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Writer's pictureShelby Smith

I “Forgot” My VCUG Test. It Made No Difference.

A woman searching for help behind thick fogged glass.

October, 2022.

I had no way of knowing the month would forever split my life into two halves: before and after.

I was pregnant with my first child. We got the positive test on my husband's birthday, after months of trying. Almost immediately, I noticed a shift in my weekly therapy appointments. We had a new problem that needed solving: The overpowering, unexplainable rage I felt everywhere in my body every time I thought about my first prenatal visit.

And the lies I told myself. The constant, desperate lies. Deep down, I must have wanted to believe them: That my pregnancy was only difficult because I'd been sexually assaulted, more than once, in college. That I have been protective of my body ever since. But that wasn't enough to alleviate the immense physical and emotional distress I was in.

A lot of people don't understand the ugliest parts of trauma recovery—not unless they've lived them or supported a loved one who has. Healing isn't always pretty, especially when it involves sexual trauma. For me, the anger was often uncontrollable, yet directed at no one in particular.

But I was incredibly angry. Angry enough to chuck my stupid copy of What to Expect When You’re Expecting book across the room and burst into angry tears, all while I resisted the urge to punch the wall. Why?

I had just tried to read the chapter explaining what happens at a woman’s first prenatal appointment. And all I could think was: Don’t fuc*king touch me. I will NOT let you touch me. You will NOT come near my body.

I started to panic. It felt like I was already stripped naked on an exam table, with freezing hands and objects and instruments shoved up inside me. It took all my energy not to explode. I can’t do this, I thought, knowing it wasn’t true; I would do anything for my child. But at that point, I knew.

I knew I had no choice but to accept that there was something else going on here. Something more complicated than sexual assault in young adulthood.

The feral rage, barely containable, made it hard to see straight. My stomach churned when I realized how far back it went—that raw, violating "feeling" I felt all over; the same feeling that made me want to peel the skin off my body. It made me remember my many visits to the pediatrician’s office. Eighteen years of them. And at all of them, I behaved the exact same way.

I put my dumb pregnancy book down for the last time. I texted my therapist. It was time to face the music.

It was time to figure out where it all went wrong.




VCUG Trauma: The Missing Puzzle Piece

My good friend and co-founder, Mollie, used a metaphor for VCUG trauma that really resonated with me: finding the lost piece of your puzzle.

She explains in her interview that many former VCUG patients spend their lives carefully assembling pieces of their puzzle, searching for answers—knowingly or otherwise—to explain their lifelong hardships. Suicide attempts. Depression. Self-harm. A paralyzing fear of doctors, intimacy, and childbirth.

The VCUG test is usually the last piece of the puzzle, and it can take a very long time to find. I’m no exception.

“I don’t know what’s wrong with me,” I told my therapist at our next appointment. I was agitated, impatient, anxious; I couldn't stop bouncing my knee against the floor. “I just always thought I was…I don’t know, a private kid.”

It sounded dumber out loud, but it was the only explanation I had at the time for that feeling. The one that made me dead silent at every doctor’s visit, that made me angry-cry at every age, that filled my young body with enough rage to murder a village. I fought and fought and fought with my parents before every visit. It was never any use.

And I knew exactly what would follow. I thought obsessively of it up until the moment it happened. My pediatrician, telling me to lie down on the table. My face burning deep scarlet with anger and humiliation. That brief second where I strongly considered screaming, “NO!” but my mom’s stern gaze from across the room made me think better of it.

My pediatrician’s freezing hands down my pants, her back always angled toward my mom and sisters so they couldn’t see.

A childhood photo of Shelby on the first day of school.

“I’ve read everything online, and I can’t tell if what happened to me was abusive,” I pointed out. “Some articles mentioned that pediatricians do touch kids…well, down there, but they also said it's shady if the doctor doesn't look where they’re touching, because what’s the point of that? Or if they angle their backs to block the parent's view, because then…” I shook my head impatiently. “Ugh, I hate this! I hate her. I HATE remembering her touching me."

I stopped, stunned at the volume my voice had reached. What the hell is going on?

My therapist kindly validated my fears, and at the end of the session, we settled on a neutral conclusion that gave me peace of mind without the guilt: I wasn’t sure if my pediatrician’s behavior constituted sexual abuse, but at the very least, whatever took place was inappropriate, and my body was clearly trying to tell me so.  

I wish I'd known that I had hours left before everything changed.


The Truth Will Set You Free

Arriving home after therapy, I felt much more calm and collected, chattering to my unborn baby as I cooked my lunch, giving them the low-down on our family. In my cupboard sat two mugs titled “Grandpa” and “Auntie” for my dad and best friend, the perfect gifts to pair with the sonogram photo I yearned for, but would never receive.

