Josh pulled into the doctor's office parking lot and got Maggie out of her seat right away.
"See? Got you out right away as promised. Now, can you also be good for the doctor? Papa Josh is going to be there the whole time, okay?"
Maggie put her head on his shoulder and her thumb in her mouth.
Josh went in and got Maggie registered. He filled in the forms as best as he could, making sure to list the social worker's name and number as another contact, since Maggie was technically a ward of the state.
He sat down with Maggie on his lap and they looked at one of the picture books that was in the waiting room. Josh pointed out the animals and would make the appropriate noises. Maggie would look up at him and put her hand on his mouth as he made sounds.
"You don't like my barnyard sounds?" He smiled at her.
Maggie pointed at the dog in the book.
"He looks a little like Jim, doesn't he?" Josh said. Maggie pet the picture.
They were then called in so Josh put the book down and followed the nurse into the exam room.
"Okay, first we need to get her weight. Can you stand her up here on the scale?" She asked.
"I don't think she can stand," Josh said. "She doesn't walk and she did pull herself up on her knees yesterday, but she hasn't stood."
The nurse looked at him warily.
"If you look in her chart, there should be a note that she's my foster child and what I know about her. Which isn't much."
The nurse flipped through the notes.
"Oh! Okay. Got it. Can you sit her on the scale?"
"Okay Maggie, I'm going to put you down here for a minute. Then I'll pick you right back up, okay?"
Josh put her down and immediately she put her hands up for him to pick her up.
The nurse worked as quickly as she could to get Maggie's weight. Once she had it, she told Josh he could pick Maggie up again. As soon as he did, her thumb went into her mouth and her head went onto his shoulder.
"I need to get her height. Can you lay her down here on the table?"
"I can try," Josh said and explained to Maggie what he was doing and why. She wasn't thrilled, but she lay still, looking up at Josh.
"Good girl," Josh said, smiling.
"She's still in a diaper?" The nurse asked.
"She's not toilet trained yet. That's what the children's home told me."
The nurse nodded.
"Okay sweetheart," the nurse said to Maggie with a pleasant smile on her face. "Can we change you into this?" She pulled out a cloth gown with cartoon characters on it.
"She has burn scars all over her body," Josh said to the nurse. "I saw them last night when I gave her a bath. Just so you know."
"Okay. I'd need to see those anyway, so we can document them."
With a little coaxing, Josh and the nurse got Maggie undressed. The nurse looked at the scars and noted them on the chart. They then got her into the little gown.
"She has some on the soles of her feet, too," Josh said. The nurse sighed.
"Poor kiddo," she said. "How is she eating and drinking?"
"She eats with her hands. I tried a spoon and that was a bit of a disaster. But she can pick up food and eat it. She likes strawberries and yogourt. She's not sure about cucumber and she likes dipping carrots in ranch dressing. She had some macaroni and cheese for lunch yesterday and mashed potatoes, chicken and peas for dinner last night. She can't use a cup by herself. She spilled it on herself."
"Okay," the nurse said noting it down.
"How does she sleep?"
"She had a nightmare. She has her own room but I brought her into my bed after her nightmare. She slept okay there."
The nurse nodded.
"How many words does she say?"
"None," Josh said.
"Not even 'mama' or 'dada'?"
Josh shook his head.
"All she's said is 'umm umm' when I give her strawberries."
The nurse looked at Maggie and smiled at her.
"Do you know how old she is?" She asked.
"I'm guessing three? I don't know."
"Okay. The doctor will be in in a minute. Maggie," she said, turning her attention to the girl. "Dr. Peterson is going to come see you, okay? He's going to look in your eyes, and your nose and he might tickle your toes! Okay?"
The nurse smiled at Josh and left the room. Maggie put her arms up again for Josh to pick her up. He did and sat up on the exam table with her.
The doctor came in just then. Maggie looked at the doctor.
"Good morning, Maggie, is it?" Josh nodded.
"Well, let's see what we have here," he said. "I've read the chart and the nurse's notes. You said you think she's three?"
"It's my best guess. My buddy's daughter is almost two and Maggie's just a little bigger than her, so that's my best guess."
"Okay, let's take a look. Maggie, can you open your mouth really wide like a lion? Like this?" The doctor opened his mouth wide. Maggie looked at him. "My light here wants to see inside your mouth. Can I take a look?"
Josh encouraged her to open her mouth, and she did.
"It looks like she's got her five year molars. She might be closer to five."
"She's too small to be five," Josh reasoned.
"Well, based on the notes from the hospital, which you kindly had sent over, she was severely malnourished. That will likely have stunted her growth. You're going to need to find her a pediatric dentist. Her baby teeth are in rough shape. That's going to affect her adult teeth.
Now, it says here she's not speaking yet? Can't use cutlery or drink from a cup?"
Josh nodded.
"And she's not walking or toilet trained?" The doctor continued.
"Right," Josh said. "She can sit up on her own, and she pulled herself onto her knees last night while I was trying to coax her into a bath. But she hasn't stood on her feet at all that I've ever seen. The children's home said she didn't walk."
The doctor nodded.
"Well, the good news is, as long as there is no physical issue, these developmental milestones might still be reachable since she's still so young. She's well behind her peers, but with time and love and support, I think she'll catch up. I'm going to refer to you a physical and occupational therapist to work on those deficiencies. I'll also going to refer you to a nutritionist to work on getting her weight up. She weighs less than the average three year old at possibly nearly five. I'm also going to refer you to a speech pathologist."
Talking to Maggie the whole time, the doctor checked her ears and nose, looked in her eyes and felt her stomach and hips. He rotated her legs like she was on a bike and tickled her feet. She pulled them away.
"Okay, that's good. I think with time and therapy, she'll be able to walk."
Josh smiled.
The doctor then said without a medical history, they were going to have to start her immunization series again. Josh wasn't thrilled but he was glad he hadn't said that there's be no needles.
The doctor made some notes and said he'd have those referrals sent off right away. The nurse came back in with a few needles on a tray. Josh was dreading this part.
"Okay, three quick jabs, and we'll be done."
The nurse cleaned Maggie's legs and then got her attention. She played a game with Maggie, keeping her attention the whole time while quickly injecting her legs and putting bandaids on before Maggie even realized what was happening.
"She might get a bit of a fever and be a little under the weather over the next 24 hours or so. Just keep an eye on her and make sure it doesn't go over 103. Just use a cool cloth on her head or a cool bath. You can give her Motrin or Tylenol. Get the liquid kind. With a syringe. They're easier. If it goes over 103, take her to the hospital."
Josh nodded.
"We're going to need to see her again in two months for her next round of vaccines."
Josh nodded again, looking at Maggie who was trying to figure out what had just happened.
The nurse left and Josh got Maggie changed back into her clothes. They booked the next appointment and the receptionist said the therapists would be in touch with him to set up appointments.
Josh strapped Maggie into the car and smiled at her.
"Well done, Peanut," he said.