When You Don’t Find What You Expect to Find
All three of our kids had the same kindergarten teacher. Mrs. Goldsmith was great. One of the things I learned from her was the importance of children learning to recognize patterns.
Pattern recognition allows us all to function in life. Experience teaches us what to expect and that allows us to fluidly move through life.
When we don’t find what we expect to find, it sets us back.
One time, one of our nurses was interviewing a young woman at triage. On the nurse’s list of questions was, “Do you have any pain in your ears?”
The patient replied, “I don’t have any ears.”
When the nurse didn’t know how to take the response, the young woman pulled back her hair, showing that, indeed, she had been born with no ears. Who would have expected that?
Let me tell you about a time when I didn’t find what I was expecting to see. A young woman came in complaining of lower abdominal pain. I asked her all the usual questions and examined her, including feeling her abdomen. I then informed her that I needed to do a pelvic exam.
She told me that would not be possible, as she had no vagina. I am not sure if I was too proud to listen to her or if the idea that a young woman would not have a vagina was too bizarre for me to take seriously. Either way, I just blew off her response.
When the nurse had the patient all set up in the stirrups, her legs and crotch covered by the sheet, I stepped in between her legs and grabbed the speculum. I put some KY jelly on it and pulled back the sheet. I am sure I must have looked really stupid as I peered up between her legs, lubricated speculum in hand, and found nothing. Well, not really nothing. She had normal external genitalia and pubic hair. But there was no opening into a vagina.
After recovering from my shock and embarrassment, I apologized to the young woman and did what I should have done earlier: I asked her some more questions.
She had been born with no vagina. Further investigations showed that, inside, she had a normal uterus and ovaries. When she was a little girl, this caused her no problems.
After she became an adult, she consulted doctors to see if they could fix her problem. She had been told that a functional vagina could be surgically created for her but there was no way to do so and preserve her uterus. She would be able to have sex but never able to have children.
She really wanted to have kids so she had declined the offered surgery with hopes that someday, she might find a way to have a vagina and keep her uterus, allowing her to get pregnant and bear children.
So, she faced an interesting dilemma. She was unable to have sex or get pregnant because she had no vagina. Yet she refused to have a vagina created, holding onto the hopes that someday she would be able to get pregnant.
It has been twenty-five years since this experience. I wonder what happened to her. I also hope I have become more humble and skilled in dealing with situations where I find, or don’t find, what I am expecting.
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During my first month of employment, scheduling various types of return appointments at a very busy OB/GYN practice. I noticed the patient I was assisting did not have any record of annual “Well Woman” appointments (which include vaginal swab tests, vaginal and breast examinations, hormone needs review, bloodwork, etc.) Innocently I asked the patient if I could schedule this type of appt for her, of which she replied, “Well, that would be kind of difficult! I don’t have a vagina.” I asked if a “Follow-up” appointment would be appropriate for her current needs and she agreed.
I think my face cooperated with being professional, respectful, not shocked or cold hearted, and within my job description, but only she could confirm on that one.
I immediately got the impression she got a kick out of giving her response. I thought “what do I really have here?” she did have breasts, and I’m sure other annual “well woman” needs, but had to leave my coureousity there, afraid to boggle everything, and too stuned as a new employee to look at how that days appointment had been booked. Thankfully at least she was satisfied with a “followup” and her needs would be taken care of. Much braver now!
OK Tad, I’ve got a physiology question for you about this one. If she has a uterus and ovaries, I presume she has a menstrual cycle as well. But what happens to all the blood, etc., that would normally discharge? Does the body just reabsorb it in her case? Doesn’t that cause her problems?
Good question. I suppose it just resorbs. I will ask one of my gynecology buddies about that.