I was 28 when I visited a gynecologist for the first time, as a scientist in a foreign country, nonetheless. Requesting the morning off from attending to my cell cultures was the easiest part. I had even made the effort to schedule an appointment at an expat-friendly, English-speaking women’s clinic in the heart of Milan thinking it would calm my nerves. But my bloody cuticles and shaky legs begged to differ.
I soon met Dr. Sondrio, a tall, blonde Italian woman in her forties who greeted me with careful English and a smile. I could feel my shoulders tense as we walked into her office. I told her this would be my first ever pap smear, and to my surprise, she was unfazed by my statement. She explained the procedure with her slow, but curated choice of English words. She didn’t tease me for being a virgin for so long like previous doctors had. She simply assisted me into a reclining chair and made sure I was comfortable, as she collected a sample from my cervix for analysis.
Before leaving, Dr. Sondrio slowly asked me one more question: “Are you vaccinated against HPV?”
“Yes,” I replied as I hurriedly threw my purse over my shoulder. I was now more preoccupied with the thought of leaving the clinic and grabbing a cappuccino before heading into work. My cheeks felt warm as I walked quickly to the closest café, thinking about how Dr. Sondrio’s question sounded so similar to one I had gotten before—except then it felt more like a threat than a medical procedure.
My parents simply stared at the pamphlets — the word “sexually-transmitted” had stopped them in their tracks.
Like in many South Asian households, the “sex talk” in mine was non-existent when I was growing up. My sister and I had to depend on an afternoon workshop in fifth grade to inform us about the surreptitious topic of sex. Our fifth-grade teacher was unsuccessful at being her normal lively self — the topic seemed to make her uncomfortable as well, transforming her into a textbook-reciting robot. The hesitancy that restrained our parents and educator from speaking freely about sexual health convinced my sister and I to believe it was something to be afraid of. However, as we approached high school, our pediatrician wouldn’t allow our family to continue shying away from the topic.
After a routine medical visit, my pediatrician Dr. Reece asked my parents and I if we could stay for a few more minutes to discuss a new vaccine. My parents didn’t think twice about it — growing up in India made them more than willing to accept whatever a doctor recommended.
Dr. Reece handed my parents pamphlets as she confidently declared, “Gardasil. It’s the first vaccination of its kind, intended to protect girls from strains of the sexually-transmitted, high-risk human papillomavirus, or HPV, which can cause cervical cancer.”
My parents simply stared at the pamphlets — the word “sexually-transmitted” had stopped them in their tracks. My dad sort of chuckled before asking if it was even necessary for his barely teenaged daughters. My mom took it as an offense, as if our family pediatrician was suggesting the vaccine itself was going to make us sexually active. Her defensiveness made my doctor double down.
“The point is to protect them for the future, even if they are not sexually active right now,” Dr. Reece continued. “It’s better to be vaccinated in case something does happen…like an unwanted sexual encounter.”
The mere implication of sexual assault made my mom tense. She didn’t want to talk further. My dad continued to stare at the pamphlets, but finally shrugged his shoulders in defeat. The science made sense to him, but he didn’t have the energy to fight my mom right now.
“Maybe next time, Dr. Reece,” my dad sighed.
Eventually I did get the vaccine when I was 21, when my dad relented, knowing I would be leaving for graduate school soon. It was a topic we left untouched for years, as I finished high school and undergrad, but one summer afternoon over chai and baby samosas changed that. The food helped us to communicate with an even-temper. While we left the word “sex” out of the entire conversation, I learned that my dad had been a supporter of the HPV vaccine all this time. We just had to work around my mom.
“At this point in your life, it’s just best to be safe going forward,” Dad stated firmly. “Get it done, and you don’t need to tell her.”
I made an appointment with a new clinician in early 2014, since Dr. Reece and I had parted ways after I turned 18. My new doctor made no attempt at informing me about advances in the field—advances I was unaware of in my early twenties, but now, as a trained cell biologist, I feel disheartened for not knowing. A new version of the vaccine came out later that year. Gardasil-9 was an improved version of the vaccine, providing protection against five more high-risk HPV strains responsible for 20 percent of cervical cancers. Looking back, it would have helped to stall a few more months for Gardasil-9. Life wasn’t in a rush — I didn’t meet my sun-kissed Italian until about seven years later.
His name was Enea. I met him a month after I arrived in Italy, with one single date igniting a spree of blissful weekend moments. I always considered myself a pragmatist, and I never planned to fall so quickly into a relationship. The fact that Enea was so upfront about being STD-free, “disliking alcohol, and hating smoking meant I too could be vulnerable and open to a romantic, monogamous relationship with him — something that fear, hesitation, and unsubstantiated misconceptions about sex prevented me from pursuing before.
