It’s okay, Doc. If you’ve seen one, you’ve seen ‘em all!
Why does everyone always make that same joke? I always wonder if it’s meant to comfort me or the joker. If I’ve seen a thousand, does that mean I might be less interested? Don’t they want me to be interested? They came to me for advice, after all. Presumably it is meant to de-sexualize nudity. Like if I’ve seen it all, it probably doesn’t turn me on anymore. That is the most depressing thought possible. One of the popular complaints about doctors is that we have a hard time seeing the patient as a person, that we don’t relate on an individual human level. And yet, when faced with that uncomfortable interchange where clothing becomes an issue, the person at the point of revelation objectifies herself to remove any sensual element, to ease the momentary conflict that represents both a glimpse of a power imbalance and a fleeting vulnerability. Sometimes, though, it’s the physician who is assailable.
In medical school, we had to practice the heart and lung exam on each other. The class was divided into genders (as far as they knew); our instructor was this crusty old French Canadian, whom I had really admired up until then. She felt that it was necessary that we take off our shirts and get into gowns for this exercise, and there was nowhere to change. While I was wishing that I had shaved my armpits, she chose one of us (who happened to be the most reserved and modest, and later became a dermatologist, perhaps due to this very experience), and sat her on a desk to use as a model for the exam, which I guess is the way they do it in Montreal. As the instructor went for the location of the mitral valve with her stethoscope, she flung wide the future dermatologist’s gown, and left her sitting there for a long, painfully embarrassing time while we all tried to focus on her chest and memorize the four locations to listen for murmurs: A-P-T-M (aortic, pulmonic, tricuspid, mitral) the mnemonic for which is All Physicians Take Money, the only one I can think of that involves currency. More typically, mnemonics for memorization in anatomy are weirdly sexualized. The bones of the wrist can be remembered by Some Lovers Try Positions That They Cannot Handle (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate) The structures that pass through the superior orbital fissure: Lazy French Tarts Lie Naked in Anticipation of Sex. The twelve cranial nerves: Oh, Oh, Oh, To Touch And Feel a Valley Girl’s Vagina And Heiny. I imagine that it goes without saying that the rest of them are also misogynistic and um, grammatically painful.
The cardiopulmonary lesson was relaxing compared to the Pelvic Exam Module. During this path to a bleeding ulcer, one reads a book about how to do the exam, watches a video, and inspects a model to review the anatomy. Then there is a “simulated patient” who is a woman trained (and paid) to be the recipient of pelvic exams by bumbling medical students and to provide them with “feedback” in order to hopefully polish things up a bit before they are wielding a speculum amongst the masses. The idea is to role-play, to pretend that I am a real doctor (ha!) and that she is a real patient. Part of the requirement is to recite out loud all the steps so that the preceptor, (a fifty-something guy sitting on a metal chair in the corner scribbling on a legal pad) will know that I have memorized the exam and have some clue what I am doing. This is a damn sight harder than it sounds. Faced (literally) with the actual lady, and her actual, you know, pelvis, aware of the guy in the corner, and having to say out loud things like, “I’m going to separate your labia now,” it is very difficult to remember to palpate the ovary and inspect the cervix. When it is blessedly over, she is supposed to gently explain all the things you could have done better. In my case, it was even worse. She sat up and smoothed the sheet with her hand. I noticed her wedding band, but thankfully I have no memory of her face. Her shiny pink cervix, yes; but the color of her eyes, her age, and her hairstyle have all vanished. As the guy in the corner and I both waited, his pen poised above the paper, eyes on the clock, the back of my neck wet and clammy, she said (I swear to God), “That was very nice. Have you done this before?” She paused, sweetly, expecting an answer, but there was no way I could possibly form a useful sentence (Like what? Yes, but it’s not usually so brightly lighted? Yes, but usually after dinner and wine? No, but I already know where everything is?), so I just said no, and smiled sheepishly.