Get mad. Get involved.

I'm so with Garfield on this hating Mondays thing.

Clinic was rough today. My first patient needed to be admitted (she knew this. She showed up with a suitcase). It's a long and fairly arduous thing to admit someone, and generally takes longer than a clinic appointment. Fortunately, someone who saw her last time dictated a fabulous H&P (it was me) so I could just cut and paste all of the history. I made it just under the wire so it was done before my next patient.

Meanwhile, the patient sat in the waiting room until - I'm not kidding - 5 pm waiting to be sent to the floor. There's got to be a better system than this.

I had a little bean bowl lunch with Ruthie, which is always enjoyable (she's insane. And I love her for it). And then my afternoon ensued. I had three really difficult cases and one poor lady who's quarantined in her house with MRSA. But one of those afternoon four was especially hard.

One of my patients was raped last week.

It was awful. It was an awful situation. There are details I'm obviously not going to share that made it especially heinous. I felt so bad. She's one of these abused kids who sort of ended up with "VICTIMIZE ME" stamped on her forehead, I think. She was already having a rough time of things (that's why she sees me), and then she gets slammed with this. It's a damn shame (it's always a damn shame). She's a little histrionic, but generally just sort of sweet and funny when she lets her guard down. And it never fails to amaze me the moments in which someone so otherwise worldly can end up being profoundly naive. But she's stronger than she knows, and she's going to come out of this okay. She'll never be the same, don't get me wrong - this is a particularly loud bell that cannot be un-rung - but I think she'll persevere.

But I'm listening to her story, and what really overwhelms me is this sense I get all the time when listening to these stories - I do not understand what motivates people to do things like this to others. I mean, I get the whole forensic ideas of, this happened when they were small, so this and this and this shows up in their personality, combined with this temperament and this inciting event and this is how the whole complex plays out, blah, blah, blah. But what I can never wrap my little brain around is...when does this feel okay? When, as a human being, does it seem like something acceptable to hold a woman down and rape her? To molest a child? To beat an elderly woman? To defile and humilate another life? Does that really feel like a normal path to sex/love/power/whatever delusion they hold? When does this seem like "something you do," like reading the paper on Sundays or going to the grocery store?

I just don't get it.

But it happens. It happens over and over and over again. Sexual assault happens to one in three women and one in nine men. To prostitutes and beggars, college kids and working moms, to doctors and lawyers and socialites. It happens to handicapped people and to the mentally ill. It creates handicaps and mental illness, and it perpetuates itself. But in that, some will flounder and drift downward, some will find strength they didn't know they had, and some will even find enough to lend that strength to others.

April is Sexual Abuse and Assault Awareness Month. Support your local Rape Crisis Center - give money, give time, give provisions, give prayers. Get involved with Threads of Compassion or another group that supports survivors. Get involved with a SANE program if you're in the medical field. Get involved in advocacy and victim's rights. Or just listen to a friend that needs to tell a terrifying story. Let people know they aren't alone. Be proud that you survived, or that your sister, your husband, your grandmother did.

Let no one stand alone who has fallen victim. Be aware, be involved, let this be out in the light of day.

Love/Hate Friday

First, the hate.....

Seriously. The pine pollen is out of control. Look at this nonsense! It's like that awful yellow chalk dust from grade school, times, like, a billion.


Blahhhh. And I'm out of Zyrtec.

We're not even going to discuss the pine pollen paw prints on my carpet.

But, something cool did happen today. Actually, today was in many ways awful. Crazy pregnant lady hates me so much she won't even talk to me. New schizophrenic girl just gets worse every damn day. I had to get between her and her mom last night because she was "prophesying" loudly and angrily and was terrifying her already somewhat fragile mother. My ECT patient is still wacky, but at least she's a pleasant and giggle-prone wacky at this point. And my one patient I thought had done so well and with whom I was positive was getting better and who had this peculiar habit of hugging me and whom I thought I had done really well by wigged out and went complete borderline whack-job on me after my attending agreed with me in rounds that we were discharging her and then decided she needed to stay (and of course sent me to go tell her). I've gone from being "the only doctor she ever trusted" to the worst doctor ever in like, 2.8 seconds. That? Hurt.

But. I have this one patient. We've been doing individual therapy while she's in, and she's been doing a great job. Today, she told me that she'd heard the other girl yelling that I lied to her (I didn't) and she told me she was scared that I would do the same to her. That just about broke my heart. But we talked through it and she processed it well and it ended up being a fairly positive thing.

She processed it well. I? Am still pissed at the other patient for even making her think that. I'll get over it.

Anyway.

I've been giving her art therapy assignments, and for today I told her to draw me a picture of the inside of her head. She gave me this one to keep.

The picture really doesn't do it justice. The design was preprinted, but the color, and the explanation she was able to give me, was all her. I'm going to frame it and put it in my office next year.

She's an incest survivor. She's stronger than she knows. She's way braver than she thinks she is. She's just awesome.

Love Thursday...

...will be postponed until Love Friday. Day was long. Patients SO crazy. I'm so tired.

But.

The fact that it's taken me three days to mention this should be a clue as to how bad the past week has been. It's April. Which is a month important for reasons far beyond May flowers.

April is National Sexual Assault Awareness Month. Today, in fact, is the SAAM Day of Action.

I haven't quite figured out how I want to "celebrate" this month, yet, but we will. Because it's important to acknowledge those who've been victimized, and those who've survived. Those who are still fighting. Those who still don't have a voice. Those who stand by in support. Those who work hard because saving even one victim is worth everything. And all of us whose lives will never be the same.