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The nurse came in. I had my examination; it was as bad as I imagined. It was painful. It was awkward. It was embarrassing.

But the worst part came after the exam.

By Cass Irvin

My sister had breasts when she was twelve. She was very modest and would absolutely not uncover her chest when she had to go to the pediatrician.

Mom fussed at her and called it "false modesty." She said Dr. Carlson had seen lots of little girls' chests before.

I thought my sister was being silly. But that was the last time my sister went to a pediatrician.

I, on the other hand, didn't have breasts until I was sixteen. I was in and out of the hospital a lot. All kinds of doctors and nurses saw my breasts. Our pediatrician was a family friend. He knew we had hospital bills so he didn't charge us for check-ups. I kept going to him until I was nineteen.

After I started college I knew I should be more grown up. I decided I was going to see a general practitioner if I got sick -- and a gynecologist.

In college I met my first best friend. Lynn was like me: she had been sick a lot and was in and out of the hospital; she even had an older sister! We understood each other and did lots of things together. We met our first boyfriends at the same time. We lost our virginity around the same time, too.

Once we started socializing, Lynn and I decided we'd better think seriously about what we were about to do. We were conscientious, liberated women of the Seventies. We decided how far we intended to go and we prepared to be responsible for ourselves -- and our actions. We wanted to experiment with sex and not get pregnant just like all the other girls we knew.

We had not done anything yet, but we both felt that the opportunity, which had eluded us until now, was fast approaching. We were going to make this decision about who, where, and when very carefully. When it came, we wanted to be prepared; we wanted protection. We were not entirely sure we were ready for love yet but we were sure we were not ready for babies. We were going to get The Pill. So off we went to the "gyno." Of course, our mothers were unaware of our real reason for going. We were liberated -- but not crazy!

Is everyone's mother the same? While intending to make things easier, do they all go out of their way to make things worse?

My mom tried to explain, in exact detail, everything that was going to happen to me at the doctor's. She was trying to make it not so scary. She was trying, all right!

"I worried that Mom would mention to someone that this was my first visit. And she did. To everyone: the nurse at the reception window, the old lady sitting beside us

"Well, of course you have to take all your clothes off! How do you expect him to examine you down there with your panties on? They'll just be in the way."

"OK, Mom," I responded with a tone I hoped said: Enough, Mom. ENOUGH.

"But before that," she continued. "You'll have to give the nurse a urine sample. They give you a little cup and you have to go in it."

"I have to urinate on command!" I shrieked. She kept talking. She was not paying any attention to me.

"Of course, sometimes it's hard to go if you're nervous. We'll see if they'll let you put it in a jar before we leave for the doctor's.

"You'll have to put your legs in these stirrup things and spread your knees apart. That's so he can examine you better. He'll stick this thing in you. It looks like spoons. That's so he can open you up inside, so he can look way up inside you."

"Does it hurt?" I wasn't sure I wanted to hear this.

"Well, not exactly. . . well, yes. It always hurts the first time. But just relax. If you don't relax it will hurt more that it has to."

"Thanks for the info, Mom. What's for dinner?"

"While he's got that thing in you, he'll do a Pap smear." The term somehow sounds demeaning.

"Mom, let's change the subject!"

"Don't worry, it'll be over before you know it. We all have to go through this, you know. You'll get used to it." (She was wrong. I've never gotten used to it!)

Lynn and I scheduled our first gynecological appointments for the same week. Mine was first. My mom took me.

It's strange sitting in the doctor's office, waiting. A room full of women; all ages, shapes and sizes. We know what's going to happen to us and all of us are acting nonchalant, as though being here is the most natural thing in the world. We're all making small talk.

I noticed that the older women, women my mom's age, seemed to be the most nervous even though they were trying not to look nervous. Are they all like my mom? Do they find anything to do with sex embarrassing? Mom's gruesome description of the exam, I'm sure, was influenced by her discomfort at the telling of it.

I worried that Mom would mention to someone that this was my first visit. And she did. To everyone: the nurse at the reception window, the old lady sitting beside us. At least she didn't say to the doctor, "This is her first time."

Mom came into the examining room with me to help me undress. I tried not to seem freaked out when she offered to stay while I was examined.

"I'm grateful -- really, Mom -- but I'm grown, I'm a woman now and I don't need my mom holding my hand." Or present for private doctor-patient conversations!

The doctor came in the room. After a minute of pleasantries between him and Mom -- "Hi, how are you?""Fine.""How's Mel? How's the fishing at the lake?" "He's fine. We spend most weekends there. Have you been down lately . . ." -- I stared daggers at Mom.

