What an obstetrician / gynecologist really think during your examDave Smith
If you’ve ever wondered what annual checkups are like from the other side of the stirrups, here’s a look inside my head during an appointment.
Before entering the exam room, I take a moment to prepare: a quick sip of coffee, a look at his table and a look at his picture (I am terrible with the names, but once I see his face I remember you). Upon entering the room, my smile is genuine (99% of the time). I really enjoy the opportunity to catch up with my patients on their annual exam: preventive health is my passion.
The annual exam is much more than a Pap test. I make sure I stay up to date on all screening tests and lab tests, especially if you don’t have a primary care doctor. I check your history, all the time as I write on my ridiculous laptop, which prevents me from looking into your eyes. Still, I enjoy catching up with you, especially hearing about your children that I delivered a few years ago. However, if you manage to ignore me talking about running, adoption or literature, I will become too talkative and then begin to feel guilty for the other women waiting patiently at the cold exam tables. Usually, I return to the task quite quickly.
I listen to your heart and lungs and then lie on the table for your breast exam. This is one of the most important and difficult parts of the exam. I try to concentrate completely on the task in question, carefully palpating each breast layer, especially the thicker fibrous tissue. This level of focus should make my face look fun, because you comment that I look worried. I assure you that I am concentrating. Then I try to relax my face, while trying not to focus on my facial expressions but on the exam. This is hard.
Then, in everyone’s favorite part: the pelvic exam. You tell me that “you really hate this part” while you slide across the table. I assure you that everyone hates their Pap test, including myself. This sometimes laughs nervously. Then I encourage you to slide further down the table (no woman slides down enough on the exam table).
While I sit on the rolling stool precariously placed between her legs, I am always worried that I will fall forward … (this would be mortifying for both of us). You make a comment apologizing for your lack of feminine grooming. I tell you that I don’t care, and I really don’t care. The vagina is just another part of the body for me. I see 30 of them a day.
However, what I do notice (but I will never tell you) is the smell of your feet. My nose is 2 feet from your vagina, but inches from your sweaty fingers (put on some clean and nice socks for your next gynecology appointment!).
After your exam, I review the findings with you and make other medical recommendations. Expresses concern about fatigue, low libido and weight gain. I listen, ask questions about your symptoms and order lab tests to look for any underlying problems, although I suspect the results will be normal. I know that most of the time, these types of symptoms are related to lifestyle choices and the stress of modern motherhood. I become obsessed with how to say this in a way that is not offensive and that also makes you receptive to change. By talking about diet, exercise and healthy lifestyle choices, I realize that these are challenging changes for everyone and I hope to provide some useful level of motivation.
Upon leaving, I hope that in our brief interaction you have made a difference in your health. Maybe I have simply assured you that you are healthy, or maybe I have convinced you to have the mammogram you have been putting off. But above all, I hope to empower him to make healthy choices until we meet again.
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