Friday, August 6, 2010

Clinical MisAdventures

Wow. Almost four months away until I am done with school and on to the next phase of my life. But right now, I can really only think from day-to-day tasks.
We have to get 300 clinical hours from June to August, so that roughly equates to almost full time at the clinic. So I have been really getting not only a medical but also a social education.
A little background: I'm in the South Bronx, in a pretty economically depressed area. Pretty much EVERY patient I have is Dominican or Puerto Rico, African American or Jamaican, or a mix of the above. Pretty much everyone speaks Spanish as a first language, but about 80% also speak English quite well. High blood pressure, diabetes type 2, smoking, obesity, asthma, lower back pain, are pretty much part of everyone's medical record, with many also struggling with drug use (heroine, cocaine, marijuana, benzos, percocet). There's also a smattering of other problems: anemia, cancer, neurological disorders, etc, that we see on a daily basis. So that's a pretty broad overview. But now, to be more specific:
Fridays at the clinic. We are all so tired. Those who have full or part time jobs outside of this clinical requirement are even more so. So Fridays, after having been there all week, have a tendency to become somewhat of a s*&tshow. Today was no exception.
The patient flow was continuous, from the time the doors opened at 8am until we cried "We give up!" (not really) at 4:30pm. This week, I had drug-seeking patients ("The pain is so horrible in my (fill in the blank) and percocet is the only thing that helps! Also, I'm allergic to aspirin, ibuprofen, motrin, toradol, acetaminophen, so you HAVE to give me percocet!")When I started in January, wide-eyed, bushy-tailed, and incredibly naive, I would think, "Oh, this poor person! Here you go, here's some incredibly addictive and very-high-in-street-value opiates!" Not really, but I have become infinitely more credulous in the almost nine months I've been there. I've heard every excuse in the book, and some are even so creative that I have give props where props are due.
Now, that's not to say that all are BSers. There are people with legitimate pain out there, but anyone who is a regular at the clinic know our policy about not writing for addictive pain meds. Especially since one of the major things we do are drug-addiction rehab initiation and following.
Today, we were all absolutely fried, and it was only 8:30 in the morning. My first patient was one of my favorites. I got a frequent flier, I'll call her Lucinda, who is there probably 4-5 out of 7 days. So really, every day. It's pretty much a joke now, because I'll see her standing outside when I get to work in the morning, and say, "Hey, _____, haven't seen you in forever!" and give her a fist bump. She'll laugh. And she'll come in with some BS request or complaint which we'll address, and send her off, knowing that she'll be back tomorrow for something or other. One day, she wanted a prescription for an air conditioner. Seriously.
Yesterday I had a guy, just out of jail, who wanted to get started on our suboxone program for heroine addiction. Suboxone is a much better detox drug than methadone, and is easier to titrate down until the patient is not craving opiates any longer. While taking his history, he tells me he has a history of doing heroine for 25years, but hasn't done it in the past 2 weeks. But I'm still in withdrawal. Hmmm. Wait, no heroine, no cocaine, nothing in the past two weeks? And your urine tox report will show that? Yes ma'am. Okay, but you have to be actively in withdrawal before you can start on suboxone, otherwise it isn't safe for you. Oh I am, I am. Okay, but if you haven't had any drugs in two weeks, you'd already be through physical withdrawal. Psychological withdrawal, undoubtably, but not physical.Hmmm. So I go get Dr. D to suss out what is going on. Then he tells Dr. D, after a few repeated questions, Yes, I've done 6 to 7 bags a day of heroine for the past two days. What the heck???? It blows my mind why he'd lie to me, but tell the doctor the truth. I'm here to help you buddy, and I can't if you are giving me a line of baloney! I was ticked.

Also of note, we code all of our services (ie. complete physical, drew blood, gave vaccinations, etc.) with something called ICD-9 codes which make it possible to bill insurance companies, Medicare, etc. Well, one of my fellow students found an ICD-9 code for "falling off a gangplank", no kidding, which is E382. My career goal is to have a patient that has fallen off of a gangplank and being able to code for it. Even better, if I can differentiate between how it happened: saber-point, rifle, musket-point, blind-folded, due to attempted mutiny, etc. Man, why don't we have more pirates at the clinic? I'm over all of the hypertensives:)

I feel like this post is rambling; I am too tired to write anything more coherent. But it was an insane week, full of unbelievable patients. Man, I need a vacation.

