Episode 8 : Can I Touch You?

Dr.Sophia:
Hello everyone. Welcome to the Dr. Sophia Podcast. I'm an ObGyn practicing for over 15 years in my native New York City. And I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we will talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more. Disclaimer, this is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Welcome to the Dr. Sophia Podcast. I'm joined by my co-host and good friend Touseef Mirza.

Touseef Mirza:
Hi everybody. So today we're gonna have an interesting conversation, right, Dr. Sophia?

Dr.Sophia:
We are.

Touseef Mirza:
I'm sure you're intrigued by the title, which is, can I touch you? So let me just give you a little bit of context. So I was talking with Dr. Sophia and I had asked her, have you ever been published, in terms of somebody doing a story for you? And then you told me, yeah, actually there was, how many years ago was that?

Dr.Sophia:
Maybe two or three.

Touseef Mirza:
Two or three years ago that you were published in, I think it's a digital platform magazine. It's called The Grio. And it was actually written by one of your patients?

Dr.Sophia:
Yes.

Touseef Mirza:
So can you describe a little bit about what she talked about in the article?

Dr.Sophia:
So she was just explaining and describing her experience with having me as her physician. And it was really a beautiful surprise. she had an experience with a previous pregnancy that was very traumatic. And so even when she came to me as a patient, she came with that kind of lens of having been traumatized and, and really feeling very adamant about having a black female physician.

Touseef Mirza:
For a second pregnancy?

Dr.Sophia:
For her second pregnancy yes. And, she actually came to me by chance because she had been looking for, at the time, my partner, who was like a living legend as far as ObGyns are concerned, but she was unavailable. And so I was the one that tended to her, and we forged a really great bond. Fast forward, it's time for her to deliver. And at the time I was working in a hospital that is an academic hospital, and so we have residents. And as such, that means that I was basically like a professor. I was teaching residents and I had a male resident who was tending to the patient. And we went in together and we went in to examine the patient. And, you know there are things that I do that I don't even think about. I just, it's so automatic. It's so ingrained in me, an integral part of who I am as a physician.

And one of the things is I always wanna make sure that I'm always honoring my patient in the sense that I always ask, is it okay if I examine you? Is it okay if I touch you? And that was part of it. That was one thing. And then the second part was knowing her story. So in and out of what she had gone through with her first pregnancy and how different this was for her the second time around having had a premature delivery the first time, and now having what we call a full term pregnancy this second time. And so the first thing was making sure that my resident asked to even examine the patient. And then secondly to question if he understood the difference with who she was as a patient having had her first pregnancy being a premature delivery versus now being a full-term delivery. And how understanding that history and understanding how does make her different or how does that make that particular delivery different?

Touseef Mirza:
So you were training that resident to ask a certain type of questions?

Dr.Sophia:
I was definitely training in terms of how to ask certain questions, but more so to have an understanding of who the patient is and who's sitting in front of you, and also how to engage with them in a way that is always respectful. But those were things that I was doing, like I said, like-

Touseef Mirza:
It's second nature.

Dr.Sophia:
It's just second nature. So when she came to me afterwards, and, you know it probably was at her postpartum visit or something, and she really divulged to me how her experience had been so dramatically different from her first experience. And that one of the things that she really said, which really sat with me, and, and I was just like, wow, I'm so thankful was that she said, you gave me back the faith in medicine.

That's big. And that was huge, you know? And I said, but I don't know what I did, tell me what I did. And then she gave me that story, which I hadn't even remembered. And she gave me the story of the fact that you know, I made sure that that resident knew her story and, and, and had a lot of respect when he went to touch her, to examine her. And that, you know, you have to ask, there's no automatic touch, just especially something so intimate as a vaginal exam.

Touseef Mirza:
So this is why we said, I told her, I said, we need to talk about this because I don't think we, I've never heard about this type of conversation, like when we go to a physician's office, that to have enough agency over our own bodies to wanting the other person to ask if they can touch us. Because I think also when we go into physician's office, I don't know if it's different for men or women, but for women especially the way that we've been brought up, and to be nice and sort of not ruffle any feathers and just go along, especially when we don't know really what's happening also. So if you're in a doctor's care you're also just thinking, okay, I guess that's just how things are without questioning it necessarily. But when you gave me your point of view that you always ask, it just sort of felt like a light bulb went off. It's like, that's true. Why do I just assume that-

Dr.Sophia:
You have to give in, like you have to.

