Medical Interviewer Research Paper - Psychology (400 Level Course)


Medical Interviewer Research Paper - Psychology (400 Level Course)

His name on the chart was obviously Arabic, but he told me to call him Joe. Joe was a 25-year old man from Qatar currently living in Washington Heights with his brother. Simple enough. It was not so unusual; many people from all over the world come to New York City to be with relatives, find work, or seek freedom from the oppressive political or economic environment of their country. What puzzled me was that he said he was married and had a daughter whom he loved very much—but they were back in Qatar.

The motivations, he later elucidated, were purely economical. He could make much more in New York working a menial job at a grocery for 6 months than working a better job in Qatar for a year; he had been here for 5 months now and was returning in a mere 4 weeks. Discovering that he was Muslim put me at ease; knowing the strict beliefs concerning sexual morality in Islam, I thought I was in for an easygoing, unemotional interview. However, it turned out to be anything but.

To be honest, most of the interview went fairly smooth. Difficulties were only encountered during a small part of the sexual history. He became sexually active at age 18, when he was married. He used no birth control, because when he was in Qatar he wanted another child. He had no problems with sexual arousal, erections, or orgasm. His relationship with his wife was great—there they never hit each other, here they talked on the phone about once a week. He never used any drugs. He had never taken a drink of alcohol, but he was a fairly heavy smoker, he said, “like everybody in Qatar.” Relations with his wife consisted of oral and vaginal sex.

When I started talking about multiple partners, however, he became quite uneasy. “Never have I done anything sexual away from my wife… except last month, there was this one thing.” Apparently, a month prior, he had attended a party put on by one of his friends at the grocery. It turned out to be a pretty normal party until about 3 hours in, 4 prostitutes arrived. It turns out that his friend had pooled his money with several others and arranged these women to come entertain at the party. Within 15 minutes, what had been a simple get-together had become a veritable orgy. Joe’s friend begged him to let one of the women perform on him, and Joe resisted until it was too much to bear, citing to me a feeling he could only describe as “lonely.” He received oral sex from two women and then, embarrassed and guilty, left and went home. Now he was here in the Young Men’s Clinic, asking to be treated for some small bumps on his penis. He had obviously never been treated or diagnosed with an STD before, and he was absolutely terrified.

For the first time, I felt less like a medical interviewer, and more like a priest (or cleric, as the case may be). As Joe talked, he looked at me, pleading—almost as if for mercy. Obviously he felt bad enough about the oral sex itself, but these bumps were a solid physical reminder, and I couldn’t help but feel, as I’m sure he did, that if the bumps would go away, he could much better deal with his guilt. I have always thought that a physical reminder of transgression makes the misdeed more difficult to deal with; the bumps or the scar or whatever it may be screams out condemnation in harmony alongside the guilty cry of the resident superego. Here I had further proof that such was the case. And then I thought: what is the power of the medical professional if he cannot heal? If it was indeed herpes, it would never completely leave him. Tell his wife or not, Joe could not return to any sort of innocence, symbolic or physical. Although it is not my place to offer direct advice in the clinic—aside from walking someone through healthy alternatives to their behavior—Joe ended up asking me directly what he should do. After giving him the simple rundown of what antiviral medicine the doctor would give him, I told him to keep living how he thinks he should. Normally, this can be dangerous, but to Joe I knew it was both unneeded and inappropriate to tell him to avoid such behavior in the future. The very taste of our conversation had that flavor from the moment he confessed.

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