A 23-year-old woman with abdominal pain presented to the ER with her husband, a soldier who had flown in that morning from Europe after a tour of duty in the Army. During the course of the history, I asked her if there was any chance she could be pregnant.

“Of course not, doctor,” she replied. “My husband has been gone for a year.”

While palpating her abdomen as part of the physical examination, her uterus felt slightly enlarged. I therefore decided to perform a pregnancy test, which was positive. I doubted that she wanted him to know about the pregnancy at the same time she found out about it, so I asked him to step out of the room so that I could speak to her alone.

“Your uterus felt enlarged to me, so I ran a pregnancy test, which was positive.” I kept my voice down, but she didn't get the hint.

She did not look very surprised. “Are you going to tell my husband?”

“No, I'm not,” I whispered. I wondered if she thought she could keep this a secret for long.

Still speaking in a full voice, she replied, “Good. I want an abortion now. I don't want my husband to find out about this.”

I began to explain that our hospital did not perform abortions when the door flew open and her husband stormed inside. “So you don't want me to know that you cheated on me? I heard every word you said! So who was it? Who did you screw? Todd? Or the neighbor who has always had the hots for you? Tell me!”

She held her face in her hands as she began to cry. “Tell me who it was!” he screamed again.

“I . . . don't . . . know . . . who,” she said while keeping her face buried in her hands and rocking her head from side to side.

“What do you mean you don't know? You fucked more than one guy?”

She didn't reply, so the answer seemed to be, by default, yes.

“You whore! I'm divorcing you!” he shouted as he rampaged from the room. As he left, I saw a young girl standing on the opposite side of the hallway, staring into our room. I wondered how much of this she'd heard.

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