It’s not everyday that you’re told by a woman to look at her chest. In fact, unless you’re learning how to do a female breast exam, it’s generally not kosher. And so it was, that last Monday I palpated my first breasts. (This post is totally gonna nail me by porn-blocking software.)
So it’s me, three female classmates, and our patient educator/instructor. She introduces herself, we introduce ourselves, talk about if we do breast self-exams, talk about the milk line (and subsequently find out a classmate has a third nipple). I should’ve known at that point that it was going to be a breastrogen filled evening.
The instructor walks us through the exam procedure–history, followed by visual inspection and then palpation–we talk a bit about breast implants, and how that changes the way the exam works. She mentions that we should try to make the patient feel as comfortable as possible, because she’s already probably self-conscious about the exam and her breasts. Then she leaves the room to change into her gown, and comes back. I must say, throughout this whole time, I’m feeling pretty comfortable. I’m not really nervous or anxious or anything–we were having fun talking, and the instructor was really funny and nice. My friend Heather decides to go first, and before I have time to blink, *woah*, there’s two big breasts staring right back at me. Heather started out saying “Fantastic!” after the instructor raised her arms in response to Heather’s request, but the instructor reminded us that “breasts are not fantastic. They are healthy or normal.”
After the initial shock of a woman 10 years my senior rolling down the top of her gown like it’s no big deal, I started to feel that the situation was a little less awkward. And taken out of their sexual and cultural context, boobs are kinda… weird. They’re these circular, mounds of fat with tips on the end to feed babies. That’s all. I had a male cadaver, so I hadn’t really inspected the breasts before, but they just seem so foreign. I can’t imagine having them just sitting on my chest like that.
Before I get any further into a “Ewww, girls are weird,” mode, I should mention my turn. I asked the instructor the basic questions, if she does self breast exams, that she should try to do them once a month. “Maybe after paying your bills,” I quipped. She’d never heard of that reminder before. I was flattered. So then comes the awkward part. I have to reach over and untie her gown. I untie her gown, but then start to pull down her gown for her, and she calls me on it. I try again, and we go through the visualization procedures. I’m being overly cautious at this point, trying not to say qualifying words like “fantastic” or “excellent,” so I end up just saying “okay,” and “healthy,” about 50 times. She finds it amusing; I let out a nervous laugh, and try to continue, still in hypersensitivity mode.
Normally in patient interviews and interactions, I try to let my personality shine through, or I try to find some common bond with the patient, or show that I recognize that the patient’s condition is affecting his or her life. But in this situation, I must’ve been too objective, too sterile. I started doing my palpations, and the instructor said, “Man, it’s like I’m being examined by a robot.” So, I’m going along, doing my little “light, medium, deep” motion, which seems to take hours, and everyone else just starts going into bra and cup sizes and pasties and minimizers and maximizers. I’m serious at Lilith Fair or something. Estrogen’s oozing from the walls.
Anyway, we all finish our exams, and we’re reminded that this is a skill that requires practice. I guess I’ll have to start looking for volunteers.
Awkward factor: 4/10. I’m a little more nervous about tonight’s session: the male pelvic exam. Pre-exam awkwardness factor: 10/10.