As instructed, now was the time to do the pap-test.

For me it was the first time I had to use a speculum on someone else than me. I had tried to use a speculum several times on me during the past weeks to be prepared for this exam. After several try outs on myself I was able to put it in place without hurting me. I hoped that I will do it right on my patients.

I took a middle-sized Cusco speculum and put it under warm water to heat it up. Then I squeezed a good amount of KY-gel on it and spread it all over the speculum. Meanwhile Manon had opened her eyes and was watching what I was doing.

I asked her if she was ready for the speculum exam to begin, which she confirmed. So, I put the mobile light in place and sat down again in between of her feet. I put my left hand on her inner lips which made her immediately jump a little. I excused and started to open her lips by spreading my fingers. Then I set the speculum at the entrance and slowly slit it into her vagina. As soon as I thought it was enough entered I started to press on the lever to open it up. Unfortunately, I did not see her cervix which made me to take my thump off the lever and pulled it out again. Once again, I started to slide the speculum into her vagina but this time in a different angle. But again, I did not see the cervix. After taking it out one more time I inserted it angled in the opposite way and I saw the bottom of her cervix. Unfortunately, I did not see the whole cervix so I pulled it out a little, angled it even more and slit the speculum all the way in. This time I saw the cervix perfectly in the middle of the speculum. I started to tighten the thumbscrew and took my thumb off the lever.

I now took the prepared spatula and inserted into her vagina starting to take the smear. I asked her to tell me if I hurt her but she said that it was fine, no pain at all. I threw the spatula in the bin and took the cytobrush that I put a little into her os. I did not want to hurt her so I did not push it far in. This time she said it tickled a bit. I took the cytobrush out of her and threw it the bin as well.

As instructed there were no other swaps to take so I took again the speculum in my hand, started to unscrew the thumbscrew and started to take it out. I was so scared to not pinch her cervical os that I did not unscrew the thumbscrew completely. When I took the speculum out she said “ough it hurts so much, please stop”. I stopped immediately but did not find the reason. I turned the speculum about 45° degrees and continued to pull it all the way out. She yelled at me and I apologized. She said it really has hurt her. I asked if she wanted to continue or if we shall finish now against “the orders” of Cloé. She said, no it does not hurt anymore we can continue.

When I looked at the speculum I understood my error and was sure now that this fault shall never occur again when I use a speculum. The problem was that the speculum was not completely closed.