Touseef Mirza:
Just that I don't have a say, in everything that happens when I am in the hands of a physician or another type of medical doctor, that whatever that person is doing is legit. And I don't know exactly where that comes from. Maybe it was like, ever since we were kids, I think maybe we have a double whammy as women, you know because I think-

Dr.Sophia:
Tell me about it.

Touseef Mirza:
A double whammy. The first whammy being that doctors, you know, in society, they’re not considered as gods, but you know, there's an authority there. There's an authority there. There's sort of like this inherent authority. And so we're just like, well, we don't know what we're talking about, so they must know what's going on, so we'll just go along. So that's one level. And then the second level is, as women, we just have a tendency to go along with something and not willing to make somebody-

Dr.Sophia:
Uncomfortable, upset, or think we're upsetting them. I think that both those cases may be very true. And I think from the authoritative role, it's important to build that level of trust and from the door have a level of respect. And so, you know, for me, like I said, it's something that I do automatically. And I'm glad that she pointed it out because now I'm even more insistent when I am teaching. It's more than just a matter of quote-unquote bedside manner because it's like really understanding that the person in front of you is really trusting you. And you have to walk into that with the fullest level of respect. And it starts with just saying, is it okay? Is it okay for me to touch you to examine you?

Touseef Mirza:
So let me ask you, have you always done that? Do you remember when you started to say that, or?

Dr.Sophia:
Honestly, I felt like it was something that I learned in medical school. There used to be a series of three exams to get your license, and one of them was a practical exam. And in order to pass the practical exam, you had to drape your patient, meaning only expose the part of the patient in which you're examining. So that's one. But even before that, you had to say, is it okay if I examine you? And I'm glad that I went through that because it just made sense. Yes, it was a part of the exam, but for me, having learned it, it simply made sense. And I know it, even for myself when I go to a doctor, that it makes me feel like I'm being seen and I'm being heard automatically.

Touseef Mirza:
I mean, I would say also the moment that we are at a hospital or at a clinic, or even at the dentist, I mean, any type of health-related professional, we're automatically in a vulnerable situation. Because we're not just going there for fun. There's something going on. So already we have that level of vulnerability that we have to deal with. And so when somebody comes in and is going to examine you, it would be a place of having some grace of actually acknowledging the person where they are. Like, I think, you know, you're talking about respect, but it's also comforting. For me, for somebody to say, can I examine you? It's like, oh, okay. You know, like we're establishing trust. Yes. We're establishing a relationship even if it's, you know, for 15 minutes. But we have now recognized that you respect me and I respect you. And I think for me anyway, automatically I feel more safe.

Dr.Sophia:
Yes. I know for myself, when I am with a patient, that that is something I want to always come across. That feeling of trust and safety and acknowledging them as a person who does have full agency over themselves, and the establishment of the relationship that we are now forming and building. It's so easy as women to really just allow almost, it's almost as if we're so trained that things just kind of are allowed to happen to us. And we give in. And as a woman who takes care of women, I always want to make sure that, and that process and that interaction that I'm honoring them and I'm honoring them from a very strong sentiment of womanness. You know, like womanhood. That sense of, I'm here for you.

Touseef Mirza:
So this is what's interesting about this whole conversation is thankfully when you come in the room, you actually are presenting yourself to have that level of connection with the patient to make them feel comfortable, to make them feel respected. But that doesn't happen many times. And so is there a way, actually, number one, to approach that situation, if that hasn't been communicated by the doctor. Let's say the doctor comes in and just starts off, but you're really nervous, like, number one, what can we do in that situation?

Dr.Sophia:
I think it's in your right to say, I'm sorry, can we just take a moment? I feel very uncomfortable, or I feel scared, or I just need you to explain things and to ask questions.

Touseef Mirza:
And we can literally ask, can you tell me step by step what you're doing?

Dr.Sophia:
Absolutely. I think if we know that we can do that in the instance that you are in a room, and let's say you've already been asked to be undressed, and now the physician walks into the room and automatically just starts, you know, is ready to come in and, and start maybe touching you, then you say, I'm sorry, excuse me. I just, I'm not sure what you are about to do. Can you at least tell me beforehand? Especially in this day and age in medicine where everything has to be rushed, every doctor. trying to see every patient in 5, 10, or 15 minutes is a lot even at times. And it's hard, you know, even, I mean, I still think that whether it's two minutes that there's still room to establish trust, there's still room to establish honesty and respect. And so I'm not making any excuse at all for physician behavior if it doesn't look like that. But you, as the patient, should stop in the middle of whatever that interaction is and ask for a level of respect. Ask for. And, that could be as simple as saying, I'm, excuse me, can we stop for a second? I really need you to explain.

