I don’t know if it’s because the holidays put everyone on edge, but the month of December saw more tears and full-blown break-downs in my exam rooms than I had had all year.
The work that I do is often emotionally fraught, and some of the time at least, I see people when they are going through some of the most stressful parts of their lives. A new sexually transmitted infection. An unplanned pregnancy. Problems with a romantic partner.
One of the greatest disservices that I can imagine is that my patients are scheduled back-to-back every 10 minutes. If I am lucky, and if I have a few patients not show up for their appointments, and if no one is having any emotions or questions, I can usually get through a clinic day running relatively on schedule. But there is no time built in for the emotional aspect of what I do.
I bustled into the education office, lab coat swinging behind me, precariously balancing a cup of water, medications, and the patient’s chart.
“Hi, I’m one of the nurse practitioners here, I have all the meds for here and for home” is my usual opening when I walk into a room to dispense medications for medication abortions, which entail the patient taking the first round of meds in the office and then a second set at home to help expel the pregnancy.
The mood in the room instantly turns as I look at the somber faces of the couple sitting before me. I instantly curse myself for not checking in with the person conducting the education to see what kind of mood I was walking into, but, per usual, I didn’t have time.
The woman before me is curled up on the chair, staring at her sneakers, a tiny pile of torn-up tissues sitting next to her on the side table. Her husband stares at the wall, eyes blank, reflecting a feeling I know too well. I have had too many feelings in the past few days. I have emotional fatigue, his eyes say to me. I don’t have room to feel anything else.
I ask my cursory questions, note that the patient’s history has “infertility” marked down in the health history.
I pop the medications into their clear cup and tell the woman that she can take them when she is ready.
Tears instantly burst out of the corners of her eyes as she cries, “I can’t do it.”
We talk, I hear out a devastating tale of infertility, IVF trials that drag on for years, the desire for a child. And of infidelity.
We talk some more. I tell the couple that this isn’t something that has to be done today. The woman insists that she must do it, must move forward, but that it is devastating. That she is sorry. Against my wishes the careful dam around my heart splinters and tears begin to run down my own cheeks.
I don’t have time. The woman swallows the first round of medications, hugs her husband. We both cry. I hug her on my way out.
Close the door.
Pick up the next chart.