Editor’s Note: This piece has been published as a part of the Health Over Stigma campaign, which is aimed at dismantling the stigma surrounding sexual health of unmarried women, and demanding accountability from medical service providers for stigma-free, non-judgemental sexual and reproductive healthcare services. Join the #MyGynaecStory wave by sharing your own story as an unmarried woman accessing sexual and reproductive healthcare by posting it on your social media or emailing us. In this piece, a senior gynaecologist who is associated with the campaign reflects on being a feminist gynaecologist in a patriarchal medical universe.
Posted by Dr. Suchitra Dalvie
As a woman and a feminist I am beyond delighted to see unmarried women voice out their experiences with #MyGynaecStory as a part of the Health Over Stigma campaign! It is time for us to claim rights over our own bodies and the narratives of our sexual and reproductive lives. It is critical to start holding accountable the systems that have ignored, oppressed and failed us repeatedly. It is vital to create a new world where this becomes the norm.
As a practicing feminist gynaecologist, I wanted to offer a glimpse of what this world looks like from the other side of the consulting table/ examination bed.
The stories being shared are all uniquely personal as well as frustratingly universal. From my experience of work across Asia region, I can say with confidence that these will resonate with all women and girls across all the countries. As a practicing feminist gynaecologist, I wanted to offer a glimpse of what this world looks like from the other side of the consulting table/examination bed.
So what makes a gynaecologist in our country? What information is taught, what values are inculcated and what kind of a work environment does one have to survive?
We start off as 18 year olds who have managed to get into medical college after two years of intense back-breaking studies and classes. This is followed by five and a half years of even more intense and exhaustive training which is exclusively biomedical – facts, formulae, signs, symptoms, diagnosis, etiology, pathology, treatment.
The patient is only a collection of signs, symptoms, history, and pathology.
Identify pathology. Solve problem.
Ward rounds are mostly impersonal recitals of pathologies and management. We had the very rare teacher/ professor who would speak to patients as if they were real people. In any case, when you have 20 patients in each ward and four such wards to cover, names and life stories don’t really matter much beyond when did you first notice this growth/feel the pain/injure yourself/miss a period.
We have seniors who routinely crack ‘dirty’ jokes and make derogatory remarks about the women lying naked on the operation table.
When we are 19 and doing the Paediatric wards rotation, some of us fall in love with a five year old child called Ranee admitted for treatment of a brain tumour. We get books and toys for her. We try to drop in during lunch time and play with her. One day when we drop by, her bed is empty. We don’t really allow ourselves to get attached to any other patient like that ever.
We have seniors who routinely crack ‘dirty’ jokes and make derogatory remarks about the women lying naked on the operation table. We have sexist mnemonics to learn things – for example: She Looks Too Pretty Try To Catch Her.
We stand by and hear our Gynaec Professor, a woman, tell the weeping mother of an unmarried girl seeking an abortion, “She opened her legs then so why is she resisting now?” She does not offer the girl any pain killer during the abortion so as to ‘teach her a lesson.’
We stand around in the operation theatre – silent and upset, but unable to articulate why. No one says a word about rape, consent, what happened to the man/boy who made her pregnant, the consequences on the mental health of this girl and the shame felt by her mother. We feel complicit in this torture and have no idea what to do.
We were taught that India has a population problem and the solution is female sterilization. Poor people and illiterate people ‘don’t understand what is good for them’.
The hospital I worked in had thousands of deliveries in a year and we knew that sometimes when a woman gave birth to a girl the family would not come to take her home. We took rounds in the Burns ward to examine women who would say with their dying declaration that it was their fault and not to blame the husband for anything. No one ever discussed with us how come it was always young mothers with two daughters or how come so many young women’s sarees caught fire because the ‘stove burst’ at 2 am.
We never discussed domestic violence, rape, dowry, police and legal system abuses.
We were taught that India has a population problem and the solution is female sterilization. Poor people and illiterate people ‘don’t understand what is good for them’. We never discussed why no man ever came in and asked for a vasectomy.
Our forensic textbook said we needed to do a two-finger test to ‘prove’ rape. We learnt about gay and lesbian sex in the chapter under deviant sex, along with bestiality and necrophilia. We laughed over the idea of having sex with animals, we stood in grim silence observing post mortems. We threw up, we cried, we fainted, we soldiered on.
