Woman, Healthy By Nature

By Claire T. Porter, University of Memphis, Center for Research on Women

A My Turns Article

In this essay, I weave together my personal experiences "in the stirrups" with empirical evidence and theory on the medical maltreatment of women. I do not write this account with claims of authority or objectivity. Just as Lisa M. Tillman-Healy (1996, 78) takes readers into the secret world of bulimic young women by describing her own experiences with bulimia, I mean to take readers through "normal" gynecological procedures by describing my own experiences as a gynecological patient. I identify my embodied self as a locus of abuses done to women in the practice of modern medicine, rather than contriving a distance between my body and my thought process in privatized medical experiences. In writing this essay, I am informed by data that rest in my body-memory of being poked, prodded, scraped and ogled.

My analysis of the events described herein has evolved over time, from viewing my doctors' behavior as acceptable to viewing it as abusive. Rethinking and reliving these events, I attend to what is often dismissed in social science writing: the way the body remembers. The tension I feel grow up through my thighs, buttocks, and pelvic floor, the tightening of my lower back (which compels me to jump up from my chair every few minutes and do the yogic "cat" stretch), the numbness that creeps into my crotch as I re-live memories of strangers' eyes taking me in, and the eventual clench that freezes my jaw when I try to fathom why my doctors would not explain to me what would be happening to me under anesthetic are all omnipresent memory-sensations as I write. Thus, as I relive these events I rely on a methodological framework based on a process of privileging bodily knowledge in the process of creating an intellectual analysis.

Lying on the maroon vinyl examining table, with my behind hanging off the end and my feet elevated, stirrups apart, I feel a spinning sensation in my head. This scene is surreal. I want to hold onto something tightly. I want to shut my legs and never open them again. I want to giggle hysterically, flush red with embarrassment, and clamp my thighs shut. A strange man is looking at the most private and sensuous part of my body. The doctor is a thirty-something man with a degree from the University of Alabama. I can see his degree on the wall from where I lie. His eyes, which cut from side to side, make me nervous, add to the dizzy feeling in my head. As he attempts to stick the speculum in me, I unintentionally clench against the cold metal shoe horn. He repeats, "Stop tensing. Stop tensing." His command only makes me tense harder. It is as if there is no opening "down there" at all, that he has to carve one out with that thing I am sure he keeps in the refrigerator. But he finally gets it in.

As he opens the speculum and my vagina, he says casually, "I saw you in that play y'all did over there at the college." He puts something else in me that causes a disconcerting scraping sensation. I interject, "You mean 'The Scarlett Pimpernell'?" "Yes. The one where you had to wear that old fashioned-dress." My teeth are clenched in reaction to dull scraping. It is hard for me to have this conversation. "I mean, you looked gorgeous." I can feel his breath in warm puffs on my thighs as he speaks. I think about how I had to tape up my breasts and then apply makeup to my cleavage so that they appeared to bulge out of the costume. He is going to be sadly disappointed when he does my breast exam. As he yanks the speculum out of me, leaving me feeling stretched and gooey with lubricant jelly, he tells me I have a cyst. I will have to have this cyst surgically removed, he says. The doctor explains, the same casual tone in his voice, that the surgeon will slice my abdomen open from pelvic bone to pelvic bone, get the thing out, and then do "exploratory" surgery in my uterus and ovaries. My head is spinning.

The exam is over, but I cannot shake the feeling of being exposed and vulnerable. I have used half a box of tissues to wipe away all the jelly from my genital area. Then I pull on my clothes fast. The doctor returns and invites me to sit on a chair beside a small desk. He launches into a list of appointments he has made for me at labs to get tests, something about a vaginal laproscopic exam, which I had never heard of. I interrupt his monologue to ask him what a vaginal laproscopy entails. He smirks, "A tube with a little camera in it will be inserted in your vagina ... kind of like a penis." At the word penis he blurts out a laugh. "Oh," I say. I laugh to match his. He has to be my friend. My face feels oily under the vibrating fluorescent lights of his office, and I am unable to focus on any one object in the room ... but I know I should be able to handle this. He just wants to make me feel comfortable, to have a sense of humor about this whole ordeal. He did not mean to make me feel embarrassed by the penis remark. I am just overly sensitive. It is not his fault that I am misinterpreting his comments. As I continue to watch his mouth move in a monologue about barium enemas, my face flushes darker until I feel like a vein in my right cheek may explode. I look at him. He has a reddish-brown tufted mustache and blotchy skin that makes me think first of rednecks. Then an image of Hitler comes to mind. Hatred erupts. The last thing I want is for him to know he has made me feel gross and even more exposed. This is my memory of my first gynecological exam.

