Subtitle: Blurry Bottoms—Hand Me a Screwdriver (1987)
For two years Maryann, an attractive mid-30s brunette, had been putting off getting a Pap smear because she didn’t particularly like the OB/GYN doctor she had seen in the past—he was somewhat cold and distant—made her feel uncomfortable, so she put off going. Finally, fear and guilt took over, so she asked her friend for a new doctor recommendation.
Over the years, because of my wife’s hypersensitivity (at least from a male’s standpoint) to being over-exposed “in the position” for a pelvic exam, I had become very conscious of and sensitive to the feelings that most women harbor about being “in the position” with a man doing the examining (notwithstanding Jane, my nurse always standing nearby). Because of my kindly and non-patronizing demeanor and my gift to be able to assist women in feeling a bit of security in an uncomfortable situation, I had gained a reputation as a safe, caring gynecologist. However, my personal or family female friends either came to see me BECAUSE I was gentle and sensitive, OR, they would NEVER in a thousand years come to me for a pelvic exam, because they imagined that if I run into them at the store or church, I’d remember what their bottom looked like (in actuality, for medical providers all the bottoms become sort of a blur, anyway).
So, following her friend’s recommendation, Maryann sheepishly presented at our office. Taking a brief new-patient history, Jane showed her into the exam room and handed her a folded paper (“maximum exposure/minimal coverage”) gown with instructions to take off all her clothes, don the gown with the opening in the front and sit on the end of the table. Moments later, I joined them.
I glanced at the history form—Maryann was essentially healthy, although it was apparent that because of “new doctor/Pap smear” complex—she was understandably jittery, so we made some small talk to help her be more comfortable for the assessment, and with Jane holding her hand, I began with a breast exam—all went well.
Then, with my back to them, I slid on my latex gloves while Jane assisted Maryann to lie down and put her legs up in the stirrups. Over the years, I found that if the patient can’t see my face because of the drapes and position, they are less uncomfortable—kinda like “if I can’t see you, you can’t see me” sort of disconnect. I sat on a stool facing the bottom end (no pun intended) of the exam table, where, just in front of my knees, were two instrument drawers storing the exam speculae (the “duckbill exam thingies” as they were known to many female patients). Maryann was fully-positioned ready for the instrument exam. I applied KY gel to her and reached to open the drawer to pull out a sterile speculum. The chrome drawer handle fell off in my hand! I was unable to open the drawer to get the exam instrument!
Then, in one of those moments you’d like to go back and relive so you can phrase something differently, I unconsciously said, “Jane, hand me a screwdriver!”
I’ll never know exactly what went on in Maryann’s mind that moment, but instantaneously she was sitting straight up on the table with one arm covering her breasts and her thighs pressed together—I just barely got out of the way of flying feet as she screeched, “What are you going to do with THAT?”
Too late to rethink my phrasing, I immediately realized that I had done a massive faux pas, worsening an already bad situation.
Jane promptly grasped Maryann’s hand again and patted it as I displayed the errant loose drawer handle, apologizing for my poor choice of wording/timing. After a short, very quiet pause, we all had a hearty laugh—it broke the ice and the remainder of the exam was quickly completed without incident.
Maryann ended up coming back for her Pap smear year-after-year, but each year before she’d lie down on the exam table, she made me prove the drawer handle was functioning and that no screwdriver would be needed.