I’m Not Prepared for This: Part 9,475
Benjamin Cook
“Oh also, before I leave, can I have a pregnancy test?” Sarah asks as I’m walking out the door.
It’s my first night volunteering at this free health clinic. We’re in the basement of a church, a makeshift room so dimly lit that I use my phone light to help illuminate our faces. There is a desk, two chairs that wobble with every weight shift, and an old exam table that must be at least ten years older than I am.
I’d just spent 30 minutes performing a physical and filling out pages of bureaucratic paperwork so that she could work and stay in the United States. Originally from the Dominican Republic, Sarah enjoys Massachusetts, aside from the cold of course, and is here with her boyfriend and young daughter. She encourages me to practice my Spanish, and chuckles as I fumble through my words. “Cuál es su altitud?” What is your altitude? Good try at “how tall are you?” You knucklehead. I eventually get through all the work, say goodbye, and then she drops the pregnancy bomb on me, as nonchalant as throwing in a last-minute box of Tic Tacs while loading your groceries onto the conveyer belt.
“Let me double check and make sure we have some.” I respond. Double check. Nice one. You’ve never been here before! The desire to act like you know what you’re doing and what you’re talking about is overwhelming. After all, I’m halfway through my second year of medical school, you’d think I should know something! Yet, we spent maybe a week on pregnancy, and honestly, the only thing I can remember right now is that I’m pretty sure it’s supposed to last 9 months, and I think I just know that from one of my favorite movies, Knocked Up.
“Excuse me,” I ask the nurse outside the room. “My name is Ben. I’m a medical student. Do you know if we have any pregnancy tests?”
“Oh, hi. They’re right here.” She opens up a closet, grabs something, hands it to me, and scurries off in a hurry.
There I am, holding a cup and this thumb drive-like plastic thing. Now what? I see the case manager in the corner. “Excuse me. My name is Ben and I’m a medical student. It’s my first time here. Do you happen to know how to do a pregnancy test?”
“Hi Ben, I’m Veronica. No problem. Do you have the sample?” Duh. You need the urine, Ben.
“I’m about to get it,” I respond.
“Okay, I’ll be here.”
I knock on Sarah’s door. “Hi again. Here’s a cup for you to pee in so we can check your urine. There’s a bathroom right around the corner here.”
“Thank you,” She replies.
A couple minutes later, I sit back down with Veronica, a warm cup of urine in my hand. “So,” she explains to me, “all you do it put a couple drops of urine here. A line will appear here. This is the control. It just tells us the test works. Another line will appear if it’s positive. We always do two tests, just to make sure it’s not a false positive.” One line, control. Two lines, positive. Do it twice to make sure.
“Got it. Thank you!”
“Oh also, do you know if it’s a planned and wanted pregnancy?” Veronica adds. That didn’t even cross my mind.
“Oh, uh, I’m not sure. I forgot to ask her.”
“That’s okay. You need to be ready for both reactions. You have no idea if this is the best or the worst news she’ll receive all year.” I was so caught up in trying to learn my way around, racking my brain for the physiology of pregnancy, and the mechanism of action of a pregnancy test – it tests for estrogen? Progesterone? – that I didn’t stop think for a moment about the life-changing impact this will have on her life!
“Uh, huh.” I respond.
“If it’s welcomed, that’s easy. Ask about prenatal care, if they need an OBGYN and a pediatrician, their support, you know. If it’s not welcomed, well that’s usually a more difficult discussion. We have pamphlets on patients seeking abortions. We offer counseling for people who are victims of sexual abuse. And we can help them with whatever questions they have. Tell them the news straight, and wait a second. Let them process. Read the situation and go from there. Got it?”
What in the hell have I gotten myself in to. I am woefully unprepared for this. “Got it. Thanks!” Welp, here goes nothing.
I knock and enter Sarah’s room. This time, her boyfriend, Raul, is with her. He’s also from the DR but speaks very little English. “What are the results?” She asks.
“It came back positive. You’re pregnant.” I pause for what seems like an eternity, my heart beating out of my chest.
“Estoy embarazada,” Sarah says to Raul, a short, well-built man, with thick calluses on his hands. His eyes start to well up with tears that he can’t hold back. “I already knew I was pregnant,” says Sarah. “A woman just knows. It’s his first time being a father, and he’s so excited – he just needed to hear it from a doctor.”
If only he knew…
Benjamin Cook is an MS3 at UMass Med, planning on applying into Med/Peds. He is interested in primary care, hematology/oncology, and hospice/palliative care medicine. He likes writing as a way to reflect and remember funny/difficult situations.
