10 February 2010

Every woman has one

Let’s face it; no one likes the word ‘vagina’.  I blame the soft, naggingly nasal consonant sounds with which the word is endowed. It simply does not inspire feelings of fondness.

Many years ago, before I was a sassy New York diva-nista, I had the good fortune of landing a job as a guest professor at a small women’s college in Western Massachusetts. Teaching at Mt. Holyoke College was like being back in high school - in a good way.

There were “Milk and Cookies” feasts during Exams week, and Champagne and Strawberries on the Lawn just before Graduation. The distinctly feminine environment of the college encouraged an overwhelming sense of enveloping sisterhood and openness.

In those days, around Valentine’s Day, the community was treated to an annual student production of Eve Ensler’s play, The Vagina Monologues

The auditorium would be packed to the rafters with women – and a few fearless men – of all ages, races, shapes, sizes, and persuasions laughing until they cried at Ensler’s hilarious home-truths about the joys and pains of being a woman. Ensler’s objective was to create a forum wherein women could revel, relish and rejoice in this vital part of their anatomies.

So important is this part of the female body that in the US women are urged to receive annual gynecological exams to ensure that all is in working order. This is treated as serious business, and not to be taken lightly. I even recall instances when I received notices in the post and phone call reminders from the doctors’ offices advising me that “that time of year” was approaching.

Just like the term for the organ in question, no one enjoys these examinations. However, they are, we are told, a necessary and routine evil.

Apparently, the NHS would disagree.

A few months ago, I phoned my local surgery (Doctor’s Office) to make an appointment for a “full physical exam” – the code I have used often enough in the States to indicate a gynecological exam. 

There was silence down the other end of the phone. “Pardon?” The receptionist asked.

I felt myself blush.

“You need an exam for what?” the receptionist pursued the point further.

I stammered faintly, “My…my…girlie bits.”

Girlie bits?! Where on earth did that come from?! How had I spontaneously channeled my 8-year-old self?

On the other end of the phone, there was shock and panic. I hear the sound of a hand being chapped over the mouthpiece of the receiver, and muffled voices speaking swiftly in the background.

The voice returns to phone, and speaks sternly: “Sister (The Nurse) will see you next Thursday at 11:00 A.M.” With this, the call briskly ended.

I was left, on the line, feeling embarrassed and confused.

I arrived for the appointment full of dread. When Nurse calls my name, I slink into her office sheepishly.

“How can I help?” she says brightly, all smiles.

I disclose my request, and from her reaction, it becomes very clear to me that she has had no prior knowledge of my intention.

She blenched, and lost her friendly composure, as if I had just announced my return from a tour of duty as the chief paramour of the French Foreign Legion.

Her hesitancy was matched by my own shy reluctance and swirling embarrassment. Following an awkward conversation, wherein we both said little, and a lengthy and uncomfortable silence, a truce was called.

She took my blood pressure (not surprisingly sky high!) and my weight, and I then scurried away as quickly as possible. For weeks, I was troubled by this encounter (and the phone call episode) but said nothing to no one. I broke my silence yesterday when I stopped in to see my Wonderful Lady GP (General Practitioner) for a refill allergy prescription.

“How are things?” she asked, her smile always soothing. Feeling a bit disgruntled, I allowed myself vent.

After listening to my wacky tale of woe, my Wonderful Lady GP laughed aloud heartily through her beaming smile. “Oh, you should have spoken to me first. I would have warned you!”

If I had spoken to her initially, she would have alerted me to the fact that annual gynecological exams and smears are not routine procedures in the UK. In fact, according to my WLGP, many British women in the UK live their entire lives without ever having an exam or a smear at all. Cervical smears are offered to patients – as an option -- every three years.

 Now, it was my turn to blench.

“Three years?” I questioned her, bemused. “Yes,” she said flatly, and explained the rational behind it: “If the NHS got involved in annual physical exams for women, that would be all that the NHS would do. All day, every day. There are just too many women in this country, and every woman has one.”

With a policy such as this, the thinking goes thus: The only reason a woman would choose, request or require to have an exam and smear outside this three year period would be if something were seriously wrong, or grossly amiss. Hence the reactions I’d encountered.

