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âGood morning, Ms!â
Ms has hypersensitivity due
to autism. Even a slight
touch is unbearably painful!
How will Ms get through the
medical exam?
Ms sits on the exam
table, heart racing. Ms tries to focus
on the poster of a serene
beach scene to calm herself.
Dr. Hartwell, noticing
her distress, approaches
carefully. "Ms I know
this can be overwhelming.
But I'm here to help you.
We'll take it slow, okay?"
Ms nods, gripping the
cold metal bar tightly.
He starts with gentle
explanations of each step,
his voice calm and steady.
Ms tries to breathe deeply,
fighting the urge to retreat.
The door clicks shut, a
soft, final sound that echoes
in the sterile room.
He asks if she's ready,
and she shrugs. His gloved hand touches
her skin, and she tenses.
"Ms, I'm sorry," Dr. Hartwell
says, retreating slightly.
He tries a different approach,
his voice softer now. "How
about I touch with less pressure?"
The pain subsides
a fraction, but it still
remains.
Dr. Hartwell then gets out
a big metal speculum.
Ms sees it, feels it,
sheâs uncontrollably shaking.
"Ms," Dr. Hartwell says calmly,
placing the speculum down.
âSorry. To big and hard,â Ms manages.
The doctor nods thoughtfully,
his gaze never leaving hers.
âLet's use this instead,â he says,
picking up a smaller, plastic one.
It's less daunting, less cold,
but the pain lingers, unbearable.
Ms grips the bar tighter,
her knuckles white with strain.
âYou're doing great,â Dr. Hartwell
whispers, his voice a balm.
He inserts the speculum slowly,
his eyes on her face, reading
every twitch, every flinch.
Ms squeezes her eyes shut,
body rigid with tension.
The plastic touches, slides,
and she gasps, but it's more
unbearable than she feared.
Dr. Hartwell stops immediately,
his expression filled with
concern. "Would you like to insert it?"
He gently withdraws the tool. Theyâre running out
of time.
He looks around the room.
"How about we try this?" he asks,
his voice a gentle coax. "You can
sit in the chair, lean back, and I'll
examine you that way."
Ms nods, desperation in her
eyes. Dr. Hartwell
adjusts the chair, bringing the foot
rest closer. He tells her to put
her feet up, the action itself traumatizing.
He takes the smaller speculum,
coated it in gel, and tells her to
breathe deeply. Dr. Hartwell
proceeds, his movements
precise and gentle. Ms feels
the pressure, the intrusion. She
whimpers.
The doctor's eyes meet hers,
filled with understanding.
"Let's try this," he suggests,
picking up a small object.
"I'm going to use this
cotton swab instead. It's
softer, less intrusive."
Ms nods, the fear lessening
ever so slightly.
The cotton swab touches
her gently. The pain
does not vanish, but it's
tolerable, a dull throb
instead of a piercing scream.
The doctor's voice remains calm,
guiding her through the motions.
âGood. Now for a
mammogram..â
Ms feels a new wave
of anxiety crash over her.
The machine looms in the
corner, cold and unforgiving.
"Itâs important we
check everything today,"
Dr. Hartwell explains, his eyes
kind and patient. "But I know
this is hard for you. Can you
please stand up and comeâŠâ
Ms, however, is still shaking,
knows her hypersensitive
condition will render it.
The doctor notices and
quickly adapts. "How about
we skip the mammogram for
now and discuss other options?"
They talk through alternatives,
like manual self-checks at home.
Dr. Hartwell
assures her that her health
is his priority. He's willing
to work with her to find the
best approach, one that's comfortable
and effective. Ms feels a glimmer
of hope, a hint of trust and gratitude.
They agree on a plan: a manual
exam for today, and they'll
explore further options
for if needed.
Her eyes light up with hope.
They go over the instructions,
simple steps she can do herself.
Ms feels empowered by the idea
of having control over the process.
The doctor's empathy is palpable.
They practice together, a mock
exam with a plastic model.
Mis's hands shake slightly
as she mimics his gentle touch.
He corrects her grip, praising
each small victory.
âYour in need of two hormone
inoculations.â Dr. Hartwell says.
Mis's heart sinks. She hates
the sharp sting, the feeling
of invasion. She looks at the
needle, so thin and yet so terrifying.
Her anxiety spikes, her chest
constricts, making it hard to
breathe.
Dr. Hartwell notices and nods.
"Ok let's try something different,"
he says, his voice calm and measured.
He shows her a cream, explaining
how it can help.
They apply it,
waiting for it to work.
Finally, the time comes.
Dr. Hartwell holds the needle,
his grip steady and firm.
His touch is swift and sure,
but Ms feels the pain, a sharp
reminder of her vulnerability. âOne
down, one more toâŠâ
But she cries. Dr. Hartwell
pauses, understanding in his eyes.
"It's ok," he says gently. "We can
find another way." He sets it
aside and pulls out a small device.
