At the start of the second week of her rural rotation Allison walked into the small town highschool to talk to the juniors and seniors.
"This is Mrs Blouin," the principal introduced, "she is a medical student from the University of Washington and is here today to talk to you about safer sex."
"Good morning," Allison greeted, "I'm Allie and as your principal said I'm a third year medical student at the University of Washington. I'm here this month working with Dr. Mah and getting to know your families. I've seen a couple of you in clinic and it was an absolute pleasure getting to know you."
There were a few moans and groans in the crowd.
"Six years ago I was sitting in one of these assemblies already four months pregant," Allison continued, "for me this information wasn't too late. But for several of my friends it was. I'm not going to tell you not to because it is human and healthy in a loving relationship where both of you feel safe and loved, when you feel ready is up to you and your own decisions and values. I am here to talk about science. I'm going to leave my opinions on who should or when out of it today is about science. I have a beautiful and amazing six year old daughter with my husband who I have been with since highschool but Asher and I, Everly, our family is the 1% chance. I was one of you, I was scared, isolated, alone and felt like no one understood me. The last seven years have been a fight to move forward. I knew about my birth control options, I knew about safer sex. My parents had talked about it, my school had even my big sister had talked to me but I let my guard down at a party. I partied a bit too hard and listened to a boy I liked and now we've been married a few years and are rasing a special needs child. That doesn't have to be your story, learn from mine. I was frankly stupid, I was drinking underage and had too many, I wasn't aware of my decision making or in full control of it, I know I said yes but the next morning wasn't so sure about my decision. Had I spoken up and gone to someone I trusted I might have taken plan B, if I had had the courage to tell my mom or my big sister either of them would have gone and gotten it for me. If this is you please talk to someone you trust, talk to Dr Mah and there is help. Talk to the people you love and trust. I didn't and I spent weeks worried which probably only made it worse for me. When my period was late and I was scared I went to my big sister, and Annie helped me get blood work done and confirm what I suspected, she told me I was pregnant and when I got scared and started crying she just hugged me then helped me tell our mom. I thought my parents would be furious but they hugged me and held me and told me it would be okay. They helped me tell Asher who was then a good friend and is now my husband and guided us through my pregnancy and having a baby, they still help us when we need it."
"How do you get to have a baby, go to college and medical school," a girl in the back called out.
"Because my husband and family support me and help," Allison replied, "I know I'm one of the one percent who have that happen."
"How do I," the girl called out.
"We can talk after," Allison assured, "let's look at the science."
Allison continued the scientific portion of the presentation explaining the menstrual cycle and when it was more likely that a female could conceive.
"Do you have any questions for me," Allison asked.
"How did you tell your daughter," a girl asked.
"Everly hasn't asked about how old Asher and I were," Allison replied, "as far as she knows we've been together her whole life. We will tell her when she asks or the time is right. We answer her questions as they come up with proper medical terms and facts in an age appropriate way. When her baby cousin was born she asked where babies come from and we told her. My sister in law is having her second in a few weeks and Everly has asked questions and we answer, she wanted to know why Auntie Sierra's tummy was getting bigger so we explained it. When she asked where she grew I showed her pictures of me and her dad a few days before she was born."
"Ms Blouin," the principal interrupted, "do you have time to speak to the students who have questions for you after the assembly?"
"I do," Allison assured, for the first time she wanted to use her story to help teenage girls, girls like her. What she had needed was someone who had been there. She was only here for a month but she would make it work to support and mentor these girls.
Taylor continued the assembly discussing vaccines and how they were developed and the safety of it.
After the assembly the principal led Allison and a group of girls to the library. Allison looked at the girls, some with defined baby bumps.
"Have a seat," Allison gestured to the cozy looking couches in one part of the school library.
"Why are you here," a girl asked.
"Because I was one of you," Allison smiled, " I know how hard and lonely this is. I know you feel like no one gets it at all."
A couple of the girls nodded.
"I'm here to listen and to support you how I can," Allison replied, "I've spoken with your principal and I'm going to give you my email and we're going to set up a weekly zoom meeting to come together and talk. The six of you can be together somewhere, Mrs. McCarthy has offered to host it here with snacks. The girls in this room can be your biggest support. I'm from Seattle. It's a big district and they have a program for moms, some of my closest friends I met in that group. We still get together once a month with our kids who are six."
