Wednesday, March 20, 2013

A whole lotta TMI.

I actually miss my OBGYN. Yes, I’ll admit it. I never thought I’d think that, ever.  Who misses the person who routinely spelunks your nether region?  Well, if you are a particularly amazing person, who makes an effort to make her patients comfortable and relaxed, who pays attention to the individual issues, then there will come a time, after the regular appointments of a pregnancy, where that patient realizes that they actually like being around this particular health care provider.  She is just a positive, cool person, and I like her, and I like her staff. When I go there, I'm not all tied up in knots of worry about what is going to happen... I'm looking forward to the friendly people.

As I realized this today, it put me in mind of the doctors I don’t miss. And one in particular who pretty much soured me for the already trying experience of the Obstetrics and Gynecology facet of medical care. 

Being a woman sucks. Guys get all freaked out about the prostate probe but that is tame next to what women have to endure just for routine examinations. Some women handle it with little issue, and could happily lie there while reading a magazine, but for most women it is an invasive procedure. It is a procedure that requires women to bare the most intimate part of their being to a virtual stranger, and to relax while this stranger roots around inside her.

For most women, it’s tolerable, but for some it isn't at all. I know it is over-sharing  but I will come out and say that as a child, my mother took on an affair with a younger man. That younger man was purely attracted to her because she had young daughters. That resulted in my being extremely sensitive about anything south of the equator, and I do not like to go to the OBGYN at all. Ever.

A few years ago, when I was diagnosed by my primary care physician with PCOD/PCOS, he referred me to an OBGYN in Portland. I scheduled an appointment as directed, and showed up on time. I had no idea what to expect, and nobody told me what I should expect. I arrived, and was given a clipboard containing a small stack of new-patient forms to fill out. I dutifully filled them out.  One of these pages was a history questionnaire asking a number of pertinent questions; questions that would ultimately have an influence on how the doctor approaches the appointment. One of those questions was: Have you ever experienced sexual trauma/abuse?  I checked the yes box. It’s not the first time I had to check that yes box, and so I did.

Now, this office was set up to be the most efficient OBGYN office possible. Set up with the efficiency of a cattle stockyard, designed to funnel women through with order and accuracy. Come in, pee in a cup, go down the corridor to your room, get your exam, move on to the desk for instructions, and then out the door.  I was greeted, I filled out my papers, which took me a good quarter of an hour, I was sent to pee in a cup, and then directed to sit in a tiny exam room, wherein I sat for a good twenty minutes undisturbed.
Then a nurse came in with a fresh-faced young man in a white doctor’s smock in tow. “This is a student doctor. Is it okay if he asks you a few questions?” she asked. I nodded, and the student doctor settled in on the roll-stool and lifted up the clip board, and proceeded for the next quarter of an hour to ask me the exact same questions I spent the first quarter of an hour answering in the waiting room, including that fateful question about being abused. It assured me that they would know this, and approach me appropriately.

The student doctor concluded his redundant questioning, and exited, and then the doctor entered, took one look at me and turned around to shout at the nurse that I wasn't ready.  I heard some chatter outside the exam room door, and a nurse came in holding a packet containing the paper gown for me to put on, and the paper blanket they give you to cover one's bottom.  “You need to be undressed.  You can leave your socks on…” she says before shutting the door. I stand there for a second in shock. I was not told I’d be examined at all. They didn't even ask me if I was cycling. But I complied, my skin clammy cold and my stomach in a tight knot of anxiety as it always is when  go in for my pelvic exams.

Just as I clamber up onto the table, and cover my legs with the paper blanket, the doctor, the student doctor and two nurses all cram into the room, and they enter pushing what turns out to be an ultrasound machine. The doctor, between his various barked commands, informs me he is going to look for a cyst on my ovaries. I expect he is going to use the little device to slide around on my tummy to see inside. I am told to lay back, and to relax, in spite of the small horde of people all crowded around the table. I’m already on the edge of tears from this.  I then see the doctor lift up the pelvic ultrasound wand. This was my first encounter with this device. He slathers it liberally with KY and without any warning or ado, he just woopsies it right in there.

My reaction is to stiffen up, and immediately, my eyes fill with tears.  The nurse grips my hand and while he roots the thing around roughly inside me, this doctor, who expressly asked me TWICE in his forms whether I had experienced sexual trauma, proceeded to tell me, “Relax. Stop crying. I know this doesn’t hurt.”  I was sobbing by the time he confirmed and measured out my egg-sized cyst encasing my right ovary. With a disgusted sigh, he finally reprieved me of the invasive pelvic wand, and the horde filed out, one nurse telling me over her shoulder that it was okay to get dressed. Shaken and harried, I stumbled through the corridor chutes to be scheduled for surgery by the desk.

I can’t say he was a bad doctor. He was an older gentleman who obviously had been doing this job for a very long time, and who saw countless women day after day. He was getting on with business, and the operations he put in place to avoid the kind of experience I had were ignored and glossed over. If those questionnaires were not created for this purpose, they *should* be. The fact that he is a man probably also has something to do with his utter lack of sensitivity.  I had my surgery with him, and had one follow up appointment and after that, I chose another doctor in a smaller office where my personal issues were considered each time, and I didn’t leave sobbing and feeling like I’d been violated all over again.

Dr. Jill Shaw was the antithesis of that kind of care provider. She makes a concerted effort to make her patients feel comfortable, and when I expressed my issues, which I have now learned to do from the start, she handles me with sensitivity, and expedites anything down south so that she’s in and out as quickly and efficiently as possible. She remembers this about me, so I don’t have to remind her. 

That is why I miss Dr. Jill. Because she gives a crap. My pregnancy required many such invasive events, and Dr. Jill made it as painless and smooth as humanly possible. Otherwise, I think all of the additional appointments required for an ‘advanced age’ pregnancy, which includes a number of pelvic ultrasounds, would have otherwise been a terrifying and horrendous experience, ruining what should have been a joyful time.The efforts I undertook to conquer this infertility issue I have caused me to face these psychological problems every time. It was hard enough working up to the pregnancy for eight years, exposing myself to procedures and doctors and discomforts I cannot begin to describe. My pregnancy was challenging as it was. I didn't need to have trauma added to it too. I am grateful every day for Dr. Jill and her friendly demeanor and wonderful staff. I'm so glad I found her.

My advice to the hurried, insensitive Dr. Ds of this world… slow down. You implemented the paperwork, read it.  Look at the faces of your patients, and pay attention to what they are trying to tell you. And don’t turn their appointments into a three-ring circus.


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