It’s not easy to gross out a gynecologist. The job involves constant exposure to bodily fluids of all types, especially blood. And delivering a baby is in a class by itself. Even a normal birth ends up looking like Texas chain saw massacre, plus excreta of various kinds.
So when my office assistant came to warn me that the next patient had a disgusting problem, I raised by eyebrows in surprise. What problem could be so bad that it would gross out a gynecologist?
The assistant didn’t know what the problem was, but it had required unusual measures. The odor emanating from the young woman was so offensive that she could not be allowed to sit in the waiting room. The assistant had escorted her to a private exam room the moment that she presented at the front desk.
My assistant was not exaggerating. When I opened the door to the exam room and stepped in to introduce myself, I was assailed by a truly repulsive odor. I struggled to maintain a welcoming look and avoid any sign of disgust. Patients may have birth defects or injuries that frighten others, but they should never feel that a doctor is shocked.
The patient was weeping.
“I don’t know what is wrong and I can’t get rid of this odor. It’s been getting worse for the last week and in the past few days I haven’t even been able to leave my house. Each day I have even more of this awful smelling vaginal discharge and no matter what how many times I wash I can’t make it go away.”
Typically I start by taking an extensive history, but I was not sure I could stay in the room for very long.
“Let’s start with the pelvic exam,” I suggested, “since the most important thing is to find out where the discharge is coming from.”
The patient positioned herself on the exam table, weeping quietly all the while. I prepared myself to find a decomposing tumor or a strange infection. I inserted the speculum and tried not to retch.
I saw it right away. It was an old tampon.
“When was your last period?” I managed to choke out.
“It ended about a week and a half ago. Why?” the patient replied.
“You forgot to take out your last tampon. It’s been in there for more than a week. That’s the source of the odor.”
The young woman was both relieved and embarrassed.
“You mean there’s nothing wrong with me? This will go away?”
“Absolutely!”
I carefully extracted the tampon and placed in a biohazard receptacle. I called for my assistant to remove the biohazard container and take it to waste disposal. Immediately the air in the room became easier to breathe. I cleaned out the vagina with water and was amazed to see that there had been no damage to the sensitive tissues in the surrounding area.
I waited while the patient got dressed behind a curtain. We discussed that it might take a day or more for the odor to dissipate entirely, but since there was no permanent damage, I was sure that it would be gone soon.
The patient embraced me.
“Thank you so much. I’m so relieved.”
I returned her embrace and led her to the door, carefully closing it behind her. Then I turned and vomited into the exam room sink.
