A few weeks ago, a young woman sat on the edge of the table when I walked into the exam room. She was new to our clinic, and as far as I could tell hadn’t been to a clinic—hadn’t had a primary care doctor—in a while. She was quiet. She spent our first few minutes looking at the floor, answering my question with one word or two, and sometimes remaining silent. You could tell her mind was racing, but she kept any emotion locked inside her strong exterior. I spent a few minutes trying to coax out answers, trying to determine her understanding of why she has been in the hospital, of why she was here with me today, but I got nothing from her, so I stepped out of the room to collect myself and to give her some time—hoping that we both would have a moment to recharge, and that maybe this shell would melt away. She looked so tired—like she had been fighting so hard for so long.

When I walked back in a few minutes later, with a print-out of her hospital discharge summary in hand, the conversation flowed a bit more easily—she began to speak a little louder, and for a little longer. She was homeless, a mother of young children who lived with a family member in another city. We talked about her homelessness—about how she sometimes slept on public transportation to avoid the streets. We talked about her job in retail. And we talked about whether or not she wanted another child.

I think what struck me most about our time together that day was how she said that she had tried to make an appointment months ago when she was discharged from the hospital after getting a pretty serious infection. She said that it was “so hard to figure out insurance and where to go.” And she said it like the system had failed her, because it had. And yet here she was, sitting in front of me—resilient, persevering.

I handed her a piece of paper with resources for the homeless in our area, and when she left I felt a wave of sadness well up inside of me. We can’t allow for this system to become worse than it already is—we just can’t. Because for every one of her, there are 100 who just didn’t have the strength and determination to battle our already broken system.

She walked away with birth control that day. It was free, it was in her control, and there were no strings attached, and it felt good to be able to at least give her that, because that—reproductive freedom—is invaluable. Just before my medical assistant left, she came into the charting room and said “You know that patient you just saw? She said she’d come back, but only if you were her primary care provider.”