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DR. J and the Anatomy Class

As a first year medical student, I have already experienced many shocking moments, and I have tried to train myself to respond without surprise, disgust or disbelief to most of the shocking thing the human body can throw at me, but nothing could have prepared me for walking into anatomy class a few minutes late and being assaulted by a 20 X 15 ft. twat! Ok, it was on the projection screen at the front of the class, but still! It was enormous and hairy and�.ewwww. We had already done our first pelvic exams with the standardized patients (a story for another day, perhaps), but I was still shocked at the audacity of our professor to put that enormous vagina on-screen. I suppose I shouldn�t have been, since today�s lecture was on the External Genitalia. I guess that�s what I get for coming in late.


Dr. E, our somewhat flighty and bizarre head of anatomy, was in the process of apologizing to the female members of the class. Most anatomical terms for the male and female genitalia were sexist, he was saying, since early anatomists were all males who thought an awful lot of themselves. He used the example of the vulva (meaning wrapper or seed covering) or pudendum (meaning to feel ashamed) as examples. He went on to explain how to him, external genitalia is a subject that caused him a great deal of wonder, especially as a child. When he was growing up, he knew what half of his genetic contribution his father was going to give him (since he had seen his father�s equipment), but he had no idea what he was going to get from his mother. When his equipment came along, he then wondered if he was ever going to get to use it. Fortunately, he was very, very lucky and was able to use his equipment later on. Who is this guy? I wondered, as I sat in shock near the back row. Anatomy professors aren�t supposed to talk about sex and pleasure in class! I don�t want to think of him as a sexual being. He�s just Dr. E. And he wouldn�t stop. He then went on to talk about how lucky he was to then find out that he and his wife could conceive children, and that before he knew it, he was then wondering again if his equipment worked because it would deflate every time he heard the pitter patter of little feet coming down the hall. Too much information!!!


After almost an hour of this type of this strange experience, Dr. E. finished with a quote, reading from Natalie Angier�s Woman: An Intimate Geography:



�Women think they know their clitoris pretty well. They count on it as an old friend. They may even believe there is a goddess out there somewhere named Clitoris, the lady of perpetual ecstasy. The never bought Freud�s idea, �penis envy�. Who wants a shotgun when you can have a semi-automatic? But ask most women how big their clitoris is, or how big the average clitoris is, or whether there�s any difference from one woman to the next, they probably won�t know where to begin or what units to talk about. Inches, centimeters, millimeters, parking meters? Men worry that penis size matters to women. Women vigorously assure them that it doesn�t. But does clitoral size matter to a woman? A girl I�ll call Sue, now about my age, assuming that she kept her enlarged clitoris, and she may not have as I�ll discuss later: Is she a super-orgasmic adult, stimulated by the slightest rub, the mistress of her pleasure no matter how inept he partner, or does mass not matter at all and there is something else about the clitoris that gives us it�s kick? The clitoris is usually spoken of as a homologue of the penis and embryologically that�s true. It arises from the same region of the fetal genital ridge as the shaft of the penis, but the comparison is not wholly accurate. A woman doesn�t pee or ejaculate through her clitoris. Of course no urine runs through it. She does nothing practical at all with her clitoris. The clitoris is simply a bundle of nerves, 8,000 nerve fibers to be precise. That�s the highest concentration of nerve fibers that is found anywhere else in the body, including the fingertips, lips, tongue, and that is twice the number found in the penis (Dr. E doubts this. He feels that the numbers are probably pretty comparable, but the clitoris is just more compact). In a sense then, a woman�s little brain is bigger than a man�s brain. All this, and for no greater end than to subserve a woman�s pleasure. In the clitoris alone we see a sexual organ so pure of purpose that it needn�t moonlight as a secretor or an excretory device. For this reason maybe it�s best that the clitoris normally is hidden within the vulval cleft. It is in its own way a hidden joke, a divine secret, a Pandora�s box, not packed with sorrow, but with laughter.


As I left lecture that day, I started to wonder why I had been so uncomfortable with it. I mean, I�m a sexual being. I have a vagina. I was married for five years and enjoyed hundreds of hours of pleasure with my then husband. My patients will be sexual beings, and I will need to be able to talk with them openly and honestly about sex. Sex should be something that we can communicate about with others without feeling ashamed. It was then that I realized what Dr. E. was doing. He was trying to get that exact point across. If we as physicians felt that sex was something to be ashamed of, or discussed only in private, how could we possibly be there for our patients when they had questions about it? He was forcing us, shocking us, into understanding that sex need not be hidden away. It was a beautiful, strange, sometimes amusing and joyful thing that we should embrace both physically and intellectually. Being in a medical school in the Midwest, where such talk is offensive to many people, as other students complained to the dean and Dr. E was forced to apologize to the class, I appreciated what he had done for me, and for my future patients. In his apology, he said that he was sorry if he had offended anyone, but that his whole purpose of the lecture was to help bring sex out of the closet for medical students, and he was not at all sorry to have done that. Bravo, Dr. E. I and my future patients thank you for your honesty and courage, and we will continue to benefit from your discussion for years to come.


Dr. J, now a second-year medical student somewhere in the Midwest


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