"Well. . . " She finally noticed me. "I'll just wait outside. I'll be right out here if you need me."

She patted, squeezed my hand in that assuring gesture moms, grandmothers, aunts have.

"Thanks, Mom."

As she left the examining room, the doctor took that same hand: "Well, little lady. Did you know that I've known your mother since before you were born? You look just like her. Well, let's take a look inside. . ."

The nurse came in. I had my examination; it was as bad as I imagined. It was painful. It was awkward. It was embarrassing.

But the worst part came after the exam.

The nurse left the room with the slides. I was still lying on the table, this time with my knees together. The doctor took my hand again and asked:

"How are you doing? Is there anything you want to ask about, talk over with me?"

My opportunity had arrived!

Picture this: It's the early 70's, the Age of Aquarius, the peace-and-love generation. Our biggest fear then, I guess, was that we might miss something.

Picture me: a young, intelligent co-ed, lying flat on her back, nude, covered with a stiff sheet, with a very nice fatherly-type standing over her, caressing her hand the way doctors did in those days. Her (me!) wanting to sit up, not liking to have to look up at him, feeling somehow a little helpless since I could not look him straight in the eye. Lying there I felt like a naive, awkward teenager -- which, I must admit, in many ways, I still was.

And, like a teeny bopper, I beat around the bush. I couldn't bring myself to say: I'm beginning to go out with guys and I want The Pill. I was living in the Seventies brought up by parents from the Forties. Nice girls just didn't do that. If they did, they didn't talk about it. Nice girls didn't get into trouble, either.

So I screwed up my courage and said,

"Well, I'm seeing this boy and, uh, he's really nice and he likes me, a lot. And, uh, I realize when we get real close . . uh, like kissing and stuff. Well, I realize that he's bigger than I am . . . and I get worried. I mean, he's real nice and all. But he's strong . . . (I did not think it was necessary to add  "-willed") and I'm weak. And, I, well uh, I worry. I wonder if I should have some protection, or something . . . uh, like The Pill or something. You know?"

It made perfect sense to me. I was a small, frail, helpless female. It could happen! The Pill was supposed to be easy to get; it seemed like everybody was on it. It was supposed to be no big deal. But I was nervous. I was unsure of myself. I should have thought of a better story.

"Oh, no dear. You have nothing to worry about." He took my hand again and sat down beside me. He looked seriously into my eyes. I thought he was going to tell me I was sterile but I didn't think he could know that this soon.

He continued,

"I know your family, dear. I know your background. You would never meet a boy who would not respect you, or your family. You would never meet the type who would try to take advantage of you!"

I was speechless! How ironic. The boy I was interested in was one my parents would not approve of. I did have a guy who was kind of pushy, kind of persistent, kind of aggressive. But he wanted to be with me and I did not want to have to say "No."

How could I say something like that to a doctor who knew my family? I left the doctor's office sore, healthy, and unprotected.

Two days later, after Lynn's appointment, I called her. I was gushing with tales of Mom and her gory details, my exam experience and being exasperated that I did not get The Pill. I guess I over-dramatized, humorized, the facts. I was enjoying my storytelling, so it took me awhile before I realized Lynn was not laughing. She was, in fact, very quiet.

"He said I was a very pretty girl and that was shame, really, because men would be interested in me. But, of course, I should never marry.



"What's wrong?"


"What happened when you went?"

"Nothing much," she replied. Her voice was strange. It was not the Lynn I knew.

"Did he hurt you? Is that what happened. If he hurt you . . . my doctor wasn't very gentle but I guess he didn't really hurt me. Lynn, if your doctor hurt you, I bet you can switch."

"You couldn't really say he hurt me, exactly." Her voice trailed off like it does when she is thinking to herself, when she's trying to decide if she wants to tell you something, and how much. Lynn's not secretive, just sort of private about personal things.

"I saw Dr. Gardiner." She finally spoke up. "He's my sister's doctor. I went by myself. Filled out all the papers by myself."

I didn't like her tone.

"Lynn . . . ?"

"Hush! It's my turn now.

"I waited in the waiting room all by myself. My appointment was for 2 p.m. I was there early. I filled out the paperwork and turned it in. And waited. I drank coffee; I smoked two cigarettes; I used the restroom; I watched almost everyone else go into the examining room and come out. I had never done this before. I didn't know if this was unusual . . ."

"Remember," I interrupted. "If you have something to talk over with the doctor they always put you towards the end of the day." I was trying to explain away something I didn't understand myself.

