Playing Doctor

This week I left my second review on Yelp. The first was for a Turkish restaurant on Long Island that was suffering because it didn’t serve wings or show baseball games on an overhead television. The second review was for my gynecologist.

Yes, I am the kind of person who indulges in inappropriate humor for the sake of shock value. Yes, I am perversely obsessed with euphemisms for genitalia. Yes, I know that writing about vagina will likely mean that I can still keep some lesbian cred. But I earnestly reviewed my new doctor because she was that good. After taking what looked like a miniaturized toilet brush to my cervix I still wanted to sing her praises. After five different doctors looking at my nether region over the span of six months, I’ve learned that not all OBGYNs are the same. Granted, I never spat at the ones who freaked me out, or wrote angry letters to the ones who neglected to ask me questions, or keyed the cars of those who gave me backward advice. I happen to think that looking at labia all day can probably fry a brain pretty quickly, similar to pornography editors or swim coaches.

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The main reason why this doc had me clicking a five star rating on a website is because of what other doctors fail to do. The average primary care doctor spends less than eighteen rushed minutes with their patient. This seems like a ton of time to me, considering that I’ve often been in and out of an office with an exchange that amounted to a two-word description – "it hurts," "it’s swollen," "can’t breathe." I’ve always been prescribed antibiotics, but I’ve rarely understood what was wrong with me when I left. I don’t blame the doctors. They have to spend the majority of their day filling out paperwork and micromanaging bureaucratic nonsense due to the insurance debacle of this country. So for this woman to sit down with me both before the exam and after, and for her to take the time to ask me about my history, it was a welcome change from the harried gyno visits from the past, most of which seemed more like unwilling one night stands.

Gynecologists probably have to deal with more paperwork than other doctors, too. This is an assumption I’ve come to after reading that their insurance premiums are among the highest in all specializations. Being sued for malpractice is one thing when a scar doesn’t heal correctly or a boob implant leaks, it’s something completely different when the health of a baby is involved. Although the majority of malpractice claims end with the ruling in favor of the gyno, this risk of being sued left and right comes with a high price. Moreover, the possibility of being sued lasts long beyond the initial cord cutting, since many problems only show up once the child starts to develop. If my dad is reading this, I don’t think you can sue after your kid turns twenty-five.

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Dr. Gershowitz was like a hip version of my grandmother, only a little younger. She buzzed around at the speed of an NBA referee, smiling and chatting with everyone as she made her way from the examination room to the office and back again. This was a change for me. Usually, an exam was sort of like a visit to the DMV. I’d wait for an hour or so, grinding my teeth, and when my name was finally mispronounced, I was treated with the sort of brusque, cranky service that you expect from people who would rather be anywhere but at work. The sun-soaked waiting room and proficient, good humored staff were a change. I had to double-check that I was in the right sort of doctor’s office, as this sort of contentment in a doctor’s office I only associated with nitrous oxide.

Another difference was the exam itself. I’m a hypochondriac by nature, so I naturally approach the examination table as though it were an electric chair. Unsuccessful evasive tactics I have used while in the stirrups include straightening my legs until my vagina was as far away from the doctor as possible, folding my knees towards one another in order to prevent speculum insertion, and holding my breath. I also clench every muscle and orifice in my body once the doctor peeks under the hood, a ridiculous and self-defeating tactic that only makes the whole thing that much more difficult. Like a Bergman film, there’s never much in the way of sensible dialog, simply wincing and doom. It’s not as if I’m so obtuse that I don’t realize that, as with all things, my approach is probably a large part of my problem. But every tactic – from yoga-inspired deep breathing, to visualizing a peaceful forest, to trying to find the humor in the situation – does nothing to sway my screaming brain away from the fact that I am extremely uncomfortable to the point of whimpering. I feel nauseated, sweaty, and as though they’re probing a literal open wound as opposed to a metaphoric one. I just know that I want it to be over and done with, and no relaxation technique that doesn’t come inside of a prescription bottle is going to change that.

In case you believe I’m being glib, my psychiatrist wrote me two prescriptions for anti-anxiety medications for the last visit. Although I didn’t take them due to fierce paranoia when it comes to my sobriety, I had ‘em on hand.

Dr. Gershowitz is not the kind of doctor who allows for those sorts of shenanigans. She realizes that our precious time together is brief, and she’s already gone through the rigmarole of figuring out what’s going on with me medically. The time when I’m on my back is her time to chat, to let loose. I have never had a woman who I wasn’t dating insert two fingers inside of me while telling me about themselves. Moreover, I’ve never been expected to keep up my end of the conversation during a Pap smear. Dr. G actually looked at me with what was almost impatience when I hesitated offering my opinion about the West Coast as she finished dusting the cobwebs away from my uterus. Oddly enough, this tactic worked. Because she wasn’t letting me lay there and think it was a big deal, and because she acted like this was more of an opportunity to connect, not dissect, I wasn’t allowed to get sucked into my usual spiral of panic. By the time my adrenaline had gotten to the level I normally associate with having that part of me probed, my panties were going back on. I was amazed. Finally I was presented with an example as to why OB/GYNs make nearly $300K a year on average.

When I researched what’s normally involved in the field, I was even more impressed. Sure, like most doctors, gynos have to go to medical school and then partake in a residency program. After that they usually attend some sort of fellowship for a subspecialty, such as Maternal-Fetal Medicine, Reproductive Endocrinology, and Gynecological Oncology. This fellowship often lasts about three years. Following the fellowship there are examinations and certification from the American Board of Obstetrics and Gynecology. Then, after four years of undergrad, four years of med school, and three years of a fellowship, they enter a career where the number of patient care hours per week averages around fifty. Often because of labor and delivery, they work at all hours. Certain practices allow for more schedule control, like private practices where the baby extracting stuff is left to family physicians, hospital OBs, and midwives. Clearly tons of factors like where they practice can affect a gynecologist’s schedule, but you have to think that this is some pretty exhausting work, in spite of those elementary school jokes that the boys made about it being an easy job.

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I give every doctor I see a ton of credit. Not only are they busting their ass in a system that is filled with legal minefields, bureaucratic pitfalls, and mountains of paperwork, they also have to hear people complaining all day. If they spend more than two minutes in a room with me and I don’t leave feeling like a donkey’s lower colon, I figure that I owe them a repeat visit. In Dr. Gershowitz’s case, I’d like for every vagina on this damn island to go to her. Their owners would probably leave feeling a whole world healthier and happier. New York would be a more laid back, peaceful place. Maybe the girl next door would even start smiling at me in the hallway. But I kind of doubt it.

And to put the cherry on the oversharing sundae, I have menopausal level estrogen, which means that reproduction will require more scientific intervention than Jeff Goldblum’s acting in The Fly. Although I’m under thirty, for me to have a baby, a sperm would needed to be guided into my egg with more precision and planning than a moon landing.