Devoreaux: Hey there, Alexandra. What’s going on today?
Alexi: Hiya Dev! Remember, please call me Alexi. I’m so not an Alexandra.
Devoreaux: Oh, yes, of course, I’m sorry I forgot you asked that last year. Let me make sure that’s listed in your health record!
Alexi: Ugg. My stomach hurts so much lately and I’ve been throwing up a lot. Or at least feeling like it.
Mom: Devoreaux, can I speak to you privately?
Devoreaux: Of course. Let’s step into the hallway.
Mom: She also hasn’t been acting like herself lately. I think something else must be going on, but she won’t tell me anything. She didn’t even want me to come today, but
Alexi: [calling through the closed door] Hey, Mom, why don’t you just go to the waiting room, okay? I can handle this on my own.
Devoreaux: How about I talk to Alexi while you wait for her? Teenage girls often will open up to me when their parents aren’t in the room, okay?
Devoreaux: So, Alexa...I mean Alexi, what’s going on in your life? Do you have a boyfriend? Or a girlfriend?
Alexi: Boyfriend, yeah. Gregor is totally awesome.
Devoreaux: Are you sexually active?
Alexi: You aren’t going to tell my mom what I say, right?
Devoreaux: Of course not! Any information that you share with me will be kept confidential. So...are you sexually active?
Alexi: Uh huh. [in agreement]
Devoreaux: What kind of birth control are you using?
Alexi: Ummm, nothing?
Devoreaux: When was your last period?
Alexi: Uh, I dunno. Maybe about…..6, 7, eight weeks ago? Like 2 months maybe? I don’t really pay attention because they are kind of irregular. But they aren’t heavy so it’s not that big of a deal if I’m surprised.
Devoreaux: I’m going to recommend a pregnancy test.
Devoreaux: Alexi? It's positive, you are pregnant.
Alexi: [silence]
Devoreau : Would like me to ask your mom back in so I can discuss this with both of you?
Alex : No. Oh, god, no, absolutely not!
Devoreaux: Ok, but if you need help talking with her or we can have you work with a family counselor, if you’d like. The office has several options to collaborate with outside resources. Meanwhile, you need to make a prenatal appointment with an OB-GYN, start taking prenatal vitamins, and….
Devoreaux gets a call later that day.
Mom: Hi, this is Alexi’s mom. I’m wondering what happened earlier today? Alexi came out of the appointment very upset and won’t tell me what diagnosis you gave her.