Monday, January 30, 2006

Dichotomy

Does anyone else share the dichotomy of feelings I have towards my patients and their families? On the one hand, I feel tremendous sympathy for them. Many of them are poor and uneducated, and frankly have not had many breaks in life. The stress of their everyday life is high, with concerns about money and transportation always near the surface. For those of us with our own cars, simply needing to take a bus to work or the hospital, as many of my patients' families do, would be a time consuming chore.

On the other hand, though, I feel tremendous frustration with some of them. It doesn't bother me if a teenager comes in with their first pregnancy. Accidents happen, anyone can make mistakes. But when a woman comes in with her fourth or fifth pregnancy at age 21 or 22, I want to say to them, what part don't you get? Don't you get that by having one baby as a teenager you greatly increase your chances of not finishing school, but that with two or more kids at an early age it's almost certain you won't get much of an education? Don't you get that you're condemning yourself to a lifetime of dependency and poverty? Don't you get that someday you'll want better for yourself and your kids, but you won't be able to do anything about it but buy lottery tickets?

I want to respect everyone, but some people sure make it hard.

12 Comments:

Blogger Barbados Butterfly said...

Frustrating indeed. But that emotion is proof that you care - and sometimes that's all that you can do.

5:23 AM  
Blogger PaedsRN said...

I wonder about that too. Thing is, I started switching back and forth between looking at them as individuals and as one node of a system.

Flattering, ain't it? Just another node... but this way, I get to look at all the other nodes linked to them, how they were affected, why they came to regard babies as something less than massively significant. I dunno... I guess it just helps me keep perspective if I see them in context. That and, just maybe, what I do will make a difference, one time out of a hundred.

4:06 AM  
Blogger PaedsRN said...

Oh, and welcome to medical blogging by the way :) Will be nice to have some more baby-based blog entries around, so I'm not the only one writing 'em!

4:08 AM  
Blogger TC said...

For a period of time I lived in a homeless shelter. I was lucky in that my middle class background gave me something to strive for, so I went back to school and finished my degree. But once I asked a little girl that lived there what she wanted to be when she grew up. She looked at me with utter amazement. She didn't know that she could BE something. She just expected to follow her mom's footsteps of being black and poor.

5:45 AM  
Blogger Alice H said...

My mom's partner's family seems to have that problem. We were so proud when one of her nieces made it to 18 without getting pregnant. Next thing you know, she's got two kids - three and a half and two and a half. They were taken from her two years ago, and I understand that she's been pregnant at least three times since then, but has miscarried.

I think there's something in the culture of their family and their neighborhood that encourages having babies at a young age. Her aunt, who is 34, has a year-old granddaughter, and no one thinks anything of it. There aren't many positive examples of women having careers in their family - really there are only two, and both of them are lesbians.

4:03 PM  
Blogger ~Moi~ said...

yes frustrating. the situation is hard to understand depending on how you were brought up. I wonder if some people have just lost hope in their situation or simply dont care.

12:24 AM  
Anonymous Chris and Vic (CAK) said...

I imagine these young women are simply following along in the footsteps of other women in their family/milieu. In addition, my guess is that as kids get older, they are taking care of their sibs, and so they know they can take care of babies/little kids. So, if your mom and grandma before did this teen-mom thing, AND you have been involved taking care of your younger sibs, it is kind of a logical,natural consequence.

Did any of us imagine, as teens, that we could and would achieve more than our moms? Is book-smart better than street-smart? Is it not bare-bones survival and nothing extra for people who are poor?

If I was the mom of a teen mom, I would take her down to the college campus and ask her to try to see herself/visualize herself in college, with a backpack of books, going to classes . . . using the campus daycare . . . getting up early, riding the bus, etc.

Tonight on public TV, there will be a show on Oprah and her ancestors--it is actually a show on genealogy. No doubt there will be discussion on "O" breaking out of her cycle of povery, how she did it, etc.
Chris and Vic

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