Medical Complexity

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The family

John Age 48 Ex-army. Tends to get angry when he doesn’t understand. Pragmatic.
Christine Age 44 Recently stopped citalopram (Rx for reactive depression) . The couple have been foster parents for l4yrs.
Denise Age 16 TOP 8 months ago after unwanted pregnancy. Recent stapedectomy.
Louise Age 13 Fostered from age 9. Calls foster parents “mum” and “dad”. Compulsive liar. Smokes, drinks, and sniffs Tippex.
Emma Age 9 Very laid-back. Communicates well with Louise when Louise is in “child mode”.
Carla Age 38 The “lodger” – a friend who was taken in by the family after she left her husband and developed a drink problem.

The scenario

Louise brought by Christine. Louise had been a bit of a handful for the past year. Three days ago had stayed out all night with 3 “rough” boys (aged about 21) and 2 school friends. Eventually found drunk by the police at nearly daybreak.

The boys have been charged with supplying alcohol to minors. Christine is worried that her foster daughter has had sex with the boys, and doesn’t believe Louise when she says she hasn’t. She says the police suggested that she was brought to the doctor, and demands that Louise be examined straight away to see whether she has had sex or not. Louise maintains that she is still a virgin.

You are also the local police surgeon.

It is 6.10 pm and you have a practice meeting starting at 7.00pm. Your wife/husband has planned to go out and your babysitter has just cancelled at the last minute.

How would you handle this?

 

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