I walked into Jesse's room early the following morning. I knew she had very good care by the staff there overnight, and she needed a lot of rest. But I also was struggling with my feelings for this beautiful woman. There was an obvious important attraction between us, but I was her doctor after all. And would this be appropriate for me to fall in love with one of my patients? I decided to focus my attention and skills on her health and well being, and see how she felt too, as she healed and grew stronger.
Her eyes were closed and she looked tired and pale. I knew the nurses had awakened her even earlier to take her vitals, so I quietly slipped in and put my badge in the computer to check her record. I was reading the nurse's entries from overnight, and I heard a quiet voice say, You're here. I looked at her and my heart melted. Good morning, Jesse, I said. How are you feeling? Because of the extent and length of her surgery, I had ordered that she stay in the overnight part of the clinic, rather than being released the day of. We had manipulated her insides a lot to get to and remove the diseased tissue. She was going to be weak and sore for awhile, even though she only had four small wounds on her belly. Pretty wiped out, she answered me. I know. We had to do quite a bit of work in that belly. That's the main reason I wanted you to stay overnight with us. Oh. I thought you just wanted to see my smiling face again this morning, she said. Well, that too, I added. We both smiled. I couldn't look away from her face, and again, surprsing myself, I reached out and brushed her hair across her forehead and stroked her cheek. Jesse, I'm sorry. I think I've been inappropriate with you. A long silence followed, and then . . . Have many of your patients fallen in love with you, or am I the first one, she said. Now, hanging onto each others hands, we began to quietly laugh. Oh, owww, she said. Oh, be careful. I imagine your belly is really tender. I released her hands and said, I just want to take a quick look, and I pulled the sheet and blanket carefully off of her and lifted her gown up to expose her incisions. Very carefully I looked at and touched each one to make sure there was no unusual swelling or warmth indicating infection. I was aware that Jesse never took her eyes off of me as I covered her again. Looks very good, I told her. Even though I really wanted to stay with her, I needed to get to the clinic. I assured her that I would be back about midday, and after she had more rest, and we would talk about when she would go home. Both her mother and sister were anxious to take care of her at home, so that would be a big factor as to when she would be released.
My appointments were full for that morning, so the time went by very quickly. Another young woman, only 25, also came into my office appearing to be suffering with endometriosis. Through tears she described the monthly agony and erratic periods she struggled with. After I conducted a thorough pelvic exam, I decided to do an endometrial biopsy right then, in order to see if we could diagnose her as quickly as possible. My experiences with Jesse made me even more sensitive to the challenges so many women of all ages experienced with this condition. And in this young woman's case, I wanted to help her as soon as possible. I instructed her to relax while laying on the table as my nurse and I got the instruments ready and then returned to the exam room. My nurse gave her two ibuprofen before we began. I repositioned her in the stirrups, focused a high intensity lamp, washed and dried my hands, and then put on exam gloves. My nurse did the same and I sat down on the stool at the end of the table. I had just done a pelvic exam to be sure I knew the size, shape and position of her uterus, so I was ready to begin the biopsy by placing a speculum in her vagina. I visualized her cervix and scrubbed it with antiseptic. Suddenly, she said she was uncomfortable with the speculum in her. I closed it slightly, pulled it out a fraction, and put it back in. That's better she said. Her legs were shaking slightly. I tried to assure her that this would be very quick, but she should take some deep breaths and try to relax her pelvis. Easier said than done, I know! Using a tenaculum, I grasped the cervix and pulled it straight out to make it easier to sound. I inserted the sound through the os and sounded the uterus. My nurse handed me a suction pipette. Ok, take a deep breath. Exhale. And again, I told her. At that point, I slid the pipette through her cervix and began to rotate it to collect blood and tissue from all sides. Ohhh, she cried out slightly and her legs jerked inward. Hang on, honey, I said. Almost got it. Relax your legs. Her legs slowly opened, and I removed the pipette containing the secimen I needed. I handed it to my nurse and she expelled the contents into a bottle to go to a lab. I'm sorry, I said. Oh my gosh, she added. That really hurt. Do you have some cramping, I asked. Yeah, a little. I still had the speculum inside of her and I was making sure she didn't show any unusual amounts of bleeding. You will probably spot a little today, I said as I released the speculum and slowly removed it. But if it's anymore than just spotting, call me, okay? Okay. As soon as we get the results of this and your pap test, we'll be in touch. I had stood up and pulled the leg extension on the table out and lifted her feet from the stirrups, making sure she was covered. Just stay here and rest as long as you need to, I said. My nurse stayed with her and massaged her abdomen until she was ready to get dressed and go home. I could feel a resolution rising in me that I would be strongly focusing my work from now on on this debilitating disease.