What a Papaya Taught Me

The CN Tower, mighty and tall, greeted me when I stepped off the ferry. The small town girl that I am was completely taken aback by the endless avenues, the towering skyscrapers, and the multilingual crowd. OMSW Toronto, the event that brought me to Ontario, already promised to be unique: hundreds of medical students from all across the province were to gather in downtown Toronto for a weekend.

A night out showed me how surprising Toronto is, but the papayas lying on the tables of my first scheduled workshop were more than unusual. Expecting some mess, I rolled up the sleeves of my freshly ironed blazer, ready to discover what these Ontarians were up to.

“So papayas are closest in texture to a woman's cervix”, explained the OB/GYN resident in front of the room. The apparatus she held in her hands while installing a mock IUD (intrauterine device) was familiar to me, but then she switched to an instrument that I had never seen.

Some faces started showing signs of disapproval, and I was wondering why this technique, called “manual vacuum aspiration”, provoked such a strong reaction in the crowd. As a medical student interested in reproductive health, hearing the words “cervix dilation” and “before 12 weeks” did not shock me as much.

“Before 12 weeks.” Those words rang a bell. First trimester, right? Now I understood why some of my colleagues were wincing.

Abortion: one of the medical school's biggest taboos, often mentioned but never explained. Even after a year of training and several internships, I never had the opportunity in my medical curriculum to develop a thorough understanding of the issue. As the resident proceeded to dilate the papaya's “cervix” with a cannula and carefully inserted the manual vacuum aspiration device, I stood still because I realized how lucky I was to witness such an occult knowledge.

As the participants experimented the different techniques on our own, once the demonstration ended, different opinions flew around the room. However, even if points of view were polarized, all medical students sitting in the room agreed on one thing: the medical curriculum does not teach us sufficiently. Some students attended lectures, others have acquaintances that got an abortion, but none of us really knows how, as physicians, we are required to handle the issue.

That weekend in Toronto unexpectedly complemented my medical education. What impressed me were not the techniques nor the statistics, but rather the wisdom that the residents shared with us. Even though I am only a medical student, I have to start cultivating that same compassion for my future patients. Whether we might agree or not with the moral underpinnings of abortion, it is a health care service that might be needed by women we will meet in our practice.

Like I have already heard so many times, “Abortion is health care: trust women.” As a future physician, I pledged to serve my patients, not to judge them.

- Nina N. (Université de Sherbrooke)

[Editor's Note] Family planning and reproductive health continues to be an area of unmet need for many communities. The decline in the number of abortion providers Canada-wide, coupled with increasing administrative and economic restrictions on abortion provision mean that women need to travel longer and longer distances from their own community to seek this legal medical service at their own expense. Yet, reproductive health care, especially pregnancy options, often remains left out of undergraduate medical education. 

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Read more about Nina's medical school reflections and experiences on her blog at http://www.usherbrooke.ca/bloguesapart/auteur/ngun2201/ (in French)