I once worked in an area populated by a large number of people from a certain ethnic group. Suffice it to say that most Americans, given their xenophobia, are not particularly enamored with this group of people. In an attempt to prevent my untimely death, I won't name this group, but I will discuss things about them that most Americans would find peculiar.

Their pain tolerance, or lack thereof: Judging how much pain a person appears to be in is certainly a useful clue for a doctor (or a mother, for that matter). This diagnostic tool is virtually useless in many members of this group, unfortunately. I've had some patients, with nothing more than a sprained wrist, bellow a bloodcurdling scream that made me wonder if they were giving birth to twins and passing a kidney stone at the same time.

Their social support system: I am all for a good network of friends and family to support a patient in need of TLC, but this can be overdone. Way overdone. On many occasions the patient would come in during the middle of the night not just with their family members, but also with a few dozen people from their block, all dressed in pajamas. The ER was too small to hold all of these folks, so they would roam the hospital's hallways and even its ORs. OR access is restricted for sanitary reasons, but the “Do Not Enter” signs meant nothing to them.

Their code of honor: If they felt that their family honor was debased by a fornicating 16-year-old daughter, the father might kill the daughter. As they say, father knows best, correct?

I actually met a family in which the father had murdered his teenage daughter after she became pregnant. A few years after this happened, they brought another daughter to the ER, complaining of abdominal pain. “Oh no!” I thought, “is she pregnant?” Medically, it was a plausible explanation for all of her symptoms and signs, and I had to find out.

The nurse took me aside. Whispering into my ear, she told me of the first murder, and said that I shouldn't let any men in the family know that I was ordering a pregnancy test. Given their propensity to go wherever they darn well pleased, it was impossible to keep them away from the desk where I was writing my orders. Consequently, I employed a high-tech security measure: I shielded the paper with my hand. Annoyingly nosy, one fellow kept asking me, with an evil smile, “What are you writing, Doctor?”

I thought, “As if it is your damned business!” I did not want to start a war, so I just smiled and gave him a verbose explanation filled with sesquipedalian medical words, which meant nothing, both to him and me.

He nodded in apparent understanding, as if it would be a sign of weakness to admit that he was baffled by big words.

When the lab tests came back, I took a deep breath and checked them. Yes, she was pregnant. I wondered what to do next.

The patient's Mom approached me. Grabbing my hand as if for both moral and physical support, she looked deeply frightened. “Tell me, Doctor, is she pregnant?”

The nurse reassured me that it was safe to tell her the result. When she heard my “yes,” she fell to her knees. Still holding my hand, she looked up at my face and began sobbing, begging me not to tell any of the men in her family. They'd kill the daughter, she said, and from their track record I did not think this was a groundless concern. When I said that I would not tell the men, she—still on her knees—began kissing my hand, and thanked me over and over again. The Mom promised to “have this taken care of.” She never specified what she meant by that, but I assumed she meant abortion.

Years later, as I was mulling over this event, I wondered, "What would Dr. Laura do in such a circumstance?" For those of you who don't know her, Dr. Laura Schlessinger is the host of a talk-radio show who enjoys moralizing, and seems to have a ready answer for everything.

Would Dr. Laura condone the abortion, or risk the murder of the teenage girl? The latter would also kill the unborn baby, of course. I was so intrigued by this ethical dilemma that I faxed it to her, and later sent a copy of the first book in which this story appeared. I never heard from her.

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