by Karin Cook
Once inside the bathroom, I leaned against the door and sprayed myself with Love’s Baby Soft perfume along my neck and arms, adding a final squirt down my underpants.
• • •
Elizabeth sat in the backseat, suspicious, pressing her feet into the back of the driver’s side. Mama was wearing a turtleneck sweater-dress under her coat. It was long and green to her ankles and looked like a giant wool leg warmer with sleeves.
“So is this your doctor or ours?” Elizabeth asked, once we were under way.
“Both,” Mama said, “but you should treat her like your very own.”
“Her?” Elizabeth asked, bolting upright and leaning into the front seat.
“Dr. Murdoch isn’t just for women,” Mama announced, “she is a woman.”
In the waiting room, Elizabeth and I read magazines and tried to ignore Mama’s comments as she filled out our medical histories on a clipboard. Nothing on the form seemed to apply. No surgeries, no pregnancies, no allergies.
“No, none, no …” Mama said aloud as she checked a series of boxes for Elizabeth and then whispered. “When was your last period?”
Elizabeth shrugged and shrank down behind her magazine.
“Didn’t you write it down somewhere?” Mama asked.
“No,” she said.
Mama sat up and raised her voice slightly, “Maybe Ms. Penny knows.” This dig surprised me coming from Mama, but it worked. Elizabeth blurted out a date she thought might be right. Mama took out her calendar and touched the point of her pencil down on each square. “Wednesday?” she asked. “Thursday?”
“Yeah,” Elizabeth said, quickly, “one of those.” She turned her back so that it seemed as if Mama were looking over her shoulder.
Mama sighed and shifted papers, bringing my medical history to the top of the clipboard. She checked no for every question on my form without even asking. In the family history section, she penciled in the words mother, breast cancer, and mastectomy.
I looked quickly away. Those words sounded so cold, as if Mama would be sick forever. And at the same time they seemed too simple.
There were two other women with clipboards in the waiting room. One had been crying and the man with her was holding a jar.
“Don’t stare,” Mama said, moving over one chair to block my view.
Dr. Murdoch called our names and said that she wanted to see us as a family first. She was tall and serious, younger than I expected, with a deep voice. She was wearing lipstick. She brought us into her office, but did not sit behind her desk. Instead, she pulled her chair around so that we were clustered, two facing two, as if at a restaurant. I felt unsure as to how to sit, aware of the distance between my knees and the doctor’s. Mama crossed her legs and wrapped her foot around the back of her opposite calf. Dr. Murdoch leaned forward over her legs, a manila folder and notepad resting on her flat lap. Her straight, brown hair was cut to her chin. She tucked a piece behind her ear before she spoke.
“Why don’t you fill me in on why you three are here today,” she said.
Mama launched in. “It was my idea,” she said, her voice animated and instructional, “the girls have been concerned about …” she hesitated, “they have questions about their bodies.” She turned in her seat to face Dr. Murdoch, “You know, about what is normal for their ages.”
Dr. Murdoch listened closely, her upper body easing forward, ready to break in at any moment. “Uh huh,” she managed to say before Mama continued.
“And, try as I have to establish open lines of communication, we seem to have experienced something of a breakdown in the last few months.” Mama crossed her arms and lowered her voice. “Maybe it has to do with my surgery last spring, and since then I haven’t been all that … I don’t know, available, I guess. Whatever the case,” she pulled at the neck on her turtleneck, “I just wanted to be sure that the girls had access to all the necessary information.” She smiled at us. “How can you expect to grow up to be women if you don’t understand the woman parts of your bodies?”
This last question embarrassed me. I sat back in my chair and focused my eyes on Dr. Murdoch’s desk: a smooth glass paperweight, a pen set, and a prescription pad. The framed degrees on the wall listed her full name in calligraphy.
Dr. Murdoch spoke in a calm, quiet voice, “First, I’d like to acknowledge your openness, Mrs. Burbank. Not many girls have the opportunity to speak frankly with their mothers,” she looked across at me and then Elizabeth.
Elizabeth took everything as a reprimand. She glanced down and bent one leg underneath the other. Mama reached across, tapped Elizabeth’s knee with the back of her hand, and then pointed to the ground.
Dr. Murdoch kept talking. “You should know that you’re getting off to a good, healthy start by coming to a gynecologist now. Whether you visit regularly or choose to come just this once, you should know that the strictest confidentiality will be maintained.” She stopped for a moment. “Do you know what I mean by confidentiality?”
I sat up, ready for the quiz; Elizabeth gazed blankly at the posters on the wall in front of her.
“Confidentiality means that your privacy is respected. It means that you can ask me questions and I will keep all your medical information private, unless I have your permission to discuss it with your mother.”
Elizabeth perked up, cut her eyes in Dr. Murdoch’s direction.
“Please feel free to ask any questions that you might have at any point.” Dr. Murdoch looked at each of us. There was a long silence. “That’s what this visit is for.” She took another sweep around the room with her eyes. “Either now or when we meet privately.”
“Is there anything you want to ask?” Mama looked seriously at Elizabeth and then quickly at me.
