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Scars Go More Than Skin Deep

TIMES STAFF WRITER

Nathan Schank wears the scars of the fault line.

Each time he looks into a mirror, the 7-year-old with the cowlicked brown hair sees the aftermath of the 5.2-magnitude earthquake that struck Northern California’s wine country two years ago.

The temblor left $55 million in damage, rattled vintners and other residents and caused no worse than minor injuries--except to Nathan. Striking at 1:36 a.m., the quake collapsed the fireplace in the living room where Nathan was having a slumber party with his older brother, Adam, and a teenage cousin. He was crushed under an avalanche of bricks and mortar that wreaked havoc on his insides and shattered his right arm and pelvic bone. Doctors gave him only a 20% chance of surviving.

Nathan lived. After 28 operations, a 14-inch stitch line snakes down his chest past his navel. He carries a patchwork of other scars on his legs, right arm and hip, where surgeons took skin grafts. Doctors plan to operate on him again today to close tissue in his abdomen.

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The rambunctious second-grader resists discussing the accident with his parents. But he will occasionally approach strangers to announce, “I’m the little boy hurt in the earthquake,” lifting his shirt to show the jagged stitch work. His parents and doctors see something more: a child forced to face death, one who is still struggling with the enormity of what happened to him.

He’s become part of a series of studies on the effects of post-traumatic stress syndrome on infants and children. Although experts once thought the malady afflicted only adults such as rape victims and war veterans, the studies show that children can suffer it too.

Researchers say children often carry painful reminders of such events as earthquakes, fires, car wrecks and violent crime, but exhibit symptoms differently from adults.

“Parents tend to underestimate the amount of trauma kids experience,” said Dr. Herb Schreier, a psychiatrist at Children’s Hospital in Oakland who examined Nathan. “But we’re finding that small children, particularly those under the age of 5, exhibit their emotional scars in different ways. And we need to set new definitions.”

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Studies involving some 100 patients have examined reactions in children, some of whom have yet to speak. One case involved a 2-year-old who watched her father murder her mother. Another featured a teen who witnessed the murder of both parents several years apart.

Schreier said many traumatized children eventually suffer panic attacks. Others regress emotionally when faced with reminders of painful events.

For Nathan, the stress of the earthquake lingered in outbursts of anger. Almost immediately, he began having temper tantrums at the hospital, throwing things at the wall and at his mother when he didn’t get his way.

At home, he’ll pout: “I wish that earthquake killed me. I wish God didn’t save me.” Other times, he’ll ask, almost out of nowhere: “Why me, Mom? Why did I have to get hurt?”

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Schreier fears Nathan has a long road ahead. “With his scars, he has physical reminders,” he said. “Over the years, it will be harder for him to distance himself from this.”

Doctors say today’s operation on Nathan is routine. But his mother still worries. Since Nathan left the hospital in January 2001, she has become more protective, watching for the unkind stares of strangers.

At the family’s new home in American Canyon, not far from Napa, Nathan seldom wears a shirt in the summer heat and is not self-conscious about his body. But one day a friend of Adam’s told him, “Don’t show me your scars. They’re ugly.” That’s when Kimberly Schank explained to Nathan that not everybody understands what he has endured.

“I told him, ‘I love your scars. You know why? Because they saved your life,’ ” she said. “ ‘To me, they’re beautiful. They’re a part of who you are.’ ”

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Now, every night when Nathan goes to bed, his 34-year-old mother makes a point of kissing the scars “to show him that it’s OK, that I’m not grossed out.”

But Kimberly Schank knows she won’t always be there to explain away people’s rudeness. And when Nathan hits puberty, a time when teenagers worry about their bodies, what then?

For now, she can only reassure this energetic boy who likes to whisper into his mother’s ear and create goofy faces to make her laugh, the boy who keeps a poster on his bedroom wall showing a kitten imagining itself as a tiger, with the caption “Dream Big.”

Anything to ease Nathan’s murky memories of waking moments after the earthquake struck early on a Sunday to find himself buried in bricks. His mother remembers the horror of finding both her boys curled up in front of the fireplace that she and her husband knew was cracked but had not asked the landlord to fix. Frantically, they scrambled through the bricks to reach their sons.

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Adam was only slightly injured, but they knew immediately that Nathan was a different story. Yet it was only after rushing him to Queen of the Valley Hospital in Napa that they realized the gravity of his condition--when a nurse told them: “Your son is in very serious trouble.”

The boy was taken by helicopter to Oakland’s Children’s Hospital, where doctors operated to stop the bleeding in a leg artery and to relieve pressure from blood filling his abdomen. He was given 14 units of blood, enough to fill his body twice over.

For weeks, his intestines were so swollen that doctors could not close the wound. Instead, they covered the area with plastic wrap, leaving them partly exposed.

Months after he was hospitalized, Nathan took a big step toward being a boy again: He asked for his bicycle--a blue Diamondback with training wheels. His parents brought it to his hospital room. Soon he started talking about climbing trees and becoming a movie star.

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Nathan’s mother plans a Labor Day weekend barbecue to mark the second anniversary of his accident and his anticipated homecoming after this week’s surgeries. “We’re all still dealing with this,” she said. “For me, it’s the remembering, the hurt of seeing my son incapacitated.”

The day is part of the family’s effort to rebuild itself.

After Nathan was injured, Delmar Schank took months off without pay from his job at a family-owned fire extinguisher business to be with his son. Now money problems have forced Kimberly to work part time at a gas station to help pay the bills.

They still worry about 9-year-old Adam, a shy boy with piercing brown eyes who has drawn deeper into his shell.

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He recently confessed to his mother that when she and Adam’s father were at the hospital with Nathan for five months, he thought they didn’t love him anymore.

“Talk about breaking down,” Kimberly said of her reaction to Adam, who now sees a therapist. “That little comment just made me realize how much that earthquake has left its mark on those boys. And our entire family.”

Each morning before work, Delmar, 35, goes to his sons’ room to kiss them goodbye. “You just don’t realize how in a split second you can lose everything that’s dear to you,” he said. “Now, not a day goes by that I don’t hug my boys, even if they don’t know I’m there.”

At the family’s new home, no glass frames hang over the beds. Furniture is bolted to the wall. The Schanks aren’t taking any more chances.

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For now, Nathan talks of his scars as though they were just the remains of some bad bicycle spill. “I need to show you something; it’s the scar,” he says to a visitor, lifting his T-shirt. “Sometimes, they get cold.”

Both boys repeated school grades--Nathan because of his injuries; Adam after falling behind from the stress of seeing his brother suffer. On the refrigerator hangs a reminder of some important dates: Tuesday, which was Nathan’s first day of second grade, and this morning, when he heads for the hospital.

Kimberly Schank has taken her boys back to visit their old house in an effort at closure. On a recent trip, Nathan climbed onto a fire hydrant and threw dirt clods into the street.

Rather than scold him, his mother beamed: “For now, that’s his best therapy. Just being a boy.”

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