My previous post about the patient who didn’t believe she would get pregnant from unprotected sex garnered comments along the lines of “how could she think that?” It got me thinking about another recent visit. My patient was a single mother with 2 daughters. During a routine visit, we were chatting about her kids when she told me that her oldest daughter had gotten her period for the first time. After a few moments of “Oh my gosh, they grow up so fast” comments, I asked “So, did you talk to her about what this means?” My patient said “Oh sure, I told her that it means she’s growing up and turning into a woman.” My next question was “Did you tell her that she can get pregnant now?” My patient’s answer was, sadly, typical: “Well, I don’t know what to say to her about that. My mother never talked to me about this stuff.” Then she asked me what she should say. I tried to explain the basics of the menstrual cycle and female fertility, in language that she could use with a 12 year-old. I told her my opinion, which is: knowing that having a period is part of how a woman gets pregnant is really important for adolescent girls. And knowing that sex is connected to pregnancy is also really important. After giving the patient my sex ed talk, I ran down the hall to the pediatric clinic to find some pamphlets on puberty or sex. To my surprise, I found…nothing. Really, pediatrics? No information on the menstrual cycle? No age-appropriate information on sex? I even asked one of the doctors if they had something hiding in the back of a file cabinet somewhere, but was told that they had no written information on the topic. Well, I’ll be damned. No wonder these conversations are hard for parents to have.
- Appointment reason: “Swollen buttocks” Actual complaint: hemorrhoid.
- Transcribed note, from dictation: “An MRI was done of the parade, and was negative.” (MRI was done of the brain)
- “My doctor gave me a medication for my nerves. It was called ‘Filivah'” (Ativan)