Doctor knows best

I’ve already written about my experience with smear tests, breast checks and preventive cervical cancer treatments. Cervical cancer prevention has been an ongoing issue for me for the past five years and I would strongly encourage every woman to go for regular check ups. Don’t fear the smear, ladies!

Being in the small group of women for whom test results don’t go back to normal after one or more loop procedures (removal of abnormal surface cells from cervix), I thought I’d share my experience with the public free healthcare system in Ireland. Spoiler alert, it has been less than satisfactory at times.

My main issue has been the lack of information provided to me during consultations and treatment. I’m grateful to be able to avail of a free service which does work very efficiently. Unfortunately though, communication with doctors and health care professionals has been inadequate, not permitting me to make informed decisions.

With recurring low-grade cell changes and the worry about possibly getting cervical cancer, I placed my trust into doctors who never really explained any of the procedures or their long-term side effects to me. Any of my attempts to engage in conversation were usually stifled, and my concerns about the impact of the treatments on fertility were brushed off with a ‘Let’s wait and see’ attitude.’

After two loop treatments, which didn’t seem to have done the job, I began to research a bit myself. Of course that’s not ideal, given the amount of contradictory information you find online and anecdotal experiences of other women who might have a very different medical history. What became very clear to me, however, is that many women going through this process are not properly informed by their doctors and cannot make educated decisions regarding their own bodies.

Personally I often felt intimated during consultations with doctors. The free public service also means I’ve had different doctors every time I went to the clinic for a check up. They’d be rushing in and out, and rarely seemed to take time to engage properly with me. Since a gynaecological examination is fairly exposing (quite literally), I wouldn’t feel comfortable to ask a lot of questions while the doctor was performing a procedure. And after all, I definitely don’t want to get cancer so I better go along with everything, despite not knowing how high the risk of me getting cancer actually is.

While my experience with doctors has been a mixed bag, the nurses have been the only constant in this process and have been incredibly kind and caring. They wouldn’t let me leave the clinic after a procedure until I had a cup of tea and a biscuit. Tea cures everything, even cancer!* (*This comment is factually wrong and was only used for comedic effect.)

With growing concern over the effectiveness of the treatments I’ve had received so far, I armed myself with a number of concrete questions which I asked during my latest consultation a week ago. Those questions revolved around fertility issues, side effects of treatment, concrete risk of cell changes developing into cancer. While the doctor was able to answer some of my questions, he couldn’t tell me how high the risk of getting cancer was or if there was any risk at all with low grade cell changes. He simply said they wouldn’t let me out without a clear test result and usually a hysterectomy is performed in cases like mine.

He dropped the H-bomb as if he was merely talking about pulling a rotten tooth. Sure, who needs a womb?! This callous approach lacking any sort of empathy is probably not uncommon in the medical profession. I’ve heard plenty of horror stories from female friends suffering miscarriages or dealing with complicated births who were treated with little or no respect, let alone kindness or understanding.

Being left in the dark about serious health issues that have quite a considerable impact on my life is what infuriates me the most in this situation. I’m asked to put blind faith into a stranger who clearly does not care about me. Unless I push for answers myself and fight my corner, I have to put up with the attitude of ‘doctor knows best’ and decisions and control over my body are taken out of my hands.

This of course is indicative of the attitude to women’s health care in Ireland in general. As we are approaching a referendum on repealing the 8th amendment, the paternalistic approach to women’s health care has come into sharp focus. Women in Ireland are being treated as if they are unable to comprehend matters concerning their own bodies, decisions which have life-long consequences are made for them by others who supposedly know better.

It’s not surprising then that I was made to feel bad about asking any questions at all, for being a nuisance questioning the doctor’s approach, for standing up for myself when nobody else would. It was made very clear to me that I’m not an equal in this conversation, despite the fact it’s my life we are talking about.

I continue to be a strong believer in preventive care when it comes to health matters and I don’t intend this blog post to be a deterrent for women to get regular smear tests and gynaecological exams. It is important to be fully aware of what’s going on with our bodies in order to be able to make informed decisions in a timely manner. This, however, requires a change in attitude (and law in relation to the 8th amendment) to give women complete control over their own bodies and lives. We deserve better!

I’ve requested my patient file and will obtain additional opinions from other specialists regarding how to proceed with my treatment. Nobody is touching my womb for now!

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