Tuesday, July 13, 2010

Word Play

Got this from a dear friend who knows my love of making up new words and switching around the letters in previously established words. Enjoy!

Subject: Humour for the Intelligencia

The Washington Post's Mensa Invitational once again invited readers to take any word from the dictionary, alter it by adding, subtracting, or changing one letter, and supply a new definition.

Here are the winners:

1. Cashtration (n.): The act of buying a house, which renders the subject financially impotent for an indefinite period of time.


2. Ignoranus : A person who's both stupid and an asshole.

3. Intaxicaton : Euphoria at getting a tax refund, which lasts until you realize it was your money to start with.

4. Reintarnation : Coming back to life as a hillbilly.

5. Bozone ( n.): The substance surrounding stupid people that stops bright ideas from penetrating. The bozone layer, unfortunately, shows little sign of breaking down in the near future.


6. Foreploy : Any misrepresentation about yourself for the purpose of getting laid.

7. Giraffiti : Vandalism spray-painted very, very high

8. Sarchasm : The gulf between the author of sarcastic wit and the person who doesn't get it.

9. Inoculatte : To take coffee intravenously when you are running late.

10. Osteopornosis : A degenerate disease. (This one got extra credit.)

11. Karmageddon : It's like, when everybody is sending off all these really bad vibes, right? And then, like, the Earth explodes and it's like, a serious bummer.

12. Decafalon (n.): The grueling event of getting through the day consuming only things that are good for you.

13. Glibido : All talk and no action.

14. Dopeler Effect: The tendency of stupid ideas to seem smarter when they come at you rapidly.

15. Arachnoleptic Fit (n.): The frantic dance performed just after you've accidentally walked through a spider web.

16. Beelzebug (n.): Satan in the form of a mosquito, that gets into your bedroom at three in the morning and cannot be cast out.

17. Caterpallor ( n.): The color you turn after finding half a worm in the fruit yo u're eating.

The Washington Post has also published the winning submissions to its yearly contest, in which readers are asked to supply alternate meanings for common words.

And the winners are:

1. Coffee, n.. The person upon whom one coughs.

2. Flabbergasted, adj. Appalled by discovering how much weight one has gained.

3.. Abdicate, v. To give up all hope of ever having a flat stomach.

4 esplanade, v. To attempt an explanation while drunk.

5. Willy-nilly, adj. Impotent.

6.. Negligent, adj. Absentmindedly answering the door when wearing only a nightgown.

7.. Lymph, v.. To walk with a lisp.

8. Gargoyle, n. Olive-flavored mouthwash.

9. Flatulence, n. Emergency vehicle that picks up someone who has been run over by a steamroller.

10. Balderdash, n. A rapidly receding hairline.

11. Testicle, n. A humorous question on an exam.

12.. Rectitude, n. The formal, dignified bearing adopted by proctologists.

13. Pokemon, n. A Rastafarian proctologist.


14. Oyster, n. A person who sprinkles his conversation with Yiddishisms.

15. Frisbeetarianism, n. The belief that, after death, the soul flies up onto the roof and gets stuck there.

16. Circumvent, n. An opening in the front of boxer shorts worn by Jewish men

Wednesday, June 30, 2010

Infidelity

I read something tonight that really affected me...and, I had to write about it. The article chronicled the relationship of a husband and wife, married twenty years, who suddenly had to deal with the devastation of his betrayal. Here are some excerpts:

Gary's Story

Walking down the hallway that night was one of the hardest things I'd ever done. I knew this could be the end of everything I cared about--my family, friends, business, church--all of it. But I had to deal with it now...I whispered my dreaded confession (to Mona, his wife) "I've betrayed you. I've been unfaithful." How did this happen? We had a good marriage and three sons we loved deeply. But the busyness of life had pulled at us, and we'd gradually grown apart. Then a friendship with a co-worker had gotten out of control. One innocent touch insidiously led to more. An affair began, and a day became a week, then a month, then three years.
When Mona and I got married, we knew our marriage would work. We were best friends who loved and respected each other. 10 years later we both became Christians. Now we had another tie to hold us firmly together. But in our packed schedules, we rarely had time or energy for "us". In reality, we'd become caught up in a life that was pushing us along separate paths.