A few weeks later, an email with a PDF attachment appeared in my inbox from Dr. Sondrio. I nonchalantly clicked through but paused after seeing a bold “positivo” stare back at me. My eyes hung onto that word for what seemed like an eternity.
My vaccine had done its job, protecting me against the notorious HPV-16 and HPV-18 strains, but to know I was positive for another high-risk strain that could have been prevented by the new vaccine? I couldn’t help but fall back in my chair and feel like I had been let down by the people who should have been there for me. While there was an initial roadblock with my parents, why didn’t my doctor guide me properly? Most importantly, why didn’t Enea know?
I took a full workday to digest the information, purposefully locking myself up in the microscopy room to prevent sending Enea angry texts. It felt easier to call him once I got home from the lab, sitting cross-legged on my cool apartment floor and anxiously biting my nails.
“Hey, I got my results back from the gyno. Apparently, I have a high-risk strain of HPV?” I informed him.
It felt unfair that I had to suffer from something out of his control, but it was something I realized he had no control over to begin with.
There was a pause on Enea’s end before he spoke, “Strange. I thought you were vaccinated?”
His tone seemed untroubled. One part of me appreciated his calm demeanor, while the other wanted to shake him for sounding so naïve and blameless.
“I am…so this must mean you carry it. You’re the only person I’ve ever been with,” I continued in a shaky voice, “I mean, I’m surprised all the other girls in your past never brought this up.”
Despite the blame I was throwing onto him, he replied gently, “Babe, the fact that you know you have it is a good thing…for both of us. Not like I can do anything to help myself though. I was never offered the vaccine as a kid. All the docs assumed it was meant for girls. I probably got it from a girl who never got vaccinated.”
I wanted Enea to apologize for his past, for being with women who were naïve or were not as careful as me. It felt unfair that I had to suffer from something out of his control, but it was something I realized he had no control over to begin with. Dr. Reece practically begged my parents to get my sister and I vaccinated, but Enea’s doctor from a small Italian commune probably never considered that boys could be affected too.
Though I was still left with a diagnosis to grapple with, talking to Enea helped. The virus was now in my system, and all I could do at this point was to continue to be proactive with my care. Fortunately for me, I was able to undergo another exam that allowed for a closer look of my cervix, and thankfully, the virus hadn’t caused any damage.
After the exam, Dr. Sondrio made sure that I stayed tranquilla, and not worry myself over the situation — as long as I followed-up with a gynecologist every six months, it really shouldn’t be anything to worry about.
As I left the clinic, my phone buzzed. Dad had been trying to reach me all week, and I knew I could no longer keep using my busy work schedule as an excuse to avoid him.
“Hey kiddo, it’s not like you to not call me. Everything ok?” Dad asked, the concern obvious in his voice.
“Yeah…I-I’ve just been really exhausted from work,” I replied, doing my best to hold back stubborn tears itching to break free. The stress of keeping a secret from him was finally getting to me.
Our conversation was short and mundane, over within a few minutes. Once Dad knew I was safe, he let me be. Despite the fact our relationship had matured over the years, I still felt ashamed to update him on my recent health scare.
I thought his inexplicit acceptance for me to get the HPV vaccine the summer before grad school was all I needed to be open with him about related conversations in the future, but I was still afraid. Confessing my HPV diagnosis would force us to come face-to-face with facts and assumptions I wasn’t yet ready to discuss…at least with him:
Yes, I was having sex, but that didn’t mean I wasn’t being safe.
Yes, I got HPV from a man who wasn’t vaccinated, but it was the poor communication between the pharmaceutical industry and doctors that was to blame.
Yes, the virus is now in my system, but I will be okay.
I’ve spent countless days in the lab staring down at cells under a microscope, watching how they respond to drugs, interact with other cells, and even brace themselves for attack against viruses. It can lead to a scary aftermath — but only if left unsupervised. All I can do at this point is to continue to be vigilant in my future exams, and check-in on my girlfriends to make sure they are taking care of themselves too.
As I was making peace with myself, I realized I had missed my turn for the metro stop. Instead, I found myself facing a small, lush park with a metallic playground at its center. It was just the three of them at the swing-set — a young woman and two round toddlers, a boy and a girl. An exhausted smile was planted on the mother’s face as she pushed her kids higher and higher into the sky, and their collective laughter echoed around.
I couldn’t help but imagine myself in the young woman’s place, pushing a son and a daughter of my own on a swing-set. A time would eventually come around when I would need to have a chat with them, perhaps over chai and baby samosas, about their bodies, health, and the importance each of them played in protecting themselves and others. And with their full, warm bellies and curiosity piqued, I will hopefully get my message across. My story told. And most importantly, earned their trust, knowing that regardless of what life throws at them, they could always come to me.