Imagine, it’s a random Monday morning. You’ve just finished your second coffee, relaxing in your pyjamas still, sprawled out on the couch with your latest Netflix binge on. Suddenly, a letter comes through the door. However, on this occasion, this isn’t just any letter. It’s that letter. The NHS’ official invitation informing you of your eligibility for a cervical screening test. For some, a reaction to this invitation may be a simple shrug of the shoulders and you’ll book it after the episode playing out on your TV finishes. Another completely normal reaction, especially for those who have never received an invite before, may be one of trepidation. If, like me, you are a survivor of rape, your reaction may be something far more distressing.
When I received my invitation through the letterbox, I tore it open and felt the familiar icy cold chill of a panic attack invade my body as the words sank in. 'You have been invited to book your first cervical screening test' may as well have read, 'You’re going to go through it all over again'. Logic completely evaded my thoughts. Deep down somewhere within my subconscious, I knew this was a vital medical examination. Most women living in the UK who have received their first cervical screening invite this year will have been brought up as girls with the legacy of Jade Goody. For those who don’t know, Jade Goody was originally known as a contestant on Big Brother who was diagnosed with cervical cancer. At the time of Goody’s diagnosis, the UK was seeing a rapid decline in women aged 25-29 attending cervical screening tests (Guardian, 2009[HC1] ). Goody’s diagnosis and widely documented journey with cancer raised awareness and increased understanding surrounding cervical cancer, and the decline reversed. I distinctly remember when Jade Goody unfortunately passed away, girls in my year at school were invited to have the HPV (human papillomavirus) vaccine. We all entered the school assembly hall, shivering from how cold it was, and lined up. There was a hum of chatter with Goody’s name floating around the room. Undoubtedly, we all knew what she had been through. I didn’t really think of cervical cancer or screenings after this. I knew I would be invited to have one when I turned 25. I knew it would be uncomfortable to think about. What I didn’t expect was for it to absolutely terrify me.
So many irrational reactions sped through my mind. I wanted to tear the letter into a million different pieces, throw it away, or just place it under a load of other discarded letters and pretend I never saw it in the first place. At the time, I was still going through the motions of accepting how I had been raped. Even the mere thought of going through the test made my body stand on edge. It felt like I was being invaded all over again. As days and weeks passed, I did what my therapist really rolled their eyes at - I put it to the back of my mind. A technique I used purely out of self-preservation. If I buried it deep enough, there was a chance I could forget. But the chances were slim. No matter how much I tried and tested the one technique generations of women in my family had practiced, it sat there festering in the back of my mind. As I explained in my previous article[HC2] , it took some time for the realisation to hit me, and when it did, it hit me like a tonne of bricks. It took getting the letter itself to make me confront the fact I had been raped. Even still, the thought was still there but my actions surrounding it were non-existent. I avoided booking an appointment as if it were the plague. It was strange to me as I had started dating during this time and the idea of having sex with someone hadn’t particularly phased me. Then again, I hadn’t liked any of the people I had dated enough. But that’s a story (or several ill-fated, albeit funny, ones) for another time!
So, why was it that this consensual, medically important act frightened me so much? Was it the fear of the unknown or was it the possibility of having to be vulnerable again? Could it have been both? So many puzzling questions swarmed my thoughts that I once again desperately attempted to push them back. But, like acknowledging my rape, this wasn’t a thought to take the back seat. I needed to educate myself on everything: from how the procedure would go, to why I always resorted to ignoring something clearly, deeply embedded in my mind. I frantically searched on Youtube and on the NHS websites ‘cervical screening test procedure’ for testimonies on how it would go. It did little to comfort me. The cause of my anxiety was far too rooted in something else. I didn’t want my body to be invaded again by a stranger. Moreover, I felt utterly alone with my experiences. It took another week until I finally mustered up the strength to book the appointment. When I finally picked up the phone to call my GP, my hands were physically trembling. But there was one resounding sentence in my head; How much more can he hurt you?
It sounds fiercely dramatic, but this was the only way I had reasoned myself to pick up the phone. The day before I booked the appointment, I was having a bad mental health day combined with a chronic pain flare up. Whenever these days crop up, I choose to prioritise resting. After I had found some kind of peace, I asked myself that same question. It was a necessary question to ask myself. If I put off the screening, it was naïve to think there was zero chance of something cancerous not being present. There was always that chance. How much power did he have over me, for me to ignore the chance? How much more burying could I do? If I left it for too long, if there was something there, would it be enough to kill me? Would my fear of him extend so far to lead to illness or potential death? So, when I picked up my phone the next day, whilst my hands were shaking, it was the question I continued to repeat over and over again until the receptionist's chirpy voice broke past my noisy thoughts. I wanted to regain my power back. Booking this appointment was the first step. The fear of what my rapist had done nearly led to me avoiding a vital medical procedure. However, the courage I found within me led to going through with it. If there was something there, they would find it. I was not going to allow fear to potentially be the death of me. It wasn’t effortless. It was anything but. I’d delayed the inevitable for weeks because I was wrapped up tightly in this fear. But once I broke through that fear, I knew it was one step forward to liberation.
