Last time I went in for a Pap smear, the panic started in the lobby. I filled out the paperwork through blurred vision, closed my eyes, counted my breathing. In, two, three, four, hold…. out, two, three, four, hold… the panic ebbed but lingered, resurged, breathe, two, three, four… they called me back.
I got through the conversation with the nurse wondering if she failed to notice my red eyes or thought them better left unmentioned. The doctor came in to me perched on the paper-covered exam table in my shirt but no undies, no socks, covered in a ridiculous paper blanket that was the only barrier between her rape instruments and my most vulnerable opening. I told her about the panic. She offered to go slow, to use the smallest possible speculum, I could stop her anytime.
It didn’t matter. When I lay back on the table, I was a bug upturned. Legs open but everything else clenched against her push. It is impossible to write what it’s like to have the speculum shoved inside me, but “shoved” is a start—because the speculum, of course, has never been jammed up my vagina. I’ve had gentle and caring practitioners, but it doesn’t matter. Experientially, the instrument is a shovel scraping gravel inside of me, it’s a drill that worms into my core, a rip and a tear that opens me from the vagina down my center and through my soul. After the last Pap I was tortured by images of the gynecologist tearing me open like a doll, rending me with her bare hands. I ripped like thread.
To lie on my back is vulnerable. From my back, it would require an immense outpouring of core strength just to sit up. I can’t mobilize quickly. I can’t run, or fight, except to kick. I can’t fend off anything or anyone except with my legs, which I’ve been asked to splay. I channel great emotional strength to keep my feet in the stirrups because the speculum is a spear and I don’t know that I won’t be robbed of everything when the spear rams into me. I don’t know that. So I try to keep my heels in their cups, I pretend that the paper blanket is covering me where it matters even though I know she can see everything, and half the world, half of me, is in my vagina right now, and it’s exposed. The rest of me is… somewhere.
I leave myself, kind of. I’m not up on the ceiling looking down, I’m not out of my body, quite. But I can’t be in my body, either. I’m just somewhere. And I can’t breathe and she asks how I’m doing. I’m not okay. Would I like her to continue? Just keep going. It’s awful. She scrapes, and I feel it IN.SIDE me. She’s apologizing because she knows I’m not okay. It’s done, but it’s not done, it lingers, my vagina knows it’s been there, it’s not okay, it is not okay. I’ve done wonderfully. Do I feel this way during sex? Healthy sex requires communication! Light banter about men and how hurtful they can be, advocate for yourself! It’s a pit, where everything was, half my world, it’s a pit that’s nauseous. You can’t hug a hole inside you, it’s just there. It’s too deep to reach. It’s ravaged and nauseous and in me. Deep in me. Deep, deep, deep.
On my birthday this year, Nursing Clio published this article by Lizzie Reis about her experience getting fitted for a cervical cap at the Berkeley Women’s Health Collective. And a bell went off in my head. What if I reclaimed the Pap smear by inserting my own speculum?
When I called to make my appointment at A Balanced Life Healthcare last week, I was sure to let the receptionist know that I’m a rape survivor, and that I wanted to consult with the practitioner before my exam. I brought my sister with me to the appointment, and I asked the doctor how she felt about me inserting the speculum myself. She was totally open to the idea, and showed me not just the speculum, but the other tools she would use to take samples of my tissue. My sister modeled for us on the exam table, and the doctor used a plastic model of the female reproductive organs to show me the most effective angle of insertion. I was giddy. I peered into the plastic vagina and it was the dummy, the object—not me.
The doctor left the room, and I applied lube to the plastic speculum and opened my own body. I clambered onto the table. My sister helped me tilt the exam table up like a chair, and we called the doctor in. I invited her to look into my body, that I had opened willingly. There was no push. There was no shovel, no rape, no rending, and I stayed. When she left the room again to allow me to dress, I became nauseous as usual and the light-headedness descended. I thanked myself silently for refraining from eating before the appointment, and I breathed. I put my head down. And I knew that I would be okay. I was nauseous, but I wasn’t flooded. I didn’t need to leave myself. The doctor sent me home with my very own plastic speculum.
It’s been a few days since the exam, and there is a subtle shift in me. This is my body. This is my vagina, mine to open, mine to claim, mine to speak for, mine to protect, to love. This place in me feels sacred for the first time in years. It feels like it can maybe be a portal for loving energy, and not just for sex and hurt.
I’m writing this because I hope that for some person, maybe, the kind of exam I had can make a similar difference. I’m writing this because even the gentlest practitioner can’t completely shift the power dynamic for her patient when it is she who holds the instrument. I’m writing this because I have hope and hope multiplies when it is shared. Today in my journal I wrote:
The difference is slight
but affects everything
the cracks now align, allow a
shaft of light
where before there was only a jagged edge
opening on darkness
this cave has become