fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

A Good Day

“You know what they say, Dr. Chew—every day above ground is a good day.”

My next patient, for whom this is a mantra, is in the waiting room when I duck out for an overdue bathroom break. Her bleached blonde hair is tangled, her jeans tight and faded, her face mashed like a boxer 20 years her senior. Her gray eyes vigilantly scan the crowded room.

Of course I asked her how she was, even though my bladder protested. Was it three years already that I’d been seeing her? From my first weeks as a registrar, I’d been zealous about the promise of benzodiazepine contracts to “stabilize people and engage them with regular care, so we can establish a trusting relationship and gradually work on health care and harm reduction.”

Three years later, she was still on 30 mg of diazepam a day, just like when we started. But … but … but … we’d also talked in that time about blood-borne virus screening, quitting smoking, and mental health. She kept turning up every fortnight to get her script. She talked to me about her other half, who was in prison. Buddy sounded like a nasty piece of work to me, but I kept my face neutral, spotting the softening in hers when she talked about him. Even when she mentioned that he’d goaded her after a fight to “hawk my box on the street—and that was the one thing I never did!”

It’s taken me more than two years to persuade her to be screened for cervical cancer. She pushes down her skinny jeans, and then I see it. The tattoo above her hairless pubic bone.

“THIS BELONGS TO ME” it reads, in fading greenish-black capital letters. A home-made job.

I turn away to gather the cyto-brush and speculum, as well as my composure.

I’m extra gentle with my step-by-step explanation, my pelvic exam, my specimen collection. Her cervix appears, soft and baby pink between the silver speculum blades, an anemone retracted for self-protection. This is preventative health care, I remind myself. I smear the slide, explaining fixation and cytology, hiding behind science. What I’m doing stops women from getting cervical cancer.

I want to go back in time and stop more than cancer: Stop a man from tattooing her. Stop her from hooking up with Buddy. Stop the drugs and the pain behind them. Stop family violence, abuse, and neglect. Stop a little girl from getting hurt.

Stop the world from being so brutal and hearts so tender.

I slide the specimen into the pathology bag while she dresses. She slides back in the chair, crosses her legs, shoots me a crooked grin.

“There ya go, doc—we did it!”

She’s right. We are above ground, and it is a good day.

Joo-Inn Chew
Canberra, Australia

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Comments

4 thoughts on “A Good Day”

  1. This is heartbreaking and heartening, both. A beautiful story to read, and a human connection to celebrate. Thank you Dr Chew.

  2. Great story–your compassion comes through loud and clear. You are a gift to her: brava to you for keeping a fragile relationship going. It’s worth it.

  3. Dear Joo-Inn, thank you a million times for sharing this story. I can hear your voice, and hers so clearly. She sounds like an amazingly grit filled person with whom you have established trust; kudos for your work.

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