Response To Self-Harm When Getting Medical Care
My stomach aches when I sit in the waiting room with my daughter at any of her checkups. She has had so many appointments this last year, from cardiologists to gastroenterologists, and an endless amount of various mental health visits. For each of them, the same thing has to be explained. At every blood draw I watch her pull her sleeve up in the lab chair, and each technician seems to have a different response. Some say nothing, some will inquire, some look horrified. Sometimes we just say outright that she has self-harm history. I have also spoken to nurses or providers outside prior to starting the visit, just to give some warning of the issue.
We went to a dermatologist last summer, which was so highly rated. We wanted to get advice on scar treatment if that was appropriate, because my daughter’s large scars itch and are very pigmented in color. I have heard there is a window of time in which to treat those, after the injury, so we wanted to inquire. It was packed in the waiting room, and we waited over an hour. Once in the room, it was clear that we were being rushed along. She did not want me to stay in the room, so I explained the issue and waited in the hallway. The dermatologist did not respond with a good bedside manner, in my opinion. She didn’t look closely at the scars, and she wasn’t empathetic. She didn’t reassure or offer any real advice on options in treating them. She prescribed two ointments and sent us on our way. She had barely exited the room when she walked directly into another patient room. It was evident that she was overbooked but her utter lack of empathy left us frustrated. It took a huge amount of trust to undress and allow a stranger to look at her scar-ridden body, just seeking out help.
It also reminds me of the first time I took her to the emergency room for an injury on her arm that needed treatment. When we got into the evaluation room, one nurse was kind but the other attacked her. “What did you do this with? What did you use? Were you trying to kill yourself?” Over and over she asked her these questions in a stern tone, and my daughter was unable to answer them. She looked down the entire time and was only able to nod that yes, she would like to be evaluated. We then entered the mental health unit where we spent the next 6 hours talking repeatedly to the various medical providers. None of them had the same tone or treatment that the initial nurse did when we came into the unit. We were approached with empathy and kindness. Again, it made such a difference in my daughter’s response to being treated.
This week my daughter had her first visit to gynecology and I explained that since she’s 18 and would be going in alone, she would need to explain the circumstance since the provider would see her legs and know. She came out happy and relieved after the appointment and said they were very nice. They asked her about counseling and services to be sure she was getting the help she needed, and wanted to be sure a parent was involved and aware. They did not judge her or make her feel badly for having these injuries. She was able to go and take care of a health issue independently, without dread.
Response to this situation is so varied. It makes a huge difference to respond kindly and gently in these circumstances, and I do think it has a great impact on getting medical care when needed. We don’t want those that self-harm to avoid medical checkups or necessary appointments for fear of being judged or looked on negatively by providers. It is important to teach our teens especially, to advocate for themselves, and speak up if they aren’t getting the proper level of care. It is my hope that more providers will approach these occasions with compassion and patience.
