Last year, because of the Affordable Care Act I was able to provide essential preventative office healthcare for women. Some of the women had not had a pap smear for several years, and others never, due to lack of health insurance. A few women required further intervention due to abnormalities diagnosed by screening but I knew they would be okay because it was discovered in time. If we hadn’t, it would be another story, a story I know too well.
I think of her often. I think of her when I am informed of any possibility that healthcare for women could be compromised. I think of her when I encourage women to have pap smears. I think of her when I examine the health disparities experienced by African American women.
I call her Jenny. Jenny was a 33-year-old African American woman whom I cared for while in training to become an Obstetrician and Gynecologist. She was only a few years older than I was at the time but she was dying from cervical cancer; a cancer that is almost 100% preventable by a timely pap smear. But Jenny’s suffering was not just about the pain that we often hear being experienced by people with end stage cancer. It was something that had a more profound effect on her womanhood. Jenny’s cancer, as advanced stage cervical cancer does, had eroded from her cervix through the walls of her vagina through her bladder and rectum. She was incontinent of both urine and stool. It meant that the canal that allows childbirth was no longer separated from the canal designed for waste. She was forced to wear diapers. Despite that Jenny still had a cheerful disposition and when I visited her she had a bright smile, a smile that I will always remember.
Suppose Jenny was your mother, your sister or your daughter?
Haywood Brown MD, President of The American Congress of Obstetricians and Gynecologists of which I am a member, issued a letter to its members last Friday regarding the draft healthcare bill currently in the U.S Senate. It discussed, among other changes; that the healthcare bill could result in women loosing access to primary and preventative care and maternity coverage. Not only would it have the potential to create more situations like Jenny’s but it would decrease maternity coverage in a time when American women have the highest mortality rate of any developed county, and furthermore, the rate is rising even as it declines in the other developed countries.
So as a physician, an Obstetrician and Gynecologist, and a woman I do take it personally when the healthcare of women is being threatened, because I know I could see many more tragedies like Jenny’s and her’s was hard enough.