Chapter 22: Diagnosis

Jacob returned home with good news about my internship. Apparently Peter has been taking care of some business.

Thinking about Peter still makes me feel guilty, so I wasn't as excited as Jacob wanted me to be. But I clarified that I was nervous about the appointment, and he understood.

Now we're here, in the waiting room, I suddenly realize I'll need to explain the doctor why exactly we are there and I don't feel like I can do that.

In the past year, I've gone from never ever talking about it, to telling both my therapist and Jacob the details about my past. I can't handle another one, especially a stranger. Since I moved here, I haven't needed a doctor yet. I found a female doctor on the internet and that's where I booked my appointment.

Before I get a chance to tell Jacob I changed my mind, a friendly looking lady in a white coat invites us into her practice.

"You are here for a smear test?" she says, and immediately continues, "you can take off your lower clothes and get on this table."

I look at Jacob with wide eyes, ready to jump up and run out of here.

"Hold on a second," Jacob says, "can we talk a moment first?"

"Of course," the doctor says surprised, sitting down behind her desk.

She looks at me patiently, but all I can do is stare at Jacob and beg him with my eyes to rescue me.

"The thing is," he starts, and the doctor faces him, "Bella has been sexually abused, as a child, and has never been examined. We would like to try an examination now, but we're not sure if that will be possible, because she is still suffering some trauma."

"I see," the doctor says in a professional tone, kind, but without pity or shock. Doctors probably hear that kind of stuff all the time, I try to assure myself.

She turns to me again, "are you aware of any injury?"

I shake my head.

"Do you experience pain during intercourse?"

Again I shake my head and I stutter, "we haven't… I mean… I never…."

"I see," she nods, "how about tampons? Do you use those?"

"No."

She thinks for a few seconds.

"Listen, here is what I suggest. I have one more patient after you and then there is a break. If you can hang on for ten more minutes, in the waiting room, I'll attend to that other patient first and then I'll have more time for you. So you can relax, is that alright?"

We both nod and she leads us back to the waiting room.

While we're waiting, Jacob and me repeat the same conversation over and over.

I whisper to him, "I don't want to do this, let's just go home and forget about it."

"We'll give it a try," he reassures me, "she knows you find it hard, if you're not okay with it, we can leave then."

When we are invited back in, the doctor gives me time to get undressed and climb onto that uncomfortable chair. She shows me how to put my heels into the metal thingies and my heart races in my chest. In the mean time, she pulls a chair closer so that Jacob can sit next to me and hold my hand.

I feel like I'm about to give birth. The women who take place here must feel that same fear and terror.

"Alright, Bella," the doctor starts, while she puts on her medical gloves. "I'll first check for scarring in the exterior parts, don't worry, I won't touch you unless you tell me it's okay."

She lowers a light that shines between my legs and I hope Jacob won't look. In a way, being like this feels humiliating, but Jacob doesn't think so, as he whispers in my ear "you're so brave."

"This all seems okay," the doctor confirms and looks at me questioningly. I nod and then I feel her hands on my skin. Immediately I tense up, like I would when hearing the dentist drill, but no panic so far.

"Nothing here either. Now, if we are going to check for interior scarring, I am going to need you to relax completely. If you are able to relax completely, it won't hurt. I'll go slow and keep asking you how you're doing. Okay?"

I nod, but as I'm trying to keep my legs steady, I feel cold sweat running down my forehead.

She sits up and says, in a patient voice, "take whatever time you need to relax and let me know when you're ready."

Jacob squeezes my hand and whispers "just a try." I nod to him, close my eyes and take several deep breaths. Slowly, my legs steady and my muscles relax. My heart rate slows down until I finally whisper "okay." We came here for a check up and I won't back out without trying.

I feel something cold push against me. I saw her lube that thing up earlier and it slides over my skin easily, but then it comes to a stop. She pushes a little harder, but there's no way it's going in. It's not as if it hurts, but I can feel it just won't fit.

And that's what I say, "it's too big."

"It seems big, yes," the doctor agrees, "but not too big. The vagina is extremely elastic, when completely relaxed. Maybe I'll give you some more time?"

I shake my head, "no, I'm relaxed now."

She tries again, pushing a little harder this time, and I cringe when a flash of pain is sent up my abdomen. The doctor keeps the device still, but the pain remains.

"Just take your time again to relax and we'll try to go a little deeper."

"How far is it in?" I breathe. I feel like she just put needles a foot long into me.

"An inch maybe?" the doctor responds and I almost want to quit, but she adds, "just take your time."

Again my eyes close until the pain subsides. I nod, but when the doctor pushes in a little further, I nearly cry out in pain.

When she notices the tears in my eyes, she pulls back ever so gently and simply says, "not today. Please get dressed."

I feel like a complete and utter failure, when I take a seat next to Jacob. I brace myself to hear from her I'm so scarred I'll never be able to have sex, trauma or not.

"Have you heard of a condition called vaginism or vaginismus?"