Thankfully, my Wonderful Lady GP has also practiced medicine in Canada and the US, and as such is more familiar with our approach to the yearly female check-up.

“So,” said Wonderful Lady GP. “I’m happy to give you an exam if you want one.”

Well, truth be told, no one actually wants to have to that done. I’d rather have a root canal without anesthetic! If I’m offered a “Get Out” clause, than I will certainly take it: “No thanks,” I said. “I can wait.”

All of this now has me wondering. Can one deduce from this that the NHS is lax and negligent in their care of British women? Or, are health care providers in the US over-zealous and opportunistic – lining their pockets by encouraging women to undergo a needless, annual, routine procedure?

One thing is certain: Britons and Americans are divided by a common language; and clearly, ‘vagina’ is not part of the vocabulary.


Anonymous said...

Funny post for today. I was just thinking about writing a post of my own about the two letters I have received inviting me to schedule a cervical smear. In fact, I tried talking to John about it earlier today, but he wasn't much help and I don't think it's a topic that he'll be interested in reading about over at GOTJ.

I think I understand clearly that you didn't get one ...is that right? I was kind of hoping you had so you could tell me what to expect ... sort of here versus there kind of chat, but it sounds as if yours is on hold.

Funny stuff though with the 'girlie bits' ... I may give that conversation a miss with the receptionist when I do make my call.

It's a brave new world ... init? :)

Moni said...

US providers are overzealous when it comes to many health care issues, partially because it's a much more litigious society. I should know, I'm a law student in the US! Doctors here are much more likely to practice "defensively", where they're overly careful in order to cover their ass.

As this Mayo Clinic link explains (http://www.mayoclinic.com/health/pap-smear-guidelines/MY01148) the recommended US guidelines are probably a lot different than you remember. First one at 21, every 2 years in your 20s and every 3 years in your 30's! Like many things, the word has been slow to get out. Also, people are suspicious of changes that require less screenings because they think that health providers are trying to decrease their quality of care in order to save money.

Victoria Plum said...

Crikey ... I thought that the three-yearly appointment was enough!! :)

NFAH said...

Yes, you've got it -- "health care providers in the US over-zealous and opportunistic – lining their pockets by encouraging women to undergo a needless, annual, routine procedure" and mostly able to enforce it by holding birth control pills ransom if you don't come in annually for a yearly prescription.

Iota said...

Oh gosh, I've been meaning to blog about this. What I want to know is, what are they looking for, in the annual exam? I was also a bit horrified to read in a book designed for young teens that they recommend the annual check up, as soon as you start your periods. That must be fearsome. I can't imagine how intimidating that would be at age 12 or 13.

I think the annual smear test is a good idea - who wants cervical cancer to go undetected for up to 3 years? But what on earth else do they check for?

You don't have to answer. I'm sure I could google it.

And I hate having to tell the receptionist what my medical issue is. So much for patient confidentiality.

Kneazle1 said...

Urgh not the most pleasant of procedures at the best of times, a necessary evil. I always thought that it was five yearly here in the UK, but then I tend to wait for the missive from the doctors surgery to book.

The receptionist and nurse really shouldn't have behaved like that, they are supposed to be professionals. Luckily for me I haven't had this kind of reaction, although my last one was an ordeal for both the nurse and myself!

Deidre said...

I went to Mount Holyoke! Ahh, M&C's. Good times.

My roomie first year was in the vagina monologues and she got drunk after opening night and in her sleep just said her monologue OVER AND OVER AND OVER again.

And in Australia, they require a pap smear yearly too.

Anonymous said...

HAHAHA. This cracked me up. I had a similar incident... thought not nearly as awkward.

I went in to see a gyno and get a "smear" and switch up my BC pills when I was there. I went to a local place my BF's mother recommended to me. When I explained that I hadn't had one if almost a year and that I knew, being on BC pill I needed one every six months, she looked at me like I was asking them to give me a boobjob covered by the NHS. When she explained that girls only had them every few years—or maybe every year—I said "ok, let's start now and I won't come back for a while!"

How crazy... I think the NHS just hasn't learned how to manage their funds yet. Ugh.

Goooood luck! You can always come back to the states to visit and pop in. ha