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My Visit to the Gynecologist

In a well-intentioned effort to pave my way toward full assimilation into American culture, my parents chose to honor my deceased grandfather by naming me Jules and sparing me the more European name Julius. They meant well, but Julius is clearly a name only a man could use, whereas Jules is an appellation carried equally well (or equally poorly) by men and women. As a result, those who have never seen my portly (and that is a euphemism at best), balding, bearded, bespectacled frame sometimes refer to me using feminine pronouns. Articles have been written about the things Ms Rothstein has said, and the propensity of some people to transform the name Jules into "Jewels" has never helped the matter. From this I have discovered that you can live with gender confusion as long as you are not the one who is confused

Perhaps it was because of these experiences that I took special note of events on a recent sojourn to an urban emergency department. There is nothing like a morning bout of vertigo to remind you of the importance of the physical therapist's role in the care of labyrinthine disorders. So it was in the midst of a weekend of work on APTA's clinical research agenda.

After experiencing the usual indignities of patient registration, I was ushered into an examination room, where I quickly sought comfort lying on my back. With a colleague there to protect me and keep me company, I awaited the physician. When he arrived, I turned my head to look at him, and the movement inspired my eyes to dart from side to side in that dance we call nystagmus. As my eyes settled down, my gaze fixed on the physician's ID badge. All I could discern was the boldface print under his name: "Ob/Gyn." Without hesitation I exclaimed, "You're a gynecologist!" and he responded, "We rotate through the emergency department." I knew that, of course, but I did not want to be reminded that someone who more routinely used a speculum was about to use an otoscope. I wished I had come on the day when the ENT resident was rotating through.

I know all about teaching hospitals. I work in one. But that episode reminded me of the insular and sometimes peculiar world in which I live. My jocular colleague who observed the encounter has chosen to elaborate on my visit to the gynecologist, but good taste demands that I do not recount the tales he has told. Because he too is responsible for a major clinical service at a teaching hospital, we shared some insights into the world of health care, but we both were caught off guard by the situation. In addition to dealing with their fear on a visit to the ER, should patients have to wonder about the specialty of their examiners?

Our facility recently survived a visit from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), so I am acutely aware of the rules that we all must follow. You can usually tell when JCAHO is visiting a facility because of the ubiquity of postings of the patient's bill of rights and the omnipresent ID badges—badges worn by those whom you have never seen wear badges before. My ER gynecologist was following the rules, but there should be something more. Health care professionals at mortality and morbidity conferences never discuss the death of common sense, but perhaps we should. Can't we, for example, afford name badges that relate to the setting?

When I explained to the ER physician that I had nonalcoholic steatohepatitis resulting in cirrhosis, I thought I was clear. This did not keep my gynecologist from insensitively asking, "Are you still drinking?" According to my colleague, I loudly repeated the words "nonalcoholic steatohepatitis." Make no mistake, however: By all manner of communication, verbal and nonverbal, this physician seemed to be a caring individual attempting to do the best job he could. The problem is that we sometimes forget how we appear and the consequences of our appearances and behaviors. Similarly, an exceptionally kind ER nurse seemed to be incapable of referring to the medicine I was about to take as meclizine, assuring me that if I took my mescaline, all would be well. I felt the spirit of '60s drug guru Timothy Leary floating about us in that ER.

Perhaps the best insight into the world of health care and the affectations of health care professionals came from the maniacal mind of Mel Brooks as he played the character of the 2,000-year-old man. When queried by his comic partner Carl Reiner about what health care was like 2,000 years ago, Brooks explained that there were giant caves with residents and interns and that the principles developed in those caves are still in use today. Reiner, ever the magnificent straight man, expressed astonishment and asked, "What are these principles?" Brooks replied, "These principles are people walking by you [and not caring] when you are screaming... The same wonderful indifference to the sick and the dying we have today, we invented that." In this exaggeration lies insight.

As a frequent user of our health care system, I am simultaneously impressed by the growth of a caring attitude among professionals and by the thousand deaths that common sense dies every day. Sometimes health care professionals need to be at the other end of a stethoscope or at the receiving end of an exercise prescription to remember what the world looks like from that perspective. Although my labyrinthitis has long passed, I hope that my visit to the gynecologist—and the lessons I learned there—will have a lasting effect. Without wishing you ill, I hope that each of you gets to have a similar visit.

A man can learn a lot from a visit to the gynecologist.

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This Article Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rothstein, J. M Search for Related Content PubMed PubMed Citation Articles by Rothstein, J. M Related Collections Professional-Patient Relations All Editorials Jules Rothstein Social Bookmarking                      What's this?