Story No. 499: Dr. Ryan from Louisiana

My colleague, who I’ll call Dr. Lisa, came to my clinic for her Adolescent Medicine Rotation. She proved herself adept in general pediatric medical knowledge and diagnosis, but she shied away from options counseling and open discussions of sexual health. She often spoke of her support for President Trump, an administration that has been attacking access to reproductive health care at every direction, and I worried that would affect her patient care.

One day, Dr. Lisa came to get me out of a meeting to see a patient who we’ll call Michael. She had diagnosed Michael with a large inguinal hernia requiring surgery. He was tearful. Michael had come in for a sports physical and was being told he couldn’t play and needed surgery. Dr. Lisa had managed the surgery referral scheduling with the nurse, called Michael’s mom who was on her way and things were tied with a bow. I complimented her on a job well-done.

It wasn’t until the next Monday when Dr. Lisa said, “Oh, one thing I forgot to tell you about that hernia patient from last week.”

She then told me when she initially walked into the exam room to see Michael, she found him, a 15-year-old boy, taking pictures with his phone of female genitalia in an anatomy book. She asked Michael if he needed some information or if she could explain something for him. She then began to walk him through the finer points of female gynecologic anatomy and reproductive health. He then shyly admitted that he was afraid he had a sexually transmitted infection. But he was not sure because he thought he “had not had sex, but he wasn’t really sure what was down there or what went where.”

Dr. Lisa then used the textbook to more specifically describe vaginal-penile intercourse and discuss his symptoms and do a thorough medical examination including a genital exam. It was then that she discovered he did not have an STD, but he did have a large hernia, and they discussed the need for surgery. I remarked what an excellent job Dr. Lisa had done. She then replied it was only due to the training on sexual health she had received rotating with our team that she was was able to confidently and effectively care for that patient.

What she didn’t know is that she taught us a lesson, too. We should expect all trainees to provide compassionate care to everyone and to do a better job every day.