Last week I had my first mammogram. If you’re thinking, wow, isn’t she a bit young for that?, first, thank you!, and second, my doctor recommended starting now due to the impressive history of breast cancer in my family. Yes, we have had genetic testing, and no, the BRCA mutation was not found. Which most likely means that my family carries some gene that increases the risk of breast cancer but that hasn’t been identified yet. But the reason that I share this is not to focus on potentially concerning aspects of my DNA (or on the controversies regarding the utility of mammograms as a screening tool) but the actual experience of the mammogram and how it translates to my – and, I would suggest, every clinician’s – patient interactions.
There is no shortage of jokes about the discomfort of undergoing a mammogram, usually involving an image of a steamroller or of a woman walking around with her breasts flattened to resemble shelves. And yes, the part of the machine that I now know is called a compression plate does, in fact, cause more compression than I had anticipated, even after having seen countless cartoons suggesting the same. Was it comfortable? Not really. But it also wasn’t the part that surprised me the most. That honor goes to the number of times the mammography tech manipulated my breasts and the sheer confidence and nonchalance with which she did it.
I had imagined there would be some positioning to get everything into place on the machine. But there was more than positioning: there was pulling, poking, lifting, rolling, and really just a striking amount of contact between her hands and my bare breasts. I started wondering how many scans the woman did each day, how many breasts she kneaded and massaged into position, and how uncomfortable I would feel in her role. It actually made me glad to be the one being adjusted rather than the one doing all of the adjusting.
How did she handle it? As I alluded to above, she was completely unfazed. Not only was she not uncomfortable in the least, she was authoritative, collected, and downright chatty, though she maintained an unwavering focus on the task at hand. With each push and twist I felt more and more impressed and appreciative. Can you imagine how awkward the encounter would have been had she not been so comfortable with the process?
As a physician, I have had plenty of interactions that were less than comfortable, whether due to the topic being addressed or the body parts being examined. I would like to think that I have projected, if not complete comfort, at least a sense of calmness and competence to put my patients at ease. But this woman took it to the next level, giving me something better to strive for in my own encounters, something from which anyone in healthcare can learn. I’m not afraid of this interaction, her demeanor seemed to say. I am prepared to do my job and to do it well.
And she did, on so many levels.