We both shook our heads. Why did everyone always want to know if girls had questions?
Dr. Murdoch went on to explain that during our first visit she would introduce us to the type of exams that we’d continue to have throughout our adult lives. Some exams would be more appropriate as we got older and wouldn’t be performed today, but there were others that she would do in the exam room a little later on and a couple we could learn to do on our own. Dr. Murdoch also mentioned that she was aware of our mother’s condition and that sometimes children might worry about their own risk for such diseases. She stopped to wait for a response. I tried to get Elizabeth to look at me, but she wouldn’t. She kept her head down and bounced her feet until Mama reached across and grabbed her shin to quiet her.
Dr. Murdoch gestured to a rack on the wall. “I have lots of pamphlets that you can take home with you and read at your leisure.” Mama leaned over, took one of each, and put them in her purse.
Dr. Murdoch stood. “Okay, Tilden, why don’t you come with me,” she suggested. “Elizabeth, you and your mom can wait outside in the waiting room.”
In the exam room, I dressed in a paper gown. It took me a while to figure out which side was the front and which was the back. Dr. Murdoch knocked once before I was ready. When she came back a second time, I was seated on a stool with the gown opened at the back, my underpants still on.
Dr. Murdoch clipped my medical history to the inside of a folder and took a pair of glasses out of her white coat. “How old are you, Tilden?” she began.
“Thirteen. And a half.”
She measured my height and weight, wrote her findings in my chart, and showed me a growth curve, indicating that my measurements were average for my age. She then instructed me to get in the diving position and go up and down slowly while she checked my spine and hip bones for signs of scoliosis. “Make sure you alternate which side you carry your books on,” she said and touched each vertebra with her fingers. She pressed down on my shoulders. “Better yet, get a knapsack.”
Afterward, Dr. Murdoch directed me to the exam table. She indicated that her questions were going to get slightly more personal. She wanted to know how I felt about that.
“Fine,” I said, wanting to impress her.
“Are your menstrual periods normal?” she asked.
“I don’t know.”
She looked up over her glasses. “When was your first period?”
“Never,” I said.
“Oh,” she said, “that’s perfectly normal.”
“But my sister has hers,” I blurted out.
“That happens sometimes,” she said. “Don’t worry. It won’t be long.”
Something about her voice sounded so certain. I would have given anything to feel sure. She wrote with quick gestures in my chart and then brought her gaze back to me. “Are you sexually active?” she asked.
“No.”
“So you don’t need any information about contraception this visit?”
I shook my head. I kept imagining what Elizabeth’s session might be like. She would be a more interesting patient. She’d had hickeys and gotten a yeast infection from wearing too much spandex.
“Do you have any questions about anything? Puberty? Reproduction?”
“Not really,” I said. “There was a movie I saw at school.”
Her voice got a little soft. “Any concerns about breast cancer?”
I hadn’t expected that question. The tone of her voice made me feel like crying. I looked down at my feet. The underside of my sock was twisted on top. I bent down to fix it, my own question pulsing in my head.
“Are you sure?” She asked again and waited for me to say something.
“When will my mother be totally better?” I asked at last.
Dr. Murdoch look surprised and then sorry. “I can’t answer that,” she said, “you should talk to her about it. As much as you can—both of you, I mean.” There was an awkward silence. “I can give you some general information if you want.”
I felt flushed. “That’s okay,” I said.
Dr. Murdoch continued on with the examination, directing me to lie back on the table. As I moved my legs, the paper on the table crinkled and stuck to the backs of my thighs. She demonstrated how to do a breast self-exam, slipping one of my arms out of the gown and exposing the right side of my chest. I felt self-conscious about my flat chest, but Dr. Murdoch didn’t seem to notice; she pressed in and out on my breast in a circular motion. She spoke as if I weren’t lying naked before her, explaining that if I were older, she might be looking for inconsistencies, anything out of the ordinary, any lumps or bumps. By the time she worked her way to the center, my whole breast had hardened into a firm knot. “Want to try?” she asked.
“Not really,” I said and slipped my arm back in the gown.
“Would you like to see your vagina?” she asked.
I didn’t want her to know that I had seen all there was to see, my legs pushed up against my bedroom door, the full-length mirror bearing down, showing all of me. I had matched myself up against the vaginas in Our Bodies, Ourselves. When I didn’t respond, she gave me a hand mirror—the kind a hairdresser offers for you to see the back of your head.
Dr. Murdoch encouraged me to take off my underpants, saying that a girl should know what her vagina looks like before she shows it to anyone else. She pointed to the vulva, labia, and clitoris with a long Q-Tip, talking throughout the entire exam. Her voice distracted more than prepared me; despite her warnings, I jumped every time I felt her touch. After she’d named the external parts, she turned to a poster of the female reproductive system. She pointed out the vaginal canal and the ovaries with the Q-Tip.
“Some day, when you’re older you can have a pap smear to check the cells on your cervix.” She tapped the cervix on the poster.
