I have been a physician assistant for more than 20 years now, but I encountered one of my most memorable patients during my first year in practice. At the time I was working in the women’s clinic at a county health department. A new patient came in for her routine annual pap smear exam. I remember she had her young son with her.

During the exam I noticed some suspicious bruises on the patient’s arms. I asked her how she got the bruises and she said she didn’t recall, but I could tell by the look on her face she knew. I told her I was concerned for her safety and asked her if she was being abused. She said no. 

I still shared with her resource information and phone numbers and encouraged her to seek help if she ever felt she and/or her son were in danger. She thanked me and walked out of the clinic.

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About six months later, I received a letter from this patient. In the letter the patient thanked me for recognizing her abuse. She said that I was the first person to ever ask her about her bruises, although they were a frequent occurrence. She said our encounter made her realize that she couldn’t hide the abuse and live in denial anymore.

A few weeks after her appointment with me, the patient said she found the strength and courage to leave her abusive husband. She and her son moved out of state, were living with family and were safe! 

Sometimes it is hard to ask our patients personal questions, because we don’t want to assume the worse or offend them. But if we aren’t asking them, who is? Clinicians need to be strong and advocate for our patients. It’s our job and they are depending on us.

Linda New is a physician assistant from DeBary, Florida.