An Exceptional Pap Smear
By Dena Harris
For a procedure that takes under ten minutes (the longest part is waiting for the doctor to enter the room), the pap smear gives a lot of bang for its buck. My annual meetings with my gynecologist are so fleeting I probably wouldn't even recognize him on the street. This suits us both just fine.
During the last several years, my pap smear has come back abnormal. I wasn't overly excited about being abnormal until I looked in my dictionary, which defines, abnormal as both "unusual" and "exceptional." The second definition I like. How many women can brag of leaving their gynecologist with an exceptional rating?
For the most part, abnormal has been a minor inconvenience; each year I must return for a second pap smear six months after the first. The second test unfailingly comes back normal. Frankly, after three years I had been growing suspicious about the need for the second test. More than anything, it seemed an easy way for my doctor to make an extra buck.
This year was different. The second pap smear also came back abnormal.
I was scheduled for an exam in which a vinegar solution is used so when the lights are turned down any abnormal cells are highlighted. During the exam my doctor commented-with my glowing vagina in front of him-that I had an extremely small amount of abnormal cells. Being more than willing to give up my exceptional status for the tradeoff of not having cancer, I was pleased.
When my lab results came back, one area indicated abnormal cells were still present, and an appointment was made for a removal procedure.
When I arrived, the nurse walked me to the procedure room and showed me the surgical equipment. Check. She pointed to what I swear was a wire cheese cutter.
"No," she said, "That removes the cells."
I wondered if I could have brought my cheese cutter from home and saved myself a bunch of money. The nurse showed me the super-sized cotton swabs, the colposcope (a big microscope), and the tiny cauterization tool used to seal the wound. No problem.
Then she pointed to a very long, very thin, and I must say, a very sharp-looking needle.
"And of course, that's the numbing solution," she stated.
"Yes." I said. "Of course."
I wondered if she could hear the screams inside my head. Some people have a high tolerance for pain. I am not one of them.
I climbed onto the exam table, thumbed through a back issue of Good Housekeeping and tried to forget about the needle. Surprisingly enough, it is somewhat challenging to relax while lying on a tissue-wrapped metal table, naked from the waist down, and covered with only a thin cotton sheet.
The doctor entered and asked how work was going, and what I thought of the weather. In my eight years of seeing him, he has always asked the same questions. Sometimes in the waiting room, I daydream of scaring him by starting an actual conversation.
Pleasantries over, he inserted a speculum into my vagina (mentally, I refer to this as the "car jack" since that's what it feels like as it pumps and holds the walls of the vagina up and out of the way). He then swabbed my cervix, and dimmed the lights as if we were preparing to watch a feature film. Peering down the walls of my vagina through his microscope he wondered aloud if it would be all right, if he took a bit more cervix tissue than originally planned.
Lying on my back, feet in stirrups, "car jack" propping me open, I thought it considerate of him to ask.
"Sure," I said. "Go for it."
I was told to expect a pinch from the Novocain needle. And in all fairness, that's all it was. Still, I flinched.
Okay?" the doctor asked, pausing.
"Yes," I replied. I felt like I was seven, wanting to show him what a big, brave girl I was. "I just felt that pinch."
"Hmmm-mmm," he murmured, and jabbed me again with the needle. Every now and then he paused to scribble notes on my chart, so I was left lying with giant microscopic eyes aimed dead at my vagina. Sometimes the nurse leaned over and, unable to place her eyes against the lenses, squinted in the general direction of my vagina. I wondered what she is trying to see.
Once I was numb, the doctor picked up the cheese slicer.
"You may feel another pinch (more screaming inside my head). But try very hard not to move. Okay?" he asked.
"Okay," I answered. But there was nothing I could do to stop my leg muscles and buttocks from tightening and beginning to shake. I wanted to cry out in my own defense, "I'm only shaking because you told me not to. It's your fault!"
When we finished, the doctor looked at me and said, "No vaginal penetration for two weeks. But you can touch and finger one another."
Well. Let the romance begin.
The doctor left and the nurse helped me up. She mentioned that some women become faint during pap smears. Yet, here I was having a procedure and I was doing just fine.
I managed to conceal my disappointment while thinking, What, no token for bravery? Not even a lollipop!
In three days, the nurse called to let me know everything looked good. She scheduled two follow-up visits-one to make sure I was healing from the surgery, and one for yet another pap smear three months down the road (more money for my doctor).
I told her I would be there for both.
And I may just bring my own lollipop.
This article first appeared in the May 19, 2002 on-line issue at einkwell.com