“let’s call it as it is”

dicussing the topic of a working up an abnormal pap, i noted a couple concepts we didn’t quite go over.  i started asking about “CIN I” and how to work it up after you reach a certain point on the diagnostic and management algorithm.   CIN = cervical intraepithelial neoplasia – it’s basically what happens when you get one of the nasty hpv viruses (16, 18, the 30s, etc) and can’t fight it off yourself.   i should also preface this story with the fact that i pronounce acronyms, so CIN is “sin” – sort of ironic when you are talking about what is considered a sexually transmitted infection. 

“so after a patient has a repeat pap after their biopsy shows ‘sin’ one – er, i guess i shouldn’t say that, i could really offend someone.” 

you know what a classmate’s response was (albeit joking – still not funny)?

“oh come on, let’s call it like it is.”

normally, this is the type of joke i might laugh at.   what makes this person’s joke not funny, is the person who made it.  she is one of my best friends (although a little less so now), who has known about my trials and tribulations when i went through having an abnormal pap, which was positive for hpv.  this was followed by a colposcopy and one biopsy (which made me hope it wouldn’t turn out bad), and was found to have probably CIN 2, which is moderate dysplasia.  then i underwent a leep, which is where they burn off half your cervix, which was a tough decision because it increases your risk for cervical incompetence (but the other option was worse).  cervical incompetence means my cervix in the future may not be able to support the weight of a baby and i will have an increased risk of preterm labor and miscarriage.  awesome.  

this ‘friend’ knew all this.  it doesn’t help that she has also lived an absurdly sheltered life.  she was married to her high school sweetheart and didn’t have sex until marriage.  she has never had that person cheat on her with another person – and her greatest difficulty in life is her mother driving her nuts, her husband being in another state, and now, she’s pregnant (although that garners less sympathy because it was secondary to her supreme laxity with birth control pills).   living this sheltered life, she continually makes inappropriate jokes around attendings and other people in general, such that she is bound to offend someone.  me in this case, but everytime she does it, i try and suggest her watching what she says.  she just brushes it off. 

well, that’s all fine and good, but i refuse to tolerate that kind of behavior.  no friend of mine has ever said anything so disrespectful or thoughtless regarding a disease i will probably have to worry about for the rest of my life.  a disease 60% of the population is able to fight off, but my body is apparently unable to (probably a lot to do with life stress). 

call it like it is?  okay:

people who contract hpv are not whores, and it’s not a sin to have hpv.  all it takes is to date a guy who has had sex with multiple partners, or basically anyone who has had sex with more than person.  it could be 2 people. your whole life.  or just one but that person was with more than 1.  that’s it.   and what super sucks?  you can’t test for it in doods.

and we definitely do not need future doctors out there propagating the social stigma related to it, when parents are already up in arms about the possible implications of giving their daughters the gardasil vaccine when it has the chance to spare a woman the stress and anguish of cervical cancer or its precursors. 

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