Department Of Snarky Thoughts While Looking At The Rear License Plate
Of The Car Ahead Of Me At The Traffic Light.
“Isn’t that sweet – one of the license plates Jesus made while
he was doing 5-10 at the Federal Penitentiary for money laundering….”
* * *
Department Of Gummie Bears, Schmummie Bears – Have You Tried…
Dateline: 9:20 am Wednesday; message from daughter Belle. In her work as QA manager for a hard cider company, Belle is privy to the FDA’s product recall list. She sent a copy of the latest list, with this intro:
“The FDA email recall list is the gift that just keeps on giving!”
* * *
Department Of I’m Not Sure What, Exactly, Prompted This Memory
Number 3,2781 In A Never-Ending Series
Sub- Department Of Lost In Translation
I’m thinking what brought this to mind was a podcast moiself recently listened to, wherein the various stories presented had to do with the protagonists having to make do in unexpected circumstances.
Dateline: a midweek afternoon; the mid-1980s, Planned Parenthood clinic in Santa Ana, CA, where I worked as an Options Counselor/Clinic Aide. At that time perhaps 30% of PP clients were bilingual or Spanish-only speaking, and there were always at least two bilingual clinic and office staff scheduled. On that fateful day, we were short staffed in the clinic, with only one clinician (a Nurse Practitioner, “Serena,” who spoke only English) and two clinic aides – moiself, and Anna, who was bilingual.
I was halfway through my afternoon Clinic Aide shift. Brief clinic logistics: both new and returning patients checked in at the reception desk. “Renee,” the clinic’s receptionist, either pulled the existing chart or created a chart for a new patient, then placed the charts in order of appointment time/patient arrival in a chart holder which was affixed to the door between the reception area and the clinic waiting room. I was surprised when the door between the reception office and the clinic opened, and Renee, holding a chart in her hand, personally escorted a new patient back to the clinic. This was unusual.
What was also unusual was the new patient herself. She looked to be in her late 30s (most of our patients ranged in age from late teens to early 30s), and was dressed to the nines: immaculately coiffed, glistening black hair; a string of fresh water pearls around her neck; a tastefully expensive diamond ring on her left hand [1]; a tailored linen suit… She had a bearing of Old Money ® about her, and looked as if she were headed for a corporate cocktail reception and not a women’s health clinic.
Renee pulled me aside and said that the patient, “Señora Rica,” spoke no English – Renee had learned what she was about to tell me from the PP accounting secretary (“Dina”), who was bilingual and whom Renee had grabbed to translate when Señora Rica [2] came to the reception desk. Señora Rica: age 36, in good health; no allergies; not taking any medications; has two children who are back at home with her husband; currently using an IUD for contraception; lives in Guadalajara; has been visiting relatives in Santa Ana for the past two weeks; began having heavy heavy vaginal bleeding two hours ago; she was not in pain; it was not time for her menstrual cycle. This PP was the closest medical facility Señora Rica’s family knew of; Señora Rica insisted on driving herself to the clinic, sans accompaniment. [3]
I wondered aloud why la Señora had not been referred to an ER, but dropped that concern when I saw that I’d made the already twitterpated Renee even more hyper. The other clinic aide, Anna, had just left for her lunch break – this was before cell phones; there was no way to reach her. So: we have two non-bilinguals – moiself, and NP Serena – in the clinic for the next hour. I told Renee that I’d get la Señora set up for an exam and that Renee needed to get that bilingual accounting secretary back to the clinic, pronto, to interpret.
Moiself just happened to have started studying “clinical” Spanish – and by just I mean, like, two days prior. I’d taken Spanish in high school and had learned next to nothing useful ( ¡Qué sorpresa! ). And although by my junior year my high school’s student body was majority Hispanic-surnamed, the words and phrases I’d picked up from my friends were, how you say, hardly genteel and not at all respectful (nor Castilian grammarly-correct). Still, with my minimal skills I was able to escort Señora Rica to an exam room, where, after apologizing for my abysmal Spanish, I asked her to disrobe from the waist down, put on a drape, and take a seat on the exam table. I told her that I would be right back with the clinician, along with someone who spoke better Spanish than moiself.
I exited the exam room just as Renee and the Very-Nervous-Looking accounting secretary, Dina, and the NP, Serena, arrived outside the exam room door. Fortunately, there were no other patients in the clinic waiting room. I quickly got my comrades up to speed…which was way below the speed limit, as I didn’t know much. NP Serena gave a sneak preview to Dina re what Serena and I would be asking the patient, via Dina’s translation. Serena asked Dina to first please introduce the three of us; we’d need to know at what point the patient was in her reproductive cycle, whether or not she might be pregnant, and she should be informed that the clinician would be performing a pelvic exam which should reveal the status of Señora Rica’s IUD…. And could Renee wait outside the exam room for a minute, until we all got settled?
