“I want your expert advice, doc,” said Nurse Zulu. “Can you see this patient with me? I don’t know what is going on.”
The patient was a 15 year old girl who had been complaining of bellyache for the past two weeks. She had been seen last week and given some antacid tablets for indigestion, but this medication had not helped.
She said that the pain was in her lower abdomen, but she didn’t volunteer any further information. It was not related to her periods, eating, passing urine or moving her bowels. It was constant, nothing made it worse or relieved it. She was not taking any traditional medicine, she had no past history of note and there was no family history of abdominal pain. “Kunyanga, ” she kept repeating, bellyache.
“Have you ever had sex?” I asked. “Is there any discharge?”
No, she said she was a virgin.
She laid on the examination couch and I felt her tummy. She winced as I pressed on her lower abdomen. I said that it would be helpful to do a gentle internal examination and she agreed. I put on my super bright headlamp and Nurse Zulu said, “That’s doctor’s magic light. It can tell if you are a virgin.”
The girl’s eyes widened and she whispered, “OK, I lied. I had sex last month!”
She had pelvic inflammatory disease.