Sexual Healing by Dr. Margarita Kressin

OK, people. I have said this a million times in my clinic and am appalled at some of the responses, so I am telling the world (or at least the people who read this blog). PLEASE LOOK AT YOUR GENITALS.

If you have to think when the last time was that you looked, it’s been too long. Once a month is all I ask. Like when you do your breast exam or inspect your testicles — which you should be doing once a month. (I can see some people cringing since they don’t do these either.)

It seems so logical, so easy. For the guys, bend your neck. Whoop … there he is. Pull back the skin if he is not circumcised. Inspect. Is there anything new, anything that does not look right? Smegma? No? All done. If there is something funky, call your doctor.

To the females in the house: grab a mirror. No one is that flexible. Look. Anything new? Red? Discharge? If you have a question, ask a physician if this is normal.

Now we do this LIFELONG. This practice will detect abnormalities earlier, prevent unneeded surgeries (like dorsal slits or circumcisions for guys who can no longer pull the skin back), notice changes, and identify lesions, tumors, etc …

This is not gross. It is good practice; hygiene even. It is just a body part. A body part that sadly gets neglected. So please look and make sure it’s OK. It literally is good for you and your health. Just look.

My nurse came out to me after she finished explaining instructions for a test to a patient.

Joan says thank you and then she says, "It’s so nice to be in a place where people listen and are nice."

I look at my nurse incredulously.

Reasons why Dr. Kressin would have an incredulous look after such a comment:

1. As if to say, how else should we treat a patient?
2. What else should the patient expect from a doctor, or another person for that matter?
3. Where are these patients coming from since this is not the first time someone said so?
4. How exactly are these patients treated in the outside world?

We are not patting ourselves in the back. I don’t think we treat one patient differently from the next. Granted, we do treat patients that have complicated, long-standing, and embarrassing issues. And there are days when I pray, "Please grant me the serenity to ..." But it’s just patient care. When did that change?

A fellow physician came up to me one day. I apparently had treated his wife.

You were the first person to let her talk without interrupting. She has been blown off before thinking that this is all in her head. Thank you.

In my field where we talk about private body functions, sensitive topics, and catch patients at their most vulnerable, there is little room for rudeness and arrogance. We, as physicians, should remember a basic rule in life. Just be nice.

I do think that there is a range of sexuality. Much like anything else out there, I think sexuality has a huge gray area and not so black and white. I have met women who are what we like to call “high T” women or high testosterone women. Samantha from Sex and the City comes to mind as an archetypal representation. Then there are those that think sex is good, but consider themselves not very sexual in general.

Why do I bring this up? It seems that there is a belief that perhaps our clinic can change one’s tendencies. As my chairman says to his pre-prostatectomy patients (these are men about to undergo prostate surgery for prostate cancer, and generally they have questions regarding sexual function after the procedure): if you don’t play the piano before the surgery, you ain’t gonna play it afterwards.

Now there are women who are by nature sexual and who for whatever reason — whether it is their partner, health reasons, psychosocial changes — change their habits. We also find that these are the women who are devastated when their sexuality is diminished because of the aforementioned factors.

Then there are those who in their nature will never be very sexual. There is nothing wrong with that but it is an unfair expectation to think that we can change that. Another way to put it is this: You know how there is always one person in your department or office who is always funny and witty and whatever comes out of his/her mouth is always catchy and hilarious and people gravitate toward him/her? They grab attention, because they have that inherent quality. I would like to be that person. I will never be that person because it’s not in my nature. As hard as I try (and there are days when I am darn funny), I will never be that kind of person. One of my partners is like that, so is one of our chief residents. It’s part of their personalities, and they don’t even have to try. I can take lessons on how to tell a joke or story-telling, but I will never reach that kind of natural repartee.

I don’t mean to imply that if women are not happy with their sex life they should just accept it. I emphasize the importance of getting checked especially if this is a change they have recently noticed. I just want to put forth a realistic view of sexuality and of what the medical community can do. There is definitely better living through chemistry. But I have yet to find a pill that will make me play the piano.