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I went into a patient room at my urgent care day job today to see a patient with chief complaint “sinus symptoms.” A routine visit, I was in and out in 3 minutes flat. It’s a very mechanical process when you’re seeing 50 a patients today, 95% of whom have one of ten diagnoses seen over and over. I walked in, though, and said, “I’m Dr. Spaar. I understand you’ve been having sinus symptoms,” as I always do. And I turned and got some hand sanitizer from the pump om the wall as I always do. And turned around to face the patient as I always do. And I’m sure he said something like, “Yeah it’s just all this pressure right here,” and he probably gestured to his face like patients always do when they present with a sinus infection. But I didn’t hear him.

Something about him, something about the look he gave me, reminded me so much of Jeremy. The look in his eyes. My stomach dropped. My body went numb. My heart started racing and things started closing in and going black. I quickly moved away from him to get the otoscope off the wall as he talked. I couldn’t look at him, at his eyes. And I needed a moment to panic without him seeing. I went about examining his ears and sinuses and lungs and asked the questions I was supposed to. I finished as quickly as I could and told him his diagnosis and plan and escaped the room. I did not look him in the eye.

And afterwards I found myself thinking, I wish I could have just said to him, “I’m sorry but I can’t look you in the eye because you remind me of my rapist. Nothing personal. I’m just fairly terrified right now.” It would have made me feel better, I think. And if rape survivors did this, wouldn’t the world be a better place? Why do we carry the burden alone? I think about what he did to me daily and yet there are so many people allowing themselves the comfort of pretending rape and child trafficking are not common. And it will never end as long as so many people remain so comfortable.

And maybe I’m wrong about this patient. Maybe he’s a rape survivor too. But rape is a systematic method of oppressing women and so I speak of women here as survivors and men as perpetrators and those conspiring in silence. Because statistics.

I rarely get triggered these days. It was a small blip in my day. But so many women are not as lucky as I am. They are living in the day in day out hell of PTSD. It is holding them back from who they are supposed to be. Creating a space for mediocre men to take the rightful place of exceptional women in many cases. Very few women in my situation would have graduated medical school, gotten a residency and graduated it as well. How many women have dropped out of college and grad school because of rape? How many have set aside ambitions and settled for a small life? And how many men have benefitted from this?

Perhaps the next time this happens I will tell the patient what I am feeling and why. And perhaps he will complain and I will be reprimanded. But I have learned long ago it is the keeping quiet that destroys your career, not the speaking out. Because it is the keeping quiet that takes your soul. There will always be another way forward even if your school or your job or your family or your husband reject you. Silence will eat you from the inside and take it all away. You will pretend at being alive until you can’t anymore.

And so perhaps next time I will tell the patient what I am feeling and why as I go about examining his sinuses and writing his prescription. Because a life of silence, however small, is not living.