This Side of Doctoring: Reflections from Women in Medicine

Chin, Eliza Lo

Last Updated: Nov-09-2017

Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Summary:

This Side of Doctoring is an anthology published in 2002 about the experiences of women in medicine. While the essays span multiple centuries, most are from the past 50 years. They reflect on a multitude of stages in the authors’ personal and professional lives. In 344 pages divided into twelve sections, including "Early Pioneers," "Life in the Trenches," and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor in the U.S.. All but a handful of the authors are physicians or surgeons. There is a heavy representation from institutions on both coasts, especially the Northeast. Four men were invited to reflect on being married to physician wives. There is one anonymous essay concerning sexual harassment and a final essay from a mother and daughter, both physicians. Beginning with the first American female physicians in the mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary Putnam Jacobi, the anthology proceeds through the phases of medical school, residency, early and mid-careers, up to reflections from older physicians on a life spent in medicine. Many of the authors have names well known in the medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass, Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a few.

The essays and poems and letters have, as a partial listing, the following subjects: family influences in becoming a physician; professional friendships; marriage; children and their impact on a woman’s career in medicine; the decision not to have children; ill family members; illness as a physician; establishing one's sexuality as a physician; struggles with male physicians and their egos; mentors, both female and male; memorable patients (often terminal or dying); the life of a wife-physician, or mother-physician; the guilt and sacrifice that accompany such a dual life; the importance - and easy loss - of personal time or what internist Catherine Chang calls “self-care” (page 334). The anthology also touches on how women have changed the practice of medicine in various ways, prompted by the growing realization, as family practice physician Alison Moll puts it, "that I didn't have to practice in the traditional way" (page 185) The authors write about the wisdom of setting limits; training or working part-time or sharing a position with another woman; and the constant face-off with decisions, especially those not normally confronting an American man becoming a doctor.
One conclusion is evident before the reader is halfway through the book: there are many approaches to becoming a fulfilled female physician including finding one’s identity in the field. Implicit in most of the essays and writings is the lament from obstetrician-gynecologist Gayle Shore Mayer: "Where is the self ? There are pieces of me everywhere", (page 275) recalling a similar cry from Virginia Woolf's Orlando, another essentially female soul trying to find what Richard Selzer has called "The Exact Location of the Soul". Several authors discover that female physicians have unique gifts to offer their patients. As internist Rebekah Wang-Cheng writes, “I am a better physician because I am a mother, and I know because of my experiences as a physician that I am a better mother.” (page 151)

There are sections at the end devoted to a glossary for the lay reader, resources for women (as of 2002), and generous notes about the contributors (which section also serves as a useful index of each's contributions).

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Augustown

Miller, Kei

Last Updated: Oct-03-2017

McClelland, Spencer

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Set in the loosely fictionalized Jamaican town of Augustown (“loosely,” as it bears a strong resemblance to August Town, which was absorbed over time into the expansion of Kingston), the novel spans three generations of a single family. The novel moves back and forth easily through different moments in time, from the birth of Rastafariansim in 1920 under British colonional rule, through the post-colonial division of the island and its citizens into turbulent threads, to the present day of 1982, where the same tensions run strong as ever.

Ostensibly a family novel, the story centers on Ma Taffy, her niece Gina, and Gina’s son Kaia, and it boils down to several key moments in their lives. But these moments are brief in the overall bulk of the novel, the majority of which is devoted to the fleshing out of the world that permits – and, as we ultimately realize, requires – that such moments come to pass. There is the miracle of the preacher Alexander Bedward, who, as seen through the eyes of Ma Taffy, could have literally floated up to the Heavens; the comically doomed marriage and foiled aspirations of schoolteacher Emanuel Saint-Josephs; the errand run by Soft-Paw, a young gang member; the second chance that comes before the well-to-do Claudia Garrick; the friendship of Clarky and Bongo Moody, and their run-ins with the police. As Miller moves between these characters, the forces pushing Ma Taffy, Gina, and Kaia to their conclusion become clearer and harder to resist.

Despite the complexity of the novel’s structure, Miller easily weaves all of the component parts together. The result is absorbing and affecting, a novel that is as much a family drama as it is an exploration of the legacy of colonialism, religion, class conflict, and violence.

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I Am Nujood, Age 10 and Divorced

Ali, Nujood; Minoui, Delphine

Last Updated: May-05-2017

Saleh, Mona

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir follows the journey of Nujood Ali, a young, Yemeni child bride from a rural village. She was later named Glamour's Woman of the Year in 2008.

The memoir begins with Nujood’s escape from her husband’s house and how she made her way—alone—to a courthouse in the country’s capital where she was determined to win a divorce.

Nujood’s father pulled her of school when she was in the second grade and forced her to marry a man much older than she. At this time, the minimum legal age of marriage for girls was 15, but many families—especially in rural areas—continued to engage in marrying off daughters much younger than this. Nujood’s father’s reasoning (which echoes the reasoning of many others who engage in this practice) included having one less child to feed, preventing Nujood from being raped by strangers, and protecting her from becoming the victim of “evil rumors.” (p. 54)

In a practice common in Yemen, her father moreover stipulated that Nujood’s husband would not have sex with her until she had begun to menstruate; the husband did not wait and instead raped Nujood after they were wed.

