to be rehashing all the reasons why that particular fantasy wouldn’t ever come true.
Taking a steadying breath, she knocked on the door and entered the exam room.
With tachycardia, bulging eyes, and rapid weight loss, her first patient probably suffered from hyperthyroidism. After giving him a complete examination she gave a lab slip to the nurse and asked him to schedule a follow-up appointment for a few days hence.
Chelsea washed her hands and went to the next patient room to read the chart notation.
Five patients later, and feeling good about her morning, she stood outside an exam room, reviewing the nurse’s note. Hannah Belew. Sixteen. Wants to go on oral contraceptive.
“Hi, Hannah.”
The petite young woman on the exam table didn’t appear to be in her teens, much less like she should be asking for birth control. However, Chelsea refrained from pointing out her observation as the girl already looked like her hackles were up.
“The nurse’s note says you’d like to discuss birth control. I’ll need to ask some questions so you and I can decide together which birth-control option is the most appropriate for you.”
“OK,” the girl said with a pink tinge to her cheeks. She didn’t meet Chelsea’s gaze.
“Have you ever had a pelvic examination before?”
Mouth agape, the girl shook her head. “No way.”
“Are you sexually active?”
She hesitated, giving Chelsea her answer.
“You won’t tell my mom any of this? Patient confidentiality and all that, right?”
A sticky question if ever there was one.
“I’m not obligated to tell as long as you’re not threatening your life or someone else’s.”
“I have a boyfriend,” Hannah admitted, apparently satisfied with Chelsea’s response. The young girl shrugged her shoulders. “He likes sex.”
“Do you?” Chelsea asked the obvious question, catching the teenager off guard.
“Like sex?” Hannah averted her eyes and took a moment before answering. “I like my boyfriend.”
Apparently Chelsea wasn’t the only one who could answer with diplomacy.
“Hannah, if your boyfriend really cares about you, he’d like you regardless of whether or not you agree to have sex.”
Regardless of whether or not long scars marred your back.
Kevin hadn’t, and Chelsea often wondered if the scars from his rejection ran deeper than those of the surgeons who’d operated on her scoliosis.
Then again, Jared had also rejected her, without having seen the imperfections of her body. But she’d understood, even respected his determination to do the right thing as she’d been underage.
Hannah didn’t speak, but Chelsea could feel walls being thrown up. The young girl didn’t want to hear what needed to be said.
“At your age,” Chelsea continued, “abstinence is most often the wisest choice, but, regardless, sex is an important step in a relationship. Both parties should be ready for that step and should enjoy making that step when the time arrives.”
“He didn’t force me,” Hannah said pointedly.
“Perhaps you were ready for that step,” Chelsea continued gently, “but perhaps you weren’t and only went along with what your boyfriend wanted because you were afraid of losing him.”
Hannah’s lower lip disappeared into her mouth and the girl squirmed on the exam table, crinkling the protective paper covering the vinyl top.
“It’s my job to help you take care of your health. That means your mental and emotional health as well as your physical.”
“I’m not sick,” Hannah insisted. “I just want to go on the Pill so I won’t get pregnant.”
“Even if you go on the Pill, you still need to make your boyfriend wear a condom. The only way to protect yourself from sexually transmitted diseases is to abstain or have your partner wear a condom.”
“Or to have sex with a virgin,” Hannah added with a touch of irritation. “I know all this already. We went over this stuff during health class when I was in junior high school.” She eyed Chelsea suspiciously. “You’re going to tell my mom, aren’t you?”
“No, but I recommend you tell her.”
“Me tell her? You have got to be kidding me.” The girl snorted, her expression dramatic. “I thought you said your job was to look out for my health, not to get me killed.”
“Your mom wouldn’t kill you.”
“Maybe not,” Hannah admitted. “But she wouldn’t let me see Brett anymore, and that’s worse than dying.”
Having fallen hard for Jared at only a year older than Hannah, Chelsea wouldn’t judge the girl. Neither would she point out that her entire life was ahead of her, whether Brett remained in her life or not.
“Whether or not you tell your mother is your choice. My job is to give you the best information I can so you can make wise health-care decisions. In this case, having an open discussion with your mother is what I believe to be best.”
Ha, like she’d ever had an open discussion with her own mother. These days, she and Iva only saw each other a couple of times a year. Thank God, as she didn’t think she could survive more. Only through Will did Chelsea find contact with her parents tolerable. Sometimes she wondered if they would even include her in family activities if not for her brother.
What right did she have to advise Hannah to tell her mother? What if Hannah’s mother made Iva look warm and cuddly?
“It’s your call,” she said softly. “But I want you to at least consider talking with her.”
“Sure.” Sarcasm never dripped as thickly as it did off Hannah’s flippant tongue.
Chelsea took a deep breath. She didn’t seem to be getting through to the teenager.
“OK, let’s move on. We’ll discuss the different birth-control options you have.”
Hannah’s gaze narrowed. “What kind of options?”
“Pill, patch, shot, cervical cap, intra-uterine device, all of which require a pelvic examination first.”
The girl cringed. “You have to see me down there?”
“To do the thin prep test that checks your cervical and vaginal cells, I have to physically examine you.”
The girl’s face fell. “I don’t think I can do that.”
“Have a pelvic exam?” Chelsea clarified, wanting to make sure she understood