The day before the appointment, I was wracked with nerves. I’d been up and down throughout the night having flashbacks and nightmares. His voice continued to echo in my head. When I would wake up, I would think about the procedure. My mind conjured up every single reaction it could think of. You’re going to completely breakdown, you’ll throw up, you’ll have a panic attack. So when my sleep-deprived self finally crawled out of bed that morning, the first thing I did was cancel a date I had set up. The second thing I did was cry in the shower. The third thing I did was get dressed. Finally, the last thing I did was start walking to that appointment. When I got there, I was thankful to be greeted by the sight of an empty waiting room. Immediately, I went into the corner of the room in anticipation of anyone else arriving. I was going to be that annoying person who loudly tapped their foot and I really did not give a single shit. I was nervous as hell and getting the sensory reward of a foot tap was somewhat helping to distract me from the overwhelming nausea. Was I going to throw up after all? For once, not being an early eater was a good thing.
When the nurse called my name out, I completely disassociated. It felt like I was in one of those Disney moments where a character smells something real good in the kitchen and floats over to the oven. Except, I was floating over to an examination table and instead of getting baked goods I was getting a swab up my cervix. As the nurse described the procedure to me, I was half in and out of this dissociative state, desperately endeavouring to make sense of what she was saying whilst trying to distract myself enough to not puke right there and then. When there was a moment of silence, I knew I had to use my voice. I couldn’t keep it to myself. Quietly, I said to the nurse I felt very nervous. But I needed to be louder. I wanted to say it out loud.
'I’m nervous because I’ve experienced sexual violence. I’m scared it will hurt. I’m scared to go through it again'.
The first thing the nurse did was give me a small smile and reached out to give my hand a squeeze. In such a reassuring voice she told me I wasn’t alone, and I was not the first survivor she had met. She offered me another person to be in there to hold my hand. Whilst I was grateful, I declined. She offered me a different size speculum and asked if there was anything in particular she wanted me to do or say. I asked her not to tell me to just relax, as this was something my rapist had said, and she said she understood. She showed me the different speculums and gave me the choice of which one would feel most comfortable. I chose the smaller one. She asked if I wanted general chit chat or some music in the background. I chose to talk about how my knickers were from Primark. She asked me if she wanted her to leave the room as I got undressed or if I wanted the curtains pulled. I chose to have the curtains pulled. When she inserted the speculum, she asked if I was okay. I chose to say I was okay. When it was time for the swab to go in, she told me. I chose to say, “Thank you for telling me”. Afterwards, she asked if I wanted to get dressed again with her in or out of the room. I chose to get changed behind the curtains. When it came to filling out some final details, she asked if I wanted more time to talk. I chose to say, “Thank you, but I feel okay now”. There is one statement I really want to stress here: I chose. Everything was about choice. When I was raped in my own bedroom, there was no choice. But in the doctor's office I had dreaded seeing, I had choice. I was safe there. I had the autonomy I feared I wouldn’t have.
Just before the appointment finished, the nurse had a few parting words that eroded any lasting anxiety I’d had: 'Just remember, you’re not alone'. Those words stuck with me, and I would like to echo them in this article to everyone who reads this.
You are not alone.
You are not alone in your moments of fear and anxiety. You’re not alone in wondering whether you should delay booking the appointment out of nerves. If you feel alone, I would like to be the voice to reassure you that you are not alone, and you are perfectly valid in your worries. Alongside this, I would also like to be the voice to let you know how important cervical screenings are and how going through with it is yet another way you are regaining your power. You have full control over the procedure. No one else. You can ask them to stop at any point, choose a female health practitioner and whether you want to natter on about Primark knickers or have some peace. It is all up to you. Let this be your own version of empowerment.
If it helps anyone else, I thought it would be useful to collate a list of things I found helpful upon reflection when attending my appointment:
● Treat yourself kindly. I found it useful on the day to practice affirmations such as, “You are valid in your feelings” and “You can do this” to soothe any anxieties. Likewise, I also treated myself to an iced tea from my favourite cafe - give Brew and Brownie a shout if you ever visit York.
● Consider what you need and make it known. For me, I felt like I needed to say what had happened to me. You don’t have to divulge if you don’t want to. You can ask for the nurse to take their time, to have a hand to hold on, for them to give you some time afterwards or before. Remember, this is your body, your time and your test.
● Know it’s okay to cry.
● The test may only take a few minutes, but don’t let this invalidate your experience. My anxiety beforehand made the test feel like it lasted for days. I booked my test on a day off so I could recover. However, if you feel like going to work and continuing as normal will help, then again, it is your time, and you can do whatever you wish.
● Everything is your choice.
If we were to go back in time, I would play that final tip in my mind on a continuous loop. You have the power here. Finally, and most importantly, let’s allow our medical choices to be a vital part of our recovery. It’s a huge step, but it’s a step in the right direction. It’s one of the most empowering things you can do for yourself. So, to close this article, I’m going to remind you of the final tip which, in my opinion, is the most important one. Everything is your choice, and you’re not alone in making it.
