Letter to my gynaecologist

I’ve translated the letter I sent to my gynaecologist. She never replied, but it did give me some closure, because I could finally tell her how I felt about everything she did. I really wanted her to understand how she hurt me, because I don’t want her to hurt other women (she only treats women) in the same way and it would have helped me heal from this trauma. I still don’t think she actually understands, but writing this down and actually sending it to her did help me a lot. 

Dear Doctor,

For a long time, I have been in doubt whether I should do something with my complaint in regard to your consultations. I have decided to try to put it into words again. A while ago, I wrote you an email in which I tried to explain what went wrong for me. Because of that email, we made an appointment to talk about it. At the beginning of that appointment, you made it very clear we were not going to talk about my previous experiences and feelings. You treated it like a regular appointment and I was not allowed to say anything about my complaint. Even during this final appointment, I felt as if I was not allowed to make my own choices. I felt pressured by your decisions and there was no space to talk about the things I wanted to discuss. I have tried this again after the appointment by sending you another email (for example that I wanted to try TENS).

Your responses hurt me. First, it seems as if you underestimated my ‘history’, even though I told you about the severe consequences for me. You still did the internal exam (which I did not want). Then, I actually want something and you denied me. Later in your email you say that the pelvic floor physical therapist should decide, because of my ‘history’. Especially for a patient with my kind of history, it is very important that the patient can decide herself. It all comes down to: things you do not want to happen, will not happen and thinks you do want, will happen, because this is the opposite of the so-called ‘history’. You have denied me this in two ways. There is nothing wrong with giving tips or consultation and agreement, but pushing and forcing is wrong. For me, it feels as if we have never been able to consult and agree, but you just told me what you wanted. You never asked me (regarding TENS) what I wanted and what I thought I could handle. Once again, you drew your conclusions without actually knowing me or consulting with me. It feels as if you underestimated the amount of knowledge and experience I have with myself.

The internal exam of our first appointment was against my will. I told you this and you knew about my ‘history’. You could not give me a medical reason why this exam was necessary, when I asked about this multiple times (just because you always do it, is no medical reason)  and you forced me to do it. During the internal exam, you treated me like I was only a piece of meat, that could not feel, whether it were emotions (panic) or pain. You did not take the necessary care during the speculum exam. Whithout a word, you opened the speculum completely as soon as it was inserted. This hurted me physically (I told you beforehand that I never had a fully opened speculum before, and now you even did it immediately, without pauses for my body to adjust). You did not respond or stop when I made it clear you were hurting me. During the exam you never listened/looked at any of the signals my partner and I gave you (not even my body trembling, wizened and trying to get out of the chair, or my partner asking you to stop). This exam, which I absolutely did not want but you forced me to, was a traumatic experience for me.

After the exam you told me you could not help me (and did not want to help with the painkillers etc because you did not know me). I usually had to come every 6 months, to see if the painkillers were enough and because I find it difficult to stay in touch with a doctor otherwise. I find it difficult to make contact when I have an issue or question. You put me out of gynaecologic care after our last (second) appointment and I actually don’t want to have contact with you anymore. But now I do not know how things will continue. Will there be a doctor taking over my case? Because I don’t know about this, I also do not know if your warning is a realistic one in my situation. There are other test results available which another gynaecologist could use and an exam against the patient’s will is against the law. So even if a doctor wants to do an exam and I don’t want this or not at that moment, this shouldn’t be a problem. Sadly, this went wrong. Despite not knowing if someone will continue with my case, I also don’t know what I want. The experiences I have with you are still too fresh and too painful, so maybe I will never go to a gynaecologist again. Although it might be good for my physical health.

When I received the pages you have written in my file, I was shocked about the many mistakes that are in it. There are mistakes on different topics: such as the treatments I had before, my use of medication (I absolutely do not overdose!) and that the exam went very well and with my consent. Instead of trying to get everything changed, I decided to have it destroyed.

I can understand that it was not your intention to hurt me and give me a traumatic experience. Sadly, it did turn out this way. I hope this letter will help you to understand and treat patients with a similar ‘history’ better.

I cannot emphasise enough how important it is that the patient can really talk and decide with you and that you are very careful about pushing people or forcing them. Besides that you should make sure that you actually listen to what the patient and/or her companion says and that you plan some extra time for the appointment, even if it is ‘only’ a conversation. It is important that you prepare well together before an exam. Things you could do for example: give detailed explanation beforehand about everything that will happen; ask what the patient does and does not like/what might be triggering for her during the exam and which signals she might give you (such as not responding to anything/being frozen or moving nervously with her fingers). We do not all have the same experiences and the same associations. For someone putting a hand on someone’s knee or saying certain words might be calming or encouraging, but for someone else it might remember her to her ‘history’, because the attacker did or said the same things.

Lastly, I want to report to you that I have already had contact with the pelvic floor therapist. She said that TENS for menstrual pain is not done internally, but externally (by using patches on the lower back). I wanted to tell you this, so maybe you can inform other patients about this treatment better.

Kind regards,
Mel (Hippo256)

P.S. I assume my letter will not be put into my file, or will be destroyed because this is part of the file that will be destroyed.

I am not so happy about my letter, I think I could have done a lot better. I wrote and sent it in a whim. Writing this and reading it out loud for the first time was very emotional. But I was already emotional beforehand and that’s when I got the urge to write it down. And now it’s a bit easier for me to talk or write about it. So I think I should be proud of myself, even though I could have said things better. I was trying not to insult her, because I don’t want her to be angry but I want her to finally listen to me. I hope by sharing this letter with you, this might help you when you’re having trouble with your own doctor. I was inspired by this Dutch blogpost to put my letter in a blogpost. Because when I read that blogpost, it really helped me. It inspired me, gave me some extra courage to share my letter and I knew I was not alone. Which helped me accept these things that happened with this doctor was not just all my fault.

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