A “Routine” Procedure by JC Staff

*trigger/difficult content alert – discusses medical examinations

In my twenties, I move up north with my boyfriend.  We have been living in the village less than a year, our days are busy with commuting into the city, working and studying.  I have only been to the doctor’s in the next village a couple of times, once for an ongoing back issue, and another time for my asthma prescription.  It has been a few years since my last routine cervical smear test, and it’s overdue – but let’s face it, life is busy, the test is a chore, and it’s easy to let the time elapse between appointments.  I have been living with my boyfriend for 2 years, and have no pain or concerning issues, so the smear test is low on my priority list. Eventually, I make an appointment at the doctor’s, just to get it over with.

In the waiting room, I sit slightly nervously, staring into my phone and waiting to be called.  The village population is elderly, and a number of coughing/sniffling older people sit chatting to each other about various ailments as they wait.  I hear my name, and look up to see a young nurse.  A very young nurse.  Seriously, she looks like a teenager.  Where is the matronly older female nurse who normally works here?  Oh well.  I follow the young woman into the examination room, and start complying with her monotone instructions to remove clothing.  She’s not very friendly, and seems nervous, distracted – her words sounding wooden and stilted.  I feel a little more anxious now, as her inexperience is already palpable.  She makes no attempt to relieve my trepidation as previous nurses have done prior to the exam.

As I lie back on the bed, naked from the waist down, with the paper sheet crinkling against my skin, I am immediately shocked.  On the ceiling, directly above me is a poster.  It looks like the ones which come in the centrefold of pre-teen pop music magazines, and features the popstar, Robbie Williams.  Jeans seductively unbuttoned, he is naked from the waist up, tanned, and rippling his six-pack abs with a smoulderingly sexy look on his face.  “Just relax” says the child-nurse, with a robotic tone, as though she would rather be anywhere else in the world, but in this room with me.  “Snap”, I think, feeling exactly the same way.

I lie there, my feet in the icy cold, metal stirrups, feeling incredibly vulnerable, and trying to take in the poster and process its incongruity.  Why?  What is its purpose?  Is it implying women will feel aroused by the sight of that man, staring down at them, and will be more physically compliant with a gynaecological examination as a result?  Surreal.  A poster featuring a meadow in the Swiss Alps, or an image of a seascape with an empty beach, a bent palm tree and an inviting sunset may have eased the tension a little.  But this?… I am unable to make sense of it at all.

The procedure begins and is immediately extremely painful.  I take my breath in sharply in response, entirely unprepared for the pain having only experienced mild discomfort on previous occasions. “Sorry”, says the nurse, sounding feeble, retracting her equipment.  My tension increases now, as cervical smear tests have never felt this uncomfortable in the past.  The nurse apologizes again weakly, making another attempt.  The pain is all-consuming.  I won’t go into any further detail, but needless to say, the procedure feels very wrong.  It is not supposed to hurt like this.  The Robbie Williams poster suddenly feels very irritating, like I’m being watched by the singer, mocked, as I’m enduring a difficult and painful examination.  Feeling sexy is the very furthest thing from my mind right now.   The young clinician now quietly apologizes once more, aware of the physical discomfort she is causing.

In a blur, she finishes, and I am distantly aware of her offering me a tissue – inadequate is an understatement.  I hear her saying it’s “all done”, and telling me I can get dressed again.  I don’t remember the rest, and drive the mile or so distance home in a daze.  As I stumble into the house, feeling shaky, I go straight to the bathroom.  I am bleeding heavily, and my dress is already stained.  It was a favourite.  I throw it out – even if I had got it clean, I wouldn’t wear it again as it would remind me of the experience.  I get changed and lie on the sofa; I am feeling delicate, tearful, and the pain is acute.  I take some pain medication and call my boyfriend, crying.  He leaves work straight away and comes back to the house.

I spend two days on the sofa recovering.  When the ordeal has passed, my feelings shift from feeble and injured, to angry and indignant.  Why was the test carried out by someone so inexperienced?  Why is there a poster of a half-clad male pop singer on the ceiling above the very spot where women are being investigated for possible signs of cervical cancer?  How exceedingly inappropriate is that?  Is the sight of a famous male celebrity meant to turn women on?  Who feels turned on during a vaginal examination, for God’s sake?

I write a lengthy letter of complaint to the practice manager of the doctor’s office.  I highlight that it seemed clear the young nurse was inexperienced and should not be left alone to carry out invasive, gynaecological tests which she clearly lacks confidence in doing.  As well, I ask who thought it a sensible idea to put the poster of a half-dressed male pop star above the examination bed?  It was utterly offensive, in my opinion.  One in three women on that bed will have survived sexual trauma, and do not need a photo of a man staring down at them when they are lying there, trying to clutch tightly to shreds of dignity as they undergo a pelvic examination.  I suggest others may feel the same but are too embarrassed to raise the issue. Surely gone are the days when we are to be subject to that level of patriarchy.  (I think Robbie Williams is ugly anyway.  And conceited.)  Seriously, a half-clad male celebrity, striking a pose, conflated with a sexual health procedure is entirely inappropriate.

Finally, I state in the letter that I was only aware of the incompetence as I had prior experience to compare it to.  Any young woman who may have endured that as her first experience of a cervical smear test, would have likely been far too traumatised by the ordeal to ever go for another one.  This, in itself, is very concerning, and potentially dangerous, as cervical cancer, like others, is most manageable when detected early.  It is essential that women’s sexual health care is accessible and sensitive to women’s needs.

I received an apologetic letter in reply, from the manager of the doctors’ office, and the poster was taken down.  Gratefully, we only lived there for two years, and smear tests I have undergone since have been routine, carried out by skilled medical professionals, with only run-of-the-mill mild discomfort.  I would always encourage any woman who experiences sub-standard healthcare to speak up, challenge poor practice and expect high standards of quality care where your physical and emotional health are concerned.  You are likely not the only one who feels that way, and might be raising an issue that affects others, too. 

Your safety matters.  Your voice matters.

You matter.