The Lasting Legacy of Medical Trauma

Why I still can’t bring myself to get a pap smear

Photo by Hush Naidoo Jade Photography on Unsplash

Dear reader, This essay contains sexual violence, child abuse, and medical trauma; please take care of yourself before reading.

I had a panic attack during my first pap smear. I wasn’t scared of nudity or needles or pain; it was some other wordless terror so deep in my body. I cried and shook so severely that I watched the color drain from the tiny doctor’s face. I was 21.

“Have you been abused?” she asked.

“No,” I replied. 

I had at least two more pap smears in the years following, and I panicked through all of them. For a few days before each one, I wouldn’t sleep, and the sensation of run, fight, or hide made it hard to do anything else. Even thinking about it now, I can feel the tingling in my calves, the drip drip drip of low-grade adrenaline telling me to get the hell out.

Almost five years after that first pap, I was raped by the descendant of whalers on Nantucket, where I was living. The terror I felt following the assault was similar to the panic attacks at the gynecologist. Still, I had an exact name for what happened that night. I could justify its horror. Most people I told responded with concern, support, disgust, and outrage. It was 2013; #MeToo had yet to give us such a universal language for sexual violence.

Shortly after, I left the island. I signed up for therapy and surrounded myself with people who were safe to talk to. Now, If I hear about an assault on the news, read it in a book, or even see it on TV, I am usually okay. My mind doesn’t break loose like it once did. I talk and write about the assault openly. There have been many who have given me a template for just that, such as Roxane Gay, in her book Hunger, or pop singer Kesha, when she freed herself from an abusive manager.

Recently I found even more nuance in my own experience after reading Kate Beaton’s graphic novel Ducks, where she describes the sexual violence she endured while working in the Alberta Tar Sands. The socio-economic and power dynamics around Beaton and the men in that camp echoed that night on the island.

Since that assault, though, I haven’t been able to return to a doctor for a pap smear. Even though I’ve found creative ways to get STI screenings, vaccines, medications, and even checkups, I’m unsure if I can ever convince myself to endure that procedure again. No matter how horrific that night was, it’s not the rape that keeps me from trying to get another pap smear. Instead, it was an experience with a doctor I had tried to rationalize away.

On summer break in middle school, my parents took me to our family pediatrician to get a sports physical for Girl Scout camp. I had had several for soccer and other things before this and walked in like normal. However, the pediatrician was someone I had never met before, and during her exam she molested me. After she did what she did, she informed me of how fat I was and that I needed to be careful about boys and drugs. 

I didn’t tell anyone. 

I kept quiet because I didn’t really understand that I was assaulted. I thought it must be part of the process now that I had hit puberty. I told myself that I was overreacting. I could be a gregarious kid. Conversely, I also preferred animals and alone time to other people. I was also known for bursting into tears when I got frustrated. I thought this terror was just another moment where I was, as the adults said, “being too sensitive.”

Nevertheless, I had a hard time leaving the house during middle school. When I came home from class I found safety in food, The Lord of the Rings, and the made-up stories I typed on the family computer. I thought it was preteen angst or something similar that most of my peers experienced. Looking back, my body knew what my mind wasn’t ready to.

In high school, I buried the memory. I thought my raised blood pressure and shaking hands when the doctor closed the door during exams had to do with needles or just being a “baby.”

Even as I write this, a part of me thinks, Well, maybe that doctor was just doing her job. The rest of me knows that this isn’t true.

Now, more than 20 years after that day in the pediatrician’s office with the model train on the ceiling, I can still hear the hum of the fluorescent light in that examination room, see the cabinets on the wall, and feel the pressing of my jeans on my thighs. Flashbacks are, in essence, cliché. Mine are annoying like the ones you see in movies, whole scenes and all. When they happen, the fear makes me forget where I am.

Conversely, the writer in me rolls her eyes, annoyed watching the same darn rerun for decades. The writer in me knows that Post Traumatic Stress Disorder can be like that guy who thinks he will be famous after one fiction writing class—grandiose, vapid, and lacking in creativity. The traumatized child me wants to believe the writer me, but she doesn’t yet. 

I also fill with jealousy when I think of how banal doctor visits are for others. Meanwhile, my heart rate skyrockets whenever anyone asks about my primary care physician. Even some of my most progressive friends stared at me, confused, when I asked them to stop talking about their latest trip to the gyno. “Want to hear about the funny thing that happened during my pap smear yesterday?” a friend said to cheer me up from some other catastrophe. I begged her not to. 

If I encounter a doctor scene in a book, I skip ahead, hoping I caught it before a flashback starts. It’s harder with TV shows or movies; the scenes about them usually play unannounced, and I’m caught helpless.

The only gynecological scene that’s not made me completely lose it was in an episode of the rural Canadian comedy Letterkenny. At the little town’s clinic, the men and women sit across from each other, waiting for checkups. Tanis, one of the female characters, describes in detail what a pap is like as the men in the room cling to each other in horror. The tone of the moment not only made me feel validated, I even stayed in my body. The victory was small but glorious. 

After mountains of therapy, I have a better understanding of what happened to me. What that doctor did is no longer the secret it was. It’s not an easy conversation, but every time I have it with someone, positive outcome or not, I’m taking care of my teenage self in a way she wasn’t. 

In the last few years, I’ve learned that I am one of many survivors of this kind of abuse. In 2018, more than 150 people testified against Larry Nassar, the former doctor for the women’s Olympic gymnastics team, who, as one AP article states, “molested athletes under the guise of medical treatment.” In 2022, the University of Michigan paid a $490 million settlement split between more than a thousand people who claim that they were sexually abused by Dr. Robert Anderson during exams. In his 2013 essay “Sliver of Sky,” nature writer Barry Lopez recounts years of abuse by Dr. Harry Shier, a family friend.

Early in 2022, I read a Twitter post by one of my favorite drag queens, Willow Pill. She described her journey with gender and her complicated relationship with her body due to a genetic condition called cystinosis. She’d just had surgery on her face to make it more feminine and wrote, “Any further medicalization of my body scares me because of my medical PTSD.”

I hated that this had happened to other people too, but their stories were a life raft in the sea of silence I didn’t know I was swimming in.

When I started this essay, I wanted to write about how there should be more trigger warnings for medical content. I was tired of having my day ruined by things on my screen I didn’t sign up for. Content notices, though, are only a small part of a much bigger picture, one that includes teaching us that consent is essential in many more contexts than just with sexual partners, and honoring those who speak out even when it’s painful.

I wonder what it would be like if honoring bodily autonomy was more commonplace.st If children like me were taught it’s okay to say no? Who would I have been if I believed I deserved better? 

Gretchen Lida is an essayist, teacher, and an equestrian. Her work has appeared in the Washington Post, the Rumpus, The Los Angeles Review of Books, and many other publications. She is also a contributing writer to Horse Network and The Washington Independent Review of Books. She lives in Chicago and is currently working on her first book.