Sunday, November 9, 2008

Most Emabrrassing Medical Exam Moment EVER!

http://www.mckinley.uiuc.edu/handouts/gynecological_exam/gyne-3.jpg

I hesitated to put this up because it is so personal and so have kept it in my drafts for a few months. (Ha! I have a lot of potential blogger's remorse posts in my drafts.) Hopefully...this will be a reminder for medical staff in hospitals, clinics and offices to be more careful to protect their patient's privacy.

Years ago... I had the most embarrassing gyn exam I ever had in my entire OBGYN history. This will be one of those cathartic posts for me. I think it will help to release this once and for all. The doctor left the state years ago and I am guessing retired by now.

Maybe it is silly that I still feel the way I do about this, but then again...feelings are just that... feelings and we can't help how they come up... but rather it is what we choose to do with them that makes the difference. I really don't think about this incident..rarely anyway, but I read a post this morning that indirectly reminded me of it as I commented. And so I have decided that perhaps blogging about it will help me to experience a release of sorts.

The very professional and sweet nurse helped me get set up for my yearly pap exam. After I was "in the Bajingoland position" she elevated me somewhat and so I was not lying flat and I could see directly ahead of me. I was draped. But I know the draping doesn't always cover the ciew from the other side of the room. The end of the exam table was directly facing the doorway.

She was short.

Unfortunately for me... as she left the room and opened the door fairly wide (seemed like 10 miles wide to me at that moment) ... a man was being escorted down the hall at the exact same moment the door was opened... and he could see right over her head.

That is what it felt like anyway. I froze in position...literally held my breath and I believe I truly felt what deer caught in headlights must feel. Everything stopped for me... except the opening door and that man in the hallway walking past the door into my exam room.... and THAT seemed like an eternity! I was afraid to move or do say anything that would attract more attention to me. OH my GOD!

I really think he saw me because of the look on his face and the way he was walking down the hall with his head down..the way you would if you were purposely trying NOT too look. So he may have seen me for a split second or not... but I feel like he saw me. The other thing is peripheral vision. I have great peripheral vision and see things off to the side.

I was wearing a bright turquoise dress... that I am sure popped as an attention getter amidst the typically sterile medical environment of a doctor's office and darker hallway. I was under florescent lights! So he had to see something.

I was draped...BUT...he was at a distance and so easily would have been able to see right under there. And even if he didn't... how EMBARRASSING to even be seen in THAT Bajingoland position by anyone but your trusted medical staff... and even then...I think going to the beach would be just a bit more fun. :)

And to further compound the situation...HE LOOKED FAMILIAR! Now maybe he had one of those common faces...but he reminded me of a patient that used to come into the hospital and I had seen at church. I don't know that he was. He was middle aged, blondish/light brown hair and a tad stocky... I guess that could fit a lot of men's descriptions. I wasn't wearing my contacts and so not positive on that.

I was MORTIFIED!

All this transpired over the time it takes to open a door ten miles wide and close it again. So...I know if he saw anything..it was only a second or a few... but I am telling you...it really did feel like forever and in slow motion.

When the nurse came back in... I never said a word to her because I didn't want to cause her to feel bad. When the doctor came in...I didn't say anything to him... because I didn't want to cause a problem.

It was NOT my doctor's fault. And it was an ACCIDENT on the nurse's part. She never knew what she did.

And I didn't tell anyone... not a soul... until two nights later when I remembered the incident and felt so creepy ...that I bolted over to a friend's house and it all poured out and I cried. She would never tell anyone and is why I told her. I wasn't looking to malign anyone, but so very much needed to release my feelings and it helped. And then I told one other close friend who I knew would not ever discuss it with anyone.

I wanted to call back and tell them so it didn't happen to another patient and I admit I didn't because ...like I said... I did not want to make waves. I know shouldn't have waited so long.

