The Urachus and the Magic Chin

The head of the tyrannosaurus rex turned soft and gooey before finally liquefying.  The red plastic dripped off its chest onto the plate as its tiny arms distorted and dissolved.  Lloyd adjusted the match and opened a gaping hole in the middle of the toy.  Then, he found himself looking at a red and brown mess which smelled like an industrial spill.  The thought strolled into his head that this might not be the ideal way to spend Jess’ naptime.


Lloyd reached deep into the dish pile, his fingers scuttling along the unseen surface of the sink like a crab at the bottom of the ocean.  He extracted his son’s favorite drinking cup, the one shaped like the head of a dinosaur- pteranodon, to be exact.  Anatomically, the molded cup appeared correct to Lloyd and he should know.  His years at the museum, preceded by the doctorate degree, had filled him with a limitless store of dinosauria.  Lloyd knew his winged reptiles.  To his dismay, he was not privy to any recent paleontological findings.  Perhaps the cup did not mesh with the latest conclusions of those paid to excavate and to classify.

“Help!  Help, please!”  Jess called from the family room.  It was a call for assistance, not out of pain.  Lloyd strolled into the room and ascertained that his son was struggling with his Play-doh factory.  The toddler looked to his father like the exhausted lineman looks to his foreman.  Jess banged on the lever of the toy to demonstrate his effort.  “Help, please?”

“Let me show you,” responded Lloyd.  Sitting beside his son, inhaling the peculiar scent of the toy, he showed him the easiest way to extrude the colored mush through the toy.  “Do you see?”

Jess nodded emphatically.  “Yes, yes.”  Then he elbowed his father out of the way to get at the toy himself.

Seeing that he was no longer needed, Lloyd returned to the kitchen, tossing a few words of encouragement behind him.  Washing the dinosaur cup, Lloyd kept an ear tuned to the family room.  When Lloyd returned to his son with the cup half-filled with water, Jess accepted it gratefully.  The boy slurped as much water as he could pour into his mouth, dumping the rest on his shirt.  As he slammed the empty cup down on the coffee table, Jess announced that he was all wet.  Lloyd reassured him that it would dry.  Examining his shirt as he pulled it away from his chest, Jess considered the idea of air drying and decided to accept the possibility.  He returned to his Play-doh factory.

Lloyd poked through a pile of magazines on the end table.  Ignoring the new medical journals, the old anthropological journals, Smithsonian, and Natural History, he extracted Sports Illustrated from near the top.  Settling onto the sofa, Lloyd continued reading an article which he had begun the day before.  With one eye, he watched Jess set aside his toy and cross the room to his bookshelf.  The little boy grabbed a Sesame Street Magazine and dragged it back across the room.  After climbing onto the sofa, Jess settled in beside his father, intently imitating his father’s page turning and concentrated facial expression.


“Go back to work then,” said Cassie, trying to watch television and still look interested in having a conversation with her husband.  She’d had a long day in the pediatric ward and just wanted to think about nothing for an hour.

Lloyd looked at the newspaper in his hands.  “What about Jess?”  His legs were extended the length of the sofa, across her lap.

“Daycare.”  Cassie shrugged because it was easier than using words.

“Not a lot of call for an archaeology degree.”  Lloyd had taught science to high school students back in Chicago while Cassie went to medical school.  Her residency assignment came through on the same day as Jess’s first birthday.  Cassie had put Youngstown-Goddamn-Ohio on her list as a last chance for a pediatric residency, followed by a long string of family medicine programs.

“How would you know?”  She fiddled with the hair on his shin.

Lloyd held up the want ads in response.  “I know.”

“Youngstown’s not an archaeological city.”

“Archaeological cities are buried by dirt.  They’re excavated, not lived in.”

Cassie smiled as expected.  The commercials started blaring on the television and she squeezed the mute button on the remote.  “Did Jess have a fever tonight?”

“Yea.  I gave him Motrin.”

“How high?”

“I didn’t check.  He was hot enough.”

“We have to start keeping track.”

Lloyd put down the paper.  “I thought everybody’d decided it was a virus.”

