Legs splayed, back flat against the table, I lay before a group of practicing OB/GYN’s and nurse practitioners. They are practicing medical providers, who of their own free will, have come to a specialized program to learn how to fine tune their pelvic exam skills and be trained on proper STI (sexually transmitted infections) testing procedures, things like how to collect cell samples for Gonorrhea or Chlamydia, what to swab on the body and how to properly mount this culture on a slide that will go under a microscope to see if all is healthy in the land of genitals. The training is being housed in a branch of a major teaching hospital in the area. This branch of this hospital specifically deals with STI testing, treatment and counseling.
Before the exam, an older woman was pointed out to me. She was the OB/GYN practitioner with whom I would be co-facilitating this pelvic training. I learned that she has worked in this hospital off and on for over 25 years. I watched her bustle around in the clinic. Working with a young man, she listened to him, made eye contact, and asked him open-ended questions. Her hand gently placed on his shoulder, she walked him toward the appointment counter. It was clear that she cared, hadn’t become hardened by the long hours or the horror stories. I was silently pleased that she would be leading the training.
Now back to the table. The medical practitioners are nervous about practicing their skills in front of one another. They step away from the table when a new practitioner launches into examining my vulva for possible infections. I understand their discomfort; being peer reviewed is challenging and nerve wracking for most professionals.
But wait; while a brave soul slides on a fresh pair of gloves to conduct the second exam, I hear a question asked by one of the other professionals. “At what point do you take a Pap smear?” The veteran facilitator's shoulders subtly raise and she quietly answers, “This is a Catholic-based hospital.”
The gloves are now on, and all attention is directed at my vulva. The statement “This is a Catholic-based hospital” disappears into the air. It was a confusing response, answered in an awkward way. There is concrete learning before us now, so it’s understandable that the awkward response slips away without further questioning.
Fingers expertly move labia side to side, checking for infections and sores. Speculum slides in and opens. Cervix is found, cotton tipped applicators swab the vaginal walls and then the practitioner raises her head from between my legs and says, “Is this the point when the Pap smear should take place?”
The facilitator deflects the question and redirects the session. My interest has peaked and now I’m wondering “Why?” Why hasn’t she instructed them in the proper way to collect cervical cell samples for a Pap smear at this STI training program?
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