Awkward Moments in Gynecology: The Elevator Pap Smear Incident

I love my job 99% of the time, however one thing that can throw a hiccup in even the most pleasant day is a hospital GYN consult. When a sweet old lady from the nursing home gets admitted to the hospital for pneumonia or some other ailment, oftentimes a very thorough internist will discover that she has not had a pap smear in some years, and suddenly this becomes an emergent issue. I then get called upon to see these women in the hospital. Often these ladies are quite demented, so examining them is challenging in any situation, but attempting a pap smear in a hospital bed requires cirque du soleil-esque skills. It is pleasant for neither me nor the patient.

There are no gyn exam tables with stirrups on the wards, so to do a proper pelvic, I need 3 nurses to help hold the legs, a pile of blankets for the women to lay on, and another nurse to hold a flashlight so I can see up into Miss Daisy’s nether regions. They also do not keep speculums in the hospital, so I usually bring my own.

One particularly long day I received the message that I had a consult to see on the fourth floor: an emergent yeast infection. Awesome. After finishing office, I loaded up my flashlight, speculum, KY, and pap smear brushes, then schlepped them down the hall to the hospital. I got in the elevator with a well dressed, slightly stuff appearing woman. As I pushed the number for the fourth floor, I had what I thought was a quite humorous idea.

Holding up the speculum and flash light with a smile, I joking said to my stately elevator-mate, “Want a Pap Smear?”

She made no verbal response, but her eyes got as big as saucers and she looked at me like I’d killed her cat.

I continued with my goofy awkward grin, unsure how to respond, realizing my humor was lost on this woman.

At this moment the elevator opened and she bolted before I could say, “Obviously I was joking.”

I could see the headlines: “Gynecologist Accused of Accosting Woman in Elevator.” My mother would be mortified. I kept my eyes pealed for security the remainder of the evening, but luckily, it was only a temporary embarrassment and no arrests were made.

My humor will always get me in trouble from time to time, but I’ve learned my lesson, next time I’ve got a consult, I’m keeping my speculum to myself.