I’m due for my next pap smear later this week, that bi-annual event when the doctor takes up her silver speculum – her fingers of steel – and inserts it as far as she can to scrape off a small tissue sample to send off to the laboratory.
All of it designed as a preventative measure to rule out the possibility of cellular changes that might suggest the arrival of something dreadful like cancer.
I must have endured over twenty pap smears over the years given my age, if I do my calculations right and each time they become easier.
Even so there’s something in the process that causes me to hold my breath and gasp at the invasiveness of this procedure, this intrusion into my body that may be necessary if prevention is the aim, but nevertheless feels obscene.
When I was young in my mid twenties when I first took up the regular pap smear habit, given all the times I’d heard about the dangers sexually active women might encounter if they did not check our their inner workings regularly.
I was content to take myself off to see my then usually male GP who would leave the room to give me time to strip off my lower half of clothes and crawl onto the elected examination table and cover myself in the crisp starched sheets that were the main stay of the medical profession.
These days they tend to use towels and more recently I’ve noticed they prefer disposable sheets of material like paper for hygienic purposes. In any case there was always an attempt at modesty and the GP, my first regular GP once I’d left home and established myself as a grown up was a gentle kind man, who reeked of cigarettes and who donned the disposable gloves of his trade over his nicotine yellow fingers and always tried to engage in light conversation as he shifted the speculum into place.
Twenty or so pap smears later and I still have trouble in working out how best to position myself for this procedure. I need to be reminded every time. The way the doctor urges me to put my feet together sole to sole so that my knees spill out to either side, which apparently makes for easier access.
And what to do with my arms and hands? Let them rest by my side. Not once have I found it painful, though I recognise some women do, and perhaps the fact that I have learned to switch off my mind to this intrusion and float away on clouds of dissociation may have contributed to the extent to which I usually feel nothing during the procedure.
I learned this on my visits to the dentist as a child when I needed to switch off and float to the ceiling, to look down at the doctor whose white coat concealed the arms and gloved fingers of the monster who was about to intrude into my mouth with metal spikes and tweezers and all manner of unspeakable equipment, far worse than the speculum.
I shall try to stay awake during this next visit to my doctor. A woman for preference. A woman because somehow I imagine she is more understanding of this internal violation that we women must endure every two years if we are to stave off the horrors of other unwelcome guests.
It’s the intimacy mixed in with the coldness of steel; the clinical specificity of the doctor’s need to gather cell samples with the posturing required; the nakedness; the closeness to love making; to other forms of activity, like when you’re being raped and all those associations that turn the humble pap smear into an additional traumatic occurrence in a life that’s filled with occasions when the best thing you can do is dissociate.
I have the same sense when I’m writing. This same need to cut off from my emotions in the cold clinical way of a surgeon, so that my fingers can take up each word as it floats into my consciousness and put it down there on the page as it comes to me, not to react to that inner voice that recoils and tells me I must not write this.
I go in, invade my space, and come up with a sample that’s hopefully not cancerous, but a pointer to the illusion that, for a while at least, all is well.