Pelvic Exams and the Death Drive

Bodies give, and bodies destroy

Rachel Vorona Cote
Sep 17, 2019 · 6 min read
Illustration by Louisa Bertman

Housing a pair of ovaries begets all manner of peculiar circumstances, but one of the most distinct endemic oddities is the sensation of someone touching them. I was nearly eighteen before I experienced it. Until then, my reproductive equipment chiefly manifested as textual, rather than felt — jumbled words and diagrams, a sapless explanatory narrative of something that, despite its physical detachment, seemed vaguely lewd. Then, in high school, when my periods became excruciating, I was intermittently alerted to their residence. Each month, the howl of menstrual cramps gestured to the tumble at the bottom of me. But more often than not, the tubes and chasms and clumps rarely piped up or protested. I still think of my womb and its relevant paraphernalia like a basin out of reach, pell-mell contents cloistered to a space where I cannot dip my hand.

Each month, the howl of menstrual cramps gestured to the tumble at the bottom of me. But more often than not, the tubes and chasms and clumps rarely piped up or protested.

Enduring a gynecologist’s pelvic exam fostered a new tactile encounter — a baffling one, seemingly achieved through the transitive property. In preparation for college, my mother sent me to her doctor, the one who had delivered both my younger sisters, and who she was still seeing over a decade later when her own ovaries had grown malignant. I found the ordeal altogether wretched — the cool, antiseptic air that dawdled against my bashful body; the stirrups that, contrary to their unseemly purpose, made me clamp my knees together like magnets, the speculum that looked like an instrument of torture and, I determined, felt like one too. Then, at last there was the encore, wherein the doctor — her latex gloves anointed with goop — reached inside me to ascertain further ovary-centric information.

She grasped at my insides, and I discerned, amongst the penetrative pain, a deeper, muzzy ache. There were nubbles, like hardened cotton — they announced themselves, told me where they lived. I tried not to squirm and thought, “Oh, there’s the rest of me.”

This is the second time that I’m writing about this inaugural pelvic exam. I produced a scrap of prose immediately after that first appointment, propelled by adrenaline and an adolescent notion of my own humor and insight. From what I recall, it was a cliché-riddled screed incorporating the imagery of legs parted “like the Red Sea” — I was proud of this simile — and decrying the indignities of gel lubricant. Then, I printed it off with a flourish and presented it to my mother, who read it, laughed, and then, to my acute horror, showed it to our gynecologist at her next appointment (I’m sure she chuckled indulgently — to be clear, I have always liked my first gynecologist very much and, thankfully, specified my appreciation for her in that silly essay).

I was, initially, a little surprised at what Mom had done. She was a rather private woman, but then again, she was also a nurse: she appreciated the baked-in absurdity of a procedural medical visit, and the ways our feral and insistent bodies disregard propriety. Moreover, she had three daughters, and as a matter of course we cultivated a feminine world of private ritual where, now and then, she would disclose her appreciation for bawdy humor. I may have been dismayed to learn what a gynecologist visit entailed, but with this initiation, Mom and I shared new common ground. It was another opportunity to revel in the ways the fleshy quotidian could be ludicrous. I could never have pursued a career as a nurse or doctor; I lacked — will always lack — my mother’s practical instincts and her nimble hands. Thus, a doctor’s visit, particularly one tethered to our anatomical sameness, became a new route of intimate correspondence, another way for us to come together.

I could never have pursued a career as a nurse or doctor; I lacked — will always lack — my mother’s practical instincts and her nimble hands.

But I don’t kid myself: the burden of empathy always laid on her shoulders. My mother was my first home, and after that, she extended herself as a gentle harbor, a port of return when my own materials confounded me. When I had sex with a man for the first time, I told her almost immediately (she sent me to the gynecologist again). When I continued to have sex, neglected to pee afterwards, and caught a UTI, I called her from school, frantic. When I agonized over my attraction to a close female friend, I confided my angst to her. I brought her my fraught femininity, my unruly body; she clarified it. Propped by her love, I made my own body a home, apart from hers, but never remote.

