Mrs B. stopped abruptly at the door of the consulting room and announced, ‘Do I have to see so many people? I’ve only come to see one doctor.’ The doctor and nurse in training looked embarrassed. The instructing doctor suppressed her irritation that valuable teaching material might be lost, but knew that her patient’s wishes must come first. The trainees tactfully withdrew.
The interview was prickly. The doctor, although recognizing that the patient’s request to be seen alone might be symptomatic of some underlying anxiety, found herself not only having to contain her own annoyance, but having to accept a rebuff to all her gentle probings. ‘I’ve only come for a check-up, that’s all,’ said Mrs B. ‘Of course I’m feeling tired, who wouldn’t when the baby wakes several times in the night? The delivery wasn’t what I expected.’ ‘You expected something different?’ asked the docotr. ‘Why shouldn’t I? I went to all the antenatal classes, didn’t I? And I want you to fit me with a coil,’ she said, as if putting an end to further discussion. She brandished a leaflet. ‘I’ve read all about it, at least I don’t have to think about it.’ Think about what, thought the doctor. A pause. ‘What did you use before?’ The Pill, but it never really agreed with me, then the cap; that was fine but I couldn’t possibly use it now.’ A spasm of pain crossed her face but she was already moving towards the couch. Breasts and abdomen were examined, then the perineum – a beautifuly healed episiotomy scar, but Mrs B.’s hands were across her eyes. The doctor said, ‘Tell me what you think it is like down there.’ ‘It’s horrible, horrible. I wanted everything to be natural but the baby got stuck. They kept saying that I should have had an epidural but I didn’t want it and I didn’t want to be cut. Stitching me up was even worse; there were all these people in the room. I don’t think I’ll have a coil fitted today, I’ll come back later.’ ‘When I put my fingers inside you, can you tell me what it feels like?’ Subtly the doctor was putting Mrs B. back in charge of herself. ‘Then you can decide what method of contraception it’s going to be. You might like to go back to the cap after all.’ With the doctor’s help Mrs B. was able to recognize with astonishment how normal her vagina felt, and even managed to insert a new cap.’Actually,’ said Mrs Â. ‘I think I would like a coil. It’s possible to be a bit more spontaneous isn’t it?’ She gave a shy secretive smile. She was even beginning to think about sex.’And as long as you do it I don’t really mind if your trainees watch.’ Having shown her feelings with the doctor, Mrs B. was able to take a positive decision about herself and was back in control again.
*176/197/1*
