To the Doctor Who Didn't Take the Time to Get to Know Me
Editor's Note
If you’ve experienced sexual abuse or assault, the following post could be potentially triggering. You can contact The National Sexual Assault Telephone Hotline at 1-800-656-4673.
You asked what my food goals were, and I replied, “To eat three meals a day.” You lectured me about eating home cooked meals and snacks in-between to avoid overeating. What you didn’t know is that cooking a lot of the time sends me into a flashback. What you didn’t know is that I’m almost always nauseous either from medication or anxiety. What you didn’t know is that it’s a good day when I can eat breakfast and manage to also eat dinner. All you saw was a BMI that said I should be thinner. You didn’t see the SSRI side effects. You didn’t see someone who panics when she tries to exercise, because her heart rate increases and her body doesn’t know she is safe. You didn’t see me; you just saw a person who should eat healthier and exercise, simple as that.
You asked when my last pap smear was and when I replied, “Three years ago,” you asked if I was prepared for one today. I immediately started to panic and shook my head. Even writing this now, my hands are shaking and my heart rate is increasing. You said it would be simple, it would be over quick, it was important and then I wouldn’t have to do it again for three years since I had never had an abnormal one. What you didn’t see was a sexual assault survivor panicking on the exam table. I told you about my post-traumatic stress disorder PTSD diagnosis earlier in the appointment to add it my chart and I had my service dog with me, you neglected to ask about either. I gave you a pass, lots of people don’t like getting pap smears and get anxiety about them. My reaction was common.
But then you asked if I was doing monthly self breast exams, and I shook my head. I was really panicking at this point, trying so hard to stay in my body, to stay present. You lectured me about how I really should be doing them and said you would send me home with a pamphlet, a fucking pamphlet. I feel like all the puzzle pieces should have started to add up: PTSD, service dog, refusal of pap smear (and hadn’t had one in a long time), no self breast exams, appetite issues, and I had answered “yes” to the depression screening questions the nurse had asked prior to the doctor coming in. Did you even read my chart?
I had been to the ER a week prior with an ankle sprain and you didn’t even ask about that. You didn’t even ask how I was feeling. You saw all the mental illness diagnoses in my chart and all you asked was if I was following up with psych. You didn’t even ask how it was impacting me physically. You saw I had migraines and that I saw a neurologist, and completely dismissed talking about them further. You didn’t even ask how my migraines were. I was so dissociated by that point, I couldn’t advocate for myself.
As my general practitioner, I think you need to look at the whole picture. My mental health is connected to my physical health. It’s not as simple as you made it. And even more importantly, you need to realize that gynecological exams for survivors (and that could be anyone, and you won’t know unless you take the time to get to know someone) can be a lot more complicated than simply doing it without any preparation.
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