The Story of My Pap

Well, my morning was ruined by about 10:30am. It was snowing for the millionth time and I had already spent an hour on the phone being mean to incompetent people who somehow got jobs answering phones at student loan servicing centers. I’m trying to consolidate, I’m trying to see if I paid enough interest in loans last year to declare it on my taxes, I’m trying to get my monthly payments down so I can hopefully not continue to live paycheck to paycheck…and not one person I talked to was helpful. It took A LOT of energy to not break down before lunch. I did what I could and then had to get ready for an appointment I’ve been waiting 3 months for.

Today was a day that many female gyn providers come to in their lives. Once a year usually. I got my annual pap. I’ve been going to my women’s health NP for about 7 years now and I couldn’t be happier with her care. Every time I see her I am more and more satisfied with her preventative health education, her optimism about my life and her independence in her own practice. Now that I am a professional myself, I noticed that I receive my care in a completely different way than I had in the past. First, I’m totally transparent with her about how I want her to take care of me while I’m there. That I’d just rather pretend I don’t know anything while she asks me questions, palpates my ovaries and decides what blood tests I need. I ask her if that’s ok and she reassures me that I’m free to ask as many questions as I want, no matter how crazy. I deserve to be taken care of. Plus, she’s got 25 years on me so, she’s probably picked up a few things that I haven’t seen yet. But, no matter how much of a novice I’d like to be during my exam, I can’t help but take note of her strategies to maintain efficiency, how her exam room is set up, how she hands me, not a paper “blanket” for my lap but a real, cotton sheet to cover my legs during the exam.

Here’s what I noticed:

1. The Chart and Chat. Somehow she has perfected this ability to ask me questions, type my answers, and respond to me in a totally genuine and present way. I haven’t seen her for three years but she remembered that I was going to midwifery school, some of my interests etc. She’s also, at the same time, taking notes on a piece of paper which she subsequently hands me at the end of my visit. On it she has written a brand of food she likes and that she would like to recommend to me for days when I don’t feel like cooking dinner, the amount of omega 3s and vitamin D I should be taking every day and the name of a movie she saw recently that she thinks I would like.

She did my whole history and review of systems before I even took my clothes off.

2. She has no MA. Apparently, she would rather it be like this. For one, she gets an ENTIRE hour for every GYN pt because she doesn’t have an MA. She’ll use one for colpos or endometrial biopsies but in general, she’s flying solo. So, she hands me a cup to pee in, and in the mean time, sets up the exam room with everything she needs for me (including a cup of water because I had mentioned I was dehydrated).

3. The exam room was, yes, I can say it: cozy. There were normal pictures up on the wall, as well as info posters on self breast exams and the nuva ring. There were fun little books to look at on a little metal tray next to the exam table. As I said before, there was a real sheet there to cover my body. “I bring my own sheet when I go to the dermatologist” she told me. “Otherwise I have this piece of paper on me and it barely covers me! I’m sitting there naked! I just won’t do it.” I started to think about my patients. FYI, my NP is the tiniest little thing…I can only imagine how naked my patients feel. When I leave the exam room to let them get undressed I always say jokingly, “You can leave the gown open in the front and this luxurious paper blanket we’ve provided for you can go over your lap.” I usually get a little chuckle but, regardless, that paper blanket is ripped to shreds by the time they leave the office. Wondering how much it would cost to invest in cotton…

4. She does rectal exams. Now, I can't remember if I've had this particular type of exam every time I've seen her or if this is the very first time but wowza! not an experience you have every day. I have to admit, not only was the rectal exam not a part of my training, I never do them on annual exams. Should I? Should I do them on people over a certain age? I don't even know if anyone else in my office routinely does them...something to ask about.

5. She doesn’t weigh people. If you’re pregnant, well, then that’s a different story. But for regular GYN exams, for folks who don’t have any concerns about their weight, she forgoes it. There isn’t even a scale in the office. I was interested in knowing what I weigh just cause I haven’t stepped on a scale in well over a year and she was happy to do it, but we had to walk down two hallways and use a scale in someone else’s office to take the measurement. I remember her once telling me that women are already sensitive enough about their weight. And that if there was no real medical reason for her to take it, she won’t.

6. She told me it would all be okay. And, though it’s hard for me to embrace this way of looking at life a lot of the time, especially at the present moment, I believed her.

So, after my terrible morning of dealing with people in customer service positions who didn’t know how to deal with customers, my GYN experience was a highlight of the day. I got a clean bill of health, by the way, pending all my pap results etc.

And now I will begin my multip meditation for tonight. Already tired. Off to the hospital…