Anatomy

I went into theatre with a friend today to watch a surgery performed for endometriosis. The patient was really young, young as in, only a year older than both of us. It was kind of weird. It is like seeing your friend naked on the table. It was probably awkward for the patient too because we were hassled out of the OR (operating room) and only allowed back in when the patient was unconscious. But the weirdness just lasted a few seconds before it was all business.

I have to say that anatomy is not a very strong subject of mine, but anatomy of the genitals got to take the cake. I don’t know why, but i can never get my head around it. Maybe it is because the real thing never looks like the one drawn in textbooks. You know, it took me two years before i finally figured out that there are two kinds of penises – a circumcised one and an uncircumcised one. In my first year of medical school, i was perpetually confused by textbook diagrams. Not one textbook had the courtesy to explain whether they were drawing a circumcised or an uncircumcised penis; i just shoved my confusion under the rug. Don’t know how i finally figured it out, but i did. It was also fairly recently did i discover the urethra is not in the clitoris. (Don’t laugh, i bet most of you (friends reading this) did not know that too because we are so damn conservative.)

Anyway, so this patient’s vagina was exposed. I tried to go through the anatomy but i was utterly confused. Clearly i can identify the major parts, but the vagina is so confusing. (No wonder guys can get it in the wrong hole, this fact, i was told.) The patient looked like she had an anterior vagina wall prolapse yet she’s so young; it really is impossible. So i prodded my friend, who is male by the way.

“Hey dude, can you just tell me what the hell is that?” i nodded towards the vagina.

“I don’t know, and i don’t want to look,” was his obstinate reply.

“What do you mean you don’t want to look? We are on our Obstetrics and Gynecology rotation! It is all about vaginas!”

My friend firmly kept his eyes averted. I was exasperated.

“Don’t ask me, i am bad in anatomy,” he muttered.

“Unfortunately, you are the only other person in this room whom i can ask, so i am asking.”

“Why don’t you know this?”

“Because i just don’t!”

Anyway, i finally asked the resident. It was the urethra. (Point to note, it was not today that i discovered the urethra is not in the clitoris; it was some other day a few weeks back when i was reading up on bladder extrophy in children.) This is when i can tell you very clearly that you really got to look at the real thing to get your head around these things. Diagrams just don’t help. I cannot believe the urethra looks so different.

When i was younger, i read a book on true medical encounters, and there was this 50 year old female patient who presented with recurrent urinary tract infections. The doctor had a look and realized this patient’s hymen was still intact. But she’s married and still sexually active. How did that happen? Penetration was occuring via the urethra not the vagina. I could not believe it when i read about it. Today when i saw the urethra, i understood how it could have happened. The urethral’s orifice is larger than i expected, and closer to the vagina than i anticipated. No wonder sometimes one can accidentally catheterize the vagina instead of the urethra.

I prodded my friend and told him to look because we had to be catheterizing female patients soon, so he better get his anatomy right, or rather her anatomy. Also after i saw the patient’s vagina today, i am finally convinced that it is large enough to accommodate childbirth. Which then brings me to my next revelation – no wonder most men and some women are so obsessed with penis size. If the penis is small and the vagina is large, i suppose it is harder to get any traction? Just a few thoughts out loud…

And i am regretting not turning up for BJJ today. I just really dread the no gi training sessions, and the fact that i am not properly taught the beginner techniques before i am thrown onto the mats to fight. But now i feel like a wimp. Amazon is taking too long to ship the book i ordered. Should have just gotten the book at a local bookstore. May have been $20 more expensive but i am wasting my club fees by skipping 2 weeks of training and counting and that’s costing me $60 already. Argh. I am so annoyed with the way i analyze things sometimes.

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