The lived experiences that I have had in the gynecologic industry are far from rare. If one were to quantify experiences of medical abuse, to attempt to place on a scale from "bad" to "atrocious" my medical treatment, I do not believe that mine would score much beyond bad. The purpose of describing my own experiences "in the stirrups," and subsequently in surgery, is not to present myself as a woman who has been mistreated in an unusual way. I suspect that thousands of women have been treated far worse. Such a scale would be contrary to the purpose of revealing such intimate and humiliating experiences. As with all types of abuse, competitions among individuals or groups to determine who has been abused the most and the worst derail the discussion and diminish more nuanced understandings about the nature of the abuse. Rather than attempting to quantify experiences of medical abuse, my purpose is to explore the methodological use of bodily experience as sociological inquiry.

Waves of humiliation surge up as I go through the process of writing, re-reading, re-writing, and so on, the above account of my first gynecological exam. I realize that I have involuntarily crossed my legs. As I write, read, re-think, and re-write how my doctor had to force the speculum into me, I involuntarily clench my pelvic muscles all over again. Why do I do this to myself? Further, why do I publicize this vulnerability and coerce readers to participate in my memory, to relive it, too? And finally, why deny readers distance by writing in a present, active tense, pulling them into the immediacy of the examination? I detail these experiences using the theoretical framework of emotional sociology (Ellis and Bochner 1996, 99). My goal, by writing and reliving these experiences, is to create an atmosphere where the voice of the body is privileged and central rather than dismissed from the discourse. If the voice of the body becomes central to informing analytical, theoretical stances, then practices that are experienced as violations of the body are recognizable as problematic and unjust, and hence in need of repair.

In publicizing the personal in this essay I also follow the Black feminist theoretical principle discussed by bell hooks and Tanya McKinnon (1996, 36), who state that it is a necessary act of transgression of institutionalized power to talk in the open about private, taboo, and "unspeakable" experiences, even if doing so requires a sacrifice of privacy. hooks and McKinnon assert that activist-oriented theoretical frameworks develop when privatized abuses are publicized. They state, "The ways in which privacy is constructed and the meaning of public and private legitimize and uphold structures of domination, particularly sexism" (822). Thus, writing about what happened to me in the private space of an OB/GYN office can transgress the institutional protection that this space is afforded in society. The exploitation of women has been commonplace in the gynecological and obstetrics industries for several hundred years (Raymond, 1993, 37). In that sense, the speculum can be viewed as an instrument meant to colonize the female reproductive tract.

It still drives me nuts that I did not kick that gynecologist in the face for objectifying me when his hands were all over my pubic area. It would have been unacceptable in our androcentric, heterosexist culture for a male or female doctor, in the midst of examining a man's penis, to comment on how "gorgeous" he looked during a sporting event. I feel a wave of guilt as I think of my own harsh reaction to my mother when she described to me a gynecologist who, she explained, "tried to turn me on with his hand" during an exam. I had turned on her, asking, "Why didn't you do anything?" She had responded, "I told him 'that's enough'." I had frowned at her, believing her to be weak, even flaky, to let herself be taken advantage of that way. But after my own experience, I can understand perfectly why just that verbal rebuke was difficult for her to muster, and actually showed her bravery. I am suddenly overcome with depression at the way mom and I and most other women are made to feel, like control of our own bodies is impossible in the presence of authoritative doctors, who supposedly know us better than we know ourselves.

It is the morning of my operation. A white gown replaces my clothes. Mom helps me get it on, ties the strings in the back. I am disoriented by having had to take out my contacts and by all the people walking around me while my behind is exposed. I ask several nurses why I have to take off my bra if the surgery is all the way "down there." They all say the same things: "You just have to. It's standard policy." Then, without warning the nurse sticks me in the behind with a needle. I yip and then turn red. She says "sorry" in a flat voice and fades away into the blur of people and voices. I call after her to ask what the shot is for. She says it's the anaesthetic for the surgery. Mom tells me what a piece of cake this will be, that I'll be out in no time. People and voices are getting swirled into a syrupy mess. The shot must be putting me under. Then an African-American man in white smiles close to my face and says jauntily, "She's ready to Go!" He is pulling me along. I hear the click of mom's heels and the man humming and the rush of the wind over my face as the cart rolls along. All in slow motion. Then, I am in another room with two women in white, who lift me onto a table. Oh my God, they're about to operate but the shot did not work! I am not under yet! I hear a buzzing whir sound. It sounds like a circular saw. I struggle but my body has turned into inert pudding. I manage to move my mouth, strange sounds coming out.