But then the next time I saw my doctor... I did nicely tell him what happened. He said "We do our best." I KNEW they did their best... but I needed to hear a "I'm sorry that happened to you." It would have validated my feelings, like I wanted him to understand the severity of how much that bothered me. Instead I felt like it was glossed over.

I have two thoughts about that. The first being that ..he's a man. Maybe that was an apology in his mind... and second...maybe he thought if he used the word sorry..he would be taking responsibility for something he didn't do.

No doubt... if that happened to some women in today's environment... they would be screaming emotional damage/lawsuit... but I was not that girl... woman... or human being... not then.. not now.

I did not blame him. I did not blame the nurse. I KNOW even now... it was an unfortunate accident. I think I conveyed that... I don't remember. I certainly wasn't mad. Just upset. But I also... never let on to him just how much it bothered me. If I had been more explicit about my feelings I think he would have shown more empathy... but I was having a difficult time even bringing it up.

I don't even know if they moved the position of the exam table. I hope so.

And since I told him, at least they might have been a bit more aware of the necessity of checking the hallway before opening a door.

For all I know...that same thing has happened to me before or since then but I was lying flat and so never noticed the hallway when the door was opened. ha! If it did... at least no one could would recognize me in a bajingo lineup!

For all my joking about Bajingoland exams... it is a difficult thing for most women to do. I joke about it because it is my way of releasing the feelings I have had in recent years.. over the frequency of said exams. Fortunately, I AM well taken care of during gynecological and urological exams and they have always helped me to feel as comfortable as one can during such an exam/procedure.

I worked with med professionals for twenty years and so I know full well how hectic things can get in a medical environment. I DO understand.

I hope this post will be a reminder to any medical professionals who may meander through here that they should be aware of the patient's location/presentation and what is behind them and on the other side of the exam room door or hospital curtain before they open it.

I also want to say that I think it is awful that doctors have to work in a climate of being afraid to own up to something because they are opening themselves up to potential liability. I do not blame them because they DO have to protect themselves. I just hate how litigious our society has become.

And maybe you think I was wrong or silly to not tell my doctor right away... but I have been blessed with mostly good doctors in my life and I am someone who goes out of my way to let them know they are appreciated and the last thing I would ever want them to think is that I am criticizing them in any way. I was that way then and still am today... even more so ...because I appreciate so much more. Although... I do believe that having gone through that... I would say something immediately if there were a next time. For one thing... I am sure that nurse would have apologized profusely. I am ashamed to admit it... but I think it would have gone a long way toward helping me put it in the past.

I have always thought it was a good trait that I am protective of other people's feelings... but maybe sometimes...it's not always a good thing because otherwise how do we help or teach where we can and how do we experience what WE need to... if we are not honest about our experiences and resulting feelings? So...my tendency to try to protect other people emotionally (even when I am hurting) may at times actually prevent them from having the opportunity to make improvements where necessary; thus hindering what could otherwise be positive growth forward.

16 comments:

Rositta said...

I'm glad you got that out but it would probably saved you a lot of grief if you'd told the nurse right away. I'm going to be in that position next week, yuck, but in my doc's office there is a big curtain all around me. Makes it a little better somehow...ciao

MER said...

Your is an interesting yet disturbing story and I thank you for having the courage to tell it.

But I think you're being too kind to the medical professionals involved. It was a mistake, I agree, and no one's perfect. We all make mistakes. They didn't do it intentionally. But I think mistakes like this, with both men and women patients, are all too common in our healthcare system.

Generally, I believe, women are more likely to speak up, either at the time or later. Men hold their feelings in more. But your story shows how much men and women can be alike in this regard. These kinds of experiences can be traumatic. And it's not just the event itself -- but the cool, clinical, unapologetic attitude one gets in a statement like "We do our best." That is just not acceptable. It's unprofessional and doctors like that need to be told bluntly they had better begin to improve their communication skills.

