THE Y8 gets me to the clinic shortly before 9. Monday is a paperwork and office work day, and the phones ring almost continuoulsy. As Usual, most of the calls are for information about pregnancy testing or for an abortion appointment.
Linda, another nurse, and I stay busy answering the phones and doing pregnancy tests for women who come in anxiously clutching urine specimens. Most of the symptoms are similar: "My period is late, it's never late." "I feel sick." "I'm tired all the time."
Lisa, a frightened 17-year-old, is clearly relieved when her test is negative, and I am glad to answer her questions about an effective form of contraception. A mother calls seeking information for her daughter and solace for herself. The 16-year-old girl has told her yesterday that she is pregnant, and has asked her mother to make arrangements for an abortion. The mother is wondering how she has failed her daughter. I suggest that instead of failing her, she has been able to create a trusing relationship which enabled the daughter to talk with her about this.
Between phone calls and pregnancy tests, I write checks to pay bills for clinic supplies. These kinds of jobs are necessary but dull.
In the late afternoon, Mary, the executive director, and I work on the script for a slide presentation on abortion at a national meeting in San Francisco in the spring.
It's dark by the time I get home after stopping by the Health Department to drop off some lab specimens. Lee, my husband, left yesterday for a meeting in Minneapolis. I miss him, but since he was gone for more than three months this summer on a Navy cruise, I'm used to not having him around.
Tonight, Alex, my 16-year-old son, and I make a test run of the drive he will make to the orthodontist tomorrow. I guess I'm your basic nervous mother. Tuesday
Alex overslept this morning, so breakfast is a wild rush.
Most of the morning is taken working with Kim, a young Oriental girl, and her friend, Carol, who serves as a translator. Trying to cousel patients through a third party can be frusting, but Carol is a capable helper and I am easily able to discover Kim's thoughts, fears and feelings about her pregnancy and what she wants to do about it. She has an easy abortion and leaves smiling an hour later, armed with contraceptive information.
The rest of the day if filled with revising and retyping the slide show script, answering phone inquiries, doing pregnancy tests and responding to patient requests to send summaries of their records to their doctors.
Once I get home, I read the paper and mail, and worry until Alex drives in from the last high school JV soccer game of the year. The team has finished with a six-game win streak, and he is euphoric as he comes in. I feel guilty giving him a TV dinner on such a grand occasion, But I have already arranged to go to dinner with 11 other people from the clinic.
We go to a local Mexian restaurant and celebrate a recent successful inspection and the fourth anniversary of opening. Most of the original staff are still with us. We have a lively debate over a poll being conducted by one of the nursing magazines about involuntary sterilization. Wednesday
Today is a day off work and I'm glad of it. Geraldine, our tomcat, was in a noisy battle under my bedroom window about 4 a.m. That plus the margarita and spicy food last evening, did not contribute to a good night's sleep.
Once Alex leaves for school, I am tempted to go back to bed but instead drink coffee and read the paper cover to cover, a luxury I enjoy even more than going back to bed. Panic letter from Justine asking me to transfer some money from her savings to checking account. The dean of students at Duke warned us parents of entering freshmen that the only letters we were likely to receive from our kids were requests for money. So far, she's right.
I pick up dry cleaning, take a clock for repair and other dull but necessary stops that keep the family running. I consider those tasks in the same category as the clinic paperwork. I hang out laundry and rake leaves in the afternoon -- both are just excuses to be outside on a bright and brisk fall day. Thursday
The bus ride to work gives me a chance to finish last week's Time magazine. I stay about a week behind in world and national events. It is hectic at the clinic this morning. Several patients arrive late for their appointments. Two Spanish-speaking patients arrive four hours early for theirs.
Marta, from South America, has been here only two months. She and her four children have been living off savings she brought with her, as her husband apparently abandoned the family once he learned she was pregnant. She had hopes of a better life when she joined her husband here. Now she would like to go home but can't afford to.
Alex drove to school again today because he needed to stay late to review chemistry. I'm relieved to see the car in the driveway when I get home, but disappointed when I find he has missed out on signups for the college fair. Our dinner discussion is heavy on initiative, taking responsibility and planning ahead. Friday
A friend is driving down to Duke tomorrow to visit his son. I bake Justine's favorite chocolate chip cookies to send to her. In talking with her later in the day she sounds busy and happy -- apparently she hasn't had the freshman homesickness that the dean warned us to expect. Saturday I alternate working Saturdays with the head nurse. This is my week on, so I'm up early and open the clinic at 7:55. In the first hour, I help set up the procedure rooms, get the recovery room ready and examine two patients. One girl is confused by conflicting lab results -- a postive pregnancy test at a health department clinic and a negative test here today. A pelvic exam reveals no evidence of pregnancy, and she leaves the clinic smiling.
We began abortion procedures once the lab work and counseling are completed, and I admit patients to the recovery room one at a time. I check for bleeding, pulse and blood pressure and offer them gineger ale and cookies. Once they are comfortable, I go out to the waiting room to tell the concerned husbands and boy friends that everything is okay.
We finish seeing the morning patients by 11:45 and I begin to admit patients who have appointments for noon. In the lab I review each medical history, the lab technician draws blood and requests a urine specimen. The patients assemble in the counseling room and I introduce the women to each other. We will all be together the rest of the afternoon.
We discuss the abortion technique that will be used. Most questions are regarding discomfort. I answer them as truthfully as I can. I accompany each woman through her abortion, spending the time primarily in quiet conversation and reassurance. Each woman's abortion proceeds smoothly and with a minimum of discomfort, although one woman becomes nauseated. I assure her this in not an uncommon reaction and usually passes quickly, which it does in her case.
The women greet each other almost like old friends as each one is admitted into recovery. Two of the men accompanying them are idly thumbing through magazines when I go out to the waiting room to talk to them. The relief is almost palpable. I suggest they go out for coffee and a walk.
In the next hour we discuss recommendations for home care and each woman's plans for birth control. At this point they are receptive to the idea of contraception, and have many questions about pills, IUDs, diaphragms, foam, condoms and sterilization. Two elect to start pills, another wants an IUD when she returns for her checkup and the other will bring her diaphragm to check for proper fit and technique of insertion. With a final observation of bleeding and vital signs, I discahrge my patients about 3:45.
Charting and cleanup take another hour and a half, and it's dark when we finally leave around 5:30. Lee has flown in from Minneapolis, and it's good to have him back. Sunday
What a treat to sleep in! Once we read the thick Sunday paper, I pack a picnic lunch and we drive up to the catoctin Mountains. We hike a winding trail up a hill through the woods where the forest floor is covered with a thick layer of crackling leaves. It's a gorgeous day -- clear, crisp and bright. I wish the weather would last like this until Christmas -- or better yet, until spring.