Fingers and toes

Ralph spent his first Christmas in the hospital on a ventilator. I'll never forget those desperate days and how terribly sick he was. After that new year, when he was home and getting stronger, I was reminded of just how awfully ill he was.

These strange horizontal lines slowly appeared on Ralph's finger and toe nails. The lines became more prominent over the next few months, the nail became dull, and after awhile the nails fell off altogether revealing a shiny new nail underneath.

An example of Beau's lines.

Ralph's doctor explained to me that these were probably Beau's lines. For a period of time, Ralph's body was so busy fighting illness that his nails stopped growing. Can you imagine being so sick that cell division in the nail matrix is temporarily suspended?

These lines can occur for other reasons (none of them are good news), including malnutrition.

Recently, as I was removing Max's socks and shoes, I noticed something odd. The toe nails didn't look right.  I didn't think much of it, until a few days later...the lines were becoming visible. The Beau's lines. 

I looked at his fingernails and there they were. Fainter, less noticeable, but still visible upon inspection. 

I was stabbed in the heart...again. Since I don't think Max was sick at all from December to February, my hunch is that he was just that malnourished. With the introduction of adequate nutrition and the calories needed for catch up growth, his body finally had the resources to start growing finger and toe nails again. 

My anger burned for a few days. And then I started thinking of all the other severely stunted children in his grouppa. Ten, eleven, thirteen year old children the size of toddlers. How can this be happening?