Too often medical professionals either don't think much about patient modesty or consider it low on their priority list. A patient's feelings are the basis of their emotional health. A significant number of doctors and nurses don't even talk about this issue with their patients. And patients are often afraid to bring up the subject. Doctors and nurses come into the exam room with emotional baggage, too. Some are embarrassed to talk about out sexuality and modesty. Some don't feel comfortable with naked bodies or with members of the opposite sex. Most hospitals don't address this at all in any of their patient communication. You won't find it on their websites or in any pamphlets they distribute. There are some exceptions, but they are so rare that when you find them they stand out.

Yet this is a subject that is on the minds of many patients. They'd like to know how they'll be draped, who will be in the room with the doctor, whether they can request same gender care, how much will be shaved before surgery and who will do it, etc. They're afraid to ask and the doctors and nurses rarely reveal this information. Some medical professionals are actually dismissive of such questions and treat the patients as if the live on some other planet for asking such things. I guess some of them will say that, because patients don't seem to care, it's not an issue. I'm not sure what "don't seem to care" means. When we go to hospitals we fill out all kinds of forms and answer all kinds of personal questions. You'd think they'd ask one question or two about our modesty concerns and our choice of gender care. But you'll never find that and you're rarely or even be asked. If you don't bring it up, it most likely won't come up.

In your specific case, placing an exam table in such a position and opening a door during such an examination demonstrates an extremely careless attitude toward patient dignity and respect. Such concerns should be the foundation of care, not some sideline issue. Doctors and nurses sometimes get so into the task at hand that they forget everything else, including the fact that they're working on a human being, not a piece of flesh.

I know I've gotten off topic regarding your specific issue, but the principles are the same.

Unfortunately, one of the only ways we as patients are going to begin to solve this problem is by speaking out. It's difficult, I realize, because we don't want to be considered cranks, or worse yet, "bad" patients. And if we're actually admitted to a hospital, we sometimes feel that complaining may get us subprofessional care. I hope that's not the case, but that's how patients often feel. We're naked. vulnerable, frightened, often alone and feel powerless. That powerless feeling does much to keep us silent. And,frankly, some in the system would like to just see that we stay silent and just do what we're told.

We must not be afraid to speak up politely, tactfully, with respect -- but with firmness and confidence that our dignity must be respected. We need to make it clear that this is not negotiable. I can't help believe that most doctors and nurse will take this kind of criticism, if expressed respectfully, seriouisly. If they don't -- if they get annoyed or angry or intimidate you -- then they need to have formal complaints filed against them.

Again, thank you for having the courage to reveal this story.

Anonymous said...

That was an error on the nurse. Too
bad for them. Imagine going into the military and the Physician
allowing female clerks to stand there and watch you get a physical
nude. So much for veterans day!!!

passionstamper said...

Well said and I agree with Mer-these are professionals and they are trained to be sensitive to the patients' needs as well as the physical situations that bring them there. Personally, I feel some doctors have developed an insensitivity towards their patients' feelings over time so it's really important for us, when we are the patient, to express it when we are disgruntled about something. This is more than "mild"-it's an infringement on the privacy of a patient which should be upheld at the highest level. When it comes down to it, respect goes both ways-whether you are wearing the jacket or are on that table. We have a right to speak up for ourselves if we are not treated properly or our dignity has been compromised. After all,we are not just a piece of meat-we are human beings and we deserve to be heard and treated with respect in a situation such as this one.

John McElveen said...

I didn't see much, and the dress was pretty!

J

SeaSpray said...

Yes Rositta, you are right. I would've felt better had I acted on it at the time.

I hope everything goes well with your exam.

SeaSpray said...

Mer- Thank you for your thoughtful comment. That doctor was very special and I believe if he had realized how upset I really was (don't forget I concealed my feelings-BOTH times)I do believe he would have been more sensitive to me. He was always warm, kind and supportive of me as a patient. I know how good he was with me before that event and after and I didn't hesitate to continue on because aside from that nurse's having done that...they were a pleasant office to go to and I felt cared for. It's just too bad it happened.

