Image: Patient at doctor's visit
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When faced with intimate exams, we often find ourselves blathering on about the most mundane subjects we can conjure.
By
msnbc.com contributor
updated 10/10/2007 9:21:03 AM ET 2007-10-10T13:21:03

“Now just relax.”

Sounds so easy, right? But when gynecologists, proctologists, professional waxers and other practitioners of those oh-so-intimate exams and procedures utter those three little words, that’s the one thing that none us seems able to do.

Instead, we blather, mumble and mouth off. We ask insipid questions about our doctor’s hobbies and/or family. How’s the stamp collection? Are the twins still taking saxophone lessons? We embrace the mundane as if it’s the last life preserver on the Titanic.

Just ask Edward, a 37-year-old marketing maven in Seattle, who booked an appointment with a proctologist after noticing an odd bump in a very private and personal place. As the exam got underway, he happened to use the word centimeter. “The doctor was like, ‘I find it interesting that you used the word centimeter,’ and I’m like, ‘Well, yes, as it happens, I’m a big fan of the metric system,’ and then we got into this big discussion about the merits of the metric system,” he says. “I don’t think I’ve talked about that particular subject with anyone before or since.”

A safe, dispassionate topic like hydroelectric power or porkpie hats is not all that unusual for the exam room, says Dr. Robert Cutler, a proctologist from West Palm Beach, Fla.

“I’ve had people talk about the mechanics of how airplane engines work or people in the financial business discuss their theories of investment,” he says. “It’s my job to educate and make my patients feel at ease so I go with whatever is interesting to them. If they like boating and fishing, we talk about boating and fishing. If they prefer to pretend they’re on a desert island somewhere, we’ll do that. The important thing is that they’re comfortable.”

'We're grasping at straws'
Wanting to flee to your happy place is not an uncommon reaction when faced with a steel tray, a backless smock and a white latex glove. In fact, according to one expert, those weird exam room conversations — or the stilted lack thereof — are usually a verbal form of escape.

“There are two typical responses to stressful situations,” says Don Gabor, small-talk expert and author of “Speaking Your Mind in 101 Difficult Situations.” “We either shut down and become completely mute or we prattle on and on. And when odd topics come up, it’s because we’re grasping at straws.”

Marie, a 35-year-old development director in Seattle, found herself reverting to autopilot during one exam.

“I had to go to my gynecologist and as he gets me onto the table, he starts asking about the nonprofit where I work,” she says. “I knew he was trying to distract me by asking all these questions about the exhibits and the fundraising drive. But I suddenly found myself saying, ‘Well, you’re obviously a well-off doctor, have you ever considered a planned gift?’ I actually asked him for a donation while I was in the stirrups.”

Dr. Kim Alumbaugh, who has her own ob/gyn practice in Louisville, Ky., says distraction is a common technique that doctors use during intimate procedures. So is humor.

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“Once the exam starts and they’re in the stirrups, I always ask them to slide down another 20 feet,” she says. “It’s sort of an icebreaker. And then we’ll talk about shoes or vacations or their kids or exercise or whatever. It’s almost like a little cocktail party. You try to keep the conversation flowing.”

It's a small world
But the casual chitchat can sometimes go too far, as Barbara, a 58-year-old advertising executive discovered when she hopped onto the table of a new ob/gyn for the first time.

“He asked me where I was from originally, and I told him Texas and then he asked where in Texas and I told him Houston and then he said, ‘I went to high school in Houston!’ and of course it turned out we’d not only gone to the same high school, we’d graduated the same year,” she says. “I could not get out of there fast enough.”

Exam room small talk does serve an important purpose, explains Gabor. It personalizes the relationship between you and your doctor and may help you relax enough to open up about whatever health issue is on your mind. When you know an unpleasant exam or procedure is coming up, go in ready, he advises.

“Patients should probably have one or two topics ready to go for when they want to divert attention from what’s happening,” he says. “So when the doctors is about to poke them where the sun don’t shine, they can ask, ‘So, what do you think of the Mets?’”

Oddly enough, some topics, like baseball, pop up again and again.

“That 'Seinfeld' episode with the ‘Ass Man’ always comes up,” says Cutler, the proctologist.

The subject Alumbaugh, the ob/gyn, often hears about is stubble: “Women always apologize for not shaving their legs.”

Let's talk about sex
While sex talk seldom comes up during the actual ob/gyn exam (“I think people are trying to divorce themselves from the intimacy of what I’m doing,” says Alumbaugh), the opposite can be said for those who indulge in the equally intimate Brazilian wax.

“Whenever people come in, they always want to talk about the same issue — sex,” says Jonice Padilha, of J. Sisters International, the New York salon attributed with bringing the Brazilian bikini wax to the U.S. “They want to know if their men will find a Brazilian wax attractive and want to have more sex. They want to know if they’ll have more orgasms. They’ll talk about their kids or the weather or whether their husbands are cheating, but mainly, they want to talk about sex.”

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