Yes, there were a handful who never cared so much; yes, there were more than a handful who were in it for a lucrative career. But the vast majority would have definitely benefitted from a mainstreaming of gender and rights and connecting it to medicine as a healing art.
We made it through 8 years of training without ever hearing the word patriarchy or sexism or misogyny.
The residency training was brutal. The seniors were hostile and uncaring and thoughtless. We had no place to sleep, or even pee, when we were on call. No one looked out for us to eat any meals or even have water. The hostel rooms had barely any hot water, toilets were often unusable and rats came into the rooms at night.
Until you have run through a corridor at 2 AM with a patient on a trolley because the helper staff is busy, while also carrying blood bags , gloves and stethoscope on an empty stomach and knowing that you will be awake all the way till 4 PM the next day, don’t judge your Ob-Gyn too harshly.
We made it through 8 years of training without ever hearing the word patriarchy or sexism or misogyny. We had no internet. We had no contact with the feminist movement.
I know someone who did medicine from the Army and told me that during surgery the anaesthetists would wink and let everyone cop a feel of the woman’s breasts since she was unconscious. It made him sick to tell me this. It makes me sick to write it.
My story is now 25 years old, but even now I know of medical students who say there are rape jokes on ward rounds, college festivals have questions about gang rape and female students are policed about the clothes they wear at fests.
So, yes, your gynaecologist may be judgemental and patronising and even uncooperative and that is not okay. But remember that they are as much a product of the system as any one of us. Check out this brilliant video where Philip Zimbardo of the famous Stanford Prison experiment tells us about how good apples and bad apples may not matter as much as the barrels and the barrel maker.
Remember that modern medicine emerged from a strong patriarchal uprising which resulted in the witch hunts. It was never a women-centered system. It started with barber surgeons and flirted with leeches and purgatives. It also included Hail Marys and branding. If you study the history of medicine you will come across a hundred Fathers – Father of Psychology, Father of Radiology, and even a Father of Gynaecology (who studied a certain surgical technique on slave women without any anaesthesia based on the belief that they had a high pain threshold).
There are no Mothers of Pathology or Microbiology because women were not allowed into medical colleges. Women were seen as ‘natural’ nurses due to their maternal and caring instincts. They were of course underpaid, overworked and never received the kind of professional respect and opportunities that the male doctors did.
The system has been anti-women from its very inception.
So, yes, your gynaecologist may be judgemental and patronising and that is not okay. But remember that they are as much a product of the system as any one of us.
Of course it is now the new New Age, and we must demand better – but it’s not going to come out of a vacuum. Out of a thousand doctors who undergo this harsh training, only a handful become the kind of rich and successful that people imagine everyone does. Out of the thousands trained with only bio-medical focus, hardly a handful discover feminism for themselves.
When I first started working in the development sector and learnt with awe that there was a whole language, an entire field of work that resonated with and validated my feelings –words like feminism, gender justice, social justice, accountability. I remember asking a very prominent women’s rights academic — where was the women’s rights movement when I was studying medicine?
I have been to many women’s rights meetings where I have had women look askance at me as soon as I introduce myself as a gynaecologist. We need to remember that we are all in this together. Doctors can be feminists and women can be patriarchal. Yes doctors have more power in the current scenario. They will continue to have the power of knowledge, but let us work to find common ground whereby they don’t feel they need to be the arbiter of your morals or private lives.
I will leave you here with a quote from Rudolf Virchow, considered to be the Father of Public Health. It is still relevant and we can see the resonance in it of a very established feminist principle — The Personal in Political!
“Medicine is a social science, and politics is nothing more than medicine on a large scale.”
Suchitra Dalvie is a highly motivated women’s health expert, with over 18 years of clinical experience and over 15 years of development work experience and is currently working as the coordinator of the Asia Safe Abortion Partnership. Her recent projects include work around sex selection and its impact on safe abortion, clinical studies using medical abortion pills and capacity building of youth to advocate for safe abortion as a human right.
Asia Safe Abortion Partnership and Haiyya are coming together to organize their first Youth Advocacy Institute in Delhi from 17th – 19th January, open for youth leaders – doctors, paramedics and women working in SRHR Spaces. To know more and apply, see this form.
Featured Image Credit: Stuart Bradford via The New York Times