This week I received a phone call. A new doctor to my team was on the other end of the line. He said he had been told I wanted to speak to him following our prior appointment. I was exhausted and uncomfortable, but I decided to put what energy my day held for me into a teaching moment. A long teaching moment.
Earlier this month I had a fairly traumatic appointment with said new doctor. I’m starting to think Leo season just doesn’t like me. I’m also starting to think a fair amount of providers actually believe that trauma informed healthcare is either just generally being somewhat informed that I have trauma, or informing me, repeatedly, of my trauma. Uh, no.
Let’s run through a few of the more egregious missteps of this appointment, shall we? Let’s extend the teaching moment.
I have been dealing with a newer health issue for about 13 months now. There is a lot of uncertainty as to what it is, if it’s tied to my Ulcerative Colitis, or my Celiac, or even my TBI and changing nerves from PTSD. All this is to say, I have been waiting for answers, just getting through it, for a while. It is unpleasant to say the least. I was psyched to find out it was finally time for my appointment with this highly recommended specialist after waiting for months. I had no idea what I was in for. How is that even possible at this point? I wish I knew.
The first hour of my appointment was spent with the NP who was admittedly respectful and sincere, and had her shit together. She listened to my intake information, including a rundown of my trauma and extensive medical history, all the while treating me like a whole human being. When it came time for the physical exam, she even said, “It’ll be a ‘no’ to any rectal exam, correct?” I, of course, said, “Never a rectal exam,” and she laughed and said, “That I can do,” as a confirmation. After that, she and a supervising doctor left to meet with my new specialist and talk game plan regarding testing I need and potential solutions to follow.
He came in with the good old handshake, during a pandemic, to a high-risk patient who doesn’t like to be touched regardless of Covid-19 times. If I don’t trust and adore you, I don’t want your hugs or your pats on the arm or your handshakes, ever. That much is communicated to anybody even potentially joining my team, a team made up mostly of people I trust and adore. Anyway, this seemed off. I’m sure the way it was followed up with speaking too quick for any interjection didn’t help either. The real cherry on top was the incessant, “Most assault survivors,” and “Well, you, as an assault survivor,” as if being raped, most recently nearly four years ago, had anything to do with my latest gastrointestinal concerns. All of this may sound petty, but I assure you that when accompanied with all that came next it was both threatening and dehumanizing.
Within his first few sentences, this specialist both shamed me for declining a rectal exam, and made crystal clear that declining a rectal exam moving forward would not be an option. I want to make it known that I have had GI medical intervention for twelve years now, and I have not once received a rectal exam. I have been really, really sick, and not once has this denial, on the very few occasions I have even been prompted, been met with anything other than complete acceptance. Until now. I was shamed, as though I was impeding his ability to do his job, as though his job could not be done without letting somebody shove a finger in my rectum. My bodily autonomy was threatened. My basic human right to consent was threatened. Beyond even that, I was then informed that not only was my “no” not heard as a “no,” but also that moving forward my “no,” would not stand. I was to submit. I was to allow the shaming to move me from my boundaries. This is, obviously, disturbing. This would be a drastic and harmful violation to any person. This is perhaps even more dangerous to a population of people, survivors, who have already been violated and have been taught to stay silent rather than to advocate for ourselves. This is even more unsettling when knowing this specialist is regularly working with folks on their own healing journeys from trauma. It is all horrifying.
I could stop there and that would be enough, I think. But, there’s more. And one bit of the rest was also worth sharing. After the shaming, and the rapid talking over me, and the speaking from a place of assumption that as a survivor I must have been solely vaginally raped, he said something that I’m still shocked I heard. I am shocked it was said, but I am also shocked that in the rigid state I had entered, near tears, just trying not to black out, it even registered. He said, “I want to help fix you, help you heal, so you can get back to a normal life, so maybe in a few years you could even meet somebody,” with all the confidence of a white cis man who wants to portray himself as woke without doing the work. This one deserves dissection.
I do not need to be fixed. What I need your help healing is what I come to you for. I am a survivor. I have been on a long healing journey. Not only are you late to the party, but you were not invited. You were asked to salvage my gastrointestinal tract, not my presentation of “normalcy,” whatever the fuck that means. I am a survivor. I understand that intimately, just like the attacks, just like every bit of healing work since. Do you? Do you understand it, or do you use the words to pretend you do? You are not a savior. You are not even good at your job if it “requires” a violation of a patient’s consent. Who in holy hell told you what my life is like? Did you even ask? Who in holy hell said my healing journey started when you walked on the scene? I have been laying here waiting for you, dear savior? Who in holy hell said there is any “normal” to return to, or that I want to, or that I’m not already my “normal,” just because of your so damn woke presumptions of survivors? Hint: if you were as woke as you want to present yourself as, you would have already worked through all those projections of who we are, how we function, and what makes us. In that unlearning, you also would have learned that “meeting somebody,” is not a benchmark of healing or success. It is bold of you to assume that I have not met somebody, or that I want to. It is bold of you to assume I am seeking a partner, let alone one with any body parts to insert into me. It is bold of you to assume I want to meet somebody, not somebodies. It is bold of you to assume the first thing about my sex life, let alone the whole damn absence of one, due to my status. I am a survivor. I am a human being. I do not need to be fixed. I will never stop being a survivor. I will never stop healing. I will not hit some ceiling you design on this journey of mine. I will never look like your “normal,” or behave like your “normal,” or heal on your schedule, or be cured. Your expectations and projections are not my concern to live within. Leave the damn party if that is all you brought.
This interaction lasted around twelve minutes total. Twelve minutes. Enough damage was done in twelve minutes, that I spent the next twelve hours in physical pain from the stress, crying, and exhausted. Then I spent days in similar condition. Now I’m writing it out, after saying it aloud. My next teaching moment will probably be on proper apologies. He tried. It’s still not okay.
All healthcare should be trauma informed. Odds are, whether a provider knows it or not, their patient has experienced trauma. This is not asking too much. Whenever I catch myself questioning if it is, I reach out to two of my favorite people, pictured above. They are trauma informed healthcare providers, who believe fundamentally that basic healthcare is trauma informed healthcare, and who aren’t afraid to say it. We need more of them.
Getting Good at Running Away 