“I’m a frog, I’m a frog,” yelled the7-year-old with matted hair as she hopped around the holding room, a secure area buried in the middle of the emergency department. The room contained only a mattress on the floor, a crumpled sheet, and a plate of half-nibbled chicken nuggets that a nurse had ordered from the cafeteria thinking that the child might be hungry. A school guidance counselor had brought the girl to the hospital directly from her second-grade classroom after she began bouncing and screeching uncontrollably. All attempts to calm her had been unsuccessful.

The counselor reported that all the school knew was that the girl was likely neglected as her mother struggled with narcotic addiction. At that moment, a man’s ear-piercing shriek echoed in the corridor, followed by a string of curses. Attracted by the noise, the girl stopped hopping and tried, unsuccessfully, to wriggle her way out of the room.