I made a spreadsheet with my health history. It calmed my anxiety about my intake call with the hospital. My therapist helped me practice what I would say over the phone: I struggle with these appointments because I was raped. What accommodations or resources do you offer for women who have been sexually assaulted? (Spoiler alert: The answer was a dead, ringing silence from Baylor Scott & White. Unbelievable, given the stats.)

My mom called. I almost let it go to voicemail; I had to get back to work soon. Shrugging, I decided to take the call anyway, wanting to fill her in. When I admitted my anxiety about the appointment, tying it to the same feeling I had at the pediatrician’s, she offered me an alternative explanation for my aversion to prenatal care.

Her explanation wasn’t a theory. It was a memory—one that I’d dismissed as a bad dream a long, long time ago.

I heard, “Well, you did have this procedure…You were very little, and it was horrible. It was so horrible," and time stopped moving. My voice stopped working. For what felt like years, I stood frozen in place, completely dissociated, staring mutely out the window. I don’t remember what I saw; I was reliving the words I was hearing on the other end of the line, taken word for word out of my recurring childhood nightmare. A PTSD nightmare.

Today, all I can remember are chunks: “…kept getting UTIs…The nurse said it was a traumatic test, but I thought…They couldn’t have been more compassionate to you, but…You were so inconsolable, you were so upset, you were screaming and crying, and they had to sedate you…was just terrible…”

Say something. Even the voice in my head sounded hollow. SAY SOMETHING.

I couldn’t. Another minute went by as I relieved every physical sensation, felt the adults holding down my naked body, felt the unmistakable sensation of penetration—an unimaginable and agonizing feeling that no 2-year-old has a name for, but a feeling I had relived for over a decade in nightmares.

When the horrific bodily sensations pushed my body to the brink, when I could no longer afford to stay silent, I finally got words out: “STOP. Stop.” My fingers were shaking violently; my voice sounded miles away from the phone pressed against my ear. “I remember that. I remember. I remember all of that, okay?”

I didn't realize I remembered every part until I said the words aloud.

The next thing I remember was hanging up the phone. I walked, trance-like, into the bedroom. Opened my dresser drawer. Stared dumbly at my running clothes.

 I could go for a run. No. It already hurt to breathe; the oxygen was like fire in my lungs. I could self-harm. It was tempting; I started self-harming in fifth grade just to get rid of awful feelings just like these. I could...go for a drive.

Thankfully, the next thing I knew, I was in my car. The next moment, I was on a back road I’d never been on before. I glanced beside me, realizing how parched I was. My semi-clear water bottle was sitting innocently in the cupholder, but the sight of the water sloshing with the winding road made me sick to my stomach.

A fresh wave of suicidality crashed over me. Now that I'd remembered, all I wanted to do was forget.

My fingers were white around the wheel; it took every ounce of willpower not to sling the water bottle out the window. I refused to look at it again, convinced I’d throw up. Every time I saw the water sloshing around, I was back on the table, reliving the overpowering feeling of being violated, painfully and forcibly, over and over again.

I called my therapist, praying she wouldn’t answer; she didn’t. I left a voicemail requesting her first available appointment. I didn’t realize I had called my husband until I heard his concerned voice on the other end of the line; only then did I realize how hard I was sobbing, how impossible it was to catch my breath long enough to speak.

When I finally got some words out, they were the only ones I had. I repeated them like they were a lifeline, my last tether to reality: “I was two. I was two. I was two. I was two.” My voice finally broke. All I could do was cry.

How could they do this to a toddler? How could they do this to me?

A childhood photo of VCUG patient as a toddler.

Then, I remembered that I was pregnant.

It felt like my stomach sank all the way to the pedals below my feet. My eyes wandered to the water bottle; I quickly fixed them back on the road, angry as the unbearable bodily sensations returned. My excitement about my pregnancy was gone, replaced by a raw, animalistic, deep-seated horror.

What the hell am I going to do?

But First, It Will Piss You Off

The next several months would end up being the worst of my life. I’ll spare you the disturbing details of my initial recovery, which mostly involved reliving the physical bodily sensations of the procedure. Up until that point, I had never truly understood what was meant by the PTSD symptom: Reliving past trauma like it’s happening in real time.

It happened, and it happened often. It nearly killed me.

In those months, I self-injured significantly more than I had in the last few years combined. I would have done anything to stop feeling the men’s hands holding my legs down and open, ignoring my screams when they penetrated me, then pumping my bladder painfully full, telling me I had to “hold it” or we’d have to start over.

Watching the blurry men hovering over my naked body in my nightmare certainly wasn’t fun—there’s nothing quite like being utterly unable to move your arms or legs while enduring pain you have no words for—but it was the disturbing instrumentation of my body, the violation itself, that truly horrified me.

This time, it was all that and worse—physical pain, and the awful knowledge that it really, actually happened. That my parents let this happen to me, then spent the rest of my childhood disciplining me for behavioral problems that were the direct result of the voiding cystourethrogram test I received on July 14, 1997.

