progressed. This service fulfilled a need of her own and was done in an unintrusive, sensitive
manner.
The social worker played a crucial role in the later management of this patient as well as her doctor,
who was informed of her wish to share more personal matters with him.
The following is an interview of a seventeen-year-old girl with aplastic anemia, who asked to be
seen in the presence of the students. An interview with her mother took place immediately
afterwards, followed by a discussion among the medical students, attending physician, and nursing
staff of her ward.
DOCTOR: I think I'll make it a little easy on you, okay, and let us know please if you get too tired
or are in pain. Do you want to tell the group how long you have been ill and when it all started?
PATIENT: Well, it just came on me.
(P178)
DOCTOR: And how did it come on?
PATIENT: Well, we were at a church rally in X, a small town from where we live, and I had gone
to all the meetings. We had gone over to the school to have dinner and I got my plate and sat down.
I got real cold, got the chills and started shaking and got a real sharp pain in my left side. So they
took me to the minister's home and put me to bed. The pain kept getting worse and I just kept
getting colder and colder. So this minister called his family doctor and he came over and said that I
had an appendicitis attack. They took me to the hospital and it seemed like the pain kind of went
away; it just kind of disappeared by itself. They took a lot of tests and found that it wasn't my
appendix so they sent me home with the rest of the people. Everything was okay for a couple of
weeks and I went back to school.
STUDENT: What did you think you had?
PATIENT: Well, I did not know. I went to school for a couple of weeks and then I got real sick one
day and fell down the stairs and felt real weak and was blacking out. They called my home doctor
and he came and told me that I was anemic. He put me in the hospital and gave me three pints of
blood. Then I started getting these pains in here. They were bad and they thought maybe it was my
spleen. They were going to take it out. They took a whole bunch of X-rays and everything. I kept
having a lot of trouble and they didn't know what to do. Dr. Y. was consulted and I came up here
for a check-up and they put me in the hospital for ten days. They ran a whole bunch of tests and
that's when they found -out that I was aplastic.
STUDENT: When was this?
PATIENT: That was about the middle of May.
DOCTOR: What did this mean to you?
PATIENT: Well, I wanted to be sure it was too, because I was missing so much school. The pain
hurt quite a bit and then, you know, just to find out what it was. So I stayed in the hospital for ten
days and they ran all kinds of tests and then they told me what I had. They said it was not terrible.
They didn't have any idea what had caused it.
DOCTOR: They told you that it was not terrible?
PATIENT: Well, they told my parents. My parents asked me if I wanted to know everything, and I
told them yes, I wanted to know everything. So they told me.
STUDENT: How did you take that?
PATIENT: Well, at first I didn't know and then I kind of figured that it was God's purpose that I got
sick because it had happened all at once and I had never been sick before. And I figured that it was
God's purpose that I got sick and that I was in his care and he would take care of me so I didn't have
to worry. And I've just gone on like that ever since and I think that's what kept me alive, knowing
that.
STUDENT: Ever get depressed about it?
PATIENT: No.
STUDENT: Do you think others might?
PATIENT: Oh, someone might get real, real sick. I feel that, you know, there's no reassuring thing,
but I think everybody who gets sick feels that way once in a while.
STUDENT: Do you wish at times that it was not your parents that had told you about the condition-
you wish maybe the doctors had told you about it, had come to you?
PATIENT: No, I like my parents to tell me better. Oh, I guess it was all right that they had told me,
but I would have kind of enjoyed that so much ... if the doctor had shared it with me.*
STUDENT: The people that have been working around you, the doctors, and nurses, do you think
they have been avoiding the issue?
PATIENT: They never tell me anything, you know, just mostly my parents. They have to tell me.
STUDENT: Do you think you've changed your feelings about the outcome of this disease since the
first time you heard about it?
PATIENT: No, I still feel the same.
STUDENT: Have you thought about it long?
PATIENT: Uh huh.
STUDENT: And this hasn't changed your feelings?
PATIENT: No, I went through the trouble, they can't find veins on me now. They give me so many
other things like that with
----------------------------
* Here she expresses her ambivalence about being told by her parents in stead of the doctor.
----------------------------
(P180)
all these other problems, but we just have to keep our faith now.
STUDENT: Do you think you've got more faith during this time.
PATIENT: Uh huh. I really do.
STUDENT: Do you think this would be one way that you've changed? Your faith is the most
important thing then that will pull you through?
PATIENT: Well, I don't know. They say that I might not pull through, but if he wants me to be well,
I've got to get well.
STUDENT: Has your personality changed, have you noticed any changes each day?
PATIENT: Yes, because I get along with more people. I usually do, though. I go around and visit a
few of the patients and help them. I get along with the other roommates, so I get someone else to
talk to. You know, when you feel depressed it helps to talk to someone else.
DOCTOR: Do you get depressed often? Two of you were in this room before, now you are all
alone?
PATIENT: I think it was because I was worn out I haven't been outdoors for a week now.
DOCTOR: Are you getting tired now? Tell me when you get too tired, then we will finish this
session.
PATIENT: No, not at all.
STUDENT: Have you noticed any change in your family or friends, in their attitude toward you?
PATIENT: I've been a lot closer to my family. We get along well, my brother and I were always
close when we were small. You know he's eighteen and I'm seventeen, just fourteen months apart.
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