Tuesday, August 29, 2006

A Sheep Amongst Wolves

Grand Rounds is up today, and there are lots of good reads.

Particularly riveting is a series of stories by different women bloggers about prior rapes. I marvel at their courage in being able to write about the experience. Too many of us have experiences like this but suffer in silence, not realizing that unfortunately, so many other share similar stories.

As you probably know, I'm currently working at the VA hospital, and for the most part, really enjoy the patients that come through. However, there was a recent incident that I've been trying to process. Nothing happened, but it brings up old fears, and having just read the aforementioned posts, I think I'll write about it here.

I like senior citizens. A lot. I have a wonderful relationship with my grandparents, especially my grandfather, and because of that, tend to see the elderly VA men as harmless, wise people that are to be respected for having lived to a ripe old age. I had heard from a co-worker that some of them were "lecherous old men," but had never really seen someone blatantly inappropriate. And although they are 80 to 90 year old men, I guess it's my fault for failing to remember that they are men first, before they are fathers and grandfathers, and they still have sexual urges. And perhaps the majority are not as "normal" as people who haven't been through the horrors of combat, and perhaps they cannot be blamed for being unable to control their thoughts, speech, and impulses. But even so, the physician-patient bond seems so sacred to me that the very thought that a patient would be sexually inappropriate just seems so alien. When I first meet a patient, I don't think "man," or "woman," but rather "new person," and I don't expect them to think "woman" before they think "doctor." So I was very unprepared for the almost 90 year old man who seemed appropriate enough during the visit, but as I got up to leave, started talking about how lonely his older brother was, how he lacked "female companionship," how he had tried to call an escort service and how he just wanted to feel up a woman. Saying so as he comes toward me with hands reaching toward my chest. Luckily I backed up quickly and got out of there with neither party harmed, but it was a chillingly close call that I would rather not relive again. And got me to thinking that, as a woman physician, being in the typical small, closed examining room with a male patient really has the potential for disaster. I've certainly had times when patients with psychiatric problems move closer and closer and block off my path to the door. What if this patient had been 40 instead of 90? What if he were bigger? What if he were crazy? Things might have turned out differently. And sadly, although I am now more aloof and guarded with male patients, I don't really know what anyone could do to prevent such a disaster from happening.

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