Thursday, November 26, 2009

Next patient, please

One of my patients tonight is an immature 19 years old. In fact, I am shocked at her immaturity, though it is something I frequently see in teenage mothers. I met her in the mists of a seizure caused by eclampsia, a condition which strikes pregnant women. She has two risk factors: She is young and this is her first pregnancy.

While 19 is older than most first time mothers I encounter in this population for which I provide medical care, I believe her sexual experience began at a much younger age. Why do I think this? For starters she has 4 sexually transmitted diseases. Five if you count her pregnancy. These diseases are herpes, syphilis, gonorrhea, and HIV. Yes, HIV at nineteen. I suspect she has been working as a prostitute. She is not a run away. Both her mother and an older sister have been to the hospital to see her. The records from the county hospital show her mother accompanied her to the prenatal visits she made there.

It is hard for me to imagine what kind of life has been handed to this young woman. The facts I learned as spent most of the morning trying to fill in the gaps social work and CPS left were shocking. The stories from family members differ. "She been livin' with a relative in another state." "The baby daddy 's in jail." I can't help but think she needed multiple sexual partners to contract all these diseases and the variety of explanations from the family seem to confirm my suspicion about prostitution. Though nineteen is old enough for her to be living on her own, it seems she has been on her own for some time.

Yet I am at a loss as to what to do. Child protective services came to make sure the baby would have care. Social work has little to offer. She will leave the hospital with her mother. I am not at all sure she will continue the medications she needs to prevent her from developing full blown AIDS. I can not think to much more about the situation. She is scheduled for discharge in just a few hours and I need to move on the other, more pressing problems today.
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