Things Fall Apart

We all make choices and have to accept their consequences, but there’s so much we can’t control. The patients I’ve taken care of that I admire the most are those that accept uncertainty with courage and grace. The patients that I sympathize with the most are those who have been deprived of the opportunity to have a choice.
Marie was a beautiful thirteen year old girl. Perfect chocolate skin, big brown eyes, and hair carefully braided into neat braids. She clutched a teddy bear to her side. and stared at me anxiously. For the first time I could remember, I wished I spoke French, Marie’s only language. She had fled the violence with her family in the French Congo five months ago, and they had immigrated here, where members of their devout church would help them assimilate. Not Marie though.
A physical examination is a required part of Customs, and Marie’s secret was discovered. As so many other women and girls in her country, she had been viciously attacked and gang raped before they were able to get permission to leave the country.
Marie was pregnant. She had never even had her period and had no idea how her body had betrayed her.
Ashamed of Marie, her family had hidden her and her pregnancy away from their religious community by separating her from her family. She was sent to a foster home for teen moms while the rest of the family established a home in the northeast corner of our city. They told church members she was ill, and had to be quarantined by U.S customs.
As Marie told the nurse they didn’t want her near her little sister, worried that “she might be a bad influence.” I felt a surge of hate for her parents when I heard that. Who could do that to their daughter? Is it her fault some asshole monsters raped her, tortured her, stole her childhood and saddled her with a pregnancy?
She was so heartbreakingly vulnerable as she sat in the Labor and Delivery bed clutching her teddy bear. Marie looked terrified, and remembering the violence she’d been put through, I struggled to think of how I could possibly make this ok for her. Again, I wished I could at least speak to her in her language, instead of through the telephone interpreter. But what could you say? What could make any of this ok?
There are some things that just can’t be fixed, but at least I wouldn’t make this worse.
I tried anyways. We got an in person interpreter. Social work was called, and the nuns from her group home arrived. They convinced her mother to come in. A dense epidural was placed. We limited exams, and asked her carefully about how she wanted the birth to go. The baby was to go up for adoption, and when I asked her if she wanted to see the baby she spoke the only word I heard her say; “NO.”
How do you survive pain and violence like that? Marie was having to learn how to do this alone at the age of thirteen. I have no idea how she found the resilience, and her strength made me ashamed of my own weakness. I knew my problems were trivial in comparison, but they weren’t feelings I could easily set aside. When you don’t have a choice you just have to keep going and do the best you can at that point in time.