it out in the suburbs with soccer moms and manicured dads and, well, people like me.
"What do you plan on doing?" I asked.
"Me and Terrell. We're real happy, Dr. Beck."
"How old is Terrell?"
"Sixteen."
She looked up at me, happy and smiling. Again I managed not to close my eyes.
The thing that always surprises me - always - is that most of these pregnancies are not accidental. These babies want to have babies. No one gets that. They talk about birth control and abstinence and that's all fine and good, but the truth is, their cool friends are having babies and their friends are getting all kinds of attention and so, hey, Terrell, why not us?
"He loves me," this fourteen-year-old told me.
"Have you told your mother?"
"Not yet." She squirmed and looked almost all her fourteen years. "I was hoping you could tell her with me."
I nodded. "Sure."
I've learned not to judge. I listen. I empathize. When I was a resident, I would lecture. I would look down from on high and bestow upon patients the knowledge of how self-destructive their behavior was. But on a cold Manhattan afternoon, a weary seventeen-year old girl who was having her third kid with a third father looked me straight in the eye and spoke an indisputable truth: "You don't know my life."
It shut me up. So I listen now. I stopped playing Benevolent White Man and became a better doctor. I will give this fourteen year-old and her baby the absolute best care possible. I won't tell her that Terrell will never stay, that she's just cut her future off at the pass, that if she is like most of the patients here, she'll be in a similar state with at least two more men before she turns twenty.
Think about it too much and you'll go nuts.
We spoke for a while - or, at least, she spoke and I listened. The examining room, which doubled as my office, was about the size of a prison cell (not that I know this from firsthand experience) and painted an institutional green, like the color of a bathroom in an elementary school. An eye chart, the one where you point in the directions the Es are facing, hung on the back of the door. Faded Disney decals spotted one wall while another was covered with a giant food pyramid poster. My fourteen-year-old patient sat on an examining table with a roll of sanitary paper we pulled down fresh for each kid. For some reason, the way the paper rolled out reminded me of wrapping a sandwich at the Carnegie Deli.
The radiator heat was beyond stifling, but you needed that in a place where kids were frequently getting undressed. I wore my customary pediatrician garb: blue jeans, Chuck Taylor Cons, a button down oxford, and a bright Save the Children tie that screamed 1994. I didn't wear the white coat. I think it scares the kids.
My fourteen-year-old - yes, I couldn't get past her age - was a really good kid. Funny thing is, they all are. I referred her to an obstetrician I liked. Then I spoke to her mother. Nothing new or surprising. As I said, I do this almost every day. We hugged when she left. Over her shoulder, her mother and I exchanged a glance. Approximately twenty-five moms take their children to see me each day; at the end of the week, I can count on one hand how many are married.
Like I said, I don't judge. But I do observe.
After they left, I started jotting notes in the girl's chart. I flipped back a few pages. I'd been following her since I was a resident. That meant she started with me when she was eight years old. I looked at her growth chart. I remembered her as an eight-year-old, and then I thought about what she'd just looked like. She hadn't changed much. I finally closed my eyes and rubbed them.
Homer Simpson interrupted me by shouting, "The mail! The mail is here! Oooo!"
I opened my eyes and turned toward the monitor. This was Homer Simpson as in the TV show The Simpsons. Someone had replaced the computer's droning "You've got mail" with this Homer audio wave. I liked it. I liked it a lot.
I was about to check my email when the intercom's squawking stopped my hand. Wanda, a receptionist, said, "You're, uh, hmm, you're, uh... Shauna is on the phone."