"This is a topical anesthetic spray.
It will numb the area so you don't
feel as much." Mis nods,
desperate. He applies the spray, and she feels
a coldness spread where the inoculation
will soon be.
The doctor waits patiently, letting
the numbing agent work its magic.
Mis's breathing slows, the panic
easing slightly. "Ready?" he asks,
his voice soothing. This time,
the approach is less terrifying.
Itâs administered with minimal
discomfort. Ms winces but does
not pull away. The pain is there,
but it's muffled. Dr. Hartwell nods,
his expression a mix of relief and
determination. "Good job, Ms. You're
doing so well."
Ms needs a blood draw. She's not just
afraid of needles, but the anticipation
of pain, the cold touch of the alcohol
swab, the pressure of the phlebotomist's
grip...it's all too much.
Not to mention the actual poking prick..
Dr. Hartwell notices
and suggests a compromise.
They'll use a butterfly needle, smaller
and more comfortable, and a
warmer to heat
before drawn. The nurse
prepares the equipment, movements
efficient and kind. She's used to
dealing with anxious patients, but
Mis's fear isnât just fear or annoyance;
itâs autistic condition and hypersensitivity
that Ms herself knows limited pain tolerance.
The nurse wraps the warm cloth
around Mis's arm, and the gentle
heat seeps. Dr. Hartwell takes
his place beside her, holding the
small butterfly needle with a
cotton ball at the tip.
The nurse places the heated
alcohol swab on the inner
elbow, and Ms tenses.
It's a gentle poke and she feels the
slight sting as the nurse inserts it.
But of course the sting is magnified for
Ms.
The nurse is quick, her hands
steady with
expert ease, and the whole process
is over in seconds. Mis's heart
is racing, her body shaking.
Dr. Hartwell rubs her shoulder,
his touch a reassurance. "It's
over," he says softly. "You did it."
Ms nods. "What can we use
for next time?" The nurse asks.
âX-rays, different form of the
hormonal injection where no
needles are involved, urinal
test instead of bleeding? A
bigger room? Child sedatives?â
Ms murmurs.
Dr. Hartwell nods, scribbling
down notes. "We'll explore all
those options. In the meantime,
you can go home!"
âThanks..â Ms says.
The next appointment, Mis
goes knowing her
sensitivities have not changed.
This time, Dr. Hartwell meets her
in the hall.
Mis breaks down, despite being gratefully
understanding and trying
to be brave.
They take her to
a quieter, more private
exam room, decorated with
soothing colors and a soft,
plush chair. "Take your
time, and tell when
you're ready."
Ms sits down. She sees a
box labeled "DIY Health Kits"
and feels a spark of curiosity.
Dr. Hartwell opens the box,
revealing an array of tools and
instructions tailored to her needs.
"This is your DIY health kit,"
he explains, his voice calm
and soothing. "You can use
to perform self-exams at home.
It's less invasive, and you can do
it on your own terms." Ms nods,
a flicker of hope in her eyes, tears of
relief instead of upset tears.
He hands a small
container with a test strip inside.
"This is for urine. It's quick and
easy, and it will tell what needs to know."
Ms takes the container, follows his instructions,
each step a small victory.
Dr. Hartwell shows her
a slim device, similar to
a tampon but with a small cap.
"This is DIY Pap.
You insert it like so, then
twist to collect a sample."
The vibrating ice pack is next.
"For finger pricks," he says,
his voice calm. Ms looks at it,
a strange mix of relief and
curiosity. The thought of doing
it herself is less terrifying than
the clinic.
"Now, let's talk mammograms,"
Dr. Hartwell says, his gaze
soft. He shows her a handheld
scanning device. "This is a DIY
mammogram. It uses sound waves,
no radiation, and it's less
invasive than the traditional. You can use it
in the privacy of your home,
at your own pace. It's designed
to be gentle." Ms nods, the fear
slightly eased.
The doctor opens another compartment
in the DIY health kit, revealing
a pack of colonoscopy strips. "These
are for checking your bowel health.
They're painless and easy to use. All you do
is defecate on this, will
tell whatâs going on down there, ok?"
Ms nods.
The idea of self-examination is less
daunting than the traditional methods.
Dr. Hartwell's empathy is a balm,
his patience unyielding. He opens
the last compartment.
Inside, she finds a set of small patches.
"These are the hormonal patches,"
he says, holding one up. "They're
like stickers. You just apply one
to your skin, and it delivers the
medicine through your skin. No needles."
Mis's eyes widen. It's like he's reading
her mind, offering a solution tailored
to her fears.
Ms feels a surge of gratitude
to Dr. Hartwell. His understanding
and willingness to adapt to her needs
make her feel seen and heard, something
she's not used to, in a medical setting.
For the first time, Ms feels a glimmer
of hope that she can take control
of without the debilitating
pain nor fear of ableist microaggressions.
( emojicombos.com/neurofabulous )