Mona's Story

I was totally blindsided. He'd been having an affair with my best Christian friend for the past few years, and I'd never even suspected; I'd trusted them both implicitly. I had no idea our marriage was even vulnerable. My friends thought he was wonderful -- he did dishes and laundry; he changed diapers. We were friends; we could talk about anything. Sure, we'd had our moments in two decades of marriage, but nothing insurmountable. Had I been that bad a wife? I felt a stirring of rage. I was nauseous. Was I a complete idiot to have been so in the dark? I spent the rest of that night weeping, heartache penetrating every inch of my being. I felt more alone than I've ever been.
That night of revelation 17 years ago was beyond painful. But it also marked the beginning of our recovery. Not because either of us believed we could heal, but because we felt we had nothing more to lose. All we knew was that we wanted to follow God in this, no matter where that led.
The night Gary confessed, neither of us expected restoration. We doubted the pain would ever go away. But now we know adultery, as destructive as it is, doesn't automatically mean a death sentence for a marriage. The same Savior who enables sinners to stand pure before a holy God can restore what is in shambles to something beautiful and fulfilling.



Eventually, with a lot of hard work and prayer, they rebuilt their marriage and are now role models for couples who come to therapy for infidelity issues.

This article was so powerful to me, for a ton of reasons. But mostly because it reiterated what I already knew to be true: with God, all things are possible. Truly, He can take the most destructive and heartbreaking of situations and use them for much good.

There is incredible pain in this world; both outside us and within us. Hearts break every day, for myriad reasons. It is too much to comprehend. Relationships can fall apart, for reasons beyond understanding, and leave a destruction in their wake. But there is hope. There is always hope. Because of what Jesus did for us by dying on the cross, our ultimate enemy (Satan) is defeated, and all of the promises of God in the Bible for His children are true. The promise I have been holding close to me these past few months, as I continue to heal, is the fact that I know that what Satan has intended for evil in my life, God will use for good. That's a pretty awesome place to be, I think. What is bad, God uses for good. What is good, God uses for good. So whether bad or good, God uses it for good.

That is not to say, with pie-in-the-sky naivete, that one should just pull themselves up and get on with it and life goes on swimmingly. No. Life is hard. And to get to a place of healing and wholeness takes incredible amounts of hard work and fortitude. It takes minutes, hours, on your knees before God, putting everything in His lap. It takes support from amazing friends, and a deep-seated knowledge that you are loved. Completely. Seen completely, with all of our warts, and loved completely. It is against a foundation like that that the problems and difficulties of life can be put in their place and overcome. And much as lifting weights at the gym can make our muscles strong, lifting problems in our lives by dealing with them can make our internal 'muscles', our self-worth and identity, stronger.

And it is easy, in this situation, to take the role of the victim, and denigrate the perpetrator. But one also has to be honest with oneself, and when one is ready, and has worked through the first flush of despair. It is easy to think, "I am good; he is bad. He did this to me. He was the jerk." The thing is, even if that is true in this situation, the root of it is false. How many times have I been a jerk? How many times have I hurt others? Many. I think it helps to be able to take a look at yourself honestly and realize the ways in which you, too, are tempted. The ways that you have failed in the relationship. The things inside of you which are selfish, and unkind, and unfaithful. And then the other person ceases to be the devil in your mind, but you can see them as they are: someone who is broken, like you. Someone who has his battles and his trials in this life, like you. Someone who is imperfect, like you. Like me. It does not lessen the grief, the pain, the weight of the betrayal, but it provides a context within which to work. To look at life realistically and realize that we all, all of us, have fallen short of the goodness of God. Every single one of us.

My prayer for everyone reading this would be that you would drop all of your pain and trials at God's feet for His help. And that your hearts would experience Him, and what He has done, and what He can do.
Blessings.

