And Then I Fell Out the Window

Life, examined and punted around


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SP Adventures: Find That Uterus!

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Like the weirdest video game ever.

Today four people gave me a trans-abdominal ultrasound and about four million people (note: this might be a slight hyperbole) gave me a trans-vaginal ultrasound.

It’s been a while since I’d done any work for the university hospital as a simulated patient,and what better way to dive back in than by stripping off my clothes, getting into a gown the could double as a circus tent, and letting a bunch of medical students poke around in my vagina, trying to find my elusive uterus?

This was my first time being a model for any kind of ultrasound, so I was as interested as what was on the screen as the students. I nervously lifted my gown up so students could take turns pressing above my pelvic bone, sweeping back and forth. I’d forgotten just how far south the wand goes, and I felt bad about how unkempt it was down there. Hi, strangers. Sorry that you’re getting a glimpse of my untended bush that wouldn’t look out of place in a 70s porno. Then again, who knows what kinds of characters they will encounter on a daily basis once they’re out in the real world? Also, I quickly remembered, they are medical students. Young and nervous they may be, but they’re not exactly flustered about seeing the more intimate parts of the body. In fact, some of them seemed to forget I was a person at all, ramming the wand against me like I was made of that unforgiving rubber on some medical models. Fortunately, you can press pretty hard into the belly above the pubic bone and not feel anything.

The main concern they had for me was, “Doesn’t that hurt?” “Nnnope, push harder.” “Harder?” This was particularly true once we got into the trans-vaginal ultrasounds. The men especially seemed hesitant about pushing the wand downwards, but as I learned before when observing the female program pelvic exam lessons, it takes about 30 lbs of downward pressure just to look at the cervix.

“Is this hurting you?” “Dude, these things are designed to push out softball-sized heads. It’s fine.”

After a while, though–maybe around student #11–it did start to get taxing. Certain pressures hurt more and more, and my legs were starting to cramp in the foot rests. The weirdest, though, was that the teacher could see my bladder filling up on the screen, and so she knew that I probably could use a bathroom break before I did.

When I shifted my attention from the weird probing and uncomfortable position, though, what was happening on the screen was fascinating. And, I learned, taking ultrasounds is much, much harder than it looks. A couple rare students found the uterus right away, but most had to hunt and hunt for it.

“Now, she’s got a retroverted uterus, which is a bit unusual, so you’re going to want to go down more,” the teacher would instruct. Retroverted. Aren’t I special?

“Hey, Nina [the other model working that afternoon] has a retroverted uterus too! What are the odds?” Maybe not that special, then. It is unlikely that the students would have two retroverted uteruses in one day, though.

Students would use what the teacher called the “Battleship method,” sweeping side to side and up and down when lost to identify and scan things. Sometimes they would encounter arteries and vessels, and when they turned on the color on the screen, a section of my insides would turn into a psychedelic, pulsating party of blue and red. Each student took a turn hunting down my uterus and scanning through the whole thing, then finding each ovary and the venous plexus ( I think. I might’ve gotten that wrong. Sorry, any medical readers. Feel free to correct me), which you could see pulsating on the screen.

I also learned that my stuff moves around. “Her uterus was down here, but things have been moving around in there,” the teacher said. “Ta-da,” I said. “Just to make it more interesting for you guys.”

But seriously, stuff moves around? I have a whole new respect for the good folks who do ultrasounds, especially when there’s not even a big honking baby in there to give the uterus away.

“No, see, that’s the ovary there. It’s bigger than the left. Things can vary. It’s not going to always look like Grey’s Anatomy,” the teacher said to a student at one point.

“I don’t watch Grey’s Anatomy,” he said.

I really hope my laughter didn’t screw up the uterus hunt.

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Holy Elvis, That’s a Pelvis!

            I mentioned earlier that one of my three odd-jobs is being an SP (standardized patient). I’d expected it to be an interesting little side operation, which it is. I never expected it to lead to me standing in a room with four male medical students, one of which was pushing two shaking fingers into a beaming woman’s vagina as a brisk old lady told him what to do.

            Ladies and gentlemen, welcome to the strange world of the female program at a medical school. I’d heard about it from Lena, the woman who runs the whole SP operation.

            “If you like being an SP and you want to get more involved, they’re always hiring for the female program, which is a whole separate thing. It takes a…certain kind of person to do it, but the pay is excellent.”

