The Med Student Chronicles: My first vaginal exam

Let's be honest, I knew OB-GYN was going to be a disaster.

It was my first rotation of third year. The first two years of med school are your preclinical years, you spend hours in the classroom and at home studying and getting the building blocks you use for the clinical years.

Second year culminates with the USMLE step I exam, which is kind of a final exam for the first two years of preclinical training. After passing it, you are graduated to third year and get to be on the floor with real patients. As all of us went to med school to be physicians, to interact with people is something you definitely look forward to. Our school had a lottery system for third year rotations, and I had one of the last numbers and little control over my schedule. I got stuck with OB-GYN as my first rotation which I was actually ok with it because I knew it was something I probably wouldn't be interested in.

OB-GYN is an interesting rotation. It's something that as a medical student and future physician its good to know the basics of, however most women aren't fans of letting a med student examining them (shocking!). It's this awkward interplay between wanting to do and see stuff, and then getting constantly rejected. Especially being the first rotation of third year, we were totally green and it showed.

My first week was on ultrasound and urogyn, which was pretty straightforward. Then I went to the hellhole that is labor and delivery. There were two med students at a time on L&D, one who would work 6am to 6pm and the other one would be on 6pm to 6am. L&D is just always busy, there would be 10-12 women at a time in some form or another of labor. The service was run by a chief resident and two junior residents on at all times, along with the attending and the med students. My chief resident while I was on nights was this really awesome guy, we got along great. Two guys standing strong in a sea of estrogen, or something like that.

Anyways, we did a ton of vaginal exams on L&D. Every couple of hours the residents would examine the patients and see how dilated their cervix was, and how close the baby was to popping out. My chief was pretty good about getting me involved, and as it was still early in the rotation I hadn't been horribly scarred yet and I wanted to do stuff. Some patients were not good candidates, but their was one lady who just didn't care. She was this huge (>300 pounds) Hispanic lady. She had a few kids before, and you could tell she just wanted to pop this one out and get home. Her first exam of the night showed her to be a few centimeters dilated, and she was probably going to deliver later that evening.

So the chief and I are hanging out in the call room, killing time waiting for someone to be ready to deliver. Around 2am we decide to tour the floor and see how everyone is progressing. He wanted to examine her, and after doing a couple with me earlier on rounds he trusted me enough to do the exam and let me tell him how far along she was. I have to mention, and this becomes relevant, is that he had chewed me out on the previous exam for staring too much. You see, in order to see how dilated their cervix is, we obviously have to do a vaginal exam. And having done very few of them, I would have the patients spread their legs, stare intently at their vagina while I tried to find the opening and get in there. Ironically enough, after spending years trying to get closer to vaginas, when finally given the opportunity I had a hard time finding em. Nonetheless, my chief hammered home the point that, while doing these exams, we aren't looking for anything but are just "feeling" how dilated their cervix is.

So back to our friend. We get to her room, and he sends me in first to examine her while he hangs out in the back. She speaks no English, and the extent of my Spanish is to tell her "yo no hablo espanol". Fortunately through a series of hand gestures I'm able to convey the message that its time for me to examine her. She spreads her legs, and I dive in. She has this vacant "been there, done that" look to her. This time I'm mindful not to stare, and choose to stare at the double chin on her double chin. Her legs are so big that my hand is engulfed, I feel like I'm a engulfed in a giant cavern of darkness.

I'm feeling around, feeling around trying to find her vaginal opening. It should take about 5 seconds to find the opening and get in, I'm approaching 20 seconds which is basically an eternity to be rooting around in someone's groin. My chief is getting antsy, and I hear him clear his throat.

This is my white whale. This is my Everest. I will find this vagina I tell myself. I redouble my efforts, and slide my hand down, down, down trying to find it. As I'm losing hope, as I feel my opportunity slipping away all of a sudden I feel an opening.

I'm in!

I confidently stick my finger in the hole I've found, ready to measure her cervix. As my finger slides in she shrieks and jumps up on the bed. At first, I'm confused, but then the reality quickly dawns on me. I'm in the wrong hole

You see, the anus lies right below the vagina in females. I had managed to entirely miss the vagina, and ended up doing a rectal sans lube.

As soon as I realized this, I withdrew my fingers. We locked gazes, and just stared at each other in utter shock. I silently begged her not to say anything, realizing that even if she wanted to neither of us spoke Spanish. I also was in a little bit of a dilemma regarding her vaginal exam. I didn't want to stick my poop covered fingers into her vagina, infecting her baby. I also didn't want to tell my resident what happened as I knew for the rest of my ob gyn rotation I would never live this down. I came up with a third option, and told him that I was having trouble doing the exam and if he could check himself. He gladly gloved up, and in about 5 seconds did a thorough and competent exam.

As I backpedaled out of the room, we briefly made eye contact again and she gave a little head shake. I'll never know for sure what she was thinking at that moment, but I like to think she was saying "thank you for trying, and your secret is safe with me".

Or she may have been saying "get the *%& out of my room, and never come back".

I'll never know.