Do you get the quickie?

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Finding My Achilles' Heel

The doctor put her fingers in her ears…"La, la, la, la, la, I don't hear you!" Her colleague chuckled, cleared his throat and suggested that I move onto other more "palatable" conversation. I merely smirked, gave a small brisk head nod, and sipped my drink. It only took 30 seconds of talking about anal play to hit this MD's comfortability threshold.

Let me back up a bit. There were these three Doctors and I, sitting at a table in the bar. No, this is not the set up to some bad joke. These Docs had just come off a 16-hour shift in a gristmill of a rotation that can easily chew up the local interns. Not only do they get little sleep working from 5 AM till 9 PM nightly, but they also get a new load of patients to juggle around daily. Oh yeah, and they're supposed to keep these patients ALIVE.

They chatted casually about poo pouring out of patients' orifices and swapped stories about special enemas with nary a reaction. So why then, when chatting about anal play did those same doctors look like a five-year-old being served Brussels sprouts?But at the bar, all of that is left behind. Sitting around the table chatting each other up, our conversations drifting in and out of medical-ese, these docs develop loose-lip-itis. For example, earlier in the evening, I had learned of a last-ditch procedure used when all else fails to treat chronic unremitting diarrhea. I'm going to spare you the finer details, but I'll let you know that it involves your family members' poo, a blender, and a tube into your stomach. Yuck. But while these doctors didn't get squeamish by such a story, I definitely had a bad gut reaction. So bad, that I had to go to my "work mode," a form of mental detachment that allows me to talk about unsettling issues without making a scene.

My "work" mode is a skill I've consciously honed to quickly shut off my emotional reaction. Working with as many sexuality issues as I do, it's an invaluable aid to sexuality counselors and educators alike. And at first, it seemed to me that the doctors had a "work" mode as well. They chatted casually about poo pouring out of patients' orifices and swapped stories about special enemas with nary a reaction. "Doesn't it get to you? Don't you get so repulsed by the smell you just want to walk out?" They responded: "It's just a part of being human." So why then, when chatting about anal play did those same doctors look like a five-year-old being served Brussels sprouts? How was poo natural and sex something revolting? I had stumbled upon an Achilles' heel, a chink in their emotional armor.

I learned about the holes in my emotional armor while undertaking a SAR (sexual attitude reassessment) early in my training as a sexuality educator. It's quite a serious undertaking and strictly required for anyone planning on becoming a certified sex educator, counselor, or therapist. In an intensive three-day workshop, facilitators play hour after hour of evocative, sexually explicit films. The goal is to push participants to explore their personal attitudes, values and beliefs about sexual behavior by exposing them to many known forms of sexual activities. A SAR is designed to promote open, honest self-awareness for anyone who deals with sexuality issues in the work life.

The SAR I underwent helped me identify those parts of the human sexual experience that I'm not best equipped to work with. It also helped me fine-tune my belief structures. For instance, I have no problem talking about fecal matter as a result of anal play, but take away playtime and discussions about night soil is a strict "no-no" in my house.  Splitting hairs you may say, but this type of self-awareness is necessary when I'm working with people in the classroom. It allows me to know which conversations I can comfortably navigate or when it's time to refer the question and questioner onto another professional. I often invoke the Hippocratic oath, "Do no harm"; I don't want my personal insecurities and visceral reactions to negatively influence others.

So you can see why SARs are imperative for those of us in the field of human sexuality. But no such requirement exists for other related professions: hint hint, medical providers, I'm talking to you!

No, medical professionals are not required to take a SAR. Heck, some aren't even required to learn how to take a sexual history in medical school! The general theory has been that when there are so many things that can kill you out there, devoting time to non-fatal concerns like failure to reach orgasm, erection difficulties, or sexual identity is a waste of time.

Thankfully, some medical schools of late have started to question this antiquated paradigm. The Sexual Health Scholars Program for example is a new curriculum developed with AMSA (American Medical Student Association) and is in its first national trial run. This is a huge step forward for the medical community. Recent studies have shown how closely linked a patient's sexual satisfaction is with general health. One of the Sexual Health Scholars Program's goals is "actively engaging in curricular reform to improve sexual health training in medical education." It looks like change is starting to occur, slowly but surely.

Yes, everyone has an Achilles' heel; I don't pretend to think otherwise. But I wonder, how many of us know exactly where it is and how to professionally handle it? It isn't necessary to have all the answers but it is critical that professionals know how to safely navigate through their own poo.

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Megan Andelloux
October 23rd, 2009
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Megan Andelloux, also known as "Oh Megan," is a board-certified sex educator and sexologist. Megan defines herself as a "WASP" on a mission to bring the medical and pleasure-centric sexual models...