No, but another one does

As they were finishing up the questionnaire Dr. Gunderson started to change the subject. “Given that you’re on your own and back from your first year of college, I felt it was appropriate to look through your medical history.” Melissa started to wonder what Dr. Gunderson was on about at this point. “I was with your mother last week. We were talking and she mentioned that she often had problems with warts. More importantly for today, she recounted to me how you had a problem with warts on your toes when you were six years old.” This was true! Those darn warts made her feel bad, and they were a real pain to freeze off! How this had anything to do with her prescription was beyond her, however.

“If you are not aware, warts, whether on your feet or in your intimate area, are caused by human papillomavirus, or HPV. Now, I looked through your history and noticed that you were vaccinated against HPV, when you were 11, long after those warts appeared. That’s certainly better than nothing but still far from surefire protection. As you may know, HPV causes the lion’s share of cervical cancers, and women are supposed to undergo routine Pap tests in order to detect changes in the reproductive system before cancer starts developing.” Oh dear, Melissa though, I can see where this is going. Dr. Gunderson then explained the basics of a Pap smear and what it entailed, and Melissa was less than pleased about what would likely soon happen.

“Women are not generally expected to start routine testing until they’re 21, so I was originally going to only discuss it in the context of your future until you became that old, especially given your … inactivity in certain affairs and your vaccination status. However, your warts cause some concern, and given what I’ve heard from Stevenson I believe you have enough confidence in your body and wherewithal to take care of it to have your first Pap test today!”

Melissa started to say something, but only ended up hemming and hawing. “Oh sweetie,” Dr. Gunderson interrupted her, “I know this might be stressful for you, but I promise this will pay dividends in the long term. You know, more than 4,000 women die every year in the US from cervical cancer, and that number used to be much bigger before they had routine Pap testing! But before we do that, there’s one other thing I’d like to discuss. Your mother has had a history of breast cancer throughout her life, and there’s a big likelihood, especially with your figure, that you are also at risk. Women are only supposed to start mammograms at middle age, but I think sooner is better than later for you. Given your body positvity, I think it would be best if we did both your Pap and your Mammogram today. Call us a ‘Mam and Pap shop’, if you will!”

Melissa was dumbfounded and didn’t know what to say. “In order to do perform these exams I need you to sign these three documents, the third is for a pelvic exam” Dr. Gunderson put them out to Melissa, who took them and a pen; not knowing what to do and being surprised at the last-minute inclusion of the pelvic exam, she looked at the doctor’s heavy stare, sighed, and signed the papers.

“Thank you, dear. Now, I will need you to disrobe and put on a gown. Usually for Pap tests we have patients keep their tops on, but given your mammogram I insist that you strip completely. I’ll be outside doing my rounds and will come back when you are ready.”