Emergency Encounters: What Do You Mean?

I entered the room to evaluate a woman in her late 20s with back pain, but that wasn't really the issue. She told me how she taken Plan B a few weeks back and, based on the large amount of bleeding she had, that it had worked so she didn't think she could be pregnant…

I sat next to her and told her the test was positive. She clearly looked distressed.

"I can't have this baby," she said.

I hesitated before I spoke; maybe it was a moment of prayer. "You know," I said gently, "abortions aren't all they're cracked up to be."

She turned her head sharply towards me and her eyes locked on to mine. "What you mean?" she asked.

I continued in a quiet and calm voice, my eyes still locked with hers. "There can be a lot of guilt, sometimes depression, even substance abuse…" I could barely finish my sentence when she responded.

"I know," she said and turned her eyes away from me. She dropped her head down.

She had had an abortion before and knew exactly what I was talking about. But she was in school, and her mother lived in another country. "I can't have this baby," she said. "But I can't have another abortion."

I gave her the number for local crisis pregnancy center and told her to talk it out with them before she made any decision, that she shouldn't go someplace that sold abortions in order to figure this out.

I still pray for her for so many different things depending on what her decision turned out to be.  I hope she's all right, not just physically, no matter what her decision turned out to be.

Emergency Encounters

These days most large emergency departments have two "sides" to them: the main and the walk-in.  The main side is what we typically think of as an emergency department with the critically sick or injured patients and the dramatic interventions. Some shifts really are like that, though not many, thankfully.  Just about every shift is quite busy doing long work-ups on a lot of pretty sick patients.  I spent sixteen years working on the main side of an emergency department.

Now I work for a hospital in which physician assistants work exclusively on the walk-in side.  This side is usually given some kind of catchy name like Prompt Care, Express Care, or MedExpress to give patients the impression that they will be seen and treated quickly. Well, it is quicker than the main side, usually. In a department with an utterly unpredictable patient load, we not only get backed up, we get some pretty sick patients on occasion, too.

I work in an urban area with a lot of poverty and increasing violence. For the most part, I meet my patients for the first and the last time during our encounter.  I care for many women with procreative health problems. Almost every shift I care for one or more women with sexually transmitted diseases. Sometimes I am informing them about a crisis pregnancy or a miscarriage.  The most difficult encounters are those for which I oversee the administration of methotrexate, a toxic chemotherapy drug, to terminate early ectopic pregnancies.

Many women have had abortions.  Any small amount of prompting leads them to tell their stories of sadness and regret.  They pour out their hearts to me not just because they trust me, but because they need to tell their stories to someone who cares about them and for them.  They are Christ to me, and I pray I may reflect Christ's great love for them.  I will share these anonymous stories on occasion.