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The Other Side of the Speculum

Amazing How When I am Doing Lung Examination
and Ask Women to Take Deep Breaths

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"Eleanor" sighed, as I listened to her breath sounds. She said she hadn't taken a deep breath all day and doing so felt great.

Every woman knows about the "Annual exam". It is that visit that brings one to the gynecologist office for a pap smear but also to update the doc on what has gone on during the year and to bring any current complaints to the physician for evaluation. During these exams I examine the pelvis and other organ systems including the breasts, heart and lungs. The lung exam is the ritual of breathing deep and exhaling while the physician places the (most often chilly) stethoscope on the chest and back. This is done to elicit signs of infection, allergy or even cancer.

After thousands of lung exams I am surprised time and again, as I watch women ready themselves for the evaluation. There is a subtle shift in their bodies. There is a readiness and then relinquishing that happens in front of my eyes: there is the physical response to the request "take a deep breathe" that is the inhalation but then there is something more systemic, emotive in nature that also occurs, especially with the exhalation. The whole body relaxes as it takes in oxygen and exhales. It is as if all the worry, stress, anger and fear disappear for the briefest moments while I listen.

And the moment is not just healing for the patient.

While standing beside the patient, I find myself relishing this moment as well. Listening offers a respite – my movements stop, the conversation is stilled, allowing me to focus on the subtleties of breath sounds. I find my own body mimicking the patients- my breath slows and I take my own deep inspirations mirroring the tempo of hers before me- a metronome, gently blending "doctor and patient". Chaos is reduced for just a moment to sound and air; the stressors of my day dissolving for the shortest of moments, a meditation of sorts lasting but 6 inspirations and expirations.

Most of us pant all day long- we rarely sit still long enough to focus on our breath. There is always one more "something " to be done. In days gone by when we watched the sky for entertainment or sat idly watching the movement of grass on the plains, nature effectively slowed us down and enabled us to deeply inspire (or to be inspired deeply). In today's world, we rarely take the time to hear one's breath or to feel the depth of our inspirations. We rush from home to office, take pills to speed us up and then to slow us down. We have essentially "modernized" or pharmacologically detoured our way away from the natural rhythms of our body. As a result, we are more stressed, depressed and impaired.

We need to slow down and nourish ourselves with oxygen. Research has demonstrated that mindful breathing heals by the reduction in blood pressure and pulse, and lowers the number of episodes of pain and stress. Rather than looking for some outward modality to encourage stress release; which often demands more time and money than most of us have- try to schedule the opportunity to sit still each day. Start with just a few minutes and then extend the time up to 20 minutes and simply focus your thoughts on the listening and nourishment of your own breath. Call is meditation, prayer or reflective breathing- whatever you like, but try to make a place for it in your life and relish its capacity to help with life's stresses and challenges.

So, the next time you are having a lung exam in the doctors office, remember to cherish the opportunity and breath long and deep. An inspiration is more than just a deep breath; it is an opportunity to heal.


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Amy Novatt:
My life as an obstetrician - gynecologist started in Pennsylvania in 1990 working in a community hospital delivering babies and learning the art of gynecologic surgery. As hard as residency was, I realized early on that I had chosen a career that suited me. The practice merged my interest in women’s health, reproductive policy and surgery perfectly. I spent many years assisting woman deliver their babies and then decided to focus on gynecology (only)- appreciating that in most offices, the concerns of adolescents and women not having babies, were often marginalized by doctors. I was interested in creating a professional arena for women to discuss these non-OB related issues. I have worked in a private practice for 14 years in Rhinebeck, NY. I have seen over 10,000 patients during those years. My work includes office GYN and surgical interventions, including advanced laparoscopic surgeries while lecturing both to professional peers and lay audiences.

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