“Lack of anything better.”  She ran her thumb across the remote, anxious for her show to return.  “It probably is a virus.”


Transfixed with delight, Jess played paddy-cake with his grandfather, yelling out nonsense syllables while Lloyd’s father chanted the more traditional verses.  Inevitably, the rhyme collapsed in a cacophony of slapping hands and slippery tickles.  Jess would call out for the tickling to stop as soon as his breath allowed.  Then, when his grandfather’s hands rested, Jess would demand a new round.

The real reason that Youngstown had even made Cassie’s list of residency programs was that Lloyd’s parents lived in Cleveland, an hour away.  It seemed close enough to grandparents without being too close.  The relationship was not strained.  Proximity just tended to breed contempt, at least on Lloyd’s part.

Suddenly, Jess dropped his hands and raised his nose to capture a desirable aroma.  Looking around frantically, he was searching out something.  “Cupcakes!”  The little boy dashed to the kitchen.

Lloyd’s father smiled at the receding child.  “What are you feeding him?  He’s getting big.”

“The usual stuff: table scraps and what he finds in the yard,” replied Lloyd from the sofa.

Lloyd’s father had lowered himself to his grandchild’s height by sitting on a footstool.  Now, he struggled to rise from his perch.  Groaning, he forced himself up onto the sofa beside his son.  “Every answer doesn’t have to be a joke.”

Lloyd shrugged heavily.

The father patted his son on the leg.  “You, on the other hand, look tired.”

“Jess hasn’t been sleeping through the night.  He’s been running a low grade fever for a couple weeks.”

“It doesn’t show.”

“When he gets tired or hungry, it does.  The doctor prescribed an antibiotic, but they think it’s some virus.”

“Kids get stuff and it’s usually gone before you ever find out what it was.”

Lloyd nodded.  “It’s the things you don’t know that get you.”

“How’s the job search going?”

“Not well.  Nobody’s hiring.  At least, nobody’s hiring for enough money to make it worthwhile– daycare and all.”

“Are you sure you want to go back to work?”

“No.  I don’t know if I like any of the daycares in Youngstown.  It’s hard to find a decent teacher.”

Lloyd’s father shrugged more heavily.  “You have to trust somebody with him.”

Lloyd considered his options for the way the conversation could go: casual and negligible or deep and meaningful.  “The problem is that I don’t know anyone who’s done this before.”

His father raised an eyebrow.  “What?  Raised a kid?”

“I never saw any men doing this when I was growing up.  I’m not sure what I’m supposed to be doing.”

Silently, the two of them chewed on the conversation’s new direction.  The air was filled with freshly baked cupcakes, distracting both of them.  “You’re right,” acknowledged Lloyd’s father.   “That boy is the most important thing right now.  Everything you do has to be about him.”  The ensuing silence disappeared when Lloyd’s father reached for the television remote control and turned on a football game.  “Let’s see if the Ravens can lose another game.”


Jess cried out for his father, signalling the start of Sunday morning.  Not for the first time, Lloyd wished his son could unearth himself from his blankets and straggle into his parents room without assistance.  Reaching tentatively for the floor with his feet, Lloyd poured from bed and stumbled into Jess’s room.  The little boy was waiting patiently.  Father received a smile and a moist hug.  Lloyd had ignored the warning that his nose had provided.  Jess needed to be changed immediately.  Lloyd settled the toddler onto his changing pad and removed the wet pajamas.  Jess had gotten a new bellybutton overnight.  “When did you become an innie?”  Lloyd asked, knowing that no answer was forthcoming.  Jess sang him a song about Cookie Monster anyway.

Carrying the active child into their bedroom, Lloyd dropped Jess beside Cassie.  Instantly, he encircled his mother.  “When did Jess become an innie?”

Opening one eye, Cassie looked at him with dismay.  “He’s always been an innie.”

Lloyd lay back down on the bed and sighed.  He doubted that he did not remember the appearance of his son’s belly, but it was possible.

