Involuntary pelvic exams given to anesthetized women of color
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Involuntary pelvic exams given to anesthetized women of color
Medical student exams should not be hidden in the fine print
Teaching hospitals give me a headache. TV shows like “Grey’s Anatomy” would lead you to believe they’re far more organized than they actually are. I didn’t realize they aren’t until an ambulance took my grandfather to a well-known one in Chicago a few years ago.
I was his caregiver at the time and working from home. That same day, we’d gotten into a debate regarding me canceling his cell phone (that he never used and always lost) contract. For whatever reason, he still wanted that phone and grumbled in another room about “taking away my privileges.” I left him alone. He was healthy enough to get to the restroom on his own, but after a while, I wasn’t hearing any activity in the background of his home — not even a toilet flushing. I went to check on him. I thought he was sleeping at first glance. He was not.
I don’t know who is working behind the scenes, but this had been my biggest gripe for years about teaching medical hospitals — until I learned about involuntary pelvic exams.
When I got to the hospital, I had to tell the story of finding my grandfather unconscious from a low sugar level (due to diabetes). He was alive (to my relief), but I still felt ashamed. I had to tell this story over and over and over again. One doctor looked at me with judgment in her eyes, as if having the audacity of working from home while being a caregiver was a sin in itself. And to assume my grandfather was sleeping quietly was even worse, in her mind.
Meanwhile, my grandfather was hanging out in his hospital bed, referred to me as “Da Punkin” when hospital attendees asked him to identify me and was far more interested in returning home. Even when I apologized to him, he couldn’t have cared less and just wanted to know where his street clothes were.
Recommended Read: “Prepare Your Daughter for Her First Gynecology Visit ~ As uncomfortable as sexual health topics may be, not forewarning her ahead of time is worse”
But medical students kept coming into the room, asking me why he was sent to the hospital. First, there was one student. Then there were a set. And then another set. I got to the point of wanting to just yell out, “For fuck’s sake, gather ’em all up so I can tell this story one time and be done with it.” Although this hospital was far less chaotic than another one he was in without medical students, they’d lost his dentures. I was pissed. I don’t know who is working behind the scenes, but this had been my biggest gripe for years about teaching medical hospitals — until I learned about involuntary pelvic exams.
Medical students need to learn, but at what cost?
My gripe about medical students asking me to retell the ambulance story repeatedly feels like small change compared to an episode of “This American Life” that I just found out about. If you haven’t heard about this already, women who were undergoing gynecological exams were also getting pelvic exams that they didn’t know about — from medical students.
Who was most likely to be the target of these exams? While anyone could be (depending on location), patients without insurance, those on Medicaid and women of color were common targets. And, according to Washington State Democrats, it “took lawmakers two years to pass SB 5282, in part because they crafted an exception to protect sexual assault victims.” As of June 2020, medical providers are now prohibited from doing pelvic examinations on women without their consent if they will be unconscious or under anesthesia.
I thought about this for a long time, not only that I had no idea that this was happening in the first place but more along the lines of if I would give permission for someone to do so. Considering I long ago agreed to donate my body to science in the event of my death, I wholeheartedly understand why human beings can advance science for the greater good. But it feels like trickery for surgeons to allow extra exams on you and then medical students following up right afterward. Even worse, according to “This American Life” interviewees (skip to 45:22), medical students were being left to go at it alone.
And then after that happens, here comes another set of untrained fingers to do the same thing?
I don’t so much mind someone making sure my body is OK. That’s the entire reason one goes to the hospital (or doctor’s office) in the first place. But is it too much trouble for a woman to give the green light for someone to “stick their fingers inside the patient’s vagina to examine the cervix and uterus”? Shouldn’t the patient authorize the doctor to “place another hand on the abdomen and [press] down, trying to catch the ovaries between the hand on the abdomen and the hand in the vagina to check for abnormalities”?
And then after that happens, here comes another set of untrained fingers to do the same thing? Why was this being treated like a big secret? It’s almost as if the medical industry expected women to say “no” to helping advance science if they knew what was happening while they were unconscious.
I, however, would more than likely have agreed to it. As long as it is an honest exam that helps advance science, is done medically and professionally, and could help my health in the long run, do your thing. But hearing this news took me right back to the disorganized way I was asked about my grandfather and the ambulance. It felt too much like a frustrating game of Tag without any clear direction.
Stop treating black women and poor women like lab rats
I’m troubled that I wasn’t more surprised by poor women and women of color being a heavily targeted group for this practice. However, anyone who knows the history of James Marion Sims (the so-called Father of Modern Gynecology) already knows that black women have a tortured history with modern medicine. Granted, this pelvic exam procedure was done while they were unconscious instead of the heinous things Sims did. (Read what he did to 18-year-old Lucy with a sponge that led to blood poisoning, and the list goes on.)
And at this point, it’s too little, too late, but these kinds of practices — whether for a good cause or not — do nothing but make black women (and men, along with other minority groups) even more distrustful of the medical industry. Of course, the excuse will probably be that patients should have looked closer at the fine print for all the procedures that were completed. But if you’ve ever been to a hospital, whether as a patient or the loved one of a patient, you know that you’re getting a lot of paperwork and instructions and questions about treatment thrown at you all at once.
In an instance with another family member, I remember a doctor and nurse growing quite impatient with me because I wouldn’t allow them to keep giving a family member steroids after she didn’t like the hallucinate effects. She started crying, thinking I would allow them to give her the steroids anyway. I said “no.” The nurse, in turn, told me, “If this were my [insert family role here], I’d get it done.” My response, “Good thing this isn’t your [insert family role here].” To no one’s surprise, this family member was discharged from the hospital less than 24 hours later. And without the steroids, she is still fine to this day.
The minute someone hesitates over a potential procedure, both patients and loved ones can start to feel like they’re in a police investigation room and giving all the wrong answers.
I can only speak for me, but I’d like to have a level of trust for the medical industry. You’re giving them a great deal of permission to do all kinds of things to your body. You want to believe it’s for the greater good. But the minute someone hesitates over a potential procedure, both patients and loved ones can start to feel like they’re in a police investigation room and giving all the wrong answers. Someone somewhere in the medical industry needs to be the liaison between nurses, doctors and patients to clearly explain what they’re signing beforehand.
In the past two years, along with centuries more, nurses and doctors have been tasked with an exorbitant amount of pressure due to coronavirus. But that doesn’t give anyone a free pass to just do whatever they feel like to your body.
Not going to the doctor or hospital at all when something is wrong will only be punishment to oneself. But if going to the doctor or hospital can lead to involuntary exams, unnecessary pressure to undergo treatments that patients either don’t understand or don’t agree to, and then the loved ones who have to give the green light get bullied into doing so, I hesitantly understand why people take their chances and let nature take its course. While it won’t stop me from getting scheduled exams and well-researched vaccines voluntarily, learning news like this makes it that much harder to defend the industry.
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