Tuesday, June 22, 2010

Thoughts of Great Randomosity, ie. Stuff I like, Stuff I don't like

Today was a pretty tough day at clinical. Mostly because of my attitude. But I am tired, sorta sick, and just a crabby-pants. So, to get myself in a better mood, I continued adding to my mental list of Oddities. It's just random stuff I've come across recently that I've thought, "Wow, I really like that!" or, "I don't like that".
First, "I like that"s:

1. Tee shirt idea for me and my fellow NPers: "Watch out. Today, I have no patience for my patients."
2. I like that both tai chi and chai tea are real things and are created by doing one of my favorite things, switching around letters.
3. My neighborhood pick-up bball games. Right now, there is a tourney going on, with one very funny emcee, who just said, "And the shot is taken by Jerry Curl (a teenage boy who did have a jerry curl)and he misses! No relaxer on this court!" etc. I like funny commentary.
4.My cat. She always has a purr for me. And a much-needed snuggle.
5. Old episodes of the Office. And new episodes of the Daily Show. And Late Night with Jimmy Fallon.
6. Socks without holes in them. I have too many socks WITH holes in them, so when I find a pair without, I rejoice.
7. Dancing by myself and singing songs I make up about whatever I am doing, ie: "Cleaning the dishes, yeah yeah, scrubbing this fork, yeah yeah..."
8. Dental floss. I had an incident on Saturday where I was out and had something stuck between my teeth that felt like a two-by-four but was invisible and had some floss in my purse for just such an occasion. Ah, sweet relief!
9. That a two-by-four is really a one-and-a-half by a three-and-a-half.
10. My friends who stick by me and love me, even when I irritate them.
11. Remember those sticky hands and sticky feet we used to get out of dime machines and then throw against the wall and they'd stick and then sloooowly slink down? Yeah. Love those.
12. Checking if pasta is done by throwing it against the wall. NOt sure if this is really even an accurate method, but I love doing it anyway. Feels like sanctioned food-fighting.
13.Alliteration. "Amanda always accesses Adam's aorta" and the like.
14. The word 'ilk'. I love that word.
15. The word 'hassenpfeffer'. Don't even know what it is, but I like how it sounds.
16. The emotional vulnerability of the guys on the Bachelorette. I know, I know, I am vehemently opposed to that show, and Bachelor, but this season I got hooked. But I really like how the guys are actually appearing to care about more than themselves. Unless it is just staged. BUt I'm going to try to shelve the cynicism.
17. Being able to use the word 'shelve' as a verb, and as pertaining to an emotion, instead of just being a noun.
18. That "The Amsterdam Inn" backwards is "Eht Madretsma Nni". Sounds foreign.
19. OMGosh. Fawlty Towers. Enough said.
20. The word Schmuck. Love it. Saying it, seeing it, whatever. It is so onomatopoetically satisfying.
21. My cat's sweet little kitty feet.
22. Saying, "Malfeasance for malfeasance's sake." and watching people's reactions to that.
23. Writing on the subject line of my checks subjects completely unrelated to what I am writing the check for. For example, on check to my psychologist last week, I wrote on the subject line, "A new toaster". I don't know why, but doing this really tickles me.
24. Being able to talk about medical stuff and form almost-complete sentences composed entirely of acronyms.
25. A good dollop of wasabi that will really clean out the old sinuses.
26. A bratwurst with ketchup, sauerkraut, onions, mustard (dark brown), relish, that has been grilled for awhile and then boiled in beer. Dangit, that is so good.
27. Watermelon seed spitting contests. I need more of those in my life.

Stuff I don't like:

