Sitting before me, smiling, was a 14-year-old girl.  Her mother was sitting in the chair by the stretcher.  The girl had been nauseated.  The question was, ‘why is she nauseated, does she have a virus?’  The subtext was ‘is she pregnant?’

Ultimately, the answer was ‘no.’  I delivered the answer, cryptically to avoid privacy violations, to her mother, her friends and her great, hulking boyfriend who was with the family in the emergency department.  When the nurses discharged them, she was sitting on said boyfriend’s lap, with mother in the room.

I’ve had a conversation about this before, with other mothers and fathers and teens.  I’ve talked to boys and girls.  It’s my ‘what are you thinking?’ talk.  I didn’t have time or energy to get into it this time.  I just walked away to the tickled smiles of friends and family, resting happily in the knowledge that their friend, daughter, girlfriend could continue her sexual adventures, unimpeded by the pesky biological reality of pregnancy, and obviously unconcerned with the high probability of sexually transmitted infection.

She was on oral contraceptives.  I wonder if the person who wrote them for her talked about disease, or pregnancy.  I wonder if they cautioned her, or just said, as always, ‘use a condom and your pills and you’ll be fine!’  (In stark contrast to reality).  I wonder if they saw what I saw:  a child having sex.

Sure, she’s fourteen.  She has reproductive capacity and all the right parts.  Of course, in ages past she would probably have been a wife with one child already.  But life expectancies were remarkably short in past times.  And often, developing a family was a means to food production and security, and the way to propagate a family in which death would occur to early for many of the young.  Those times have passed.  Food and medicine are available. People live very long lives.  Education and prosperity await my patient if she desires.

More than wondering about the people who distributed her contraceptives, I wondered about her mother.  I see the resignation in parents so often.  They seem to say to themselves:  ‘Well, she’s a teenager.  What can you do?  They have sex!  It’s natural.’  They watch too much television, read too many ridiculous magazines, absorb too much pornography or gossip or bad advice online.  Our culture has decided that these boys and girls, these teenage boys and girls, are just adults with acne.  The truth is, their brains are not ready for what we allow them to do.  Their brains aren’t ready for what society is encouraging them to do.  The pressures of intimacy, the possibility of parenthood, the pain of disease, the enormous emotional and physical consequences of the tragic default escape button, abortion.  These are children who should not be exposed to such as that.  Those are children who we, as a culture, are failing rather than liberating.

Parents need to be encouraged to say no.  ‘No, you can’t stay out all night.’  ‘No, you can’t have your boyfriend over when I’m not home.’  ‘No, you can’t go to that party, leave town with his friends, hang out with that crowd.’  The list goes on.

Is it that single mothers are overwhelmed?  Possibly.  The threat of a protective father looms large in the mind of many a young man who dates a girl.  If no father is present, the threat is remarkably lower.  Is it that no one was taught anyone better, not even the parents?  Certainly, many of the parents I meet grew up with the same moral laissez-fair attitude I see now.  Maybe that’s it.  Or is it that tons of parents are just too self-centered, too busy, too easily influenced by bad ideas to step in and make rules?

I suspect there is truth in all of those.  And I suspect there are many reasons for the behavior of the young boys and girls we see in clinics and ER’s because of sexual activity: the decline of families; the decline of intact marriages; the lassitude of the church in speaking moral, spiritual truth in love; the laziness and political correctness of physicians, nurses and teachers, the cultural suicide that judges and legislators have brought down upon us.  It’s all a toxic soup.

But floating in that soup, drowning, cooking, are legions of teenagers who are doing what they shouldn’t.  They are teens having sex.  Rather, they are children having sex.  And it’s time we rescued them.

So the next time you see it, think about your patients or friends or family in the big picture.  And be a pesky moralist.  And actually show some concern.  In the process offer them a choice, an option, a sense that maybe abstinence might be a good idea for lots of reasons!

Maybe they’re doing what they’re doing because no adult seems to care about them anyway.


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