It was 2 a.m. on a typically hectic Friday overnight shift in the emergency department.
A young woman, Kelly, checked into triage, accompanied by her older boyfriend Jim, who explained that Kelly had abdominal pain and some vaginal bleeding. Jim wanted her checked out and maybe some pain medicine to help her rest at home.
Kelly had no identification. She appeared younger than her stated age of 18. I also noticed track marks punctuating both of her arms: a sign of IV drug use. She immediately looked to Jim after answering all my questions.
If this sounds suspicious, that’s because it is. While clinicians are trained to address Kelly’s medical ailment, many of us fail to recognize the larger social cues right in front of us. It appears that Jim is in control of the situation. Kelly is young, maybe very young. As a clinician I must consider Kelly’s living situation, and her relationship with Jim.
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