"Really," one of the girls asked.
"We do," Allison said, "can we start by introducing ourselves? I like to know everyone's names."
The girls went around the room introducing themselves. As they chatted Allison shared about the importance of prenatal care and being open and honest with the doctor.
"Can you deliver my baby," one girl asked.
"I can't," Allison replied, "I'm only physically in town for a month and I can work with Dr Mah but I'm not a physician yet."
"How did you handle it," the girl asked, "I have a month and my baby is here and I'm scared of labor."
"My husband well boyfriend at the time, mom and sister were with me," Allison replied, "and it was hard and scary and I didn't understand it even though I had been to classes and seen videos and done the research. It hurt. I'm not going to lie to you. It really hurt. Ev had a big head."
"How did you," the girl pressed.
"I tried to trust my family, I cried, screamed, I had an epidural," Allison replied, "I let my anxiety take over and made it worse for myself."
"Would you have another," the youngest looking girl in the room asked.
"We will when I finish med school and have a couple years of residency finished," Allison replied, "my older sister and I are 25 years apart so as long as it's closer than me and her we're good."
"Do you regret it," another girl asked.
"No," Allison smiled, "I do not regret my family. But it's not the only option. I have friends who are wonderful single mothers either by their own choice or circumstances. I know a couple others who chose adoption and chose loving families for them, some are involved and others chose closed adoptions. My brother was adopted and two of my cousins are."
"What should I do," a girl with red hair asked.
"I can't tell you that," Allison replied, "you are the only one who can make that decision. How far along are you?"
"23 weeks," the red head replied.
"Feeling okay," Allison asked, "how is everyone feeling?"
"Not great," a brunette admitted.
"What's going on," Allison asked.
"I'm throwing up every day still," the brunette replied.
"How far along," Allison asked.
"22 weeks," the brunette replied.
"Soon sweetheart," Allison replied, " is it improving? Talk to your doctor."
"My mom won't let me be alone with Dr Mah," the brunette replied.
"Avery you have a right to your medical care," Allison assured.
"I'm 17," Avery replied.
"You still have a right to a private conversation with your medical practioner," Allison assured, "you all do. It's your choice if anyone else attends with you."
"I don't want to keep my baby," Avery said looking at her shoes, "I don't want to kill them but I'm not ready to be a mom."
"Then there's supports, you can find an adoption agency or talk to social services and place your baby for adoption," Allison replied.
"My mom said I have to keep it and raise it because she was stuck with me," Avery replied.
"No," Allison replied, "you have a choice for you. You get to make your own decisions."
"How can we help," the redhead asked.
"Stick together," Allison advised, "the six of you need to support each other. You don't have to be best friends but you should stick together."
"Do you have other friends," a blonde asked.
"I do," Allison replied, "you need them and your friends. The people who make you feel normal but you need people who understand you as well."
"My mom doesn't know," a second brunette said.
"Alivia you should tell her," Allison replied, "does anyone you trust know?"
"My dad," Alivia answered, "I live with him and my step mom, they know."
"Good," Allison said, "are they supportive?"
"Grace is we talk a lot," Alivia answered, "I don't think my dad knows what to say."
"Mine didn't always," Allison said, "does he show support other ways?"
"He drives me to school now I used to walk," Alivia said, "he's turning the attic into two rooms and putting a new bathroom up there."
"That is support," Avery replied.
"It is," Allison said, "my dad didn't know what to say but he did things."
"Mine makes my favourite dinner," the red head said, "or food that I want to eat when I want it."
"Good," Allison smiled, "lean on your family. It's hard."
"It is," Avery said.
"When does it get better," Alivia asked.
"Slowly," Allison said, "you get to know your baby, your body eventually finds a new normal, you figure out how to balance life. I think my daughter was about a year before I felt really settled. I had a lot of melt downs. Nights I sat up sobbing and I had to learn to trust my family. To trust Asher. I started to see my mom in a whole different light."
"Your mom," Alivia asked, "what did she say?"