"No," I reply, already feeling the dread of what she will say next, "is it bad?"

She doesn't reply to that question but starts explaining, like a teacher to a student and we both take in all the new information, knowing instantly that her diagnosis is correct.

"Vaginism is a condition that is both mental and physical, in which the pelvic muscles spasm, making intercourse painful or even impossible. It is often caused by sexual trauma: your body has been conditioned to associate sex or touch, or even men in general, with pain and therefore your body developed a strategy to protect itself. These reflexes happen on a subconscious level and they are not in your control. That is why you believed to be relaxed, just now, but your pelvic muscles were cramped completely."

"So it's not damaged?" I ask.

"For as far as I could see, no. But I haven't been able to do the internal examination. I won't be able to do that until you treat the vaginism."

"It's treatable?" Jacob asks, holding my hand in his.

"Yes it is, but it's not an easy or fast treatment. There is no pill to cure it. It will take a lot of time and effort, a lot of patience and understanding, to teach your body new reflexes. If you say the trauma started in childhood and to this day, you haven't been able to ever use tampons, then this is an advanced stage."

"Patience and understanding is not a problem," Jacob says, and the doctor seems pleased.

"I can refer you to Dr. Smith, she's a pelvic physical therapist, a very sweet lady who's helped some of my patients with similar problems."

Another one knowing my secret, another stranger touching me. I'm not sure I'm willing to go that far.

"Can't I just learn to relax those muscles myself?"

"Yes, that is what she will teach you. But it's not easy to overcome reflexes which have been programmed for ages, by just using your will power. Especially not if it's muscles you didn't know existed. On top of that, you have a trauma to deal with as well. I noticed how nervous you were, this isn't just muscle cramps, Bella."

"But I'm already seeing a therapist."

"Good, maybe you should tell them about this diagnosis, they might be able to help?"

I nod. The thought of talking to Tom about my sexual issues isn't very appealing, but letting in another stranger isn't appealing either.

"In the mean time," the doctor continues, "you can start by exploring yourself. Since you were not aware of any possible scarring, I assume you don't do any self-play."

My cheeks flush bright red when I shake my head. What's that got to do with anything?

"That is natural if you grew up with an aversion for sexual acts. But self exploration doesn't have to be sexual. You can learn to feel, with your fingertip, when the muscles are tense or relaxed, and try to find ways of controlling them."

"Can I help in any way?" Jacob asks. I know he probably feels helpless in all this.

"No," the doctor states. "You can be the kindest and most patient man alive, and I can tell that she trusts you, or she wouldn't have brought you here, but this is something she has to do by herself, without pressure."

"He wouldn't pressure me," I object.

She turns to me. "No, but you would. As soon as there is someone else involved, there is possible disappointment, because you like to reward them for their help with progress. When it's just you trying to find the right muscles, it doesn't matter if you can't figure it out today, you just try again tomorrow and nobody has to know."

We both understand her point and nod.

"I'll give you the address of Dr. Smith, you can think about it. I know this is something new for you, I'll also write down some addresses of websites with complete and accurate information."

"Thank you."

In the car ride back, Jacob awaits my response patiently. But when I don't talk, he asks "will you talk to Tom?"

I sigh and answer reluctantly, "I'll try."

"You don't have to. We've got a diagnosis, we can look up information and let it rest. This isn't urgent, right?"

I like that he's trying to put my mind at ease. Hearing the doctor say that this condition is curable must give him hope of us making love one day. But my statement of never being able to, wasn't because I thought it was physically impossible.

I have to admit, lately, the idea of being closer to him still and have him lay on top of me with that same bliss my hands can give him, it does seem more appealing. Less scary. But these flashbacks I don't control, even if I wanted to.

I guess I do need to talk to Tom about those, he's sort of an expert in sexual trauma, I'm sure he talks to his patients a lot about building a new sex life, even if it will be awkward as hell for me.

In the next few weeks, I get over some of my own fears and I do address the issue with Tom. As expected, he's very relaxed and not at all uncomfortable with this topic. He repeats some of the same things the doctor mentioned before, that self exploration doesn't have to be sexual and it's best for one's health to know your body thoroughly.

I do make progress with that too. To this moment, I refuse to talk to Jacob about it, because I am still very embarrassed to touch myself down there, even though "everybody does it". I have found the muscles that tighten whenever I get just a little anxious, but I still haven't found a way to control them. Especially when I get emotional.

I guess that's what the pelvic therapist is for. That might be a next step in my long and trying recovery. I do feel hope of getting better some day, and it feels good to be working towards the future, but right now, I feel like I've taken enough steps. I've taken myself out of my comfort zone enough for the next few months.

I just need a break.

I feel guilty about taking so much time, but of course, Jacob is ever patient, not pushing me at all and telling me lots of times how brave I am and how proud he is of me.

So despite everything, for the first time in my life, I feel blessed.

AN: So what do you think about this new diagnosis? Have you ever heard of such a thing?