I repeat to the two women, "Wait! I'm not under yet! I'm not under yet!" They are both laughing in big snorts and cackles, lifting up my gown. I struggle to get away from the buzzing whir and their laughing. Everything is swirling and twirling together, and I fall away.

Muffled voices are calling my name. I am at the bottom of the lake in Pocono, and my mom's side of the family, decked out in absurdly bright cocktail attire, are calling me from the water's edge. That must be why they sound blurred and sluggish. It is so nice and warm down here, but they must want me to swim in to shore. That bright light up there is getting brighter and brighter ... I burst through to the light, and moan. I want to vomit. I feel a slicing, throbbing pain in my stomach. A large picture window streams in morning light, white washing the bed I am lying in. So many people, I cannot focus on any one. Is it morning? Where's Roger? I want to hold his hand and sob, it hurts so bad. Women in white are talking to me: "Claire, you can push this button whenever it hurts, and pain killers will go though the tube into your arm." Somehow, my hand has traveled to the little red button with the speed of light and my index finger clicks it over and over again. Pain is mixed with confusion and the frustration of not being able to control my body. I fall back into the warm water.

This time, I fight the swim up to the light. Up there is pain. But a current is sucking me upwards. Exhausted, I let it whisk me up. My mom and a nurse are talking to me as I try to make it three feet to the toilet. Every time I lift my leg off the floor, a searing pain strikes my abdomen. The nurse is lecturing me, "...and how well you heal now will determine how well you do with your pregnancies." I manage a grin here. She assumes I will be having babies. It is a given. I have a womb, therefore I will have babies. Their serious faces both seem silly, verging on absurd. I let out a too-loud giggle and then snort- laugh at their perturbed faces.

A week has gone by since my operation. My mother takes me to the surgeon's examining table in Atlanta. The nurse comes in to "prep" me, and drapes a white sheet over my bare below-the-waist region. When the doctor comes through the door, a young man in a similar white lab coat is at his side. He whips off the sheet as a magician pulls the tablecloth from beneath the plates, while saying only "hello" to me, with no eye contact. The young resident does not make eye contact with me, but I see his eyes wandering over my whole body. I know that look. I feed off that look. He wants me. I feel a rush of adrenaline. He thinks I am pretty, maybe even beautiful. I could seduce him, make him beg... This is sick. He knows nothing about me. He does not know me, but he wants me? How dare he just peruse my naked body, appraising me like a luxury car he wants to test drive. Do I even matter? Do I even exist except as a body?!

"Closely connected with the absence of self is the dispensing of existence experienced by women... Women undergoing these procedures report a sense of nonbeing" (Raymond 1993, xv). I cannot help feeling that my body, especially the most private areas of it, has been taken away from me. This surgeon and the horny resident both assess my pubic area. Now the vision of my genitals is held in their brains. I feel I possess my sex less and less and feel them both smug in the fact that they own it. What a power trip for them. Bastards.

A hilariously out of place image pops into my mind as I lie there being examined: I am in a Wonder Woman costume standing beside me as I lie on the table. I throw my golden lasso over my stolen pelvis, announcing valiantly, "I'm taking back my pussy!" I try to hold onto the power of this fantasy, that I am not only the prone me on the table but also a "Wonder Me" who can save myself, but it seems to escape me almost as soon as I imagine it. I have that achy feeling circling the rims of my eyes that means my body wants me to cry. But I am too disconnected. To cry, I have to feel truly righteous in the knowledge that I am wronged. How can I feel that I am wronged by the renowned surgeon and his assistant who have saved my womb? They are doctors, and doctors do not harm; they heal. That is the whole point. So none of my body's aches or my sense of bodily dispossession is even worth entertaining. These are unjustifiable feelings. So I shut them down and float with the sense of nothingness.

Tracing my scar, which grins along the border of my now growing-back-in pubic hair, with his ungloved index finger, my surgeon says to the resident at his side, "Would you look at that? It's healing perfectly. Practically imperceptible." He smiles up at me then. "You'll be able to look just as good in bikinis."

"Doctors add to the exposure, often by making comments that promote the sexual objectification of the experience for the woman" (Raymond 1993, 37).

