Welcome to the “Speculum” Series

Hello, and welcome to “Speculum”, a podcast/blog where we open up and inspect the most sensitive topics in medicine! Have you ever wondered what it is that makes patients trust their family physicians enough to disclose a traumatic incident of domestic violence? Or how nurse practitioners sensitively approach conversations about sexual history with patients? Well, so did I. My name is Alyssa, and I am just a second year medical student that wants to learn how to gain trust and maintain the dignity of my future patients when we inevitably have to have an uncomfortable conversation. So, my quest for this project is to recruit and interview as many health care providers and patients as I can to discuss how sensitive topics are approached in clinical settings, what could make these conversations easier, etc. etc. I hope to cover a wide variety of topics, from mental health, to sexuality, to substance abuse, and more. I hope that these podcast interviews will make us think about how stigma around these topics may impact health, and inspire us to do something about it.


A bit of background on how this project found me: when I was a little undergrad aspiring to medical school, I was dead certain that if I became a doctor, I was going to be a neurologist. The brain is pretty neat, after all. Surprising to me, but not anyone that actually knew me, within the first few months of actually being in medical school, I realized my passion was not in neurology, but women’s and sexual health. In hindsight, I had always been interested in women’s and sexual health, but for some reason I had never considered it as a career path. Anyway, with this realization came an opportunity for me to work with some physicians in a sexual health clinic on some patient resources designed to help women with sexual dysfunction reach orgasm. Working on that project was an amazing experience, and I learned a lot about women’s sexuality. However, unexpectedly, that project also taught me a lot about the stigma that still exists around sexual health. Namely, when I would talk about my project with others, some people would chuckle awkwardly and avoid eye contact with me. Though I probably shouldn’t have been, I was a little bit surprised by these reactions, because I was working with people involved in sexual health, and sex was a very normal and casual topic of conversation. I suppose I forgot that sex was still a taboo topic for a lot of the general population. These experiences got me thinking. How do doctors get full and truthful sexual histories from patients when people seem, in general, so unwilling to talk about sex? Then, expanding on that thought, how do doctors get full and truthful histories about ANY taboo topic from patients?!


So, here I am. Ready to learn about how sensitive topics are handled within the medical community and what I can do to reduce stigma to make these topics less sensitive! Thanks for coming along on my journey and learning with me.

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