1. The phrase 'Carbon footprint'. It sounds pretentious and stupid. And seriously, does anyone even really know what it actually means or how to actually compute it? Whenever anyone says it, I internally roll my eyes at them.
2. Fads. I have always had an aversion to fads of any type. Doesn't matter what it is, I probably won't like it, just on principle. Which is silly and pointless of me, I fully realize. But still.
3. People who are mean to things weaker than them, and I mean weaker physically, mentally, socio-economically, educationally, whatever. I HATE that.
4. The word 'panties'. Ick. Don't have anything against underwear, just can't stand that word.
5. Light bulbs that burn out before they should. Just irritating. Especially when reading a good book.
6. The current slew of pop stars. Especially Miley Cyrus's attempt at whoring herself out to, I don't know, get more fans or something? I want to put some clothes on her, wash off the nasty makeup, sit her down, make her a cup of tea, and tell her some things about life. Or just look at her and say, "Lindsay Lohan." That oughta do it.
7. That posting something on Twitter is called "tweeting". HATE that.
8. Milk that tastes bad even though it is nowhere near its expiration date. I mean, c'mon. I have to trash the whole half-gallon, which ain't cheap!
9. When I'm wrong about something that I feel like I should have been right about. Like BMI.
10. Soap operas. Pretty much all daytime TV. I can feel the brain cells being sucked out of my ears if I even am in the same room with a TV playing daytime whatever.
11. The oil spill. If I let myself think about it, and how much damage it has done, I get sick. I can't watch the news and see the pics of the poor animals covered in oil. My stomach literally hurts.
12. When people use JC as a swear. Or anything. Other than in reverent and worshipful ways.
13. Buying an ugly purse or whatever just because it is made by a famous designer or has a big C on it. Gag.
14. Pretty much anything done because everyone else is doing it and thinks it's cool. Lame-sauce.
15. Lady Gaga. Don't hate the music, but she's just strange. And, in my opinion, and as someone who is all for individuality, she's over-the-top.
16. Political correctness that has been taken to an extreme. Everyone is so afraid of offending other people that it has become almost absurd, the extent to which people will do mental gymnastics just to avoid "not being intolerant."
17. Constipation. It's the WORST. Thankfully, not something I often deal with, but man. Nothing can put a damper on your day like constipation.
18. Bed bugs. I've never had them, thank God, but they are everywhere in NYC and just gross.
19. When my computer gets too hot and slows way down. And also that I lost the letter P off of my keyboard. Now after O on the top line is just some weird looking mechanical thing.
20. Oprah Winfrey's empire. Sorry Oprah, I'm sure you're a nice person and I'm happy for your success, but your 24-7 Oprahness annoys me.
21. Patients with stinky feet who take off their shoes for long amounts of time in the exam room and I almost pass out. But then I remember Jesus washed stinky feet, and pray for strength.
22. The janitor's closet at clinic that used to be an old bathroom that has faulty plumbing which traps the stuff flushed from the upstairs bathroom directly above it, making clinic today smell like a sewage treatment facility.
23. The Real Housewives of Wherever. Bethanny Getting a Life. Kate Plus Eight, Jon Minus Everything. Bla Bla Bla. Any reality show. No one cares. (says the girl writing a blog about her thoughts...I realize the irony, people)
24. Eating parts of things that just shouldn't be eaten. Chicken feet. Cow tongue. Cow stomach. I'm getting ill just thinking of it.


There are so many more, and I'm sure I'll add to this list, but I'm hungry now and I'm going to eat my Chipotle, that I shouldn't have bought cause it isn't in the alloted budget for the week, but whatever. But that reminds me. What I like #28. Credit cards to buy Chipotle with.