Jess poked him in the side with his feet.  “Cowboy?” he whispered.  Lloyd smiled and nodded.  Jess tossed off the covers and climbed onto his father’s knees.  Rocking back and forth while hanging onto his father’s hands, Jess called for the horse to go faster and faster.  The ride continued until Jess tumbled onto his mother.  After a brief respite, Jess climbed off the bed and ran to grab some books for reading.  On his way back, he tripped and landed hard on the books.  Embarrassed more than hurt, Jess cried loudly.  Lloyd picked up the fallen child and carried him back to the bed where Cassie enveloped him.  Unable to regain his self-control, Jess continued to wail.  Looking to his father he held out his left hand with the index finger extended.  Lloyd took the hand and held the finger beneath his chin in a tight clasp.  Immediately, Jess began to breathe easier.

“The magic chin,” commented Cassie.

“Magic chin,” agreed Jess.

Lloyd rolled his eyes, hoping that it would always be so easy.


Cassie stumbled into the living room, half asleep from putting Jess down for his nap.  Lloyd looked up at her, half blind from deciphering want ads.  “Should I just give up?”

Cassie rubbed her eyes and tried to answer.  Catching the taste of sleep in her mouth, she paused for a drink of water.  By the time she returned, Lloyd had turned on the television.  She sat down and waited.

“What do you think?”  He asked, annoyed.

“I think you should do whatever you want to do.”

Lloyd looked for some solid ground from which he could proceed.  “What about Jess?”

“We’ll figure something out.”

“I like staying home with him.”

Cassie patted his leg without saying a word.

“I think I’m good at it.”

She nodded.

“I just don’t really know.  I mean, it’s not as if my father stayed home.  I feel like I’m surveying unexplored land here.”

Cassie smiled at him and said, “You’re a good father.”

“Yea, well, what about the money.  I’m not doing such a good job with that.  I should have a job.”

“You had one in Chicago.  You can get one here.”

“Yea, McDonald’s is hiring.”

“You can do better than that.”

“You haven’t been looking in the want ads.  I’m not a nurse and I’m not a mechanic.  What kind of job is out there for me?”

Cassie turned off the television.  “Then stay home.”  Her voice stayed even.

“I don’t know how.”


“Something’s wrong with Jess’s navel,” said Cassie on Monday.  Jess curled over his mother’s shoulder, fighting the day’s exhaustion.

Desperate for a hopeful nugget within the classified ads, Lloyd did not even look up.

“I want to call Dr. Lucas.”

Tossing the want ads aside, Lloyd said, “Their office isn’t open yet.”  Cassie already knew this.  The next thing that Lloyd heard was her voice on the telephone.  Lloyd found himself wondering how serious this could be.  Cassie was the physician and she was unwilling to wait until the office was open.  Maybe Cassie was not getting enough sleep, but the other doctor would reassure her.  Funny-looking bellybuttons just did not seem that urgent.


From the entry to the emergency room, Lloyd could see a pair of paramedics hovering around an infant strapped to a gurney.  The child was on a respirator.  The mother stood between the paramedics, looking off into space.

Lloyd found Cassie and Jess at a check-in station near the entry to the examining rooms.  Lloyd sat down and took Jess into his arms.  He preferred to answer the questions, but found himself speaking softly to Jess.  Cassie provided insurance information while Jess fidgeted.  The boy was showing signs of fading energy.

A security guard manned the door to the treatment area.  “Two visitors per patient,” announced the sign over the guard’s head.  A constant parade of distracted people seemed unable to read.  The guard entoned an ancient form of security chant: “Two visitors per patient.  I’m sorry, ma’am, only two visitors per patient.  I have to stop you there- just two visitors per patient.”  Periodically, the guard pointed at the sign in order to provide support for his position.

Cassie finished answering the intake questions as a triage nurse approached wearing an oversized white sweater covered with buttons.  Many bore the photographs of smiling children.  Others featured dancing animals.  Jess perked up a bit at the sight of the colorful buttons.  Lloyd found himself wondering if she wore the same sweater for the adult patients.

