"Now, you can just go ahead and take your shoes off and pop up on the exam table - this here -"

It is not a table. It is a weird bed covered in paper. "I will - break the paper."

"Oh, that's fine. Lots more where it came from." She turns to smile just as brightly at Alfirin. "- oh, also, both of you should drink some water, we are going to take a urine sample, which is where you pee in a cup for us. It can help us learn a lot about your health and how you are doing."

"...Do we have to?" They are obviously going to use it for dark magic of some sort. Why else would they want her piss?

"It's really important for helping us get the whole picture about your health. It lets us run some tests to make sure you don't have anything going wrong with your body, including some really serious diseases like diabetes. It doesn't hurt at all, it's very easy. I know it's a bit gross, but it'll be really helpful."

Iomedae hates these people. "Can we do the civil disobedience?"

The receptionist is in fact accustomed to foster teenagers coming through this office. And objecting to this thing. "You're not gonna get in trouble for failing the drug test. We need to know what you're on so we can help."

"I think I did not drink any drugs, unless they were mixed food and nobody told me. Do I still have to?"

"We don't just test for drugs, we also test for the sicknesses I mentioned, and for other things that are important to your care plan!" Also teenagers lie constantly.

Iomedae wishes they'd just hit them. It would be clearer. There is a part of her that wants to dig her heels in and refuse and see what happens and that part of her is very dangerous in a slave and needs to die. 

She also doesn't want to give in, though, that makes Alfirin the one who's being difficult. "Can you do this some other time when we know more about doctors and America?"

"We'll have some followup appointments but you can't just save every procedure you don't like for the followup appointments, that means it'll take a lot longer to get you an appropriate care plan. And some things the pee test checks for, like diabetes, or pregnancy, we'd want to address right away. We wouldn't be taking good care of you if we missed it for months more."

"Pregnancy?"

"Having a baby. Though, of course, if you're pregnant, you have lots of options, you absolutely do not have to have a baby. But the sooner we know, the more options you have to access other services, that gets harder later in pregnancy."

Iomedae has so many confusions she doesn't even know which to articulate first. 

"I not have child, no man ever lie with me. If I have problems, I having them a long time, I don't see why they will worse now."

If I was with child I'd conceal it from you because Emily and Claudette say that educated Americans believe that babies don't have souls and killing them is all right. This woman looks very educated. She wears glasses and a uniform and speaks with the American important-people cadence. 

"I am not having a baby also. I do want the drug makes women not have babies. I want do pee test next time, know more about doctors."

Evelyn stepped back out of the exam room and has been hovering at a distance, because it's not, generally, actually doing kids a favor to hover right there and micromanage all of their experiences with not-always-fun-but-definitely-necessary childhood experiences like doctor's appointments. Also it doesn't do her reputation with the clinic staff any good if she gives off the impression of being the sort of helicopter parent who overreacts to everything; she needs to make sure that it's the case that when she does put her foot down about something, it's taken seriously and doesn't just come across as her being difficult. 

At this point, though, the internal screaming has gotten loud enough that she clears her throat. "The girls are just learning English, and I think they would be more comfortable doing the test later once I can explain to them what it's for."

And this is by FAR not the first time a child has freaked out and refused to give a urine sample. It took over a week of coaxing to get one from Lily, and Evelyn ended up having to do it in the bathroom at home and then drive it over to the outpatient lab in a baggie. Evelyn...did not even think to talk them through the contents of a doctor's appointment, like she would have with a younger child, and in hindsight that was perhaps a mistake and she should have plowed through the awkwardness rather than trying to dodge it and throw it at the clinic staff. These kids have no idea how modern medicine works. Who knows what bizarre misunderstanding is going through Iomedae or Alfirin's head right now? 

"Why don't I just take a prescription for the test?" she suggests. "I've done it that way lots of times before. I can get it done at one of the outpatient labs and have the results faxed to the clinic, it's actually faster sometimes, and it won't take up any time at a followup appointment." 

And she's not worried about pregnancy for either of them and definitely not worried about drugs, but saying that won't actually be more convincing to the staff, she'll just - keep acting very chill. 

"Sure," the nurse says, "I'll see if we can do it that way." And a sympathetic eyeroll shared with Evelyn so the kids can't see it. "Right, in that case, can you both go into your rooms? I'm going to take some quick measurements - height and weight, blood pressure, body temperature - but I'm going to talk to your foster mom first."

Iomedae will go sit down on the paper table.

"I'm getting the sense we have some special care needs here?" the nurse says in a whisper when the door has closed. "I saw in the notes they're newly in foster care and English language learners but if there's specific trauma we should know about, or if they're going to be that difficult about every procedure, it's good to know in advance so we don't scare them. Their previous provider wasn't listed and we have no records."

Okay. Right. How to say this...

"There are not as far as anyone knows any records. We don't - fully understand their backgrounds - they were both found with separate migrant camps, and hadn't previously met, but they share a language they call Taldane, and our best guess is that they both somehow made it here from - who even knows, maybe Central America. I suspect they've never seen a doctor before in their lives. When they first arrived with me, they had never seen indoor plumbing before. Iomedae in particular is - pretty intensely religious, and I don't mean the kind of religious you'd expect to see in America. - Also, Iomedae recently experienced an attempted rape - she defended herself and nothing happened, but it understandably worries her that it could happen again. If she asks about birth control, I suspect that's why, and I'm comfortable with it." 

Sigh. "...They're good kids, honestly, but they're dealing with an enormous amount of culture shock. A lot of things make them anxious right now, because everything is unfamiliar, and the language barrier means it can take a long time to explain. I - realize it's kind of difficult, but, yeah, I think it's important to go slowly and explain everything in words they know." Pause. "- It might be easier to have them in the same exam room, if that's at all possible. Alfirin," she only puts a very slight emphasis on it, no need to be blatantly passive-aggressive here, "is significantly weaker on English, and Iomedae does a lot of translating for her."  

"Well, I think we can probably do that for the physical exam, if you approve and they're both in favor. I don't think we can for the behavioral health exam, we aren't allowed to run that one without a formally qualified translator. Does the agency have one who can call in?"

"...We haven't been able to locate anyone who can translate for Taldane, no." Which is one of a growing pile of baffling notes of confusion, but Evelyn does not feel like getting into a whole discussion about it with the pediatric nurse. "Alfirin is a little more fluent in Spanish, if you have anyone available for that? Though I expect some of the assessments are - just going to have to wait until they've picked up more vocabulary."

And cultural context. They're going to come across as so concerning in a behavioral health exam right now, aughhh. Evelyn also doesn't want to get into a whole discussion about that, but she does know that it's not impossible to just - decide to defer some of the assessments, until a child is more "settled" and able to cooperate with it. A lot of her former foster kids have been not especially cooperative with doctor's appointments.

"All right. We'll see what we can do." And she goes to knock on Iomedae's exam room. "Your mom said you might want to share an exam room with Alfirin. That would mean she might see or overhear your exam results, but it also means you two can talk to each other and it might be less scary, okay? Do you want that?"