By Cynthia Aralu

There was a twitter post from a woman saying that it would be great if a better device for a smear test is developed so that the cervical screening did not hurt. 

She took down this post because she got so much heat for it from Nigerian doctors, I think, because it was cervical cancer prevention week and there was a campaign ongoing in Lagos to get as many Nigerian women tested for free. But I thought her post was a great idea. Innovate. How is it ever bad to innovate?

I saw another Twitter post of a Doctor that was some sort of follow on quip from that post.

“Female practitioners and women who have actually screened agree too that it is not painful or harmful just inconvenient!”

A very obnoxious interpretation of the “minuscule data” he has gotten from a Q&A he started on Twitter. 

It irked me. What about the women who felt pain during the smear test? Were they lying about their experience and can something not be done to help their experience? A problem should always give birth to innovation but if the problem is pushed away or hushed, how in the world would people do something about it?

I explained to him that he was not being honest to the conversation if he dismisses the experience of the women who actually found it painful. I agree that the smear test is a necessary test and a lot of women find it uncomfortable but to some, it is very painful. Multiple truths can co-exist without excluding each other. I even presented a possible reason for this pain to him. The cervix might not be lying in the normal position.

His response irked me even further. I knew being unreasonable was his choice, so, I did not bother responding. However, as I lay in bed trying to sleep, thoughts played through my head of what my opinion on this is, so, I decided to write it down instead of just having a massive debate in my head. Man, I love writing but it has such bad timing sometimes, and it costs me sleep. But who needs sleep? Sleep is for the weak. But yeah, I’m going to pay for this when it’s time to get up for work.

Anyway, his response went like this:

“We’re not dismissing it. We try to allay the fears of other women by reassuring them based on the opinion and experience of most women who agree that it is uncomfortable, very uncomfortable sometimes, often painful too but only a few times unbearable except something is wrong.”

First of all, blatantly making a general statement, as he had done initially, that the test is not painful but only inconvenient, already dismisses the people who feel pain. I thought the duty of the doctor is to give the entire truth about a procedure and not one truth. If I hadn’t said something, it is doubtful he would have mentioned the other side? That to me is gaslighting. 

1 in 5 women have a tilted cervix. Why would something that common be seen as a problem, if it is unlikely to cause health issues. Of course, there are cases where pain during a smear test could indicate that there is something genuinely wrong. 

My first cervical screen was fall of 2020 and it hurt a lot. The lady chose a large speculum because it was “appropriate” for me. It is a pure mystery to me how she made that assessment, but the pain was unbearable. She just couldn’t get the speculum in the right position to allow her the movement to take a sample using the brush and she kept pushing. Then, she went for a speculum of a smaller size, highly doubtful it would be good enough to retrieve enough “cells” from my cervix for an analysis. It still hurt slightly and was mostly uncomfortable but it was better. She mentioned that my cervix is positioned differently and I felt so apologetic for troubling this lady with my “abnormal cervix” that I even apologised. She told me that I would have to come back for another screen if the lab thinks the cell sample she had gotten was insufficient. I was terrified at the prospect of going back. Thankfully, the result came back negative and I was informed my next screen would be in 3 years. I should mention that she did give me the option to quit the test but I’ve always been a trooper, so, I stayed. I have to mentally prepare myself for my next screen and I think I will have my earphones in at my next appointment. 

The loudest voices usually drown out the “other” and they are not always accurate. I just think, how many women have kept quiet about this pain because they were told there is something wrong with them, because of loud voices such as this one, and how has this stifled the innovation of a better speculum for the woman with an inverted cervix, who feels pain. 

To be fair, the doctor on Twitter sounds like a pushy Nigerian doctor, who is only concerned about the results and not the state of mind of the patient. Perhaps, this is a massive generalisation of Nigerian doctors. Perhaps, this case is only isolated to “Twitter Nigerian doctors”. Either way, it annoys me. 

I found a blogpost written by Dr. Streicher and she has a humorous and interesting take on this. 

Here is a snippet from her blogpost. 

“Finally, if you are not an easy fit, I would skip the martinis, but you’re probably better off seeing a gynecologist as opposed to a general doctor for your annual exam. Gynecologists are not only the most experienced at inserting speculums, but have multiple sizes that vary in length, width and how far they open.”

Click here to learn more about her take:

https://www.drstreicher.com/dr-streicher-blog/2015/8/speculums-are-not-one-size-fits-all

To give you a little background on her, Dr. Streicher is currently a Clinical Professor of Obstetrics and Gynecology at Northwestern University’s medical school, The Feinberg School of Medicine. She is the founder and medical director of the Northwestern Medicine Center for Menopause and the Northwestern Medicine Center for  Sexual Health . 

In all honesty, while her accomplishment is impressive, I trust her judgement without even meeting her, because she acknowledges that I exist and I am not the problem. 

Thank you for reading/listening to today’s post. Remember to like this post and share it with your friends if you enjoyed it. Follow me on my blog, katmira’s blog or my podcast, Amara’s Musings, to receive notifications whenever I have a new post. You can also subscribe below to get an email notification whenever a new blog post is out. This is particularly helpful if you don’t have a WordPress account.

Let it be, until we meet again or “Ka ọ dị” as it is said in Igbo.