Cassie was explaining to the nurse’s quizzical expression that her son might have an entrapped hernia.  Lloyd wondered why his wife never prefaced such comments by explaining that she was a physician.  The nurse treated Cassie like a mother with an extensive medical library and an over-active imagination.  Finally, Lloyd interjected a casual comment about his wife’s profession and the nurse let out a sigh of relief.

Jess happily extended his arm to have his blood pressure checked.  He screamed and wiggled when the nurse tried to take his temperature with an ear thermometer.  Exasperated, the nurse looked to the parents for assistance.  Lloyd reached out and took his son’s hand in his own.  With his finger nestled beneath his father’s chin, the boy relaxed long enough for the thermometer to take a reading.  Lloyd could only stare at the corner of the waiting room and wonder what the rest of the people in the room must think.

“All right, let’s go on back,” said the nurse.

The children’s rooms had been painted with various animal scenes.  Most of the rooms were empty for which Lloyd was grateful.  He was not sure how he would react to the sight of a child in significant trauma.  The infant whom Lloyd had seen at the check-in desk was resting under an oxygen tent.  Its mother sat nearby in a rocking chair, her face turned to the ceiling and her eyes distant.

The nurse pointed to a small room in a corner.  She left them alone with the door wide open.  A television hung in the corner, but no magazines or books were available.  Jess had fought off his sleepiness at the sight of all the interesting objects which they had passed.  Lloyd set him on a modified crib which took up one wall in the room.  Three smiling elephants had been painted behind the crib and Jess walked across the mattress to examine them more closely.  Swinging his arm like a trunk, the boy roared like a pachyderm.

“He seems to be in pretty good shape,” said Lloyd, still unclear on the reason for the trip to the emergency room.

“It could be a hernia.  It might need immediate surgery,” said Cassie, struggling to sound as if she were discussing a recipe for cheesecake.  “He has an infection.  Something’s in there.”

Not for the first time did Lloyd long to receive a little more for the money and effort invested in his wife’s medical education.  “Something’s in there” seemed like it could have been obtained for a lot less money.  “How serious is this?”  Lloyd kept his tone light.

“I don’t know.  It could be very serious.”

Lloyd understood that his wife, a physician, had spoken with Jess’s doctor, another physician, and that between the two of them they had concluded that Jess needed to go to the emergency room.  He knew that his wife was not acting impulsively, but he did not want Jess to be seriously ill.  He wanted his wife to be impetuous and he wanted to be angry with her for it.  He would really like to complain about wasting his time in the emergency room.  Nothing would make him happier.  Lloyd practiced frowning at Cassie for a few minutes.

“Hello, hello.  I’m Dr. Nabors,” announced a young woman who rushed into the room.  Recognition crossed her face as she looked at Cassie.  “Hi, how’re you doing?”  She had short dark hair and a long sharp nose.

“Not so good,” said Cassie, gesturing toward Jess.

“Do I know you from somewhere?” asked Dr. Nabors.

“I’m a second-year pediatrics resident at Northside.  We rotate through here.”

“That’s right.  You’re Cassie?”

“What brings you in here tonight?” asked Dr. Nabors.

Cassie went through a brief history of Jess’ fever.  Lloyd chatted with his son about elephants until it came time for his bellybutton to be examined.  Having grown accustomed to his mother’s stethoscope, Jess happily raised his shirt when asked.  Then, the boy screamed when fingers brushed near his swollen navel.  Lloyd leaned over his son and placed Jess’ finger underneathe his chin.  The boy’s face struggled from fear through pain to relief.

“That’s not a hernia,” said the attending physician.  “It’s too high up.”

Jess winced at every touch.

“Watch it respond there when I press here,” said the doctor, making the area below Jess’ navel move like a seesaw.  He backed away from Jess, finishing his examination.  “It’s a urachal cyst.”

It seemed to Lloyd as if every other adult in the room sighed with pleasure.  Dr. Nabors even appeared to look at Cassie with blossoming admiration.

Lloyd grunted his ignorance.

“The urachus is a vestigial structure leftover from the womb.  Your son still has his and it’s become infected.”

