Today I’m taking a break from the on-going conversations with and about my emotional well-being. Today is a day for considering how I want to interact with the hospital.

After talking about it for months, I’m now just one week away from surgery–a hysterectomy and repair from pelvic organ prolapse. I’ve done a lot of reading and thinking to prepare myself, and I had extra meetings with both the surgeon and her nurse to make sure I’m prepared and that they are sensitive to my needs. My biggest need, of course, is to know what’s about to happen and to have it all happen with as much respect and dignity as possible. I don’t ever want a repeat of the humiliating, triggering test I had last fall.

One of the things I have worried about is what happens after the surgery, when I’m back in my hospital room. Will I have different nurses in and out, poking me in personal places, very nonchalant and possibly with the door open because, after all, they’re used to it? My doctor suggested weeks ago that I write a letter to go into my file that specifies how I want to be treated.

I still haven’t written that letter .

The reason I haven’t written it is that I can’t decide how much I should reveal. I could just keep it simple, with my basic request: Please don’t do anything to me without first telling me exactly what you are going to do. I would appreciate it if you would be particularly attentive to my concerns about privacy and dignity.

What I can’t decide is whether to add something like this: As a survivor of childhood sexual abuse, I am especially sensitive about the way gynecological exams and procedures are conducted.

To me the cases for not including the information about my background is 1) I should be able to make this kind of request regardless of the reason for it (i.e. why should I have to justify myself?); 2) it’s none of their business that I have a history of abuse; 3) I don’t know them and don’t know who I can reasonably trust or not trust with very personal information; 4) it seems kind of presumptuous–it’s as if I’m assuming that I am more sensitive than other women, and how would I know that? There are plenty of reasons to be sensitive about strangers poking around in your vagina, after all.

The case in favor of including it is 1) it might make them take the request more seriously and 2) it might make them think about other patients with a similar history who may or may not feel able to bring it up.

I’d better decide pretty soon or there won’t be any letter at all.