This is a bit long, but the prompt made me get this out. Now, 37 years later, it seems rather dramatic, but this was really an awakening for me!
Women are heavily involved in health issues and institutions. From shamans to physicians, to x-ray technicians, to health care consumers, we have always filled many roles in whatever health system has existed in the culture. My perception of my own role has recently changed through a process of self-evaluation. I want to share some of that process, that evolution. I also want to share some of the readings which helped me in my growth.
When I define myself, I am first a woman. Born female: two X chromosomes, two ovaries, a vagina, a clitoris and a uterus to distinguish me from a male. Then forced into a mold by a society that felt a need to bend and twist me to its own design. I am a woman doctor. Years ago, I saw the “doctor” part as my primary identity. Now I have a truer perspective. I know that my role as physician, healer, helper is an extension of my woman-ness.
Over nine years ago I first entered the medical world as a health provider. For nine years, they taught me, trained me, tried to form me into a “doctor.” I hope they have failed. I now look back over those years, trying to figure out what they have done to me, how they have shaped me, what I must unlearn. Four years of medical school, five years of residency in obstetrics and gynecology; now in my tenth year of training, seeking a more humanistic approach through counselling—what have those years wrung out of me? What has filled the gaps and chinked the holes where they tore my woman-ness out of me? My answers are still incomplete, but he questions continue to multiply.
I started to question my training’s effect on me a little over a year ago. I had had to suppress doubts and challenges before then, I now realize, in order to survive in that patriarchal bastion of society we call the medical establishment. Toward the end of my residency I began to surface from the immersion in medical academia, looking ahead to my career plans for the future. I began to feel a slowly growing discomfort, even disgust, with the roles women fill as both providers and consumers of health care. Personally, I felt a distrust rom male resident doctors because I was a woman and I was good at my job. I suffered the sexist jokes, especially after my divorce (as if, how dare I not be attached to a man?) I saw women professionals treated as appendages, not permitted to question or be creative; saw them turn against each other in their oppression; felt humiliation at seeing my sisters accept these roles. But, especially, I saw the women patients, the “girls,” the “dears,” the “honeys.” I heard male physicians speak paternalistically to these women, their patients. Then, outside the women’s rooms, I heard the more blatant condescension. I began to get angry.
The anger was simmering in me, but it was unfocused. I still had a few months to go in my residency. THEY held a power over me still. I did not know how to break out of my dis-empowerment. Then I met a young woman in my clinic who helped me, unknowingly, to start in the direction I needed to go. She was a “DES Daughter,” exposed to powerful hormones while still in her own mother’s womb. She came to me for medical procedures and advice. After I had performed the necessary tests and we had discussed her questions, she asked if I could recommend further reading for her. I admitted that I did not know of any. A few months later another woman consumer, also DES-exposed, told me about a book which she had read and found useful. So I bought it to read, to see if I would recommend it to others.
That book was Barbara and Gideon Seaman’s “Women and the Crisis in Sex Hormones.” It turned out to be more than extracurricular reading for me. As I read, I found myself bristling at many of the authors’ accusations against the medical establishment. I found much of the style inflammatory; I identified issues that were presented without balanced viewpoints. However, as I read further, I began to want to try some of the suggestions for uses of vitamins and other “non-traditional” remedies (indeed, I began to take B-6 supplements for premenstrual breast tenderness with great success). When I finished the book, I had the overall impression that it had conveyed some very useful information, and I began to question my first reactions. I recognized that I had been identifying with the establishment which the Seamans were challenging. I began to ask myself, why NOT do things differently? It was a monumental question, a giant step.
After I finished my residency, I began to read more. I had once heard Barbara Ehrenreich speak, and now I looked for the pamphlets she had written with Deidre English: “Witches, Midwives and Nurses: A History of Women Healers” and “Complaints and Disorders: The Sexual Politics of Sickness.” The authors of these booklets offered me clear analysis on the exclusion of women from healing fields and their exploitation as medical consumers. I began to view the medical profession with suspicion. I began to identify myself first as a woman, and secondly as a physician, wanting to be separate from the patriarchal, male-dominated system. I was able to disengage myself and see that system with a new perspective. I felt as if the medical establishment were being exposed; I saw its nakedness.
The writing of this article was spurred by the next book I read. Its message disturbed me deeply. Gena Corea’s “The Hidden Malpractice: How American Medicine Mistreats Women” is devastating. It is a thorough, well-documented indictment of the essentially male medical system. I was impressed with the minimum of medical errors (although I was sure that the few present may be singled out to discredit or ignore the book). Corea’s style is clear and only rarely provocative. She deals with medicine’s treatment of women both as healers and as patients to be healed, delineating the oppression they experience in both roles.
As I read Corea’s book, I became very perturbed. I began to question medicine’s mistreatment of women. I could only agree with most of the accusations Corea makes, for I had seen or heard of the situations she describes. I examined my own experience and discovered that I, too, had mistreated women in both their roles as healers and consumers. I began to realize that I had to question the attitudes which I had slowly internalized over the preceding nine years. Early in medical school I had recognized that I wanted to avoid buying the total package of traits and values that make up the accepted doctor “profile.” I thought that I had succeeded fairly well. But now I was shocked to discover that, merely having existed within the system for so long, I had become a part of it. I had absorbed many attitudes which I had not wanted. I recognized that, in questioning the system now, I was questioning and doubting ME. It was a frightening confrontation with myself.
Over the last year, I have explored my feeling. I have attempted to identify and discard learned prejudices and paternalism. I have become a political activist in women’s health issues. I have also, in some ways, become more frightened. Where do I now fit as a physician, as a woman physician? I have been reevaluating all my future plans, all my investments in the system. Instead of the well-outlined future in academic medicine which I had laid out for myself, I now want other options. I am searching for some way of working with women in a non-paternalistic setting. I want to use my skills to enable women to resume a central role in their own health care. I want to be my sisters’ partner, not their provider. As of now, I have not been able to identify a situation in which I can meet all these goals. There is a lurking fear in me that I will be unable to find, or create, what I want and need.
There is also a sense that there is SO MUCH to work against. The realization that my goals are political, not just personal, pits me against a very large, very powerful status quo. My dilemma about my future career plans reflects the problems of all women who interact with the medical system as it now exists. Finding a job in which I can be a sensitive partner in women’s health care would imply that the system is willing to respond to our needs. And medicine is not eager to do so.
Along with these concerns, I am also experiencing a revitalization. I know that I can recapture the part of my woman-ness that was wrenched from me by those who wanted me shaped in their mold. I see that I have returned to my first identity as a woman, and have found it intact, albeit wounded. I also feel hope and joy as I experience a desire to change the way my sisters are treated in the medical world. I am looking forward to an uncertain, but challenging, future as a WOMAN working to heal and love other WIMMIN.