Now, bear with me. Here’s where it gets interesting.

The Little Girl Who Forgot

What are the effects of VCUG trauma on a child who develops dissociative amnesia after her VCUG?

If you’re reading this, you’ve probably also read The Body Keeps the Score by Bessel van der Kolk. His words are true. Truer than true. I can't stress that enough.

My body kept the score.

A shot of strange man entering childhood bedroom, silhouette reflected ominously against the wall.

Most providers reassure parents that kids are “too young” to remember their test. But they discount the intensity of the trauma that makes these children forget. Forgetting boring, routine events is not the same as forgetting life-shattering trauma that your mind can’t bear to remember.

After the VCUG, I imagine my brain exclaiming, “Keep this in our long-term memory? Fuc*k that!” and booting the entire day out the door, or trying to. Reducing it to a recurring bad dream was the best it could do, ramping up its effort with self-doubt, which intensified the older I got.

Well, if I DID have a major vaginal surgery, my high-school self thought nervously, SURELY Mom or Dad would’ve told me that. Right? Also, why on earth would a little kid need a surgery like that? What’s the point? And…on and on and on.

The message from my brain and body couldn’t be any clearer: Deny, deny, deny.

But the body can only deny so much. And it was only a matter of time before my brain caught up.

Before & After

“I wish I never found out about this stupid test” are bitter words I’ve said aloud many times. Looking back, I realize I never truly meant them.

That isn’t to say that healing from VCUG trauma isn’t the most difficult thing I’ve ever had to do (it is) or that this test didn’t completely ruin my childhood (it did) or that I didn’t suffer adverse health effects as a direct result (I did).

But if I hadn’t found out about the VCUG test, I have no doubt the highway of my life would’ve ended in a catastrophic crash—a self-created one.

The first time I remember wanting to die, I was 11 years old. But the lifelong dissociation, the alien isolation, and the mind-numbing terror I experienced at every single doctor’s visit were nothing new. When I traced them back, I would lose sight of the thread—that is, until I heard “VCUG” for the first time. 

I may have “forgotten” my VCUG for 27 years, but I essentially lived the same life as other former patients. I experienced the same adverse health consequences as the little girls who did remember.

And that’s why I’m writing this today. Everything I was as a child was exactly how the made VCUG made me:

  • I was overly private and protective. I never undressed in front of anyone. I would yell angrily at siblings or parents who accidentally walked in on me changing.

  • I was potty-trained. Then, I regressed. If you walked into my childhood bedroom in the early 2000s, you'd find an oversized stuffed rabbit tangled up in my comforter. It was a bribe from my parents to stop wetting the bed, which I did for weeks immediately after my procedure (developmental regression is a common effect of childhood trauma). My embarrassment as the eldest daughter was nothing compared to the humiliation of visiting the pediatrician, where I sat in ashamed silence as my doctor clipped an alarm to my underwear, cheerfully explaining that it would wake me up every time I wet myself. While my parents didn’t know they were “bribing” their daughter to stop showing signs of PTSD—to stop having the VCUG nightmare that was causing the bedwetting—it certainly didn’t help my self-esteem or validate my experience, intensifying my shame and confusion.

  • I cannot lie on my back. As a child, I slept like anyone could rip away the comforter at any time and penetrate me. For as long as I can remember, I have always slept belly-down, blankets pulled up tightly over my head, always high enough to cover my ear; I didn't want to leave any penetrable part of my body exposed. If I must lie down, such as at the dentist’s or getting an eyebrow wax, my legs will always be firmly crossed, my hands clasped over my waist so I will immediately feel any contact below my stomach. When I took swimming lessons as a kid, I was the only child who couldn’t float on their back. (Still can’t. How on earth is any former VCUG patient supposed to “relax” enough to do that? Give me a break.)

  • I was sexually compliant. The majority of my sexual experiences were not consensual. Every time, I blamed myself for not vocalizing “no.” In the moment, I couldn’t speak—partly due to physical difficulty, and partly because I was terrified of the reaction I would get. I was too afraid to disappoint boys out of fear that they would proceed anyway, and more violently at that. It took many years of therapy to heal from the perspective that VCUG gave me and forgive myself for not vocally dissenting to sex. I didn't really see "no" as a viable option. (And why would I? It certainly wasn't an option when I was 2.)

  • I hated and punished my body. I showed symptoms of anorexia for many years, obsessively calorie-counting, over-exercising, and constantly comparing myself to other girls. I skipped lunch at school where my parents had less control over me. When I looked at myself in the mirror, the word “fat” came to mind every time. One of my strongest memories in high school is sitting rigidly in every chair, never leaning all the way back in my seat, because I was mortified by how fat and pale my thighs were. Transitioning into swimsuit season as a teenager was when my self-harm became exponentially worse. No matter what, I loathed the girl I saw in the mirror.

