CARNAL NATION

Last night I received a phone call from a dejected and broken medical resident friend of mine. He admitted to me that he was close to tears from having to make life and death decisions for patients on a daily basis. I listened sympathetically to his worries and fears and tried to comfort him; the first few years of being a doctor are grueling. Eighty-hour work weeks designed to expose residents to as much illness as possible take quite a toll. The first year in particular is notorious for causing new medical providers to break. I mean, how many episodes of Scrubs feature some intern crying in a supply closet? Thirty-hour shifts, constantly being grilled (or "pimped") on minutiae you don't know, exposure to new illnesses and procedures non-stop, and dealing with sick people at one of the worst points of their lives is enough to cause anyone to snap. But especially more so when you are expected to know everything because, after all, you are the doctor.

I offered a new way of thinking about the situation: the fear of doing something wrong can be paralyzing, but only if you don't admit to it. The key really is to acknowledge your fear and uncertainties, and to recognize that you're probably going to make mistakes. With the "higher ups" grilling you like a filet mignon, it makes some sense not to show your weakness, your lack of information. I mean, who wants to get chewed out in front of your peers? But hiding will, of course, merely compound the problem like a splinter left to fester in your thumb. Getting the painful and mistake-laden learning process over now will prevent more serious and potentially deadly mistakes from happening later.

But how are they supposed to know it all? Especially when it comes to gynecology or sexuality issues? As a gynecological teaching associate, I see the same questions and the same mistakes made by our future speculum-wielding physicians over and over. Medical providers are rarely schooled on sexuality issues at length. Most of their formal education is squeezed into 10-12 hours of lecture time and focuses on birth control, STI pathophysiology and its treatment. If they come from a particularly liberal medical school, perhaps they were given a twenty-minute training on inclusive language to prepare for the fact that they may someday have a gay patient. As an aside, it boggles my mind that GLBT issues still have to be consciously "included" into our medical school curriculum.

Certainly there is no definitive collection of information on human sexuality. And though there are various attempts at official curricula, there is still much left unanswered. But what is more disheartening is how much must be RE-answered. On a recent trip to visit colleagues in California, I was introduced to several issues of a 1930's magazine entitled Sexology: Sex Science Illustrated. In a time where sex certainly was not talked about in public, here was a monthly scholarly magazine dedicated to providing sex information to adults.

After scouring the pages and becoming mesmerized from holding a piece of American sexological history, I began to notice that some of the titles seemed familiar. Headlines such as "What is 'Normal' in Sex?", "Sex Panic", "The Female Sex Drive", and "Should YOU Take Sex Hormones?", I became angry. Very, very angry. Forgive me for being pissy, but why are we, seventy years later, having to ask the same questions? In other fields of science, research builds upon research. For educators in the field of human sexuality to be addressing the same issues today that we were nearly a century ago is as though NASA were still holding speakers' panels on the nature of space aether.

It's said often in medical institutions that all medical knowledge has a half-life. That is, what is learned as a medical "fact" today may be proven to be fiction tomorrow. This discussion often leads providers of all types to reaffirm their commitment to staying abreast of the latest developments in their field. Some particularly impressive doctors show their commitment to life-long learning by wearing short white coats after they graduate. You see, in hospital dress code, the short white coat is the uniform of a medical student, and only upon conference of a medical degree are they then allowed to wear long coats. When a full M.D. chooses to continue to wear a short coat, they are symbolizing their dedication to being a student for life. That should go for all of us. We are a society of poseurs in long white coats, asking the same tired old questions over and over. Maybe if we donned the "short coat" we might finally be able to find the clitoris and definitively answer if there is indeed a g-spot.