"What ever I decided it was my choice and she would be with me every step of the way," Allison replied, "and she's kept true to her word. This month being away is hard. Trusting my daughter is okay without me. You always worry and you always want them to be happy."
"Your husband," Avery asked.
"He's a good dad," Allison replied, "Ash is a good man. I don't know what I would do without him. He's my first love, my only love. But that's our story. Yours will be different because you are you. Your story will look different from the rest of your family, from the other girls here and thats okay. Support and love each other no matter how different your stories are."
"Can we do it," the sixth girl asked.
"You can," Allison promised, "it won't be easy what ever you choose. You are the one to decide what happens next. I do know you can do it just like I know it's hard and lonely and scary I know you can do it."
"Are you sure," Avery asked.
"I'm sure whatever you choose will be right for you and your baby," Allison assured, "and that you can do it."
Beside Allison Avery began to cry.
"Can I give you a hug," Allison asked.
Avery nodded and Allison hugged the girl, "you are so strong Avery. You can do this."
Later that afternoon Allison joined Taylor and Dr Mah at the clinic.
"How did it go," Dr Mah asked.
"I think it went well," Allison replied, "the girls talked to me and eachother. I left them my email and my number and I'll help as much as I can."
"Have you ever considered OB," Dr Mah asked.
"No," Allison replied.
"Specalizing in young girls like that," Dr Mah questioned.
"No," Allison replied, "I would as out reach but I want orthopaedic surgery. I want to help kids like my daughter."
"Ms Allie," Avery appeared in the small clinics waiting room.
"Avery," Allison said, "what can we do for you?"
"I don't feel right and I was walking by on my way home from school," Avery replied.
"Let's get you checked out," dr Mah said, "Allison would you like to do the exam?"
"Avery are you okay if I help Dr Mah with the exam," Allison asked, then she remembered what Carina Deluca had told her years before, "I am always going to get your permission before I touch you and at any time if you've had enough, feel uncomfortable or need a break I will stop. It is your body and you are the only one who can decide. You are a smart, beautiful and powerful woman. Can you tell me what feels weird?"
"There's something fluttering in my belly " Avery said, "what's wrong with my baby?"
"Have you felt them kick," Allison asked.
"No," Avery answered.
"We'll do an exam and possibly an ultrasound but my thinking is that's the first time you've felt kicks," Allison answered.
"That's them," Avery grinned, the smile slowly spreading across her face.
"Let's confirm but I think so," Allison smiled.
Avery rubbed her bump, "hi baby."
"Not so abstract now is it," Allison asked.
"It's a little person," Avery smiled.
"It is," Allison agreed, "let's get you in the exam room and double check."
"Avery would you like to see them," Dr Mah asked, "it's not the best images but I have a portable ultrasound."
"Yes," Avery agreed.
"So Avery," Dr Mah said, "baby looks very healthy and is growing right on track. Do you want to see them?"
"Please," Avery replied.
Allison pointed out the parts of the baby to the teen, "Avery do you want to know the gender?"
"Can I," Avery asked.
"You can," Dr Mah replied, "Allison."
"Are you ready," Allison asked, "it's your decision. Dr Mah and I know but we can keep it to ourselves."
"I want to know," Avery said.
"Okay," Allison smiled, "you're having a baby girl."
"A girl," Avery smiled.
"A beautiful baby girl," Allison confirmed.
"Hi princess," Avery whispered.
After the ultrasound Allison said, "Avery earlier you mentioned on going nausea. Do you want to discuss it with Dr Mah?"
The teen nodded. She shared her concern with Allison and Dr Mah who suggested a couple things to try and agreed that if it didn't improve they could try medication but he was hesitant to jump straight to it.
"Ms Allie," Avery said, "do you think if I still wanted to go to college I could?"
"Of course," Allison assured, "the more education you have the better for you. Your education, your mind can never be taken away from you. Having training and skills will always help you. What are you thinking?"
"I want to be a nurse," Avery said, "like the type Mel is in that Netflix show Virgin River. "
"A nurse practitioner," Dr Mah said, "totally doable Ms Avery. I'll even make you a deal. You get into nursing school and the clinic can help pay for your books and there's a job here when you graduate."
