I am in clinic, but it is the clinic ten years ago. I have three well child checks lined up. There are a bunch of people wandering around the clinic and the staff seems pretty much missing or oblivious. I hear someone say, "Well, can't they draw his blood and send it to Seattle? They do that all the time, right?" and I worry that this will not be a well child check but someone demanding obscure laboratory tests that a non-physician provider or website has suggested. For a child.

The first child is an 18 month old. Mother is standing by the exam table, muttering with hostility about how she is not ever going to allow immunizations. "Has he had a well child check before?" I ask. "No." she says. The child looks frightened. I hear chaos in the halls: she's left the other kids to tear around. I note that my nurse has already drawn up immunizations and they are ready in a tray, needles uncovered. I am not happy about this being in the room. "Just a moment," I say, "Are those your children?" I open the door and go out to stop the two other children from whatever they are doing. The mom does not help and wanders off with the 18 month old. There are 30-40 people wandering inside and outside the clinic and no on is watching the other two kids, who are about 8 and 11. I send them from the clinic halls to the waiting room and find mom outside, eating. The 18 month old is not with her. "Are you ready to finish the exam?" I say. "I'm not done eating." she says. I look at my watch. "Well," I say, "Our time is up so we will not do his check today." It's been 45 minutes.

I am in the room with the 6-8 year old boy. No adult is with him. I sigh, and start trying to ask him questions. He looks terrified and won't answer. Then a woman and the older boy come in. The exam room now has two tables, like an emergency room drunk tank. This is obviously the older brother. Many people accompany them. The mother is fussing over the older boy who looks entitled and as if he is used to and enjoying the attention. A white haired couple at the end of the table whisper to me. "What?" I say. "Check for influenza pneumonia," whispers one of the couple. The boy is a bit coy and smiling, enjoying being the center of attention. He is not sick. There is an even older man behind them, a grandparent I presume. I am getting ready to chase everyone out of the room and even as I think that I will cancel both well child checks, I am feeling terrible about the middle boy, who is still being entirely ignored.....

...and I wake up.

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