Anesthesia, Please?

Reflections on the barbaric state of women's medical care.

Photo by Mika Baumeister on Unsplash

When you get to a certain age, things start going wrong right? Like a car with a few too many miles on it. So you get the mammograms and the pap tests and the colonoscopies and all the things to try and make sure that you don’t, well, die, even though we’re all dying inside more and more every day watching our country burn under the guise of making America great again.

Anyway, this year my annual pap test showed that I had HPV18, which can cause cervical cancer, so not ideal. To prevent that sort of thing they do a procedure called a colposcopy. Basically it's a process where they take biopsies of the cervix to make sure nothing’s going south. Biopsy, you should know, is another word for taking cells, removing flesh, in this case, from the cervix, which, if you have a cervix you know is a sort of sensitive area.

Anyway, I speak to the doctor and learn that this is an in-office procedure, so I think it's no big deal, it’s in the office. How bad can it be? But then I remember when I had a core needle breast biopsy last year and that was an in-office procedure, and, well, that was a shit show. Have you had one of these? You’re standing up, facing a machine with your breasts hanging out and your breast is placed in a something akin to a panini press that’s constructed with a hole in the center of the top panel, where a steel pipe shaped needle thing comes down like it's about to drill for oil but instead of the ground it’s drilling into your breast.

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The panini machine is taking the mammogram while the pipe thing is drilling through the breast tissue to remove the cells of the suspicious calcification. This is done while you’re awake, so you’re actually standing with your boob in this panini press watching this happen. You’re given a lidocaine injection, a needle inserted directly into the nipple area of the breast (fun!) that does basically nothing other than make you feel how you might imagine it feels to have a needle plunged into your nipple. So you do the math here. The pain is not just from having your breast flattened like roadkill under a tire, but because you’ve got a giant pipe-sized needle coming down into your breast like an oil drill. My friend J had this done a few weeks before me and she actually fainted. I managed not to pass out, but I kind of wish I had.

After the procedure the tech patches you up with some steri-strips and mentions that you will be sore and have some bruising and to apply ice packs to the area. Then you’re sent on your merry way, with your breast taped together and advised to take Tylenol as needed. An in-office procedure.

Now, back to my colposcopy. Here I am at NYU, checking in with some Amazon One process that I am baffled by. Why am I checking into the doctor with an Amazon account? I am confused and ask if I can skip the Prime Day Palm sign in and just give the receptionist my name. He says fine, but clearly I am an aberration everyone else seems to be using their palm and their Amazon acount? I just don’t want to have Amazon involved in my private parts. I think that’s fair.

Photo by Jonathan Borba on Unsplash

So I get checked in and then I get to the exam room and my doctor, whom I love, and who is a super attentive young doctor who takes care of my HRT needs and everything with serious amounts of listening and attention, tells me what will be happening. First, I’ll get two injections into my cervix – not one, but two needles into my cervix. Then he will lather the cervix in a few solutions that help him see what areas, if any, look wonky – both on the ectocervix (outer part) and the endocervical canal (inner canal). Those wonky bits will be biopsied and then sent off to the lab. Then we will fix up any bleeding and I’ll be good to go.

Um, hold up, can we go back to the two injections in my cervix, I ask. “Yes, well those will pinch and burn,” he says, “but then you won’t feel anything.” That’s not ideal; I’d rather not feel the needles going into my private parts or the pinching or burning but I guess if it means I don’t feel the thing labeled PUNCH BIOPSY that looks, well, like a long hole puncher, one that will apparently be used to punch flesh out of my cervix for examination by the pathologist, then okay.

So, I opt for the lidocaine (not that I am given a choice of anything stronger that does not involve injections into my cervix) and hold my breath when my doctor says, okay here we go, a pinch and a burn, It is indeed a pinch but the burn feels more like a blaze, but I keep reminding myself this is worth it because I won’t feel the rest of the procedure. Then he has to do the other side of the cervix so we do the pinch and blaze again. Okay, I do some deep breathing I remember from yoga and try to calm my mind. It doesn't work. I remind myself to become more of a transcendental yogi before any further medical procedures.

