My brain and body have been freaking about about Thursday’s appointment with the gynecologist. Good time for another round of letters with Anxiety. She has no trouble telling me what she thinks.

Dear Q,

I’m still not happy about that fucking bladder study piece of shit humiliation experience. It’s shaken my trust in the medical process for dealing with our issues. Is this the right thing? I’m worried you are going into it thoughtlessly, like so many other things. You are doing it because it’s expected of you, especially now that the operating room is booked and you’re on the schedule and the doctor expects it and you paid the $250 copay. It’s all rolling and no matter how wrong it feels, you are just plowing forward. But what about us? Can you think about protecting us? Should you be subjecting us to this?

You have started telling a few people. I hear you saying nonchalantly, “no big deal, it’ll be fine.” That’s bogus and just for fucking show. It’s just part of your pretending that everything is fine when it’s not fine. Do you see a pattern here?!? 

I think you need to do better for us. I’m not saying no surgery. I’m saying don’t be so blindly obedient about it. Sorry but I have to keep shaking you up until you start to do things differently.

Love, Anxiety (again with help from Anger) 

Anxiety swears a lot more than I do, probably because she’s so worked up all the time. But she’s right about me acquiescing to things that don’t feel right because I don’t want to rock the boat. I can’t keep doing that to myself. But I don’t know what to do instead. I don’t have time to think about it–we are leaving on our trip soon. I decided to do this surgery, and December 11 is the only day the surgeon is available while I’m still on my leave of absence. It will be okay. I’ll be unconscious anyway. I can’t see any real alternative.

Then I think: wait, I know the person to talk to about this. I can call my friend Kali (a pseudonym I use to protect her awesomeness). She is the super-cool, feminist, confident, hippy, creative friend who is not shocked by anything. She’s an extrovert and I’m not; she’s impulsive, and I’m methodical, but we are great together. We met when my son and her daughter fell in love in high school. Then we discovered that we also each have another son with a serious disability and bonded over that as well. I could actually write an entire post about Kali, but for now, suffice it to say she’s the one you could talk to about anything. Plus, she’s had a hysterectomy.

I call her and have to catch her up a bit, because she has moved to California and we haven’t talked since mid August. I’m on leave from work for three months, I tell her. “Good for you!” she cries out. She’s seen what my job demands and talked to me this summer when I was drowning from my workload. I’ve been taking care of health issues I neglected, resting, restoring myself. “Three cheers for self-care!” she says. I run her quickly through pelvic floor prolapse, plan for surgery, and then the appointment itself.

“I know the doctor and nurse do these things all the time, and it’s no big deal to them that I stand there in the room, half naked, prodded and monitored and asked to do things to undermine my bladder control. But for me, it was immensely triggering,” I tell her.

“Of course it is!” she replies. “It can bring up all kinds of memories of bad experiences with pap smears or other doctors…”

“Not just that,” I say. “You know the questionnaire when I first came specifically asked if patients have a history of sexual abuse, and I checked that box, but it’s like it didn’t mean anything. Maybe they never look at it, but then why even ask? They don’t check how it might affect you or if there are ways they can make it easier.”

There is a slight change in Kali’s tone, because of all the many personal things we have talked about, we haven’t talked about sexual abuse. But she doesn’t miss a beat. She talks about how important it is for doctors to respect that, and how asking about it on an intake form provides an implied promise that they will respect your needs. “It’s easy to slip up, as a health care provider. You can get really desensitized. You know I used to work at Planned Parenthood for more than 10 years, and as staff, we had to talk about it regularly, how we might have seen thousands of penises and vaginas and venereal diseases, but for the person we are working with, herpes might be something new and scary. And it’s crucial that we see the experience from the patient’s point of view, not from our own. At some point, or when this is all over, you might want to tell the doctor and nurse what that experience was like for you. It could be empowering.”

“Yes, maybe.” I was thinking I might even give the doctor a printed copy of my blog post about what it was like for me. Maybe.

“Do you even want to go forward with the surgery?” she asked me. “Or get another doctor?”

“I feel like I have to. This problem isn’t going to get better. December 11th is the only day the doctor is available while I’m still on leave. I can’t have this three-month leave, which definitely put extra pressure on all my colleagues, and then go back to work and a little while later ask for more time off for the surgery. I’d have to wait another year to take the time off. Besides, I had a ton of paid leave accumulated, but I am using up every last penny of it for this leave. So additional time would be unpaid…” and on and on with various other reasons.

“Okay,” Kali said. “I’ll tell you what I think, and you can take it or leave it. But you took off these three months to restore yourself. If you have this surgery, even with the perfect doctor, you are still giving up a lot of that time. It takes a lot out of you to have that kind of surgery. It’s draining. You want to go back to work calm and healthy, not already dragging because you are still recovering from a surgery. And to come home for your wonderful trip and not even be able to unpack your suitcase before you go to the hospital, that will feel stressful. If I were you, I would honor those three months you took and protect them.”

“You talk as though you don’t have any choice, but you do,” she went on. “You can do the surgery in March or something. Your workplace will adapt. You’ll have some leave accumulated by then, and if you have to take some unpaid, bummer, but you can do it. Putting it off will also allow you to think more about whether you want to change doctors. You don’t have to rush into this. You are allowed to change your mind. You do have control here.”

You know how sometimes you hear someone’s words and a knot in your stomach suddenly loosens up? The words resonate as true for you. That’s how I felt, listening to her; I also felt empowered. She’s right. I do have a choice. I don’t have to give up all authority of my body over to someone who isn’t attentive to the psychological impact of her practice. Or at least I can ask a lot more questions before I decide. I know Anxiety liked her words, too. They follow along the line of thinking that she was outlining in her letter to me. Anxiety has been calm and quiet ever since my call with Kali.

Kali is the Hindu goddess of empowerment. She is the goddess of change, power, creation and destruction. She is a destroyer of evil forces. I see these powers in my friend and want to build them in myself as well.