Inside and Out

Yesterday I ticked off a med student first: I learned how to do a pelvic exam. I think many of us head into this with some apprehension - fear of causing pain, fear of making a mistake, and the pressure to do it right right off the bat. Fortunately, we have a great program here - GTAs (gynecologic teaching associates). GTAs are trained patients who, in pairs, teach us (also in pairs) how to do this exam. These women are incredibly knowledgeable about their bodies, and provide us with an idespensible first-time experience. What better way to learn than on a real person, in a relaxed enviromnent, where you can take your time, ask questions, and receive live feedback?

In the past, (and present for some schools), students were required to learn the pelvic exam on rubber models or anesthetised patients. Or, they may be required to perform an exam for the first time on a random patient in clinic who is just about as scared as they are. The GTA program was developed in the 1970's by the Boston Women's Health Collective. This group worked to bring women's reproductive health issues out into the open, and made it a misson to educate women about their bodies so that they could be advocates for their own health care. The GTA program teaches us how to do "educational pelvics", which I had only read about in the Boston Women's Health Collective's seminal book, Our Bodies Ourselves. I've never seen anyone do an educational pelvic in practice. With an educational pelvic, the examination table head is raised so that the woman can make eye contact with the examiner, and observe the exam with a mirror, hopefully building a sense of participation and empowerment with respect to the exam and her health.

The whole session was wonderful, and got me ruminating over the idea of an educational pelvic. Arguably, most of us never get to see our cervix. Perhaps if women have the chance to see a vital part of their anatomy that remains perpetually hidden and mysterious, they would be more motivated to seek health care on an annual basis (pap smears, STI testing, well-woman exams). Would this be an extra 5 minutes well spent on the part of the physician?
If you've never seen a cervix and are curious, I'll direct you to The Beautiful Cervix Project, bravely made by a midwivery student who did a daily photo documentary of her cervix over an entire menstrual cycle.

To end on a lighter note, I've started the Gathered Pullover by Hana Jason. The yarn is Berocco Ultra Alpaca Light, in Peat Mix. So far, so good!