And so, what a sick joke it seemed when her body — her ovaries, to be exact, plundered themselves, turned cancerous, killed her in barely three years’ time. I am personifying because, in the persistence of grief, I remain befuddled, bereft with the lack of a culprit. Without motivation, through, seemingly, the twist of an errant cell, the body mutates from hearth to hell. It has embedded in me a desperate confusion: that there could be destruction both so total and so mindless.

In Mom’s case, the demolition began where I did, and where my sisters did too. Her abdomen ached, probably for far longer than she admitted: my mother was not accustomed to prioritizing her pain the way she had tended to mine. Finally, the necessary tests were completed; the blitz, in progress, was revealed. Her ovaries did not protest; on the contrary, they were stealthy turncoats, wreaking havoc in sinister silence. I prefer to see it this way — to nurture the fantasy that people do not die simply because their bodies go rogue, or falter, but instead fall at the behest of some malevolent force. It has often seemed to me that in the case of terminal illness, the only agent is the disease. My mother resisted, submitted herself to a scorched earth of treatments, but options are paltry when your cells are preoccupied with self-annihilation.

My mother resisted, submitted herself to a scorched earth of treatments, but options are paltry when your cells are preoccupied with self-annihilation.

But this is a convenient falsehood; it’s a narrative that supposes a victor. Cancer is not a battle the way we are inclined to frame it — winning and losing do not apply to the case. A body ebbs and flows, and we look for the possibilities inside its rhythms. We negotiate with ourselves, not with the disease.

Six months after Mom died, out of geographic necessity, I began to see a new gynecologist. They requested my familial medical history which, in fact, is not historical but atmospheric: mourning Mom has become my weather. I supplied the facts; I began to cry. I felt foolish and self-indulgent.

Yet, doctor’s appointments are a form of indulgence, an opportunity to obsess over the particulars of one’s mortality. My new gynecologist began the pelvic exam — everything felt normal, so normal, he assured. In the decadent safety of my health, I imagined otherwise. I imagined a new tumor — mine — one that would ensure my obliteration, that would atomize me and send my particles to wherever my mother’s float: still looking for her everywhere, even beyond consciousness. I am not religious, exactly; I hope for heaven without expecting it because I reject the finite circumstances of unmothering. My death drive is a function of grief and a feral, childish urge for imitation — to be like my mother, to die like her, to be, however absurd the notion, reunited.

Yet, doctor’s appointments are a form of indulgence, an opportunity to obsess over the particulars of one’s mortality. My new gynecologist began the pelvic exam — everything felt normal, so normal, he assured.

Recently, I returned to the gynecologist, recited, for the second time since Mom’s death, the tragic family history-that-is-my-present, and I didn’t cry. Now long accustomed to the routine, I stripped, donned a sheet of paper, and clambered onto the examining table awaiting the pokes and prods. The doctor reached inside me, and I thought about dying again. Then, before leaving his office, I requested a prescription for prenatal vitamins. There are, I’ve determined, certain things I’d like to do first.

Gay Mag

A new magazine from Roxane Gay offering some of the most…

Rachel Vorona Cote

Written by

Your emotional surgeon, according to some.

Gay Mag

A new magazine from Roxane Gay offering some of the most interesting and thoughtful cultural criticism to be found on the Web. Our first quarterly is coming in June 2019. We value deep explorations, timelessness, and challenging conventional thinking without being cheap and lazy.

Rachel Vorona Cote

Written by

Your emotional surgeon, according to some.

Gay Mag

A new magazine from Roxane Gay offering some of the most interesting and thoughtful cultural criticism to be found on the Web. Our first quarterly is coming in June 2019. We value deep explorations, timelessness, and challenging conventional thinking without being cheap and lazy.

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