            The certain kind of person that Lena meant included Pi (Pai? Pye? Pie?), an olive-skinned young woman with curly hair and an easy, crooked-toothed smile, who was there when I arrived to observe a female program session to see what it was like.

            Pi showed me around the cluster of rooms where just hours before I’d been psychoanalyzed and pretending to have life-ruining seizures (I swear, I’ll write a blog about being an SP soon, because it’s a blog of its own). I hadn’t, however, been to one of the small rooms where an eerie rubber pink torso sat on the exam table, sliced off just above the bellybutton, the two short stumps of the thighs spread to reveal a rubbery slit where students could practice inserting their scapula or fingers in the correct way.

            A bowl full of scapulas, metal beaky things that have caused discomfort and awkwardness for women worldwide, sat next to three flattened, rubbery models of breasts. Pi demonstrated how to hold and use a scapula, and how to insert. “You have to push down hard, about 30 lbs of pressure.”

            “Umm, ow?”

            “Oh, no, it doesn’t hurt, but you need that pressure to get below the cervix. The worst is when students don’t get it low enough right away, so you have to let them try again…and again…” She beamed at me and laughed. Everything seemed to be a secret cosmic joke for her.

            This lighthearted attitude spread over to Janet, the aforementioned brisk old lady, one of the main instructors and organizers. She came in, greeted me, then ushered Pi and I into the examination room. “When we did this last week, we got to laughing a lot. We had a lot of laughing and it was really fun. That’s sort of what we aim for. We still want to be informative, of course, and professional, but also…not like a professor.” Suddenly she’s peeling off her swater. “Sorry, I’m not a very modest person,” she said, baring her breasts. Definitely not like a professor. Pi just grins at me and looks away. “But then the next class was so grim! It seemed to stretch on forever.” Janet pulled on a bra then put her sweater back on. “How far into your cycle are you, Pi?”

 

            The groups in these sessions are never larger than four students. I supposed that when I pictured Ob/Gyn students I pictured a majority of females, but instead four athletic, tall white males came in and settled in front of the DVD player.

            “You’ll need to either tuck in your ties or take them off for the examination portion,” Janet said, then played a 15-minute video featuring her and an acting doctor going through an examination. The close-ups of vaginal examinations made me think back to puberty classes in elementary school, although none of those videos were quite so candid.

            After the video, the doctors-to-be practiced holding the scapula, then moved into the examination room to watch Janet demonstrate an exam on Pi, who grinned the whole time, baring her vagina to four pairs of men’s eyes. It might seem nerve-wracking, putting your body on display and letting people touch it as well, but as someone who took a life drawing class, I understand the medical students’ perspective. There’s nothing pervy going on here. If they wanted to see something sexual, there are millions of hours and pictures of things far more erotic than seeing a woman get a flashlight shined on her cervix through a metal thing shaped like a duck’s bill. The medical students just want to make sure they get things right. It was the same way in art class. You didn’t sit there with your charcoal thinking, “Hot damn! A naked man!” Instead, the instructor was telling you that you had two minutes to gesture draw the figure before he changed poses and you were too busy thinking, “Is this proportion right? Shoot, I didn’t draw the load-bearing leg first. How am I going to add tone? Does this even look like a person?”

            Then again, I haven’t modeled for a pelvic exam demonstration yet. I’m sure I’ll be nervous when I do it for the first time. Especially when everyone in the room takes turns sitting on a stool and peering through the scapula like a telescope to look through the tunnel to my cervix.

            Once Janet was finished with her demonstration, she broke away so that each of the medical students could practice the exam. The first volunteer’s hands were shaking as he did the breast exam and I could see him growing more frustrated as Janet or Pi corrected him.

            “Remember, we want to minimize touch. Ask her to move the gown instead of moving it herself.”

            “I’m going to feel under your arm here—“ “Examine. Remember, neutral language.” “Examine,” he’d correct, sighing.

            Once he got to the pelvic exam, his hands were shaking even worse. It was strange and oddly funny to see this tall, wide-shouldered man with the neck of a football player and an arrogant personality to get shaky and fumble over his words and procedures as Pi grinned down at him and offered advice. Poor guy. Vaginas are complicated things. I would much rather be the one spreading my legs for a doctor than to be the one staring into the abyss and trying to figure out where the hell everything was and if it was functioning properly. No wonder my gay friends are afraid of them.