NAPA, Calif. — 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.
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."
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?"
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.' "
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.