I'm Tired Of Being My Gyno's "Cool Patient"

I got a new IUD put in. It didn't go that well.
Publish date:
March 17, 2014
gynecologist, IUD, being assertive, going to the doctor

Aside from quality burritos and a handful of friends, the thing I really miss about living in San Francisco is my doctor. Though I've had spotty relationships with gynecologists in the past, Rachel "Herpes Isn't Subtle" Anderson was, and likely shall forever be, a shining example of an ideal medical provider to be poking around my cooch.

I guess it's not really fair to hold all doctors I encounter to such a standard. But even objectively speaking, I'm getting kind of tired of having to be my gynecologist's "cool patient."

A while back, Emily wrote a poignant takedown of the "cool girlfriend" trope, working against the preconception that all women are the kind of laid-back, anything-goes kind of girls whose "chillness" seems to deify them in mainstream media and among dudes. These days, I try not to get in the habit of behaving like things in romantic relationships don't bother me when they really do. I can't say the same, however, for my doctors -- especially gynecologists.

Ever since I moved to Chicago, my uterus has been a bit unpredictable, to say the least. Though I've loved the security my copper IUD has given me, becoming an Old Faithful of endometrium once a month was bad enough when my period only lasted five days. Recently, it's been going on for an average of 10 or 12, making me feel drained, persnickety and a bit like a blood-slug leaving a trail everywhere.

In 2009, my insurance wouldn't cover getting a hormonal IUD, but it does now (blessings, employer). Tempted by the prospect of lighter periods for the next five years, I decided to pop my present lil' dude out a bit early and get the Mirena strapped in there instead.

When I got to the doctor's office the morning of my appointment, things were a bit of a mess. The doctor was running late, the receptionist told me, and the normal nurse for the gynecologist was out, so a sub would be taking her place.

"That's cool," I said. "I'm chill."

The substitute nurse, whom I already vaguely knew from her work with my primary care physician in the same clinic, arrived, gave me a hug and led me to the patient room, where she had me climb on the scale and told me my weight "wasn't bad at all" for my height.

"Um," I said. Honestly, I'd've preferred not to be weighed at all, but I'm still working up the gumption to refuse outright. Still, I failed to see how the numbers on the scale corresponded, at all, with the little piece of plastic about to go inside me. "Cool?"

She smiled at me, told me to take off my pants, and left me in the office to send gyno-selfie Snapchats to all my friends.

Half an hour later, the doctor finally showed up, looking frantic. "Sorry," she said. "You've gotten one of these before, right? And I told you last time about the irregular bleeding that can happen?"

"Um, I don't think so?" I said. "Maybe?"

"No, I definitely did," she snapped. "I wouldn't have let you go otherwise."

Then why did you ask? I thought, then shrugged. "OK!"

I was starting to feel uneasy, mostly because Dr. S. seemed genuinely annoyed with the thought of getting elbow-deep up in me. This only got worse once I stuck my feet up in the stirrups. I usually love asking questions about what's going on with my cervix and how exactly procedures like this work, but Dr. S. kept acting shocked and a little offended by my inquiries. I get that I'm kind of narcissistic -- including the parts of me not visible to the casual observer -- but c'mon, shouldn't I have the right to know my vagina forecast for the coming week?

Making things even more uncomfortable, the nurse hadn't grabbed the proper tools and kept having to leave the exam room.

"Stop closing your knees," Dr. S. hissed.

"Sorry," I said. "But should I be facing the door?" Every time the nurse opened it, anybody walking by was gonna get a nice, spread-open view of Chez Katesnatch. "I mean, I don't care," I said. "I'm cool. But. Someone else might."

"Oh," Dr. S. said, turning to face the door. "Well, it's early. No one's going to walk by. But you're right, we should fix that."

"I mean, whatever," I said.

"Sorry she keeps going in and out," she continued. "I'm prepared, but these guys aren't."

"Well," I said. It didn't seem super-appropriate for someone to be trash-talking her coworkers to a patient when said coworkers were going to aid in inserting a tool into me that carried risks of perforating my uterus. "Uh, it's fine."

The weirdness just kept going, possibly exacerbated by my panicky determination to show Dr. S. that I wasn't like all those other patients. I was a cool patient, an IUD veteran, and she didn't need to worry about me one bit. I even whistled Chelsea Dagger as they slid my IUD home, partially to distract myself but also to demonstrate just how Extremely Chill I felt about the whole thing.

