It's my turn to see the prison gynecologist.  I need a surgery on my cervix, and I guess I'm lucky that I have HIV at a time when it is finally recognized that HIV can officially cause gyn problems. Here in Danbury Federal Correctional Institution in Connecticut, we're now allowed to get a Pap smear every six months. When I sit down in his office, the doc begins explaining the procedure--it's called a LEEP, loop electrocautery excision, a procedure to remove abnormal precancerous cells. I researched LEEP months ago, but I need help from him now with a different problem.

I take a deep breath and launch into it: I have special needs. Not so much because I have HIV, but because of the sexual abuse I've suffered--from a childhood of emotional abuse to hitting the streets at 13 and learning the hard way that most of the people willing to help me were predators who got off seeing me in pain, Those experiences have made it impossible for me to lie calmly on my back on a table, naked, with my legs spread open. Shame, powerlessness and fear overtake me; my body hears only those emotions, no rational thoughts can get through, the first two times I went for Pap exams, I had anxiety attacks in the waiting room. On my third try my shrink was allowed to hold my hand and talk me through the exam. So I tell the doc that I'll need to be put asleep through the exam. He laughs. I try again.

"You won't be able to do the procedure if I'm not sedated."

Still giggling, he asks, "Just what happened to traumatize you so badly?"

I don't think he wants to sympathize.  He wants to make me back down, so he will have less work to do.  Anything out of the ordinary routine of shackles, surgery, strip-search and back to the joint means more work for him.

"It's accumulation of events over a long time," I say.

He laughs again. Now I know for sure that my doctor is my enemy, and I hate him. His only concern is talking me out of anesthesia.

"This makes things difficult," he intones. "This will involve paperwork and extra security arrangements. It may mean we can't do the surgery soon." This is my doctor? I’m quite sure he's not supposed to pressure me to ignore my physical and mental needs by suggesting he'll withhold surgery.

But that’s the real deal: To the system I am merely an inconvenience. This doctor has probably been following prison policies for so long that to expect him to respond to my concerns are laughable. Hating him is a waste of my time.

I see my shrink, and she doesn't laugh, She hears cases like mine all the time and knows that abuse messes you up in invisible ways. So she agrees that I must be sedated for the procedure, and her word carries weight.

Yeah, I'm lucky this time. But I'm scared about the next, and I’m frightened for other women in here. Botched surgery can give you an ugly scar--a lifetime reminder of how little you are valued. So far, my scars, don't show up on the outside.