I do think now days, medical workers are more sensitive to patient privacy, particularly with HIPPA regulations.

It was just such a freak accident. She was short and the timing was at that moment. Sigh! I do think the exam table should not have been facing the door. I don't know if they ever changed it. I don't recall being back in that room.

I don't think it is likely that you can have a choice of what gender will accompany you in a personal exam in a hospital. They are limited with the staff they have and it depends what they are already tied up in. I do think they will accommodate if they can (the people I worked with would)but it's just not always possible.

I believe the most medical people I have encountered as a patient have always been respectful of my privacy.

I did have a weird thing happen once when I had just finished getting a hysterosalpingiogram. I was in the to get dressed and was in the middle of putting a tampon in when the doctor whipped the curtain open to talk to me. that was odd. I kept doing what I was doing and he kept talking.

To his defense...he also forgot to put the radiation vest on before beginning the procedure and the x-ray tech teased him in front of me. So he may have been preoccupied that day.

Then... after I had a baby I was just getting out of the shower. I was buck naked except for the plastic covering the nurse had put over my incision. The pediatrician whipped the bathroom door open looking for me so he could speak with me. there I was standing there...completely naked and hadn't even gotten the towel yet and so I just stood there talking with him all the while thinking about how I was standing there with nothing on. I wasn't mad at either doctor but they should have knocked.

Ha! I am now thinking that these things will never happen anymore because I had my things happen in threes events.

I hope you are not offended by my amusement because I am just one of these people who can appreciate humor in most situations. If it going to happen...it will happen to me with these things.

I am more mature now and so I believe I will politely speak up if anything like that happens again.

There is no one that I would ever have done a complaint on.

I think back then people weren't as careful.

Although recently..like last month, when my mom was first brought to a rehab, they immediately undressed her and stripped her naked. There was a huge picture window with blinds wide open about 2 beds over. Plus I was right there. The nurse walked away and I saw my mom feebly grab part of a sheet and cover her lower private area and her breasts were all exposed.

Here I am daughter and know about patient dignity, privacy because of having worked in the hospital for 20 years and just common sense... and I didn't jump up to cover her or say anything. I was shell shocked i guess with EVERYTHING that was going on.

This stuff just happens but we all need to be more sensitive about it.

I have to say that I never think about a man's modesty but of course they must have feelings about it too.

Really all any medical staff has to do is treat a patient just like they would want someone to do for them.

I do believe most do. Sometimes they are in a hurry or something is distracting them and that is unfortunate for the patient.

Believe me... I have had many occasions to be in what I call the Bajingoland position because of my many urology tests, procedures and exams these last few years and It is always an embarrassing position to be in but I have to say..they go out of their way to make sure I am comfortable.

My joke is that I have been in the bajingoland position so many times that I am surprised that like Pavlov's dogs, I don't automatically assume the position every time I see blue scrubs or a white coat.

I use humor to deal with my feelings. :)

Hi anonymous - yes, she made an honest mistake.

Oh that is awkward to have a clerk watch a physical! What's up with that? gee!

Hi Passionstamper- I agree...respect goes both ways. Fortunately most are respectful.

Thanks for your thoughtful comment.

SeaSpray said...

John, John, John! Yo always crack me up! Thanks for the laugh. I've missed you! :)

I haven't been out in the blogasphere as much lately because of everything going on with my mother but it will get resolved soon I think. It's just tough getting there... and I have been emotionally challenged lately. :)

MER said...

Thanks for your response, seaspray. Sometimes I sound a litte harsh in my posts. We all make mistakes, professionals, doctors and nurses, too. But the bottom line is I believe most people would appreciate being told of their mistakes if it's done in a polite way. Maybe even with humor, as you do. Patient dignity is such a fundamental aspect of medicine that, even if professionals are in a rush, they always need to keep that the patients feelings up front. As a patient, it's difficult to speak up. One often feels powerless. For some men, to speak up for themselves is sometimes more embarrassing than the actually embarrassment of the exam or procedure. That may be the case with some women, too.

