I don’t really understand why this thing that is routine for most women – even some of those that are survivors- is so horrendously traumatic for me. For days ahead of my appointment I found myself coping heavily through dissociation. Last Monday while working I was so disoriented I couldn’t remember what day of the week it was or what hour of the day. My mind couldn’t bear the thought of a silent hour. I strung headphones under my uniform and listened to a history podcast to keep anxiety at bay.
I needed to go. A previous Dr suspected I have PCOS and recommended I go to see about treatment for that condition and others. My periods have gotten increasingly painful. Cysts are reoccurring. I suspect endometriosis. I wanted to discuss a hysterectomy.
When I arrived I found out they didn’t take my shitty insurance, despite my primary care office saying they did. So the idea of establishing care with these practitioners for future needs or diagnostics became out of the question. I can’t afford diagnostics or procedures or surgery out of pocket. I’ve got to find better insurance.
But I was already there. I didn’t want to leave without knowing anything. I didn’t want to wait months to find out what’s next and go through the dread of facing a pelvic exam all over again. At least they could direct me to the next steps.
I came in with a list of things to discuss. My Medical Manifesto 2.0: Gynecologist Edition. I didn’t really reference it during the visit. The discussion flowed all on its own. I quickly learned that hysterectomy is not readily available without significant documentation of having tried everything else. They urge you to try hormonal birth control first. That’s not something I want to consider. The side effects of most of them jeopardize my mental health and that’s almost as terrifying as the pelvic exam. But it seems I don’t have much of a choice but to try. The resident Dr wanted me to try a hormonal iud, even though having it placed could be an ordeal for me.
The other thing to pursue is a PCOS diagnosis which would require and invasive vaginal ultrasound. None of these things could happen in this visit. They would all be additional visits at great expense out of pocket. Additionally the Dr did recommend a pelvic exam today to rule out any apparent or emergent abnormalities. I started to cry as I explained that these things are traumatic for me and I preferred to get as much done in one visit as possible. I consented to the pelvic exam. I knew that was very likely to happen at this visit and I wanted to know if there was anything bad going on.
I hate this process. I hate my feet in the stirrups, feeling like I can’t close my legs, no matter how hard I try. They always ask you to let your legs fall open. I can’t. I open my knees as wide as I can manage. But my muscles are wound tight from my hips to my toes. My partner leans over my head and grips my hand. I felt silly needing to hold on to them when I first laid back. But now, when the Dr. puts her hands on me, I squeeze their hand tighter and stare into their masked face. Leigh talks to me about inane things like the color of my eyeshadow, whether I’ve ridden in a hot air balloon… “squeeze as tight as you need to. Squeeze. You’re doing good.” The Dr. removes the tool and reports there is nothing visibly amiss. She asks consent to do a manual exam. I say yes, my voice shaky but clear. I turn my attention directly back to Leigh’s face as the Dr. begins. I can feel my face contorting into a wince and I feel my fingernail digging into the skin of Leigh’s hand. I try to relax my grip so I don’t hurt them. They are talking about the green flecks in my brown eyes. They’ve never noticed them before. Another tear escapes my eye. The green in them is always brighter when I cry. The Dr. withdraws from my body saying that she didn’t feel anything out of the ordinary. She folds away the stirrups and tells me I can sit up and get dressed while she steps out to bring the attending Dr. back with her to discuss next steps. I am sobbing and gasping before they even leave the room.
Leigh is there in front of me, embracing me and murmuring comforting words. They remind me to breathe slow and help me get cleaned up and my panties back on. We move from the exam table to the side by side chairs in the room. Leigh wraps me in their arms while I sob and try to slow my breathing down. The Drs. soon return and express concern over my distress. They find me tissues. The attending apologizes and begins talking about how myself and the resident discussed having an IUD placed. However upon observing my response to a pelvic exam she isn’t so sure that’s the best choice for me. “Even women without your history find it quite painful. I’m afraid it would be too traumatic for you… perhaps we can back up and discuss other hormonal options? The side effects of other types of birth control don’t always cause mood issues!” She chirped. It was all I could do to hear what she was saying and comprehend it. There was no way I could give enough attention to make an informed decision at that moment. I just wanted to sink into the floor and disappear. I needed to get out of there. Tearfully I confessed that I didn’t feel I was in the frame of mind to talk about this. They understood and wrapped up the visit quickly, directing us to the check out desk. Leigh helped me up and said to the Drs, “she’s pretty far gone at this point.” They nodded in understanding. My eyes stared straight ahead, unfocused on nothing and everything. I was propelled forward by the promise of home. We would just go home. Lee sent me straight to the car. Before I could get inside, loud sobs ripped through my body. I started to re-live the exam on a loop, painfully feeling it in my body, over and over. I kept hearing the Drs. voice… “I don’t feel you are a good candidate for an IUD…” I felt like the first Dr. sold it to me as the best viable option but then the attending snatched away any hope I’d been given for relief of painful, debilitating periods.
I felt deeply ashamed that I’d been belligerent or uncooperative. My hands fisted into my dress. If I could have curled into a ball in the passengers seat I would have. I forgot to breathe every few minutes and had to gasp for air when I realized I needed it. I turned my face away from Leigh in the drivers seat, wishing I could hide the tears that just would.not.stop.
I vowed that I would never seek help again for any gynecological problems. I vowed to just take my punishment in the form of cramps and cyst ruptured. I vowed I would never ask for help again. I would never have a pelvic exam. I could never let anyone touch me ever again. I never wanted to eat again. I felt like I could vomit at any time. I wanted to die. I want to die. I don’t want to feel my body. I don’t want to exist anymore. I don’t want to feel anything. I just want to die. Please let me die…. And then the flashbacks would start all over again. The feeling of hands on me in places rarely touched. The confusion of memories. Which ones happened now, which happened long ago. I don’t know. My body or brain can’t tell the difference. It feels the same. I want it to be over. I want it to end. I don’t want to feel this. I want to die to be free from this. I want to die…
The drum beats on in my head. Only deafened by small dose of cannabis to calm my mind and body. Before I was spiraling so badly I was afraid we would have to return to a medical facility for mental health purposes. We didn’t. But every waking moment I hear the drum beat from my body.