A little more than a minute after the three of us entered the exam room and maybe forty seconds after Dina had begun talking with the patient, I noticed that Dina’s lips were turning blue, and that her eyes – which had focused on the blood that seeped through La Señora’s paper gown and off the edge of the chux pad [4] under the exam table’s paper – started to roll up in her head. “She’s going,” I hissed to Serena. I managed to catch Dina before her legs’ muscle tone had morphed into al dente spaghetti. As quickly and discretely as I could, I scooted/dragged Dina out of the exam room and to clinic waiting area. I helped Dina to the floor, propped her legs up on a chair and put a seat cushion under her head. I told Dina to breath slowly and deeply, and told a flabbergasted Renee to please keep watch over Dina. [5]
I returned to the exam room. The patient was supine on the exam table while Serena performed a pelvic exam on her. La Señora seemed nonplussed by the near-swooning-drama; whatever is the opposite of nonplussed, that was moiself. I was plussed as hell, but was determined not to let any of that be seem by the patient (or Serena ). I did my best – my comments and questions bracketed with lo siento; lo siento mucho [6] – to convey what Serena needed to do to and know about La Señora.
The exam revealed that La Señora had most likely expelled her IUD, but the patient had no idea when…perhaps when she was in Guadalajara? Or during her shower yesterday morning? “I need to know if there’s a possibility she could be pregnant,” Serena told me. “We can try a pregnancy test after the exam, but the bleeding – which seems to have stopped; well, it still it might interfere with the results – the tests we have here might not be accurate.”
With the help of the calendar on the exam room wall, I was falteringly able to determine La Señora’s LMP. [7] Now, Serena told me, I needed to ask La Señora when was the last time she’d had intercourse. Oh, this is gonna be fun (not). I gulped, and tried my best to comply:
“Ah…Señora, lo siento, pero…
¿Cuándo es la ultima vez…momentito, por favor.”
I realized my high school/crude Spanish was going to fail me in this situation. I whispered to Serena that I did not know the technical Spanish term for sexual intercourse and that I did not want to offend the patient – Serena interrupted me and said that this was need-to-know info, and that I should just do my best.
My best. Muchas gracias, Serena. You want me to ask this very gentle, very patient, very gracious woman when was the last time she and her husband fucked?!?!?
I girded my proverbial language loins, and, as one does when all else fails, employed the universal language of gestures.
“Lo siento mucho, pero, ¿Cuándo es la ultima vez que…usted y el esposo…”
I could feel my cheeks flushing as I made the OK sign with my left hand and jabbed my left right finger back and forth through it.
La Señora’s eyes widened with comprehension. She smiled, chuckled softly, kindly reassured me ( “No hay problema, señiorita” ), pointed her finger toward the calendar, and gave me a date.
By the end of the exam the patient’s bleeding had stopped. She said she felt fine; her vital signs were all normal; we referred her to an Urgent Care clinic for a pregnancy test and followup exam.
Later that afternoon, as Serena was doing her charting and I was getting ready to go home, Serena complimented me on keeping a cool head and on my “ability to pivot.”
“Is that what I did? Thanks, Serena. No, really – thank you, thank you very much,” moiself responded, followed by, “You realize Renee and Dina are never going to speak to me again? And I am never speaking Spanish with a patient, never, ever, never….” [8]
* * *
Department Of I Just Can’t….
Boner Bears.
* * *
Freethinkers’ Thought Of The Week [9]
* * *
May you be entertained in traffic by other people’s license plates;
May you have the appropriate vocabulary at the appropriate time;
May you have fun going bowling instead; [10]
…and may the hijinks ensue.
Thanks for stopping by. Au Vendredi!
* * *
[1] Or so Renee (the clinician who saw her) – who always noticed such things about patients – told me later ( “Did you see that rock on her finger?!? White gold band, round center pink diamond with two rows of diamond insets…” )
[2] Yep, not her real name.
[3] And she parked at the curb right in front of the clinic, leaving her cream-colored Merecedes in the no parking loading/unloading only zone.
[4] For general/every day exams, clinics use exam table paper, which makes that distinctive, crinkling sound when you sit on it. When a patient is in labor or during clinical/exam situations involving the possibility of any kind of heavy fluid expulsion, an absorbent underpad, aka “chux” pad, will be placed under the exam table paper, where the patient will be sitting.
[5] “She might throw up; deal with it as best you can; I’m sorry but I’ve got to get back in there….” I can’t remember all I blurted to Renee but I’m sure she found my instructions…lacking.
[6] ” I am sorry; I am so very sorry.”
[7] Day one of her last menstrual period.
[8] The very next day I broke that “promise,” and would continue to break it in the following years I worked in the women’s reproductive health care field.
[9] “free-think-er n. A person who forms opinions about religion on the basis of reason, independently of tradition, authority, or established belief. Freethinkers include atheists, agnostics and rationalists. No one can be a freethinker who demands conformity to a bible, creed, or messiah. To the freethinker, revelation and faith are invalid, and orthodoxy is no guarantee of truth.” Definition courtesy of the Freedom From Religion Foundation, ffrf.org
[10] Which, rumor has it, can be made even more fun with a dose of Boner Bears.