If we don't speak up, the same kinds of mistakes are likely to go one and on.

But I do agree with you that the vast majority of healthcare professionals are more concerned these days with privacy because of HIPPA. But HIPPA often translates only to paperwork and case histories, etc. -- not modesty.

SeaSpray said...

Hi Mer-I've enjoyed our dialog. If a provider violates a HIPPA regulation they can be sued. Even if the patient doesn't report it, but a witness/bystander sees it THEY can report the provider for violating the regulations. So, that is also an impetus to be careful.

Still... and it is unfortunate for the patient...mistakes can and do happen. People are still human.

You might find a guest post I did for Medfriendly interesting. It's called the conflicted patient and is about my difficulty in speaking up for my needs because having worked in the business... I knew how hard they work, the demands on them and I didn't want to be one of THOSE patients.

It is on my sidebar of favorites.

Should you decide to read it...get a cup of something to drink though as it is long. Medfriendly called me a prolific writer. ha ha! :)

Okay...that was more recent event and so I still have to work on speaking up. :)

I swear I will from now on.

If I don't...I can always vent in the blogs. :)

MER said...

seaspray

I read your article and passed it on to some other blogs. It's extremely well done. You demonstrate how important communication is in healthcare, and why it's necessary that healthcare providers take the lead in opening up communication with their patients. Even other healthcare workers like you can feel intimidated as a patient. Imagine how it is for patients who are frightened and totally unfamiliar with the hospital culture.

Of course, your example is the ER, thus, there are mitigating circumstances. That's not an excuse, though, for what happened to you.

Communication. Communication. That's the key. Ask questions. Listen to answers. That's one essential key, maybe one of the most important ones.

SeaSpray said...

Thank you for your kind words Mer. I'm glad you appreciated the guest post. Communication is key.

I still have to tell the 2nd half of that story.

No one did anything wrong but it was also a bad experience. My stays there are usually good but that previous night and morning was one of the worst experiences I ever had. The morning was bad because I was even more sleep deprived, thirsty and hungry and I couldn't sleep because of what was going on around me and with me.

Thanks for your insightful comments. maybe they helped someone passing through. You never know. :)

Chrysalis Angel said...

That certainly was something to bring up, Seaspray. They could easily solve that problem by using a screen at the foot of the table.

I had a similar experience, but luckily, I was sitting up-right with my legs dangling off the edge of the table. Just a sitt'en there in a gown and the doctor opened the door wide open, and I was faced with a waiting room full of patients. The guys out there just froze looking at me. They looked like they couldn't believe he did that. I never went back, and I did suggest they watch that with other patients in the future. It was very uncomfortable. He did apologize for it. They just aren't thinking. It's work to them and they just don't think about it, but they do need to be reminded every now and then. I feel for you!! That was bad!

SeaSpray said...

Hi Angel - your experience was embarrassing too. What an odd thing to have an exam room door open so the waiting room can see in. I'm sorry that happened to you.

They do have a curtain but she had it partially closed and she was busy doing something in the corner. She may have thought the curtain was closed but she never turned to actually look before opening the door.

Yes medical staff are busy.

Thanks for your empathy. :)

jay said...

Unfortunately, I've reached the conclusion that refusal/failure of providers to stop trivializing the Dignity, Privacy Autonomy of clients (not patients!) is
to view it as a problem of saving face. I've confronted
offending md's...they invariably feel they've done no wrong! This hubris must be dealt with. A start might be execution for physicians who staffed draft centers during the Vietnam conflict...many would benefit from the deterrance and get partial vindication. Accidental or negligent exposure can also be as damaging as ritualized humiliation. DON'T GET MADE, GET EVEN!!!

Anonymous said...

The POSITION of the examination table!!!! Curtains could also block the actual DOORWAY. Some male patients HAVE reported having seen women on the examination table & the doctors laughed and laughed.