DOI: 10.1097/ACM.0b013e31806769dc
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PMID: 17762259
Issn Print: 1040-2446
Publication Date: 2007/08/01
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Excerpt
John entered the room and found Melissa sitting in a chair with her knees drawn up to her chest. John looked at the chart. There were notes from her hospitalization for an appendectomy, notes documenting visits every two to three weeks since the surgery, and notes on a readmission to pediatrics for a bowel work-up. Based on the notes, everything appeared normal. John was perplexed why Melissa still complained of abdominal pain.
John's first couple of questions yielded little information. “What can I do for you today?” he asked. Silence. “What brought you in?” Silence. “You've had a tough time this year.”
“Yes,” she said nodding her head.
“Have you missed a lot of school?”
“I can't ever go back.”
“What do you mean?”
“I did something bad.”
“Bad? You only had appendicitis”.
“If I told them, they'd know I sinned.”
Last August. Melissa was at home in the low-income apartment, which she shared with her mom and siblings, in Beaumont, Texas. Her mom was working, cleaning other people's homes. The pain around Melissa's belly button started in the morning. She knew it wasn't time for her period. The pain worsened and by the afternoon, she was vomiting. When her mom arrived home that evening, Melissa had a fever and was still vomiting. Although Melissa's mom lacked health insurance, she took Melissa to the community hospital's emergency room.
The physician in the emergency room palpated Melissa's abdomen and told her mom that Melissa probably had an ectopic pregnancy. Since Melissa was a “welfare case,” the physician suggested that Melissa should be taken to the teaching hospital at Galveston. “Hurry! If it bursts, she could die,” the physician stressed.
Alternatively praying for Melissa's survival and cursing her as a fornicator, Melissa's mom drove the 75 miles to Galveston. Melissa, between spasms of pain, protested she was a virgin and couldn't be pregnant. When they arrived at the teaching hospital, Melissa's abdomen was rigid. An obstetrics–gynecology resident performed a bimanual exam and declared Melissa had appendicitis, not an ectopic pregnancy. Surgeons rushed Melissa to the operating room and found her belly full of pus.
Melissa's mom returned home to care for her other kids and to clean other people's homes. Melissa stayed in the hospital for three weeks with tubes in her belly, nose, and arms. The physicians in the hospital never fully explained to Melissa what happened to her.
When school started, Melissa was still sore and scarred from the operation. She hesitated to change for physical education class because everyone would notice the scars. Wondering what to tell them, she didn't want to worsen her sin by lying so she stayed away from school until the pain and scars faded.
John said, “Appendicitis isn't a sin. My mom and dad both had it before they were married. They had operations and got well.” Melissa gave John a puzzled look. Using a book, he showed Melissa the location of the appendix and explained how it is unrelated to the sex organs. Then he reassured her, “This can't happen to you again.”
Melissa sighed, “Please tell my mom. She'll be happy to know that.” Melissa recovered and returned to school.