"Dr Mah," Avery gasped.
"I've known you since before you were born," Dr Mah said, "I delivered you. I'm friends with your grandpa. Talk to him I'm sure he'd love to help and I can promise you a job when your done."
"If I have my baby," Avery asked.
"It's hard but you lean on your people," Allison said, "it's do able. Not easy but do able. And you can always call, text or email me."
"Avery," a woman in her early 30s called entering the clinic, "what's wrong?"
"Nothing is wrong," Dr Mah said, "Britney don't worry."
"What happened," Britney asked.
"I get fluttering and I got scared and it's on my way home from school," Avery said, "mom they're moving."
"Wow," Britney said.
"We did an ultrasound," Dr Mah said, "both are healthy."
"Mom it's a girl," Avery smiled, "she's a little girl. If I want to go to nursing school how will we?"
"A girl," Britney said.
"Yes," Avery replied.
"Let's go home," Britney said.
They walked out of the clinic.
"Allison you really need to consider it," Dr Mah said, "you connected with Avery in a way no one else in town could."
"I don't want to though," Allison replied, "my story isn't to soothe patients. It's my life, it's my family. I am happy to mentor and share and work with small groups like today but my career I want to help kids like my daughter."
"What about family medicine," Dr Mah asked.
"I would do paediatrics first," Allison replied.
"You two did well today," Dr Mah said, "we've had a few older kids come for vaccines and some appointments booked. Avery I've been trying to reach for months and I was worried about her but you got her to smile today."
"Follow up with her," Allison said, 'and remind her she can always call or text me. What's tomorrow?"
"Clinic day," Dr Mah said checking his tablet, "nothing out of the ordinary for a family practice. Diabetes care, changing a wound dressing, some routine follow ups and whatever walks in the door."
"Do you still do house calls," Taylor asked.
"I do if the situation warrants," Dr Mah replied, "some of my elderly patients, new babies I go to them. Sick kids are sometimes better for me to go see. I talk to the patient or their family member and we decide if they can come in or if I should go."
"What's the criteria," Taylor asked.
"Transportation, age, concerns," Dr Mah said, "you learn to listen to the person on the phone, the sounds in the back ground and you know your community like this. Today I'm Dr Mah, Thursday I'm coaching tennis at the school. The kids learn to trust me because I'm part of the community. In small town practice you have to be part of the community and you're always on call you could be the only doctor for a couple hours drive and you have to be prepared to do it yourself. Rural medicine isn't for the faint of heart. It doesn't have the glamour of surgery but it's got a lot more heart and you have way more of a connection to your patients. I did a surgical internship and my second year of residency when I decided I wanted to connect with my patients more. The connection is important. You saw that today. Taylor, you had those kids at ease with you and you built rapport with them. You shared your story about the community you grew up in and your family. Allison, you built rapport with Avery and got her to talk to me for the first time instead of hiding behind her mom. Today you built rapport with patients. You get sent to your rural rotation to learn two things, building rapport with a community and resourcefulness. You two both have the first one, so I'm going to focus on the second with you. I'm going to have you treat patients and take the lead."
"Thank you," Taylor said.
"Thank you," Allison replied.
"Go get some dinner, a good nights rest and I'll see you tomorrow," Dr Mah said grabbing his bag and keys from his desk.
Reaching their hotel room Taylor suggested, "do you want to do an easy dinner then throw some wine in travel mugs and sit in the hot tub?"
"Easy dinner," Allison agreed, "and hot tub but I can skip the wine."
"Not a wine fan," Taylor asked.
"Rarely drink," Allison replied.
"A little bit after a day like today," Taylor said, "celebrate our success."
"One glass can't hurt," Allison agreed.
"That's what I'm talking about," Taylor smiled, "easy dinner ideas?"
"Pasta or tacos," Allison suggested.
"Tacos," Taylor agreed.
"Grocery store first then," Allison responded.
That night they sat in the hot tub with their wine.
"You've never done this," Taylor asked.
"I haven't had the chance," Allison admitted, "I don't parent after more than one drink."
"What do you think," Taylor asked.
"It's good," Allison replied, "like a real girls' night."
"It is," Taylor smiled.