So, last week I’m at the gynecologist’s office because she wanted to biopsy me on the last day of my period. “Your bloodwork shows that you shouldn’t be bleeding anymore.”
“I mean, it’s not like I’m randomly bleeding, right? It’s a period?”
“I want to check the cells to make sure it’s not something else. Now, you know you’ll feel some pain but it’ll be over by the time it starts.”
I am on her exam table in the position one would imagine. I’m focused on my breathing to regulate myself as I do during anything challenging, when unexpectedly I find myself at an 8 on a pain scale ranging from 0-10. The cut from the biopsy is not the worst part. It is followed by a cramp in my uterus so intense that my torso reflexively lifts off the table into a crunch position and I hear myself say, “Ow!”
In rapid succession, she snips three more times, each accompanied by a similar cramp.
I say “stop,” and when she keeps going, I say “STOP!”
And the doctor says…
“Darcy, you need to keep your voice down or you’ll frighten my other patients.”
I am so stunned by the combination of unexpected pain and her shaming words that I clench my teeth in a way that will make my jaw ache for days as she snips one last time, ensuring the only noise in that little fluorescent room the sound of a few tears falling onto her exam paper.
In the days since, I’ve processed the incident with those closest to me. My feelings have gone from wanting to forget the whole thing — particularly since my lab results confirm that my “bleeding” is in fact a period, despite my advanced age of 53 — to questioning whether to report her to the medical board; a process that seems tedious and likely to result in minimal consequences.
For now, I’ve made the decision to share this story with you — at the risk of appearing to crowdsource empathy — so you’ll know why what she did was so out of step with today’s patient healthcare training. I want you to understand why her behaviors more closely reflect an OBGYN from 1983 than one practicing medicine in 2023. I want you to be armed with knowledge in case you’re ever in a similar situation.
- I said STOP. If I had a history of sexual violence, which thankfully I do not, my doctor’s refusal to honor the most basic boundary a woman can utter could have caused a secondary trauma, leaving me with something called complex-trauma, which would have required me to find a very skilled therapist to facilitate God only knows how many sessions of trauma therapy, to the tune of many thousands of dollars. And since great therapists don’t grow on trees, it would probably take several therapists to fix something like that. Thankfully, I feel confident that I’m OK and none of that will be necessary. But it’s worth mentioning since 1 in 4 women have a history of sexual violence.
- The amount of pain and the type of pain was never explained to me. Guys (and I do mean men here), you know how the pain you get from a charlie horse is different from the pain you get from stubbing your toe? How one comes from the inside while the other comes from an external event? That’s how big the difference is between normal pain and the lady pain we get in our uterus. The only time in our lives we feel that type of pain is when something is happening in the reproductive region of our bodies. It’s APPROPRIATE to advise a person who is about to have her uterine lining biopsied that in addition to the pain from the biopsy, a significant cramp in the uterus will follow — and that there will be several cuts and cramps involved.
- I said STOP. A healthcare provider should have responded to my words with empathy, and at the very least should have guided me through the procedure by, I don’t know, suggesting I take a deep breath so I could exhale during the pain, the way my fucking waxer does. And the way any service provider with a modicum of emotional intelligence would. Telling me to lower my voice wasn’t far off from saying “Stop” during a hookup and being told, “Lower your voice,” from the person inside of you.
- Trauma-Informed Care is part of all healthcare training. As healthcare providers, we are required to continue our training every year to maintain our licenses. It’s the primary way they keep us abreast of advances in research and ensure that regardless of when we went to school [read: how old we are], we’re informed of modern-day best practices. In recent years, just about every continuing education course in healthcare is laced with trauma-informed guidelines. And it turns out, trauma-informed care is a thing in gynecology too.
- I said STOP. Consent is a thing in gynecology, just as it is in modern dating. No means no. Stop means stop. One quick Google search on trauma informed care in gynecology confirms it.
The American College of Obstetricians and Gynecologists says, “It’s important for clinicians to realize that they have the power to create an environment in which patients feel safe both physically and emotionally through the interactions they have with them every day. Simple things that can help shift or diminish the power dynamic like seeking permission before initiating contact, providing descriptions before and during examinations and procedures and allowing clothing to be shifted rather than removed can cause less anxiety, prevent re-traumatization, and help foster trust.” Don’t take my word for it. Read from the source here. And another here.
She needed to fucking stop when I said stop. The first time.
Here’s where I land: We as women do not talk enough about women’s health and women’s issues. Society covertly (and in this case, overtly) sends us messaging that shames us into silence. It is endemic of how we’re treated as women. Meanwhile, ads to fix your crooked penis abound.
If I could go back in a time machine, I would have asked about the pain involved and questioned why her plan was to give me nothing for it, rather than assume that because she didn’t plan to numb me, it must mean the pain would be minimal.
Basically, I did what so many of us do with MD’s:
I wanted to be an easy patient, so I didn’t ask enough questions because in the moment those two things felt mutually exclusive.
She seemed pressed for time, which frankly, is unacceptable for an out-of-network doctor.
And I failed to be my own advocate.
What I want you, my tribe member, to do, is to be your own advocate.
Do not allow a seemingly busy doctor to rush you through a process that warrants thought and consideration.
If you are a woman, I want you to use your voice. I want you to talk about your own experiences in women’s health and support others through theirs.
And please do not be shamed into silence.