Thursday, August 6, 2009

I'm glad you came here today

(For travel in Asia, go to 11/2008-1/2009 & see link below right; backpacking: Grand Canyon 4-7-2009, Winds 9-12-2008, Maroon Bells 7-21-2008, Bandelier 5-23-2008, Big Bend 3-12-2008)

A middle-aged woman came into the clinic today (her identity is masked here). Her chief complaints were diabetes and asthma. The promotora who saw her in intake asked two depression screening questions and on the basis of the woman’s answers then administered a more complete depression screen, which also was positive. When I saw her she said that “something happened” when she was 8 and 9 years old. Of course it turned out that she had been systematically molested when she was a child. She had not told anyone other than her mother until today. One of her children has been asking her, “Mommy, why don’t you ever hug me?” The answer, which she hasn’t been able to say, is that she cannot. There is something about physical affection between family members…because, naturally, it was a family member who molested her. She and I talked for awhile and it was intense there in exam room 4. When we were done, I told her I was glad she came in and that she had come to the right place. I gave her medications for the diabetes, asthma, and depression (or more accurately, PTSD). She’ll see our psychiatrist next week. I put a note in the chart that she should see our lead promotora when she comes back in and that she should tell her if she wants to see me or Mary (the other NP, my colleague, my friend), because (once again, of course) it was a male that did it to her. Photo: spacer, a device that helps people get much more of their inhaled medication in. They cost $20+ from medical supply places; we make them for pennies.

I’m grateful for the person who saw her at intake; for the other person who helped her in room 4; for our psychiatrist; for Mary; for the promotoras (all involved here); for Estevan, who taught me a lot about how to do these things; for the lady.

And I’m grateful that she came in and that our clinic is a place where people can come, bringing whatever they have – come in, there is room at the inn, bring it on in, whatever, we’ll do the best we can.

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