Sunday, May 16, 2010

Why I Quit Facebook

This has been a rough year. My roughest yet. Because I am a highly emotional, sensitive person, I evaluate “roughness” on a how-emotionally-challenging-its-been scale. This year has, thus far, been off the charts difficult. However, this is not the place for me to divulge the details of that ‘roughness’. Suffice it to say, the personal agony and grief I have experienced in 2010 has been unlike any I have ever known. But that is not the point of this entry. It is, nevertheless, the impetus behind it.
I decided to quit Facebook this year, after having been on it for many years now. It was the right decision for me to make, for many many reasons, although it was difficult to do. I discovered, through Facebook, the facts that rocked my world and led to the above paragraph. After that, for many weeks, even the mere sight of the Facebook logo took me back to that horrible Sunday morning when my world came crashing down. I could not see it without wanting to vomit. This very visceral response made me think that maybe it was better to no longer have an account, and quit cold turkey. Even though I deactivated it, a few months ago, in recent weeks, from time to time, I’d hop back on, in brief spurts, to catch up with peoples’ lives that I have no contact with in “real life”. That was one of the benefits of FB, for me, originally. I was able to keep in touch, albeit cyber-ly, with those that I would not have been able to in reality. I was able to reconnect with old classmates and friends that I had lost touch with.
However, now, what had once been a benefit has become a liability. In my current emotional state, it is crucially important for me to focus on God, what He has done through Jesus, and His very real and powerful promises that He shares with me through His Word. One of them is that He has a plan for me, a good plan, better than anything I can think up for myself. Recently, in my brief forays into Facebook-dom, I have seen the postings of friends who are getting married, recently married, having children. I see these joy-filled entries, and am filled with joy myself for these friends and the blessings in their lives. But there is also a part of me, a big part, that aches. I feel so far from that, and back to square one, and feel like God has forgotten about me. My heart has been crushed, and I see others living the life I’ve always wanted. It makes me doubt God, doubt myself, and generally feel even more buried in my personal ick. All of these things are not how I want to feel, and also, most importantly, are UNTRUE. I cannot compare myself and my life to those of others. God has a special plan for each and every one of His creation, and that I know to be true with every fiber of my being. But Facebook has become, for me, not a vehicle of blessing, but an instrument of discouragement. I don’t think that FB intrinsically has these characteristics:), like I said, there are so many benefits to it. But for me, for where I am at right now, it is unhelpful for me to continue with it.
So if you have noticed I was a friend of yours on Facebook and am now missing, this is why. It isn’t because I unfriended you:), as one sweet friend recently asked me. He texted me a few weeks ago and wondered if I had dumped him or quit FB.
Also, I have been feeling the increasing need to connect with friends and family in real time, to have deep and real relationships in person.Facebook has made it so easy for me to satisfy my need to connect by "writing on someone's wall" in lieu of a real conversation.
I just want to clarify that I don’t think FB is evil or anything; I think it is a wonderful tool for us to maintain connectivity to those that we can’t see in every day life. But, with what I am dealing with right now, and where I’m at, and my desires to build the relationships in real time that the Lord has blessed me with, it is a decision that I feel is right for me. To all my FB friends, those I still see and those I don’t, please know that you are all very important to me, and I hope to reestablish contact with you all in the future. God bless you all.

Friday, April 30, 2010

God Comforting Me Through Spurgeon

I read this today...it felt like God was speaking to me, right where I am currently. I feel like He understands. As I continue to walk, no, rather, crawl, through this, the darkest period of my life, and seek to make sense of the terrible reality I have suffered, I am thankful on my face to God Who walks with me. And for the friends He has given me who have held me through this.

"Thou art my hope in the day of evil." - Jeremiah 17:17

"The path of the Christian is not always bright with sunshine; he has his seasons of darkness and of storm. True, it is written in God's Word, 'Her ways are ways of pleasantness, and all her paths are peace;' and it is a great truth, that religion is calculated to give a man happiness below as well as bliss above; but experience tells us that if the course of the just be "As the shining light that shineth more and more unto the perfect day", yet sometimes THAT light is eclipsed. At certain periods clouds cover the believer's sun, and he walks in darkness and sees no light. There are many who have rejoiced in the presence of God for a season; they have basked in the sunshine in the earlier stages of their Christian career; they have walked along the 'green pastures' by the side of the 'still waters' but suddenly they find the glorious sky is clouded; instead of the Land of Goshen they have to tread the sandy desert; in the place of sweet waters, they find troubled streams, bitter to their taste, and they say, "Surely, if I were a child of God, this would not happen." Oh! Say not so, thou who art walking in darkness. The best of God's saints must drink the wormwood; the dearest of His children must bear the cross. No Christian has enjoyed perpetual prosperity; no believer can always keep his harp from the willows. Perhaps the Lord allotted you at first a smooth and unclouded path, because you were weak and timid. He tempered the wind to the shorn lamb, but now that you are stronger in the spiritual life, you must enter upon the riper and rougher experience of God's full-grown children. We need winds and tempests to exercise our faith, to tear off the rotten bough of self-dependence, and to root us more firmly in Christ. The day of evil reveals to us the value of our glorious hope."

Thank You, Jesus.