My surgeon then turns to the intern without covering me back up. They speak about the importance of certain procedures. The nurse stands by frowning at them and then at me. After what seems like forever, she covers me with the sheet, snapping it out over me so that it billows. As she does this, she glowers at the two doctors. They remain oblivious, still talking about procedures. The nurse's obvious disgust for the doctors' disregard for my privacy gives me a jolt of indignation. I want to scream, "I don't wear bikinis, asshole. Why don't you try to swim in that shit!" But I feel so exposed and powerless, that if I open my mouth, my voice will be sucked away in that antiseptic white void.

Making women sexually attractive to men and willing and able to bear children are the two pinnacles of a "spermatic economy," according to G.J. Barker-Benfield (1976 13). In the logic of the "spermatic economy," women exist for sex: as sex objects and/or breeders (cited in Raymond 1993, 34). Thus, what was relevant to my doctors was that they had "healed" me well so that I could still make babies and would still be attractive to men (e. g., I could still wear bikinis without my scar showing).

Four years after my first exam and subsequent surgery, I have just finished a pelvic exam with a woman gynecologist. By virtue of her gender, I am told she will transform the exam into an empowering experience. It does not seem that different, though. I am still on my back while procedures are performed on my body as though I am an object. Afterwards, she invites me to sit down and talk. Perhaps this is where the empowerment will come. She wants to engage in a dialogue with me.

She starts the dialogue by asserting that she wants very much to put me on "the pill." She is already scribbling out a prescription. I tell her she need not bother, that birth control pills affect every organ of the body, and that they have not been around long enough for anyone to know what the long term side effects are. She frowns and says, "But he must be sick and tired of using condoms". "Well, I'm not," I respond curtly. Why is it always so much easier to be curt to a woman in authority than a man?

She backs off, still frowning, and begins to look through my medical history, lying in a yellow folder. "Oh. You had an ectopic pregnancy when you were eighteen?" She sounds mildly surprised. "No, but I had a cyst removed then." "An ectopic pregnancy is a kind of cyst. Didn't they tell you?" she asks, with what sounds like a lilt of pity in her voice. I bristle. "I must have just forgotten it was that kind of cyst." I reply. The light-headed, vulnerable feeling has returned, as I am transported back to my first pelvic exam. I cannot really hear anything she says to me after this. I just keep thinking about the two words: "ectopic" and "pregnancy." I hate her all of a sudden, this bitch who wants to show up my ignorance. Who pretends that she is different just because she is a woman. And I hate myself for ever having believed that it would be different, for daring to hope that it could be, for putting myself in such a vulnerable position.

It is weeks before I can comprehend that, at the time of my surgery, the doctors must have chosen not to tell me that I had an ectopic pregnancy. Were they trying to protect me from being embarrassed, since to have an ectopic pregnancy was proof that I was sexually active? My embarrassment never seemed to have been a concern of theirs at other humiliating medical moments. Or, did they just figure that I did not need to know the technical details of why I was being sliced open? Maybe they arrogantly assumed it would be way over my head. Even worse, had my parents also known, but complied with the doctors in not explaining to me? Then comes rushing in the strange knowledge that I had been pregnant, that a fetus had lived inside me, if only for a few days, and that it had somehow made a mistake in navigation. I felt sad for that ball of energy that had some fleeting existence in me, and was then cut out and incinerated.

I am not a distanced sociologist discussing the pervasive maltreatment of women in the medical industry. Rather, I am a woman who is sometimes still humiliated by this dehumanizing treatment. I wonder if medical reform is possible. What I do believe is that transgressing the boundaries of the public with the protected privacy of the medical establishment, as advocated by hooks with McKinnon (1996), holds promise as a route to eroding the protected power of the medical establishment.

References

Barker-Benfield, G.J. 1976. The Horrors of the Half-Known Life: Male Attitudes Toward Women and Sexuality in the Nineteenth Century. New York: Harper & Row.
Ellis, Carolyn and Arthur P. Bochner. 1992. "Telling and performing personal stories: the constraints of choice in abortion." Pp 79-101 in Investigating Subjectivity: Research on Lived Experience, edited by Carolyn Ellis and Michael Flaherty. Newbury Park, CA: Sage Publications.
hooks, bell with Tanya McKinnon. 1996. "Sisterhood: beyond public and private." Signs 21(4): 814-829.
Raymond, Janice G. 1993. Women As Wombs: Reproductive Technologies and the Battle Over Women's Freedom. New York: HarperCollins.
Tillman-Healy, Lisa M. 1996 "A Secret life in a Culture of Thinness: Reflections on Body, Food, and Bulimia." Pp76-108 in Composing Ethnography: Alternative Forms of Qualitative Writing, edited by Carolyn Ellis and Arthur P. Bochner. Walnut Creek, CA: AltaMira Press, a division of Sage publications.

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