Touseef Mirza:
Yeah. I'm a little nervous.

Dr.Sophia:
I'm a little nervous. I feel scared. I'm in pain. So before you touch me, that will bring that person back to a sense of humanity. Because otherwise, it's like the person is just moving in as a machine. And, and that's why we don't go to robots.

Touseef Mirza:
So now that we know that we can actually ask for that and to establish that bond and connection, I think that the next level comes because we are women because a lot of us have been raised to just go along with what's happening. For some of us, even if we know that we can do this, it's hard to actually still implement. Because maybe we feel that it's frivolous. Maybe we feel that we are just being bitchy. Maybe we feel that we're just exaggerating and, you know, we should just go along with how things are. And I think that's very conditioned from a sexist perspective in terms of, we're just used to going along with stuff and not to question as much. So I think this is where the concept of self-worth comes in. And how do you really appreciate yourself and your body to be respected?

Dr.Sophia:
Yes. Honestly, it's why we've even started this podcast. It's so that way women, when they listen to us, when you're listening to a Dr. Sophia podcast, the whole point and goal is so that you gain a sense of self, a stronger sense of self, and understanding. Understanding of your body, and feeling so comfortable in your own skin that you are just not going to allow anyone. Because of the fact that you feel so much more empowered, you're filled with so much more understanding. And having that sense of understanding of yourself, I feel gives women an opportunity to have a greater level of advocacy for themselves, to have a little bit more ownership of exactly what's happening to them. And even if this changes, one, it starts with one person at a time.

Touseef Mirza:
Well, I'm gonna start doing that, so I'll be the first person. How about that? You know, as you were talking, one thing that came to my mind is it's so simple, but yet so complex and abstract. It's so weird, but it's really your body, it's yours. Like this beautiful body is fully mine. So if somebody, even if I'm paying the doctor for the examination, doesn't mean it's a free-for-all.

Dr.Sophia:
That's correct. It is not a free-for-all.

Touseef Mirza:
It's still my body, and a lot of women, you know, including myself, you know, we weren't taught that. I wasn't taught that when I was little.

Dr.Sophia:
No. I think as women, it's a part of why it's so interesting. I think about this and automatically in my brain just now, I went to the me too movement and that concept of the things that women have had to go through or still go through, whether it's in the workplace or at school. And, you know, nothing is that different in terms of having someone in a place of authority, and a physician is in a place of authority, and it's not okay to simply move in a way that doesn't honor the patient in front of you.

Touseef Mirza:
And I think also it's important to say that just because the doctor, if they're, or any health medical professional just comes in and starts to do their, you know, quote-unquote process of whatever that situation calls for, doesn't mean that they're a bad doctor. They're just going through the motions. It's almost like you need to bring them back.

Dr.Sophia:
Yes. You may have to bring them back to the, like I said, for me, it's bringing them back to the level of humanity. You do not have to work as a machine. You know, hello, see me, see me as a person first. You know, before you see me as just the disease that's walking in front of you or the sick person. Right. And we can bring them back in that sense that we have agency over ourselves. And so, therefore, we have to let people know that we are entrusting them with ourselves, and we recognize our self-worth. And it's because we recognize that, we can say, let's pause for a second. Who are you again? Like even just introducing yourself. Sometimes the doctor doesn't even introduce themselves. You don't even know who was coming at you and who was touching you and what their credentials are. So it's those small and simple things that reaffirm your sense of who you are. And that you are clear on having people respect you.

Touseef Mirza:
I would say that, for women who don't, haven't done this before, this might be very difficult. And I think we can give ourselves the space to explore. It doesn't have to be from zero to 100. Absolutely. You know, you can start by little steps and, and see and see where that goes. And I also, you know, self-worth is a grandiose word. And you know, what the hell does that even mean? Self-worth for me means that if you're not feeling okay, and actually we're telling you right now on this podcast that if they're going to come and touch you, even if they're touching your arm, we're not just talking about touching your vagina here. No. We're talking about anything.

Dr.Sophia:
Anything.

Touseef Mirza:
Anything, is to first recognize that, let's just start even there. Okay. That this is actually happening. Okay. And then you can actually decide. So even that level of awareness is huge.