  • I never understood the concept of consensual sex. My first “sexual” experience made me fear for my life in the medical setting. In my brain, sexual intimacy will forever be associated with excruciating pain, embarrassment, and medical trauma. I can't wrap my brain around the concept of sex as pleasurable, let alone understand sexual fantasies or any other enjoyable element of consensual intimacy.

As a child, I slept like anyone could rip away the comforter at any time and penetrate me. For as long as I can remember, I have always slept belly-down, blankets pulled up tightly over my head, always high enough to cover my ear; I didn't want to leave any penetrable part of my body exposed.
A childhood picture of former VCUG patient wearing overalls and a pink shirt.

Completing the Puzzle

Dissociative amnesia isn’t a free pass to “erase” trauma. It doesn’t help you outrun the lifelong effects. It doesn’t rid your body of the horrific sensations. It doesn’t benefit you in any way. All it does is delay the inevitable—and with every passing second, the risk of never reconciling your mind and body gets higher and higher. Your risk of being diagnosed with cancer, heart disease, and other life-threatening illnesses goes up.

Dissociative amnesia isn’t about missing pages. It’s about adding blank pages in the middle of your story, distancing you from the truth of your lived experiences. Separating you from essential knowledge that is absolutely necessary for you to finally heal.

You feel like an alien in your family, but you don’t know why. You can’t get anything right in romantic relationships, but you don’t know why.

You’re overly compliant and obedient, but you don’t know why. You can’t seem to choke out the word “no” the first time a boy touches you without permission, and you don’t know why.

You develop chronic illnesses, but medical professionals don’t know why. You can’t see an OB/GYN without having a panic attack and sobbing in the parking lot, but you don’t know why. You can’t enjoy intimacy with your spouse without feeling violated and confused, and you don’t know why.

Your entire life, you’ve experienced issue after issue after issue. You’re the only kid who can’t get it right. And as you stumble in circle after circle, desperately scanning for the root of your problems, you see none. So you look in the only place you haven’t searched: yourself.

Your dawning awareness goes off like alarm bells in your brain: Ding-ding. Winner.

You can’t see an OB/GYN without having a panic attack and sobbing in the parking lot, but you don’t know why. You can’t enjoy intimacy with your spouse without feeling violated and confused, and you don’t know why.

Once it sinks in, there’s no stopping the thought pattern from ingraining itself in your core: You’re the thing that’s wrong. It’s you.

You’re the disobedient child. You’re the bad girlfriend. You’re the lazy student. You’re the idiot who stayed with him. You’re the girl who didn’t say no. You’re the deformed body that will never be thin enough, tan enough, strong enough, sexually appealing enough. You’re everything that’s wrong with you.

Having dissociative amnesia didn’t spare me from the effects of VCUG trauma. It simply made me take the VCUG’s place as the original source of my pain. It made me the ugliest and most shameful part of my story.

I’m angry that an unnecessary medical procedure inflicted harm on my life. I’m angrier that it made me the villain in my own story. That it separated me from my authentic self. That no one bothered to rescue the little girl who continues to relive her experience on that table.

The VCUG destroyed my relationships with my family. It dissolved my self-esteem. It made me extremely susceptible to abuse. I have a laundry list of unfortunate life events, once a streak of bad luck; now, the predictable outcome of my childhood procedure: Stalking, domestic violence, self-harm, sexual assault, autoimmune diseases, substance misuse. 

I’m a walking testament to the adverse health effects of childhood trauma. I’m living proof of the real harm of VCUG. It took over a year for my neurons to finally stop firing, to stop reconnecting 27 years of dots that once led to me as the sole cause. Now, all roads lead to the voiding cystourethrogram test I received in 1997. 

If I had remembered every detail of my VCUG, I have no doubt I would’ve suffered the same adverse effects I already have.

Forgetting the VCUG made no difference. But I hope my story does.

A self portrait of a VCUG survivor.

 

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3 Comments


Guest
Jun 02

Along with vcug flashbacks and nightmares, I have always had vivid memories that haunt me, that I have always wished I could forget. But I have come to realise fragments of memories or no memory at all adds another level of complexity to healing from this trauma - the difficulty of reconciling the body memories, traumatic impacts on the psyche and the hallmarks of csa to a trauma where there is no memory that is able to be retrieved and processed. Or the absolute mental assault it must be to have those memories come flooding back into the consciousness. It is so sad the various ways everyone struggles with this trauma.

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Guest
Mar 22

I am so sorry this happened to you and for the far-reaching impacts of VCUG trauma on your life. Yes Shelby, you are absolutely making a difference in sharing your story and creating a platform to empower other survivors to recover their voices. Thank you.

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From the bottom of my heart, thank you for these kind words! They mean the world. ❤️ So grateful for your support!

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