werner@aecom.UUCP (Craig Werner) (09/28/86)
<>
"I did not go in for a Pap Smear"
(orig. title 'Cancer Patient voices fear, plea')
Denise Ann Tiffany
My Opinion, American Medical News, 9/12/86, p.29
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I walked out of my doctor's office a few weeks ago with the
diagnosis of adenocarcinoma of the cervix. My tumor was staged at 1B
(occult) -- it might have been there for a long time, or maybe it's a
recent development. I don't know which and I won't know which -- it had
been at least 5 or 6 years since my last Pap smear.
It wasn't that I didn't understand the importance of a Pap smear.
I understood. Since I was 18 years old (almost 20 years ago) I have been
reminded in magazine articles, by women friends, by my mother, and by my
husband (the health nut).
So WHY HAVEN'T I BEEN IN FOR A PAP SMEAR IN SUCH A LONG TIME?
Don't think me overly vain. I am not so very different from your own
women patients. I am a teacher, a part-time writer; I read war history
and romance novels; I love chocolate. I think I am fairly typical.
I did not go in for a Pap smear because I was afraid my doctor
would "yell at me" about losing weight.
What is wrong with this picture? A multi-degreed, intelligent,
literate (witty, nice) woman teacher risks cancer in order to avoid being
told that she is overweight.
Yes, I was overweight. At 5'7'', I weighed about 160. Before I
could force myself to face a doctor, I felt I needed to lose 30 pounds. I
took my 5 years.
I have tormented myself: I should have gone in earlier. I should
not have cared what the doctor would say about my being fat. I should
have lost weight faster.
I did not save myself the trauma of cancer, so now I want to save
the world -- if not the whole world, then at least my corner of it. Since
being diagnosed, I have begged my woman friends to make appointments with
their doctors for Pap smears. The universal response from these
college-educated upper-class pencil-thin women is, "I can't. I'm too fat.
S/he will tell me to lose weight," or "Every time I walk into a doctor's
office, I get a lecture about losing weight."
Doctors, I am sure that most of you do not begin lecturing women
about their weight as soom as they get their feet in the stirrups. But
the PERCEPTION, at least in this university-hospital town, seems to be
that you will wait until she is the most vulnerable and then inform her
that she is too fat.
I do not purport to be an expert. I am a patient, just like your
other patients. (Maybe that makes me an expert patient!) I do purport
to be a woman, though, and I did not go to the doctor for a long time
because I was afraid of being told that I was too fat.
The sad (and happy) part of this story is that the reality does
not seem to match the perception. When I finally saw my doctor for a Pap
smear, she did not once mention the word "fat." She was kind. She was
nurturing. She was gentle.
What's to be done about the PERCEPTION? I am not sure. But I
think that you can all stress, in your literature and your office
contact, that you care much more about the health of your patients than
about their cosmetic appearance. I do not know how you can accomplish
this feat with women who refuse to see you, but if my friends and I are a
valid sample, then I know it must be done.
I wonder what you are thinking of me. I complain that you will
lecture me on fat, and you don't. I speak or "perception" with very
little objective data. It really isn't fair.
Still, I think that I am (or have become) qualified to peer
around and make comments. I have come to trust my doctors within a
matter of weeks. My doctors have become the center of my universe.
Indeed, they will either save my life -- or not.
I want all of you to be like these women and men who care for me
and about me. I do not want any of you to be the doctors I was afraid of
and refused to see.
And -- I have a few lives to save. I need to persuade my women
friends to make appointments to see their doctors -- and those doctor's
might be you.
- Denise Ann Tiffany is a free-lance writer and teaches
English as a second language in Iowa City.
--
Craig Werner (MD/PhD '91)
!philabs!aecom!werner
(1935-14E Eastchester Rd., Bronx NY 10461, 212-931-2517)
"Trust me. I'm almost a doctor."melanie@houxa.UUCP (Suzy Q... as in pecQuliar) (09/30/86)
Thank you so much for posting that article, Craig. And, yes, because of you and Ms. Tiffany, you can bet I'll be calling my doctor, pronto. melanie lee