In the five years that I have done
pelvic modeling, I have attempted to teach the future doctors, nurses and
chiropractors who practiced on me the rules they should follow to do a respectful
breast or pelvic exam. Often I followed
the lead of the professional in the room with me as to what those rules were. While it didn’t necessarily seem important to
me to have the person wear a white coat when doing the exam, it seemed
important to them. So I watched as the white coat passed from student to
student as each person took turns practicing exams on me. There were other rules too. Only do the breast exam with one hand, not
two hands. Don’t touch the shoulder or
knee. It can seem patronizing. Don’t slide your hand down the thigh when
introducing your touch. Only use the
back side of your hand when introducing your touch. Don’t tell jokes or be too friendly. Don’t
say “looks good” after examining the genital area.
While many of these general rules are
helpful to consider, after a significant time doing this work I did start saying
that “it all depends.” Years later things
didn’t always seem so clear cut.
Inevitably I would come across the individual that could do the breast
exam using two hands and it did not seem awkward, or someone who did slide
their hand down my thigh and the way they did it didn’t make me feel like I
needed to correct their touch. In the
same way, I couldn’t always articulate why the person doing the exam in a
technically perfect way was still doing something that didn’t feel quite right,
yet they were following all of the rules.
It became very clear to me that it was much more important how something was said and done as
opposed to what was said and done.
It also became clear to me that the
skills for communication and sensitivity were what are most important to teach. While it is easier to focus on the things
that are easy to see and measure, it really was the more difficult, intangible
aspects of human interaction where I felt the focus needed to be.
Here are the things that seemed
most important to me to teach: Communicate
what you are going to do prior to doing it.
Learn to ask questions when you’re not sure about something. Explain why you are doing something,
especially if it is out of the ordinary.
Learn to be intuitive, to be sensitive and to ask questions in a
non-judgmental way.
This is not to suggest that technique
is not important. After having hundreds
of people practice breast exams, pelvic exams and speculums on me, I won’t
minimize how big of a deal it can be and I won’t minimize the necessity of it
being done respectfully. But I also will
go on the record to say that sexuality, even if it’s not talked about, is ever
present even if the white coat is on. I have
come to hope not for a denial of that sexuality and its presence in all of our
lives all of the time, even when we are at work; I have come to hope for a
healthier way of being with it, so that we can talk about it respectfully and
without fear with our doctors, health practitioners and the other helpers in
our lives. We all know our intentions. It is not so important whether or not we have
a sexual thought or feeling as what we do with it.
What is also true is that teaching
simple rules for behavior is not the answer to preventing harm. After years of doing the pelvic modeling
work, I wanted to teach and talk to health practitioners most about how to have
compassion for the person lying there.
How to know when one is doing something to meet the needs of the person
in front of them versus meeting one’s own needs. This is much more difficult to teach and convey
than simple rules. Not doing so doesn’t
make any of it go away. But by doing so,
hopefully we will open up more doors for compassionate care and healthy
sexuality in this society.
Reprinted from:
Miranda, S. (2005, December
14). A view from the stirrups. Minnesota Women’s Press, 21 (19), 13.
Copyright 2005 by
Susan Miranda. All
rights reserved. No part of this writing may be reproduced or
transmitted in any form or by any means, electronic or mechanical, including
photocopying, recording, or by any information storage and retrieval system,
without permission in writing from the copyright holder. For reprint
permission, email miranda_susan@yahoo.com.