The nurse, inspired, took the opportunity to exclaim every five minutes how fascinating the process was. "This is so interesting, Dr. S.," she cooed. "It's so cool to see things from this perspective!" I mean, I get it -- reproductive science is rad and my bathing-suit bits are a wonder to behold -- but again: potential uterine perforation, plastic inside of me, pain.

And the pain had arrived. The actual insertion wasn't bad, but as soon as I got my pants back on, I started to feel awful, gut-wrenching cramps. My body had woken up, taken exception to its new accessory, and wanted it out. Now. This hadn't happened with either of my last IUDs, so I gritted my teeth, trying to ride it out.

"I'll be back in 10 minutes," Dr. S. said. "Feeling OK?"

"Just a little, uh, crampy," I said, sweating.

She smiled knowingly. "I'll see you in a minute."

I waited, waited, waited some more. Finally I got up and stumbled to the bathroom, hoping that peeing would make things better. (It didn't.) On my way back, I saw Dr. S. in a different room with another patient.

"Should I--?" I said. All I could think about was getting to the Walgreens across the street and downing a handful of Midol.

"She should be in a few minutes to get your consent form signed," she said. "You and I are done until next time."

"Oh," I said, going back to the exam room and putting my head between my knees.

Finally, finally, an unfamiliar face poked in. "Katherine?" she said. I nodded; close enough. "We have your consent forms for the IUD." They swam in front of my eyes, and I signed them without reading them too closely.

I'd also proposed earlier that I should get an STD test, so I shuffled along behind the new technician to the phlebotomy room. As she tied a rubber strap around my arm, she studied my face. "Are you OK?" she said. "You look a little green."

"Fine," I said, high-pitched.

"Do you want some ibuprofen?" she said.

"Oh, god, yes, please," I said, making grabby hands. She shook out two into my palm. I dry-swallowed them, not caring that they were (apparently) 800 milligrams each. The cramping had worsened, and I didn't even feel her slide a needle into my arm to take my blood.

By the time I left, all I could think about was getting home to my electric blanket. Every time I stopped at a streetlight, I had to put my hands on my knees; when a random dude cat-called me for doing so, I snarled "NOT NOW" at him, baring my teeth like a hurt animal. I thought about puking, but I didn't want to lose my precious ibuprofen.

Two more blocks, I kept thinking. One more block. Home free. I staggered up the stairs, curled into my blanket, and passed out for an hour.

If you can't tell, I wasn't particularly happy with my experience with Dr. S. and company. But to be fair to her and the rest of the clinic staff, it wasn't as if I voiced any of my concerns aloud. Looking back on it now, I can see all the places I should have spoken up about how uncomfortable I was. Why didn't I insist on getting a play-by-play of what Dr. S. was doing? Why didn't I refuse to be weighed, or to take my pants off until all the tools were in the room with us? Why did I maintain, to the point of literal agony, that I wasn't in pain and didn't need help?

Part of it was definitely the kind of intimidation a lot of people (especially women) feel around authority figures; cowed by the thought of being mocked for making a mistake, we stay silent, even when it costs us our dignity or well-being.

But that's not the whole story for me. Ever since I first read about pap smears in Seventeen, way before I even knew what a pap smear was, going to the gynecologist has constantly been framed as a scary endeavor to be dreaded rather than a pretty routine medical procedure. As a consequence, I've found myself attempting to prove, both to my doctors and to myself, that I'm not scared of anything they'll throw at me or my twat. Somewhere along the line, I conflated being "strong and sexually independent" with "having a uterus of steel." I'm not like all those other patients, intimidated by the thought of a stranger opening their vajay with duck-lips, I'm clearly trying to demonstrate. I'm a Cool Patient.

Which, of course, is BS. I mean, in general, I'm not scared of the gynecologist. But sexual autonomy and physical discomfort are clearly not mutually exclusive. I can order STD tests and take control of my clit-health and still demand a closed exam room door. And to set myself up as in competition with the other patients -- none of whose medical, physical or sexual histories I know -- is just buying into the idea that women have to tear each other down to be successful at anything, whether or not their crotches are involved.

These days, I would proverbially punch a prospective date in the teeth if they told me I "wasn't like other girls." I just have to remember that extends to the rest of my life, too.

Kate is crotch-blogging: @katchatters.