The right side of Leo’s face was visibly swollen even beneath the hood, and an untreated tooth infection could absolutely produce facial swelling in a child.
But possible was not the same as convincing.
I rolled my stool closer to the bed, then stopped before I entered Leo’s immediate space.
I wanted him to see that I wasn’t going to grab him.
“Can I lower your hood?” I asked.
Leo did not look at me first.
He looked at Greg.
Only after that did he nod.
I gently moved the fabric away from the right side of his face.
The swelling ran from his cheekbone down toward his jaw.
Purple bruising showed beneath skin that looked stretched and hot.
Near the center of the swollen area was a round opening.
It was small enough that someone glancing quickly might have called it a bite.
But it looked too deep.
Too clean.
And too deliberate in shape to let me accept Greg’s explanation without looking harder.
There was also an odor I couldn’t immediately place.
Damp earth was the first thing that came to mind.
Underneath it was something faintly sweet.
Greg wrinkled his nose.
“Nasty, right?”
Leo stared at the pens in my scrub pocket.
I asked, “Does it burn?”
“No.”
“Sting?”
He shook his head.
“What does it feel like?”
Leo took a moment before answering.
“It feels heavy.”
Greg shifted beside the bed and checked the steel watch on his wrist again.
Everything about his behavior seemed organized around the same priority: getting out of the hospital as quickly as possible.
I needed space between him and Leo.
Not enough to start a confrontation.
Just enough to see whether the boy behaved differently when Greg was farther away.
I told Greg he needed to stand against the far wall for pediatric exam clearance.
There was no such rule.
He looked at Sarah.
For half a second, I could see him deciding whether she believed me.
Sarah’s expression never changed.
Greg moved to the wall.
That small distance changed the room immediately.
Leo pulled his left hand from the pocket of his hoodie.
Bruises covered his fingers.
A narrow red mark circled his wrist.
Not a vague patch of irritation.
A line.
I asked him when he had eaten last.
He hesitated.
Sometime the previous afternoon, he said.
Greg answered from the wall before I could ask why.
I didn’t respond to him.
I kept my attention on Leo.
The swelling in the boy’s face needed medical treatment regardless of whatever else was happening, and that had to remain my first responsibility.
I cleaned the skin beside the opening carefully.
Leo didn’t flinch.
I placed two gloved fingers against the swollen area and applied gentle pressure.
Something moved beneath the skin.
Not the ordinary give of inflamed tissue.
Not the shifting softness of fluid.
Something rolled away from my touch.
I stopped.
For a moment I wondered if I had misread what I felt.
Exhaustion can make a clinician distrust a sensation that doesn’t match the expected anatomy.
So I lifted my hand.
