I tap in my password and hit the return key. The computer adds my electronic signature to the chart and I click onto the next patient on my schedule. Reason for visit: hormone consult. I sigh and begin to frame what I plan on saying to the patient about hormone testing, therapy, risks and benefits. I walk to my exam room and lift the papers out of the chart rack by the door. I turn them over and look at the name. I raise my hand to knock on the door and I see her age. 12 years old.
"I want her hormones checked. She has had two periods and they were more than a month apart. She is angry one minute and crying the next. She doesn't like boys but all her friends do and that makes her cry because all they want to talk about is boys. Her boobs have just exploded! She fights with me all the time and I am just tired of her. She needs to get her act together. She needs her hormones fixed because there is just something wrong with her. And she needs on birth control. I hate her....but it's OK honey, I really do still love you."
I stare at the mom in disbelief. I look at the girls eyes as they start to fill up with tears and then I see her turn angrily at her mother. "Well that's OK cuz I hate you anyway."
I spend the next twenty minutes explaining normal puberty, middle school angst, variable maturation rates of teenagers and try to explain why a hormone evaluation isn't needed. I also try to explain as gently as I can why birth control is a bad idea for a 12 year old who doesn't like boys yet and who is still developing. After they leave my office I don't know whether to laugh or cry. I spend five minutes tapping out a note about our visit. I tap in my password and hit the return key. Then I click onto the next patient on my schedule.