Now he says he will wait a few minutes for the lidocaine to get to work and numb me up. I exhale and enjoy these moments when no cold sharp metal tools are inside my vagina. Then he says okay I am going to take a few samples now, like he’s going in for single origin dark chocolates. But okay. Lavone, the lovely nurse, is next to me when I see the hole puncher pole thing go inside me. And then I feel what might be described as flesh being ripped off my body because he has just taken a chunk out of my cervix and the lidocaine has NOT worked and I jump off the table and scream OWWWW!!!! FUCK!!!! My doctor says OH MY GOD, you felt that? And I say, “Yes I felt that, you took a hole puncher to my cervix and that pinch and burn lidocaine did not work!!!

He is apologizing as he pulls the hole puncher out of my vagina with a piece of bloody pulp on its end, a piece of flesh that moments earlier was part of my intimate anatomy. I am breathing hard now and crying. “Um that was a lot of pain,” I say, and he says he is so sorry and that I must have a sensitive cervix. Come again? A sensitive cervix? It’s a cervix! It’s meant to be sensitive, it’s built with nerves, full of them, bundles and branches of big beautiful nerves meant to deliver pleasure! It’s an erogenous zone, people. It’s part of the whole orgasm situation. I feel like saying, “telling someone their cervix is sensitive is sort of like saying, “Wow, your water sure is wet! Yes it’s wet, it's water. Yes it’s sensitive, it’s a fucking cervix.”

Anyway, there were a few other spots he needed to get out and so I grit my teeth and grab Lavone’s hand and try to stay on the table while he removes more bits of my most tender parts. He kept saying sorry, that he doesn’t understand why my cervix is so sensitive. I close my eyes and pray for it to be over soon. And then it is done. I am given a pad for the potential for spotting (you know from the pieces of my body that were removed without anesthesia) and told not to swim or have sex for two weeks. Tylenol for any pain. And then I go home.

Now, I wait 7-10 days for the results to come in to see how the cells turn out and hopefully all will be okay, as it was with the oil drill core biopsy, but I guess my bigger point here is to question why women go through all this without better pain management. I can imagine that if a man had to have his penis in a vice and have a needle the size of a small pipe inserted into it to detect potential penis cancer, or have his balls injected with lidocaine so a hole puncher could take little bits of them off to test for malignancy there might be a different procedure used, like perhaps general anesthesia or twilight like they use for when you have a colonoscopy which probably only gets that level of pain management because men also have colons. If only women had colons we’d be there with lidocaine and a our mouths duct taped shut.

Photo by Anthony Tran on Unsplash

The patriarchy is all over female medicine, denying our complaints as whining, stabbing and cutting us without proper pain medication, relegating research on menopause to essentially a dark alley along with our reproductive rights. It’s all infuriating when you think that this is 2025, not 1960.

I’m not sure who needs to hear this, but standards of care need to change. Women’s breasts and cervixes need to be protected from hole punchers and drill-sized needles. Proper pain management is required; we should not have to just grin and bear it. I have a sensitive cervix because it’s a cervix. I have sensitive nipples because they are nipples. And neither should just be injected with lidocaine that may or may not block the agony of the procedures.

Thankfully, this seems to be the direction we are going in. The American College of Obstetricians and Gynecologists recently released new guidelines for physicians when it comes to better treating pain during in-office procedures including IUD insertion, endometrial biopsy, hysteroscopy, intrauterine imaging and cervical biopsies. But so far, if my procedure this week is any indication, I haven’t seen it make a difference.

You’d think this would be a no brainer and would not require new medically mandated guidelines. I don’t think the Academy of Urologists would have to release a handbook on managing pain for penis or testicular biopsies, I have a feeling pain management in those instances is a given. I don’t think men are getting locals for those procedures. They’re probably getting three fingers of nice old scotch and a good dose of twilight meds.

Anyway, my sensitive cervix and I are doing just fine now. Hopefully all will be okay with the pathology report, and that’s the most important part. But also important is this: women should not have to go through barbaric procedures to keep our bodies safe from cancer. And yet, that’s exactly what we are forced to do.