The Pieces Between Us
by Preeti Tanwani, M2
The first thing I noticed was her grip.
Her fingers curled around her daughter’ s hand so tightly that the skin blanched white, then tinged blue. It read as a silent confession of fear, pain and endurance. She lifted her 5-year-old into the visitor chair, as though carrying a weight that had nothing to do with her child, but instead, all to do with the world itself pressed against her ribs. The mother climbed onto the accompanying exam table, pressing her palm into her abdomen as if she could physically hold her organs together. Her eyes refused mine.
The fluorescent lights hummed overhead in a small room at Louisville’ s Family Community Clinic, a nonprofit serving uninsured and underserved patients. The physician immediately rushed in, breaking the melodic hum with urgent footsteps. I was meant to document a SOAP note, but the air felt unbearably suffocating during this appointment. The daughter tapped her iPad quietly, a shield against the tension in the room. The mother’ s breaths came in sharp fragments. There was rebound tenderness: appendicitis. Words cut through the room with urgency: we needed to get her to the hospital, now.
She shook her head.
“ It’ s nothing,” she exclaimed.“ All the doctors say it’ s nothing. My partner says I’ m being dramatic. I think it’ s nothing. My neighbor made me come here.”
And yet her eyes kept darting toward her daughter, worry seeping into the spaces between her words. Her body spoke a truth her words denied, as tears welled in her eyes but never escaped. She continued voicing the impending consequences, her pain always shadowed by the weight of protecting her daughter from her weakness. The cost of leaving home, the impossibility of missing work, the invisible debts measured not only in money, but in expectation. She was refusing care not because she lacked understanding but because she carried the mosaic of her life in each bone, each shriek, each glance toward her daughter. Medical hesitancy was woven into that mosaic, stitched from fear, from history, from endurance demanded by culture and circumstance, and from the gaps in understanding that each patient inherits.
I was meant to continue typing, but I instead rolled my chair toward the corner and spoke seven words that seemingly changed the trajectory of the appointment:“ Do you want to play Roblox together?”
The daughter climbed into my lap. We navigated a game in Spanish, tapping and laughing, while her mother leaned back on the bed, trem-
28 LOUISVILLE MEDICINE