I went to the dentist yesterday and, like many people, I really detest going to the dentist. Probably more so than any other type of doctor. I always find it painful and uncomfortable. I routinely put off my 6 month cleanings for exactly that reason. Case in point: I only just went yesterday and technically I was due for a cleaning in March.
In addition to the dentist, I really hate needles. I can’t explain why but I just can’t stand getting shots, doing blood tests, or really even seeing needles on the TV. As soon as that novacaine shot is put on the tray my breathing dramatically increases. That shot is about as unfriendly-looking as a needle can get.
I am very clear with my dentist though that I hate coming and I hate everything about the process, and she understands. More importantly, she remembers this each and every time I have an appointment. I’m not sure if there is a note in my file or if she has an amazing memory. Regardless, what matters is that each time I am there she states that she knows I get nervous and anxious and she takes steps to address that. She always checks to see if I have my inhaler (in case I get too anxious). She always informs me what she is going to do beforehand. This alleviates some of my anxiety because I know I will never be surprised when she decides to do the shot. Lastly she always reminds me that I can raise my left hand at any point and that she will stop whatever is happening and check in with me.
Being in a dentist’s chair can be incredibly disempowering because of how it completely removes the ability to voice one’s concerns or pains. We are not able to pull away from the pain because of how it may create further pain or injury. We are subject to the dentists’ will and ability to read our non-verbal cues.
This past appointment, I had to get a single cavity filled. My dentist thought that it was shallow and that it could potentially be done without novacaine. We talked about it and I agreed to try (remember that giant fear of needles?). Turns out it was a horrible life decision because the cavity was deeper than she thought and it ended up causing a lot of pain. Twice she stopped because I winced (but had not yet raised my left hand) and checked in with me. Twice I said to keep going. The third time I winced, we decided that I would have to have the novacaine shot after all and she apologized for being incorrect about the size of the cavity. Trust me, the novacaine shot is important when getting cavities filled.
Despite the pain and trauma that I experienced, I see this most recent visit as yet another reason to stay with my dentist. She took the time to reflect on my fears, have a conversation, offer options, and incorporate what I wanted into the decision. All in all, it was an empowering experience. We made some bad choices but we made them together and we thought we were doing the best thing.
Many survivors will avoid preventative and urgent health care. Being in a doctor or dentist’s office can be very disempowering. Changing into a robe that barely covers your body and having any type of medical exam can create feelings of vulnerability. Many survivors have also had really negative responses from medical professionals. Perhaps they were given poor treatment and it retriggered memories of the assault. Perhaps they disclosed the assault and either weren’t believed or brushed off. There are a variety of reasons as to why survivors may not trust or feel comfortable in a medical office.
It is not yet standard for doctors to provide time and understanding care to each patient. Instead they are required to see a certain number of patients each day to fill health insurance quotas. Maybe it is just easier for them to ask the mandatory questions and address the acute problem at hand rather than delve any deeper.
It is not yet standard for doctors or dentists to come up with safety rules (such as raising the left hand) to make sure that the patient always has a way to express feeling uncomfortable. Our society teaches us that certain authority figures, such as doctors, must be respected and that their opinion and knowledge is much more important than ours. Therefore it may be very difficult for people to verbally tell a doctor to stop what they are doing. It may feel a bit easier to use a body cue, especially if one was discussed at the beginning of the appointment.
There isn’t even a standard for doctors to explain what they are doing beforehand. There is a belief that not telling patients what might hurt or speedily going to an exam procedure is a better practice. However, that is only incorporating what the provider thinks is best and completely ignoring the voice and wishes of the patient.
There is very little, if any, information in medical school about sexual violence despite the prevalence in society. Therefore people don’t have the information or framework unless they seek it out specifically. The lack of patient and trauma focused care can make it very scary for survivors to access care.
I am happy that BARCC offers a training for medical providers that talks about the prevalence of sexual violence and the impacts that it can have on patients even years after the assault. I am also happy that several of my friends are looking into medical school and have expressed that one of their reasons for doing so is the lack of trauma-focused care.
Survivors deserve to have access to both comprehensive and compassionate health care.
WRITTEN BY: Stacey