Bruised (Part II)

by NotDownOrOut

My Friday appointment with a physician’s assistant (“P.A.”) in the Gynecology Department at the county hospital was a trial for which I knew I was unprepared. I was nervous about it and the P.A. kept deferring her examination to take a more complete medical history.

After what seemed like a very long time, the P.A. got up and helped me put my feet into the stirrups. She started to run warm water and explained that she would be rinsing the speculum so that it would not be cold when she used it. I was just about to lie back.

Then she changed her mind and decided to perform a general medical examination first.

She listened to my lungs, my heart, examined my breasts, examined my visible hernia, and palpated every place where lymph nodes may be found. Every once in a while I trembled, but I was able to arrest my fears with the certain knowledge that this examination could not possibly prove to be as bad as the last one.

At one point she discontinued her exam to go make more notes on the computer because I mentioned my aunt’s breast cancer. She scolded me so very kindly for leaving this out during the earlier discussion of medical history.

In the end, she did the exam. And it was not as bad as I imagined. Because I have been healing over the last fifteen months. I no longer have a raging bladder infection. My bowel is no longer newly burnt. According to my last CT it has become somewhat “hardened” by radiation. I figured everything else was going to be hardened, too, but there is some resilience left and some of it is emotional.

I will spare you the description except to say that some experiences are more disturbing because of how they are done and not because of what is done.

I felt (and still feel) that I was killed with kindness. I learned certain things about my post-surgical body that no one else explained to me in the last fifteen months. The P.A. commented throughout the exam. I’ll keep some of those lessons to myself. I did appreciate the information. I just found some aspects of the exam uncomfortable. I now wish that I had been more vocal about that. It was not something I could at the time articulate well.

It was not until Saturday that I could say much of anything about the entire experience. I kept asking myself if I had been overly sensitive. I kept replaying the kind words, the scolding tone, the repeated assurances that she treats all her patients like they were family,  and the seemingly intentional delay of the exam. I acknowledged that it was not the P.A. who walked me around the halls nearly naked. I was disappointed in myself for not asserting myself more forcefully. I was kicking myself for not having medical insurance and choices and living up to my own potential so that all of this could have been somehow avoided.

Tears started to leak from the corners of my eyes as the exam drew to a close. I wiped them away with a little embarrassment. It seemed important to the P.A. that I put in words that it had not been as bad as I imagined it would be–and it wasn’t bad the way I feared it would be. But I was so eager to get out of there.

She left me there in the stirrups while she went to find the never-to-be-seen Dr. Y. On her return she announced that he was satisfied with her report on my condition and did not feel the need to see me.

She helped me sit back up and told me that there were no visible signs of cancer’s return. Her practice is to not call if the tests done are negative. We discussed the fact that I don’t use text messages so, if she needs to report bad news, then she will call me and leave me a message telling me I need to come in to see her.

After that, she left me to dress, I cleaned up and tried to leave, but she was in the next room still typing notes on a computer. I went back to my examining room to wait for her to print out some papers for me.

She explained that I will need to have an internal examination every three months for three years, then every six months for two years, then every year. She told me how I should have my hernia fixed and that I should see the primary care physician soon.

Then she pulled out her candy bowl and asked me to choose a piece of candy. She explained that her brother loved candy. She offers some to all her patients. Some of them are diabetics and, particularly after the long wait in the clinic, their blood sugar is down and they are grateful for the treat. I could take as many pieces as I wanted. The bowl was filled with Mary-Janes (a very hard toffee that I haven’t seen in many years) but there were other things, too.

It all seemed very odd to me. After all of the kind comments and reminders about blood pressure, gallstones, diet, diabetes, cholesterol, and everything else, she offered me candy. I took a mini Baby Ruth and said, “I’m going to save this to remember you. See, there’s a little pocket here in my purse for it.”

We walked out to the nurses’ station and she explained that I could ask for her specifically on my return. Lots of people do that. I showed her the note I already had put in my open calendar. It was her name followed by the notation, “SO KIND.”

I have a headache today. I still feel unappreciative of the kindness and that bothers me a little because I have gotten so used to feeling grateful that it seems terrible to me that this seemingly nice woman has bothered me so much when she said the same sorts of things other medical professionals have without giving any offense.

When I spoke of the day with my mom on Saturday she recalled once reading that, in her lifetime, doctors would end up ruling the world. They would order all of us to eat certain things and not others. They would criticize our lifestyles and dictate to us about our behaviors and habits. “It’s come to pass,” she said.

I do these things in my professional life, too. I evaluate. I comment. I criticize. I compliment. I lecture. I intend to examine my own behaviors carefully and question my methodology. But first I need to get over the feeling that I have been bruised. No wounds were inflicted. It was such a subtle experience. It was SO KIND.