"Be quiet, Kit. Don't interrupt. You're going to get me off the track and I'll have to start all over again. Now, where was I? Oh, yes. It's about 4:30 p.m. now and, finally, the nurse calls me back to his office."

"His office? Not an examining room? His office!"

"You know, his office is quite beautiful . . . built-in bookshelves and a gorgeous oak . . ."

"Lynn! Wait. What happened?"



"Well, I guess I can't say 'nothing', really. Something did happen. We talked."

"You talked? About what? The Pill? Did you come right out and ask for it?"

"No, I didn't talk to him about The Pill. Actually he did most of the talking. I didn't think it was odd being in his office. I just thought he wanted to get to know me a little first, or ask for some history, or something. Soon I noticed his questions weren't about my medical history. It was small talk.

"He asked me about the classes I'm taking in college. He asked me what I planned to do after school. He seemed more interested in my career than my health. I told him after college I plan to teach, to get my own apartment and teach for a couple years. He interrupted me. That's nice, he said. Teaching. Yes, I'm sure you'll make a fine teacher, he told me.

And, then, Kit, he leaned over towards me and patted my hand and said, 'I don't think you need to think about apartments now. Besides who would take care of you?'"

"He doesn't know how much you can do for yourself." I interrupted. "He saw your wheelchair and just thought 'helpless'." Lynn walks a little, mostly around her house; she uses a wheelchair but she's not helpless. You just can't judge by a wheelchair.

"There's more," she responded. "Much more!"

Lynn said that before she could tell him how independent she was, how she drove her own car and everything, he started talking real seriously to her.

"He said I was a very pretty girl and that was shame, really, because men would be interested in me. But, of course, I should never marry."

I was becoming embarrassed for Lynn. If he had said those things to me, I wouldn't have been surprised. We both use wheelchairs, we both had polio when we were kids. The difference was degree of disability: Lynn can walk some, she can take care of herself; I do not walk; I do not dress myself. My wheelchair has motors.

And Lynn looks normal. To see her sitting there, she looks like a normal person sitting in a wheelchair -- not someone "confined." I, on the other hand, look like . . . a crippled person. This doctor did not know her at all. I was humiliated for her. Lynn went on.

"He said it wouldn't be fair, in my condition, to marry. It wouldn't be fair to the man because, of course, the wife is supposed to take care of the husband, not vice versa. If I did find a man who was willing to take on such a burden . . . well I shouldn't be so selfish as to allow that."

"In your condition?" I repeated.

"Crippled and all. His words, not mine," Lynn continued.

"When you called for the appointment you stated you wanted an exam, didn't you?"

"He said it wouldn't be fair, in my condition, to marry. It wouldn't be fair to the man because, of course, the wife is supposed to take care of the husband, not vice versa."

"Yes, of course. I asked him about getting a pelvic. He asked me if I was having regular periods. I said Yes. He asked if I had bad cramping. I told him No. He went on to tell me most girls in my condition have a lot of cramping. Most crippled girls can't move around much and get more cramping than normal girls who can walk around and get exercise if you have cramping you can take The Pill to help that, he told me. He even asked if I had any problems with hygiene during my periods, if I had trouble. with hygiene during my periods, if I had trouble keeping clean, 'I know it's sometimes hard,' he said, 'when you're confined to a wheelchair'," Lynn continued.

I was almost speechless. "Lynn, that's awfu!"

"I told him," she continued, "I thought when a girl becomes a certain age she should get regular gynecological exams. He said that was true for women who are planning families . . . but in my case, since I wasn't having any problems, an exam was not necessary."

He'd refused to examine her! I was sick. For some reason I almost felt guilty that I had been treated so normally while she was treated . . . like a "cripple."

Both Lynn and I came away from our first gynecological experience without any protection. My boyfriend's response to my not getting The Pill: if I really loved him, I wouldn't get pregnant! I decided I did not love him that much so I waited until a "better boy," a smarter boy, came along.

I don't know if Lynn waited or not. She became a very private person after that.

Since you have to go to the gyno once a year, I got another chance twelve months later. This time I suffered no embarrassment in the waiting room. I did suffer the pains of the exam. But this time I was successful. I got The Pill! It's so simple -- when you tell the truth.

"Uh, Doctor, I have these awful cramps and . . ."

Posted March 22, 2004

Cass Irvin is the author of Home Bound, a memoir (Temple University Press, 2004). "Gynstory" originally appeared in a slightly different version in the Women Who Write anthology (2002).

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