I stared at the diagram. Spongy pink ovaries. Slick tubes. The reproductive system looked suddenly mechanical. My right leg started to shiver, that uncontrollable shaking of classrooms and offices. The way I felt before tests, my elbows cold on the desk. Dr. Murdoch looked at me, concerned, “Don’t worry,” she said, “a pap smear won’t be necessary for a while.” She hung the mirror on the wall, discarded the Q-Tip, and then left me alone to get dressed.
I felt womanly as I rolled my underpants on. There was a faint twinge, not pain exactly, but an exposed feeling between my legs. I wished that she’d given me some cream or plastic device with a prescription typed on it, my name and instructions, something I had to use daily. Something I could let fall out of my bag in front of Elizabeth.
I looked quickly around the room for a souvenir, an item that wouldn’t be missed, until my eye settled on a box of slides. I reached above the metal clamps, lined up like tools from wood shop, slipped one slide out from the stack and pushed it into the front pocket of my flannel shirt. I walked from one side to the other in the waiting room avoiding Mama, until Elizabeth resurfaced from her exam. She was carrying two paper bags, which she flashed at me while Mama talked to the nurse.
“Can I see?” I asked.
“It’s confidential,” she said, stuffing the bags into her sleeve and wrapping her coat around her.
“Did you tell her about that thing with Keith Rogers?” I whispered, before we got in the car.
“Thing?” Elizabeth said. “I have no idea what you’re talking about.”
Elizabeth and I avoided Nick and Uncle Rand as much as possible that week, hiding the pamphlets that Mama left lying around on the counters and the plastic shower cards she hung in the bathroom as a reminder about self-exams. I hated showering with that card hanging above me. On the other side of the breast information, there was material about the testicular self-exam. I took it down and brought it to school, along with some pamphlets, to show during lunch.
Samantha acted unimpressed. She plucked the pamphlet about anorexia and bulimia out of my hand. “Nurses always think everything is an eating disorder,” she said and rolled the pamphlet into a skinny tube.
Samantha was bitter because the school nurse had pulled her aside earlier in the year after the gym teacher complained that she weighed herself in the locker room after each gym class. Since then, she pretended to throw up, making mock retching sounds, every time she passed the nurse’s office.
Samantha seemed bored as I told her about my visit to Dr. Murdoch. I hated when she looked around the room, waiting to catch someone else’s eye, instead of looking right at me. I decided to show her the slide.
“I had a pap smear,” I announced.
Samantha peered into the envelope. “Really?” she asked, eyeing the slide.
It was the first time I felt that I knew more about something than she did. When I held the slide out to her, she backed away abruptly.
“Isn’t that a test for disease?” She had grown accustomed to my lies. She turned her attention instead toward the shower card. “It’s much worse for guys,” she said, studying the sketch of the testicles. “They have to cough in their exams.”
“What’s the big deal in that?” I asked.
“The nurse holds a guy’s crotch,” Sam said in a dramatic voice, “and makes him cough while she sticks a huge Q-Tip inside his dick.”
“What for?” I asked.
“I don’t know,” Sam said, “but I overheard the guys talking about the cough. And from what they said the more they have to cough the worse it is.”
“The worse what is?”
“I don’t know,” she said, “but I heard that the school nurse loves doing it. And that they try to get an older nurse so that the boys don’t pop a boner. I also heard that when they did it last time, in gym, that Jamie Sanders was in there for a long time … coughing.”
“How do you know?”
She looked at me, suddenly mean. “You don’t know everything,” she said.
Her hostility surprised me. I never felt like I knew anything around Samantha. She grew smarter every day, both about boys and school.
“What are you talking about?” I asked.
“You think you have all the answers just because …”
“Because what?”
“Because of your uncle,” she said.
“What?”
“It doesn’t really seem like you
need me.”
“That’s not true.”
“Well, you’re always at home or TransAlt,” she said, “you never even invite me over anymore.”
“That’s because of my mom being sick,” I said.
“She sure has been sick for a long time,” Samantha said under her breath. She caught herself, swore she hadn’t meant it to come out that way. “I just don’t understand what’s with you, Tilden,” she said, “you’re acting weird lately.”
That night, I found myself contemplating my breasts, checking them in circular motions, starting on the outside and moving inward, looking for inconsistencies. When I pressed down, I could feel the skeletal outline of my chest bones. Elizabeth ran into my room a half hour after going to bed and told me that she’d been doing the same thing in her room—standing by her bedroom window fearfully pressing herself in the dark. She’d found a bump, she announced, and she wanted me to check it.
“You don’t have breast cancer,” I snapped at her. “You don’t even have real breasts.”
“Please just feel it,” she insisted. She seemed shaken. I reached out with one finger and touched her chest.
“You have to feel both sides,” she said, “to see the difference.”
I pressed my hands quickly against her shirt, in sort of a shove motion, and felt her flesh give under my fingers.
“Do you think I should tell Mama?” she asked.
“No,” I said, “there’s nothing wrong. You just went to the doctor.”
Elizabeth took a deep breath. There was something else she wanted, I could tell. She lingered at the edge of my bed toying with the fringes on the bedspread. “Can I borrow that book?” she asked.
I pretended that I didn’t know what she was talking about and gestured to the bookshelf. “Help yourself.”
“No,” she said, “the book about the body.”