
Summer’s hand went to Ava’s shoulder. “She’s just clumsy,” she said quickly, her tone defensive.
“Maybe,” I said gently, my professional instincts kicking in. “But I’d like to run some blood tests, just to make sure everything’s okay.”
Summer’s brows knit together. “Blood tests? Enzo, her knee is the issue here. Why would you need to do more?”
I held her gaze, keeping my tone steady. “It’s routine. Given the depth of the cut and the bruising she mentioned, I want to be thorough. It’s probably nothing, but I’d rather be safe.”
She hesitated, then sighed. “Fine.”
I turned back to Ava, smiling again. “You’re going to be the bravest patient ever, Ava. It’ll just be a little poke, and then you can have a cool Band-Aid, okay?”
Ava didn’t look thrilled, but she nodded.
The blood test didn’t take long. Ava was remarkably calm for her age, holding Summer’s hand tightly while the nurse worked. Once it was done, I stepped out to expedite the results.
By the time I returned, Summer was pacing the small room, her arms crossed. Ava was lying back on the table, playing with a stuffed animal one of the nurses had given her.
“Enzo,” Summer said the moment I walked in, her voice sharp. “What’s going on? You’re acting like this is more serious than a scraped knee.”
I closed the door behind me, taking a deep breath. “Summer, I’m trying to be thorough. I’ve seen too many cases where something minor uncovered a bigger issue. Let’s wait for the test results, and then I’ll explain everything.”
She stared at me, her jaw tight, but she didn’t argue.
About thirty minutes later, the lab results came in. I skimmed through the report, my stomach sinking as the numbers confirmed my suspicions.
Back in the room, I pulled up a chair, my voice calm but serious. “Summer, Ava, I need to talk to you about what I found.”
Summer froze, her hand going instinctively to Ava’s. “What is it?”
I looked at Ava first. “Ava, you’re doing great. You’re such a strong little girl. But there’s something I noticed in your blood test, and I think it’s making your bruises worse and slowing down how your knee is healing.”
Ava blinked at me, her little face filled with confusion. “What does that mean?”
I glanced at Summer, silently asking her permission to continue. She nodded tightly, her lips pressed into a thin line.
“It means your body isn’t making something called platelets the way it should,” I explained gently. “Platelets are like tiny helpers in your blood that stop cuts from bleeding and help bruises go away faster.”
Ava nodded slowly, not fully understanding but trusting me anyway.
Summer’s voice was sharp. “And what does that mean, Enzo? What’s wrong with her?”
I turned my attention to her. “Ava has a condition called thrombocytopenia. It’s when your body doesn’t have enough platelets. It can happen for a lot of reasons, but the important thing is that we caught it early.”
Her face went pale. “Early? How serious is this?”
“It’s manageable,” I said quickly, trying to ease her panic. “But Ava is going to need surgery to address the damage in her knee. The wound is deeper than I initially thought, and with her platelet levels being low, we need to be very careful about how we handle this.”
Summer’s eyes widened. “Surgery? Are you serious?”
I nodded. “I know it sounds overwhelming, but it’s the best way to make sure her knee heals properly and to prevent any further complications. We’ll also need to monitor her platelet levels closely.”
Summer looked at Ava, who was sitting quietly, clutching her stuffed animal. Then she turned back to me, her voice shaking. “And you’re the one who would do the surgery?”
“Yes,” I said firmly. “I’m a specialist in pediatric cases like this. Ava will be in the best hands.”
She stared at me, her expression unreadable. “Enzo, this is—this is a lot. I need time to think.”
I nodded, understanding the weight of her decision. “Of course. But, Summer, time is a factor here. We need to schedule this soon to avoid any further risks.”
She rubbed her temples, her shoulders sagging. “I can’t believe this is happening.”
“I know,” I said gently. “But we’ll get through this. Ava’s strong, and she has you. And… she has me.”
Her eyes flicked up to mine at those last words, something unreadable passing through them.
“I need a moment,” she said, standing abruptly and stepping outside.
I stayed with Ava, chatting with her about her favorite cartoons and her stuffed animal. She was a bright, curious kid, and every second I spent with her only made the pit in my stomach grow.
When Summer came back, her face was calmer, but her eyes were red.
“Okay,” she said quietly. “We’ll do it. But only if you promise me you’ll tell me everything. No surprises.”
“You have my word,” I said, meeting her gaze.
She nodded, then walked over to Ava, scooping her up in her arms. “You hear that, baby? Dr. Pearson is going to make you all better.”
Ava smiled sleepily, resting her head on Summer’s shoulder. “Okay, Mommy.”
As I watched them, a wave of emotion hit me. This wasn’t just another patient. This was Ava. And, whether Summer wanted to admit it or not, this was personal.