Wednesday, March 10, 2010

What Happened at Clinical

I know it's not the end of Lent yet, so I shouldn't be on here, but sometimes I just have to write, no matter the constraints. Something happened in clinical last week that rather ties into other things that I've been going through personally, and I wanted to write about it.
I've been praying ever since I knew that primary care was the field that I wanted to go into, about what to do when I encountered a certain situation, a situation I knew sooner or later that I would encounter. The issue is abortion. I am staunchly pro-life; I believe that life begins with conception. I believe that God has knitted us together in our mothers' wombs, and He knows us even before that. As a provider, though, I knew that I would undoubtably come into contact with people, most likely many people, that do not feel how I do about it. However, it is my desire to give everyone, no matter what they believe, the best care I can possibly give them. Therefore, I faced a dilemma. I could not, in good conscience, advocate for the termination of an unwanted pregnancy. That child in the womb was just as real to me as though it were sitting outside, next to its mother. Yet, as a provider, it is my responsibility to provide the patient with the full spectrum of options available to her. This is what I knew would be facing me, but previous to last Friday, I had not met it outside of my imagination.
A young woman is in to see me, ostensibly for weight loss advice. However, as is often the case, her real reason came out for being there. She wanted to do a pregnancy test; she had had unprotected sex a few weeks previously and had missed her period. She was unmarried, very poor, and did not have higher than a 10th grade educational level. She already had two young children by two other men, and didn't want another kid. So we do the pregnancy test, wait the prescribed amount of time, and look at the results. Positive. It was then that I asked her if she had thought about what she wanted to do, and she informed me that she didn't want "it". I felt that my emotions must be all over my face; I nearly started crying. But I tried to hold it together, went and got the supervising physician, and asked him if I could watch him do a "just found out I am pregnant" appointment, since I've never seen one done before. He did, and after she had left, I asked to speak to him. And then I started tearing up. I told him about my beliefs, about my faith, and my severe inner turmoil over how best to be faithful to Jesus and love and serve my patient to the best of my ability. We talked for awhile about it; he is pro-choice but was very respectful and not at all condescending about my beliefs. He told me that it was perfectly alright to tell the patient that I have very strong beliefs in this area, and I don't feel that I would best be able to advise her, and then refer her to another practitioner.
One of our providers feels the same way I do about things, but tells her clients not to get abortions because then God will come down from heaven and strike them dead, or hate them forever. This is completely unbiblical, and that approach makes my heart hurt as much as advising an abortion does. I believe that these women, and the men they are with need compassion and support. I can't imagine what it must be like to be thirteen, a mother already, have no male support, and be pregnant again. How unbelievably scary. However, I also know that it is not the baby's fault, and he/she shouldn't have their life ended because of the circumstances. There are many arguments for both sides, that I will not go into here. Suffice it to say, it was an emotionally trying, yet very growing, experience for me. When I got home that night, I prayed and thanked God for guiding me through that. I feel that really, all I can do in these situations is to pray for wisdom and strength to do what is best for the patient while still maintaining my personal integrity, and also to pray for the patient and what is going on in his/her life. God keeps reminding me that I am here as a conduit of His; that my purpose in becoming an NP is to love and serve Him by loving and serving His people.
I read this recently in a book of devotions, and it encouraged and comforted me, both for some present personal difficulties in my life, and also that God is in control of all the events in life. I include it here in the hope that it gives encouragement to anyone else who reads it:

from Charles Spurgeon's Morning and Evening Devotions:
"God's people have their trials. It was never designed by God, when He chose His people, that they should be an untried people. They were chosen in the furnace of affliction; they were never chosen to worldly peace and earthly joy. Freedom from sickness and the pains of mortality were never promised them. So surely as the stars are fashioned by His hands, and their orbits fixed by Him, so surely are our trials allotted to us: He has ordained their season and their place, their intensity and the effect they shall have upon us. But although tribulation is thus the path of God's children, they have the comfort of knowing that their Master has traversed it before them; they have His presence and sympathy to cheer them, His grace to support them, and His example to teach them how to endure; and when they reach Heaven, it will more than make amends for the "much tribulation" through which they passed to enter it...to every matter there is a bright and a dark side. It is well for us if, while the flesh mourns over trials, our faith triumphs in divine faithfulness. The stormy sea feeds multitudes with its fishes; the wild wood blooms with beauteous flowerets; the stormy wind sweeps away the pestilence; a vein of good is to be found in every mine of evil...Out of the rough oyster-shell of difficulty she extracts the rare pearl of honor, and from the deep ocean-caves of distress she uplifts the priceless coral of experience. When her flood of prosperity ebbs, she finds treasures hid in the sands; and when her sun of delight goes down, she turns her telescope of hope to the starry promises of heaven."