Lloyd nodded his understanding, while inside he thought, “I went to graduate school.  This will all make sense to me later.”


Arriving home from the emergency room, Lloyd carried his dozing son into the house.  Carefully, the father maneuvered through the dark house, counting steps and leaning slowly.  In the child’s bedroom, he gently lay his son down.  Untying the boy’s shoes, Lloyd slipped them off.  After covering Jess with a blanket, he left the room, closing the door behind him.

Standing at the head of the stairs, Lloyd could hear the television come on as Cassie settled down to watch.  She would be trying to clear her mind for sleep.  Lloyd turned away from the steps and walked back to their bedroom.  Perched on the mattress, he sighed heavily.  The ordeal was over and the ordeal had just begun.  Relieved that they had an answer to Jess’ unexplained fever, Lloyd could only wonder what the diagnosis meant.  He had asked Cassie and she had known little about the condition.  She knew the important part– not life threatening.  When Cassie had heard the diagnosis, she had felt vindicated and curious.  He wondered if there was some sort of professional advantage to having a rare illness in your immediate family.


Cassie sat in front of the television wondering if Jess had woken up while Lloyd had carried him in from the car.  After unlocking the front door for them, she had gathered their belongings out of the car and followed the pair of them into the house.  No sounds had drifted down to her ears since she had finished distributing their burdens to their appointed places.

Lloyd may have gone to sleep.  That would not surprise her.  He had always had an easier time dividing his life into sections.  The emotional part did not interfere with the practical part which did not interfere with the sleep part.

Later, when she went to bed, she found Lloyd sound asleep.  Later still, she awoke to find herself alone in their bed.  Listening intently in the dark, she tried to determine if Lloyd was in Jess’ room or in the bathroom.  He always made noise in the bathroom so he was probably with their son.  She waited silently for some confirmation, but only heard her son sigh contentedly in his sleep.

Slipping carefully onto the floor, she walked into the hallway, muffling her steps by studious effort.  Lloyd was not in the child’s room.  No lights were on downstairs.  Cassie walked back into their room, trying to decide what this meant.  He was probably downstairs.  Maybe he could not sleep and had gone down to watch television.  She shut her eyes and reached out with her ears.  Movement and noise rose from their backyard.  The open windows and the summer air helped carry the sounds to her.

She went to the window and looked out.  Lloyd was perched on the edge of Jess’ sandbox.  Shadows crossed the lawn and obscured her view.


Lloyd dug into the sand with a small yellow shovel, engraved with smiling sea creatures.  Having just buried Jess’ toys, Lloyd proceeded to excavate his son’s treasures.  The larger trucks had required significant earth moving in order to submerge them adequately.

Now, the plastic shovel in Lloyd’s hand carefully traced moats around the sand mounds, large and small.  With a practiced hand, he uncovered the Matchbox cars, the sand tools, the large trucks, and the dolls.  After gently blowing sand dust from each object he lined it up with its own kind: by color, by size, and by designation.

“Lloyd?”  Cassie’s voice drifted across the lawn.  She stood in the shadow of the house, clutching her bathrobe about herself.  She waited for a response, but Lloyd only continued with his excavations.  Glancing about for neighborhood eyes, Cassie braved the late night backyard.  Her slippers shuffled across the moist grass, sounding like tearing fabric with every step.  Standing behind him, Cassie watched Lloyd slowly uncover a toy soldier and place it with the other figures queued along the rim of the sandbox.  When she placed her hands on Lloyd’s shoulders, the strength seeped out of him and his arms went limp.  The yellow plastic shovel settled soundlessly onto the sand.  “What is it, Lloyd?”

He shook his head ever so slightly and licked his lips, preparing to answer.  The words didn’t come, so he looked at his hands, curled with exhaustion.  “I’m afraid,” came out of his mouth unbidden.  His voice rasped with sand.

Cassie did not move.

Lloyd tried again.  “I’m so afraid that I don’t matter.”

Cassie felt herself sag beneath Lloyd’s burden and her hands slid from his shoulders.  “Come to bed,” she said, turning back to the house.


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