Saturday, September 16, 2006

Pregnant Pauses and Positive Results

Patient: "I need to see a nurse."

Me: "Is it urgent? They've got their hands full right now, but if you don't mind waiting I'm sure I can get someone to see you."

Patient: "I need to have a pregnancy test."

This set off alarm bells in my head...and only because of who was asking. The week before I had this patient's mother on the phone. Her 35 year old daughter is intellectually handicapped and had recently found the man of her dreams. By mixing around in the same crowd, they'd discovered each other, love blossomed and the two of them had decided to get married...after three weeks together.

But first they were going to live together. No problem there, we've all been there (well not all of us, but certainly many of us right?). Mum's dilemma, was that her daughter refused to take any form of birth control because they were not going to have sex. She'd stated quite adamantly that sex was off the cards until after the wedding...yet they would be sleeping in the same bed.

Mum was concerned that temptation and hormones would run rampant and thus her daughter and the man would get beyond the point of no return. I can see her reasoning behind that. Close physical proximity of a warm body, loving each other, wanting to touch each other, a kiss here, a touch there...and Bob's your uncle...well...he may not be...but you know what I mean.

After Mum's phone call, I relayed her fears to the doctor. Doc tried to encourage daughter toward birth control of some kind....patient dug in her heels, refused to listen and insisted it was unnecessary...nothing was going to happen.

And here she was the following week asking for a pregnancy test. I went off to track down the doc with this new information. Her eyebrows shot up..."What?!" She groaned and went off to find a nurse, who gave a less printable reaction.

Meanwhile, back at the front desk, the patient was having a conversation with the female friend she'd brought in with her. These two were leaning against my counter, talking loud enough for the full waiting room to hear.

Friend: "So...you've just been fooling around a little, right?"

*the noise level in the waiting room starts to dissipate*

Patient: "Well...yes...but we haven't had sex."

Friend: "But did his penis get anywhere near your pussy?"

*sound of papers/magazines being rustled...noone looking but you just KNOW everyone is listening*

Patient: *sheepish* "Well...um...not REALLY."

Me: *quietly* "Perhaps now would be a good time to make an appointment with the doctor to discuss your options for birth control?"

Patient: "NO!...it's ok...I just need to have a pregnancy test."

Friend: *getting impatient* "What exactly does not REALLY mean??"

*total silence...everyone waiting...for the wrong reason*

Patient: "Just some touching and kissing, WE.DIDN'T.HAVE.SEX!"

Me: *trying to encourage them into a side room* "Ladies, maybe you would like to discuss this privately through here?"

Friend: *ignoring me and getting exasperated* "BUT.DID.HE.CUM.INSIDE.YOU??!"

*Sudden warp-like flash of white from right hand corner of my eye*

Nurse: "Good Morning Ladies! Come with me and we'll sort out how I can help you shall we?"

As they ambled off with the nurse, those left behind started breathing again.

(NB: While I respect anyone's right to make their own decisions when it comes to when or if they're going to start a family...with this patient in particular and her other condition, it would have been dangerous for her health to become pregnant. Two weeks later the patient was back in requesting another pregnancy test. Both results were negative. Thankfully they got through to her and she's now covered by depo provera.)
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