Yesterday I saw a patient in clinic–an overweight white woman, 35 years old, with half a dozen facial piercings and tattoos–for a routine pap smear. I asked, as always, if she had any questions or concerns she wanted to discuss.

“I want to know about the day-after pill,” she said. “I’m having sex with my husband’s best friend.”

“Uh-oh,” I said reflexively.

“He’s fine with it,” she said, shrugging. “They’re both fine with it. But two or three weeks ago she was with the friend, “and the condom broke or whatever,” so she’d taken the morning-after pill and wanted to know if she could be pregnant. She had irregular periods, and she hadn’t had one since that episode.

We ran a urine pregnancy test (negative), I reassured her that she probably was not pregnant, etc. That part’s not interesting. What’s interesting is how different two lives can be. She’s 35 years old–the same as me. And she sleeps with her husband’s best friend. Probably there are a thousand other ways her marriage–and her life–are different from mine. But still.

Women come to the Ob-Gyn clinic and they’re so nervous, so self-conscious about their vaginas. As if there is something to be embarrassed about. Yes, there are differences between different vaginas, but these are small, inconsequential, hardly noticeable. Basically they’re all the same.

But the women. The women are all so different. And yet they don’t realize that. The things they say, right off the bat, hardly blinking at you. There was another woman yesterday, post-menopausal and with a hysterectomy. When I introduced myself asked , “How are you?” she said, “Fine…. Well, Actually, I had a nervous breakdown last month and now I’m seeing a shrink. And I’ve got this thing bothering me on my vagina. So I guess I’m really not fine. To be honest.”

That woman I saw a couple times when I was pregnant, a single mother who had just given birth and was obsessively worried about the stitches in her perineum. “Is it healing? Is it normal?” She made me check it over and over. There was no question she was odd. She seemed terrified, desperate. And she was. Six months later she committed suicide–lit herself on fire in a school yard–her little baby left behind, alone.

People aren’t very good at hiding who they are. For the most part, I think, they hardly even try.

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