Tough Conversations

I hate these conversations.

Today while sitting at the nurse’s station I was approached by two nurse’s aids. One had that “I have a problem but I’m afraid to ask for your help” look. I tried to allow her to feel at ease and made some small talk. I have no problem with staff asking me questions unlike some physicians/NP’s/PA’S. After some small talk the CNA leaned over the counter and whispered to me:

What does it mean when you have greenish stuff leaking from your breast?

OK, keep your face neutral I thought. The other CNA at the desk tried to hide her expression also as I thought.

I asked her if anybody in her family had had breast cancer.

You could see the wheels turning as she struggled to answer. She hemmed and hawed and avoided the question.

I asked her again. She danced and dodged and tried to find a way not to answer, finally she said;

My grandmother died from breast cancer.

How old was she when she was diagnosed, I asked.

She tried to change the subject and I never did get an answer out of her. She started to walk away when my question interrupted her. When was your last pap I asked?

I have two kids she answered. The oldest is seven.

I asked again, when was your last pap smear?

Seven years ago she answered. I don’t have any health insurance…

Look, I said, what I am going to tell you is going to scare the hell out of you but I have to say it.

Whenever someone has greenish fluid leaking from a breast the first thing we think is the big “C” Cancer (holding my hand up and making a big “C” with my thumb and fingers.)

I hate doing something like this. I wish I had an office where I could see and treat her and order tests regardless if she could pay for them or not. I’d pay for them myself if I could afford it. I suggested she head to planned parenthood and get a pap smear. While there they can help her with the names of organizations that can help her get the proper blood work, ultrasounds, and mammograms. I’ll dig up the resources I have but it does not make me feel any better.

I hate these conversations…

links: digg this    del.icio.us    technorati    reddit