“Ms. Mills?”

His words snap me out of the daze I’m in and I struggle to keep my focus.

“I realize that meeting a new provider can provoke some anxiety. That’s perfectly normal. If there’s anything you’re particularly worried about today, we should talk about it.”

Can he read my mind? He’s perceptive. I don’t think much gets past him. Usually this is an attribute that I admire. It's quite validating. But in this case it makes me feel transparent, exposed in a way that I’m not yet ready for. I nod in response and do my very best impression of a calm person. I don’t feel I’m doing a great job.

“If I can, I’d like to be able to offer some reassurance.”

I feel naked already and I haven’t removed a stitch of clothing. I clear my throat and swallow nervously before speaking.

“I’m just wondering about the physical. That … happens … today?”

Of course I know it happens today.

“I’m pretty anxious about it for some reason. Maybe because it’s been a while. I don’t know.” Suddenly I feel like I’m admitting some transgression. All of that helpless vulnerability bubbles to the surface as I contemplate being undressed. Exposed. Examined.

His expression is temperate, understanding.

“Also perfectly normal. About how long has it been, would you say?”

“I don’t know …” I lie, my eyes training again on the stethoscope peeking out of his pocket. “Maybe fifteen years?”

If this news startles him he doesn’t show it. He regards me impassively and nods a few times.

“Alright. So it’s been awhile. Well, to answer your question, yes, we’ll do a complete history and physical today. It sort of comes with the territory. But I don’t want you to be anxious. I’m glad you told me. We can have a chaperone step into the room if that would make you more comfortable. And we’ll move through the exam together, at your pace, so there are no surprises. Sound okay?”

None of it sounds okay, but I know this is as good as it’s likely to get. I can’t quite get myself to articulate a response, so I nod.

“Good. Other questions?”

“No. I don’t think so.”

“Alright then. Let’s get started with a history here. Would that be okay?”

I nod quietly. He wakes up the screen of the iPad he’s holding.

“If questions arise along the way, of course, just stop me and we can discuss them, alright?”

What follows is a lengthy review of my medical history with a lot of time spent discussing diabetes, thyroid disease, depression and anxiety, and surgeries. He also asks about cancer incidence on either side of the family, and makes a note of the fact that my father died of leukemia.

We start to work through a rapid-fire succession of questions on each major system of the body: history of heart disease? No. High blood pressure or cholesterol? No. Bleeding disorders? No. Asthma, COPD, other breathing difficulties? No. Obesity? No. My responses have become almost robotic as we move quickly through the questions, so I am unprepared when he starts asking questions about reproductive health and sex.

“Age at first menstrual period?”

Oh. God. Here we go.

“I was eleven.”

“And … regular periods, for the most part?”

“Pretty much.”

“No excessively heavy bleeding, cramping pain, mood disturbance?”

“I do have pain but am able to manage it effectively with ibuprofen.”

“Good. Good. Okay …”

He nods as he types, continuing to listen remarkably well despite the volume of questions he has to cover with me.

“Alright. Sexual history. When did you start sexual activity?”

“I was about nineteen.”

“Partners?”

“Yes.”

He glances up momentarily and our eyes meet. I feel like a deer in headlights.

“How many?”

Oh. Even though it’s a normal question to be asked, I have to speak over a lump in my throat.

“Three.”

“Sexual orientation?”

Good Lord. I guess we are actually having this discussion.

“Straight.”

“And … contraception you’re using. No complaints?”

I shake my head quietly.

“Very good. Okay. And … no history of breast, ovarian, or cervical cancer?”

“Not for me, no. There’s been some in the family though.”

“Uh huh … okay ....” Still typing away. He pauses as if he’s reviewing his notes. “Can you tell me a bit about that? What type of cancer and who had it?”

“Several paternal cousins have had breast cancer, one paternal aunt, paternal grandmother …”

“Hmm. Okay. So there’s some significant history there. Anything else?”

“Well, it’s not cancer, but endometriosis is prevalent on my mother’s side of the family,” I reply, just waiting for the dreaded question.

Type, type, type, tap, tap, tap. Pause. “Alright. So some risk factors there,” he nods.

“When did you last see your gynecologist?”

Gulp. I hesitate. Truth be told, I’ve put off that appointment for over a year. But if I tell him that, then I know he’s going to recommend a well woman exam. I feel a tinge of nausea pass through my stomach. He looks up in anticipation of my response.

“Umm ... I honestly can’t recall, probably a couple years,” I say reluctantly.

“Uh huh. And … who do you see?”

“Laura Simmons.”

He nods and continues his typing, leaving me to hang in a painful state of psychic limbo. Will I be able to slip by today?

“Oh, okay. We know her practice. It’ll be easy enough to find out when you were last there. Fine. Now … “

We talk about all of the specialists I see and how often, all of the medications I’m on and the dosing and frequency. We talk a little about family history and he takes a brief social history as well. I remain preoccupied about the gynecologist, hoping I’ll be spared any of that for today.

He asks for more details surrounding the hypoglycemic symptoms I mentioned earlier and we discuss them at length. This interaction in particular impresses upon me what it would be like if he were my doctor. In general I find him professional, personable, and smart – particularly when it comes to research – without being pretentious. He is forthright in confronting sensitive subjects and doesn’t shy away from tough discussions, but is intuitive and empathic in how he navigates them. He manages to be inquisitive without being intrusive, and when he asks questions, he listens. He actually stops speaking to listen. He’s pretty fantastic, actually.

As we wrap up the discussion, he gathers up my case file and his iPad and invites me to stand up.

“Before we head to an exam room is there anything you need? Water perhaps? You’ll have an opportunity to empty your bladder before we get started.”

Oh, God. They usually tell you to do that prior to a pelvic exam. I’d like to request a Valium, but instead I force a smile and follow him toward the door.