Dr.Sophia:
Like I said, I think like we've been talking about, as women, we always have to show up in a way that looks, you know, nice. Questioning and actually speaking up for ourselves, it looks like we are being, rude you know? It could be considered as being rude. It could be considered as being, as you said before, bitchy even, or hard to handle. You know, when all we're really doing, and we should feel a lot more comfortable to do it, is to say, I am here. I am a person, I am a woman, and I wanna be treated with care and respect. That's the bottom line.

Touseef Mirza:
I think from a self-worth perspective, like in the most simplest way in the context that we're talking about, it can be literally like, you are feeling something and you're expressing it. That's it. Like, it doesn't have to be, oh, I love myself, I love myself, I love myself. Because I think there's like so much stuff out there about self-worth and self-love that I wanna break that down in the most concrete, easiest way of just, your intuition. You know your body and when you feel something is off, you know it right away.

Dr.Sophia:
Yes.

Touseef Mirza:
Self-worth is about being able to express that and not just dimming that down.

Dr.Sophia:
Right

Touseef Mirza:
That’s really what that is. And so I think if we start even baby steps to become aware of that, and then recognizing like we're talking on this podcast that yes, you have a right to ask for a level of rapport and connection and trust and just start to do baby steps and see what goes because it's hard to just start something from zero to a hundred.

Dr.Sophia:
And it could really, honestly can start with just saying, I'm sorry, can you just repeat that? I'm sorry. Can you just remind me again who you are? You know, oh, can you reintroduce yourself? Can you let me know what we're gonna be doing today? I think taking that one step and that one moment of asking those types of questions can reorganize someone if they were coming at you full speed ahead. And I'm here to say again that it doesn't mean that that was coming from a malicious place, or it's coming from the fact that they are not trying to be respectful, but in the way that our medical system now, it is so fast-paced and you know, you don't have the same concept of, oh, this is my doctor who's been my doctor for years and years and years. Oftentimes, you know, you're seeing someone for the first time every time. And so even in that first interaction and in that first moment of reminding people that you are human and treat me as such.

Touseef Mirza:
I'll give an example. Last was it, I don't know when it was a couple of years ago, I went to the dentist and I have very sensitive gums. So I don't even remember what they had to do. I said, do we really need to do this? Can you explain to me why we're doing this? Because it's kind of painful. And I remember that when I said that I felt very icky inside. I didn't feel like, oh, you know, I'm standing up for myself, or, or this is about respect.

I felt like, oh my God, I hope she's still gonna be nice to me because I'm like putting her on the spot. But I just felt the need to say that to her. Even if I didn't have a good feeling because I don't do that usually. I mean, I'm gonna keep doing that more and more. So for me, it was about that exploration. And then when everything was finished, I looked at her and I said, you know, I didn't mean to be picky or anything, but, you know, I just wanted to know why we had to do all that stuff and everything. She goes, no, I'm happy that you asked me all these questions. You know, you should be asking me these questions. I'm in your mouth for two hours. You know, like, you should know why I'm in your mouth for two hours.

Dr.Sophia:
Exactly. My point being is that sometimes just taking that one step forward helps the other person to say, oh, let me, lemme make sure that I have done X, Y, and Z, which is just the basics. Introduced myself, told them why I'm here, and explained the next steps, because all of those things are what's gonna make your patient feel at ease. It's all those things that are gonna make you as the person who's being cared for, to feel cared for.

Touseef Mirza:
Do you know of a lot of physicians that do what you do?

Dr.Sophia:
I don't know. I know that, let's say, for example, my old partner, like I said, I consider her a living legend and I learned-

Touseef Mirza:
Medical partner?

Dr.Sophia:
Yeah. She was my medical partner at the old practice that I worked for, and I feel as if she embodied that mothering, it almost felt like a mother feeling.

And I went in already having my own sense of the kind of physician that I wanted to be and how I was behaving as a physician. And I feel like she fortified that for me. So if I had to think about it, at least I can say with a hundred percent certainty that she definitely treats patients in that manner. I didn't realize that it was something that was so special, to be honest. I mean, though I recognized it in her, I didn't realize that it was something that was not being done all the time, except that when my patients are like, no. And so it made it, it made it a point for me, granted, when I have my residents or medical students for them to understand, I didn't realize that these are the little things that are not necessarily in the textbook, you know, that I can impart on the other physicians that come up behind me. I want to leave our listeners with the understanding that your body is yours and it is a special temple. And no matter who is going to touch it, they should ask for permission.

Touseef Mirza:
I love that. So on that note-

Dr.Sophia:
On that note, thank you everyone for listening. Until next time.
Touseef Mirza:
Bye bye.

Dr.Sophia:
This is General medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.