How did I end up sitting on an exam table talking to a complete stranger about breast health? Well, funny you should ask? You were asking, right?
I guess I shouldn’t have been surprised when I first heard the news that I didn’t really have a primary care doctor assigned to me anymore. This is the kingdom of bureaucracy (a.k.a. The Veterans Health Care System) we are talking about. I had called their main number to ask a question about something I’ll talk about at a later date. Anywho, the nurse was quick to answer my question and then inquired who my doctor was. Oh, that’s an easy question. Oh, wait. What’s his name? It’s been awhile since I had seen him. And, really the only reason I had gone to the bother of getting one assigned to me was so that I could get a referral to endocrinology for hormones. Apparently, it had been longer than I thought since I had last seen my primary care doc. Because I no longer had a primary care doctor.
It was right there, while sitting at my desk while delicately cradling the old corded house phone, where I learned of yet another VA rule. If you haven’t been seen by your primary care doctor in 365 consecutive days (do they have rules for leap years?), you are unceremoniously dropped from their list of patients. No warning. No letter. Nothing. I guess I’ll have to schedule a check up every eleven months.
If you think about it, it makes sense. They need a way to keep room for active veterans within the system. But, I was active. Just not really with this doctor.
“Let’s get you assigned a doctor. Because you know, you can’t really get anything done here without a primary care doctor.” Those were the words that came out of the mouth of the woman on the other end of the phone. That made me smile. I didn’t say anything. But, I smirked a smirk nobody else would see as I was alone in my room. I think I had managed quite nicely without being assigned a doctor. Several years of seeing a therapist, eyeglasses, dental. All done without being assigned a doctor. But, oh well. I’ll get put back on the list to get picked up by another doctor. What could it hurt?
90 days, you say? Wow. That’s how long I was told it would take. But, within that first week of knowingly being without the safety net of being owned by a PCP, I received a call alerting me that if I wanted too, I could stop by the VA on a Saturday to get checked out and see if any of the available docs wanted me. I jest in my wording. That’s not really how it all works. But, sometimes it feels like you are a puppy in a pound waiting to be adopted.
Yesterday was the day. And so, just like any other visit to the VA, I put on my bestest casual clothes and applied makeup to my face. I didn’t hide my breasts. Don’t get me wrong. I wanted to bind my breasts and go without the facial war paint. Especially after I heard where the appointment was. The dreaded Specialty 2. Specialty 2 at the Denver VA Hospital is right in the middle of the main floor atrium. During the week, it’s filled with crusty old WW2 vets who don’t have anywhere else to go. There’s a slim walk way between the waiting chairs and the Specialty 2 desk and doors. For many of a woman I’ve spoken with where I live, the thought of walking through the atrium leads to comparisons to an absurd nursing home gauntlet where men toting oxygen tanks behind them and pushing tennis ball clad walkers in front of them hit on anything with long hair and two breasts.
Thankfully, the hospital does most of it’s work during the week. But, I wasn’t sure how many people had received the call to come in this Saturday. My appointment was at 1pm. So, hopefully, most of them had dispersed by then. If anything, I was probably expecting some Iraqi or Afghanistan war vets freshly home, getting assigned their doc. I was fairly confident. I had done this before. I had presented as myself at the VA hospital before. While it could make me a little nervous still, I knew I could do it.
I rode over there on my bike. Quickly locked it up in the usual spot. Then, made my way past the desk that was informally known as the circle desk, even though it now looks like a rectangle. There were only a few people hanging out outside the ER where the large flat screen tv on the wall was showing a program that only tangentially you could say justified it’s inclusion on the History Channel’s roster. Oh, yeah, I said to myself. That’s why I don’t own a television. With a quick zig to the right and another subtle left past the travel desk, I could see a solitary elderly couple occupying chairs in the front row of the gauntlet…….err I mean atrium. One obstacle down.
There was a man standing at the check in desk. So, I stood behind him, careful not to stand too close. But, knowing full well that I was standing in the middle of the walk way. I only had to move aside once when three young men in scrubs needed to walk by. Like I’ve said, I’ve done this before. And I’ve done it here at Specialty 2. This is where my endocrinology appointments are. I knew what to expect when speaking with the staff. And I wasn’t exactly surprised by yesterday’s interactions.
“Can I help you sir”
“Yes, I have an appointment for 1pm” *hand him my VA ID card*
“It’s on the card. But, my last name is ************”
“And your last 4?”
“Thank you, sir. Take a seat and a nurse will be with you shortly.”
Ugh. I need facial surgery in the worst way.
Anyway, I did see the nurse. Usual stats. I’m having a tough time losing weight. And the blood pressure medication keeps my numbers just south of the number they consider high. I wonder if my blood pressure would be lower if I was gendered female by anyone.
I only had to wait a few minutes for the doctor to come out. No matter how much I prayed that he wouldn’t say my legal first name. That’s exactly what he did. I really really wish the VA had a line item in their medical records that showed the preferred name. It would definitely help those of us who stay away from the VA because it feels they don’t respect us.
The appointment went well. He seemed like a nice enough man and outside of saying my male name out in the atrium, was respectful. In hindsight, he didn’t ask what name I prefer using. All other doctors and staff have done that. Oh well. We had a good conversation about my health. And lots of stuff I thought was already in my record. He asked about my family health history. Because I’ve had only sporadic contact with my dad’s side of the family, I told him what I knew. And I was able to give more information about my mom’s side. I did find out that the Pentagon has started to be more cooperative with the VA and allowed access to some details about veteran’s medical records via computer. We found several entries dating back to my last official doctor’s visit before leaving active duty. But, nothing before that.
One last question I had for him came from something I had thought of in the days leading up to this appointment. I’m starting to have enough breast growth that maybe I need to ask about how I should take care of myself. Should I need a mammogram? If not at this age, when? So, we talked about it. He said they usually don’t recommend mammograms until the age of 50. Since I don’t have a family history of breast cancer, then I can wait. And since I’m kind of in the same situation as a teenage girl in the midst of puberty, if I had it done now, there would be a good chance of a false positive showing up in the test. Good to know. But, since I had brought it up, he wanted me to sit on the exam table and take off my shirt so he could grope me………err I mean do a breast exam. Umm, okay. Even though I was an avid swimmer earlier in my life, it did seem weird taking off my top and bra in the presence of a man. But, I managed. And I sat there, almost detached from what was happening as he poked and prodded with his fingers in a professional way. All the while, explaining what he was doing. Having another person touch me like that was, although very logical and I understood what was happening, kind of weird. And, as the title of this post directly alludes to, it didn’t stop there. As soon as he was done, he donned a pair of gloves and asked me to drop my pants. I had done this part before. But, I think the last time was in ’96 when I was leaving the military. But, having just put my bra back on, even my mind was having a tough time keeping things straight (so to speak) when he asked me to turn my head and cough.
In stressful situations, I tend to try to make light of what’s going on. So, I asked him if this was the first time he had asked someone to turn and cough directly after doing a breast exam. He smiled and laughed a little less than I was hoping for and responded with “I think so.”