Throughout the book, Ali and French journalist Delphine Minoui skillfully explain how women are not given choices in Nujood's part of Yemen:

“In Khardji, the village where I [Nujood] was born, women are not taught how to make choices. When she was about sixteen, Shoya, my mother, married my father, Ali Mohammad al-Ahdel, without a word of protest. And when he decided four years later to enlarge his family by choosing a second wife, my mother obediently accepted his decision. It was with that same resignation that I at first agreed to my marriage, without realizing what was at stake. At my age, you don’t ask yourself many questions.”
(p. 23)

Ali was connected with her lawyer, Shada Nasser, at the courthouse, and her case garnered both international attention and outrage. After a hearing, Ali was granted her divorce and took trips out of Yemen, including to the United States, even meeting with then Secretary of State Hillary Rodham Clinton. The memoir ends on a happy note, with Nujood starting her education again, at a new school, and definitively deciding to become a lawyer who is committed to raising the legal age of marriage in Yemen. The authors even discuss two cases of girls who were granted divorces in Yemen after Nujood and were able to use her case as legal precedence.

An article in the Huffington Post explains that while Nujood’s memoir ends on a happy and inspiring note, there is still much more work to be done. It points out that Nujood insisted on remaining in Yemen, while her American advocates believed it would be best for her and her future to remove her from her family. Nujood’s family put pressure on her to demand more and more financial compensation for her international fame. Even though her co-author and other advocates begged her to go to school, she did not complete her education. Her father used a (likely large) portion of her book proceedings to marry a third wife. The most recent update is that Nujood remarried (circumstances and consent unclear) and mothered two daughters of her own.

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The Hidden Face of Eve: Women in the Arab World

El Saadawi, Nawal

Last Updated: Apr-27-2017

Saleh, Mona

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Dr. El Saadawi is an Egyptian feminist activist and a psychiatrist who originally published this book in Arabic in 1977. She has had a tumultuous relationship with the Egyptian government and was imprisoned after criticizing former President Anwar Sadat. During her career she worked at several universities in the United States. The Hidden Face of Eve: Women in the Arab World has seamlessly incorporated elements of memoir and critical analysis of Arab culture and Islam. El Saadawi divides the book into four sections: The Mutilated Half, Women in History, The Arab Woman, and Breaking Through. The book opens with Dr. El Saadawi recounting in the first-person her harrowing experience with female genital mutilation (a very common practice in her home country of Egypt) when she was 6 years old. She uses very descriptive, perhaps even graphic language, to describe the experience in all its horror. This early childhood memory sets the stage for the audience to bear witness to all the various types of misogyny that many Egyptian and Arab women inevitably experience.

Dr. El Saadawi then skillfully relates memories of being told, for example, to not ask too many questions because she was a girl, and states that she has never heard the word “bint” (Arabic word for girl) used in a positive fashion. These nuggets of personal experiences are inserted into an overview of the complaints of stifled sexuality and associated sequelae with which her psychiatric patients struggled. She delves into the topics of Islam’s take on non-marital sex, illegitimate children, and prostitution thrown against the backdrop of her personal experiences seeing young, poor girls who work as maids being raped and impregnated by the men of the families who employ them and then being held as the sole accountable party.

After the first section, Dr. El Saadawi broadens her focus to include the status of women starting with Eve (whom the major monotheistic religions, including Islam, believe to be the first woman on Earth). Dr. El Saadawi investigates the historical designation of women as inferior in the Jewish faith and explains that as Christianity and Islam evolved against this backdrop, they also assigned women to a similar status. She insightfully points out how femininity did not evolve independently of society but rather that femininity and a woman’s place in society (all societies) are direct reflections of socioeconomic practices or goals of that society.

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States of Grace

Lipman, Mark; Cohen, Helen

Last Updated: Jan-24-2017

Grogan, Katie

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

States of Grace follows Dr. Grace Dammann, a pioneering HIV/AIDS physician, as she navigates life following a catastrophic motor vehicle accident that leaves her severely physically disabled. Before the accident Grace was a devoted caregiver at work and at home. She was the co-founder of one of the first HIV/AIDS clinics for socioeconomically disadvantaged patients at San Francisco’s Laguna Honda Hospital, honored for her work by the Dalai Lama with a 2005 Unsung Heroes of Compassion Award. She was also the primary breadwinner and parent in her family with partner Nancy "Fu" Schroeder and adopted daughter Sabrina, born with cerebral palsy and HIV. During a routine commute across the Golden Gate Bridge in May 2008, Grace was struck head-on by a car that veered across the divide. She miraculously survived—her mind intact, her body devastated. She endured a prolonged coma, innumerable surgeries, and a marathon of rehabilitation. The documentary picks up Grace’s story when she is finally discharged for good. She returns home to acclimate to a radically altered life, one where she is wheelchair-bound and dependent on others for simple tasks of daily living. The film captures the rippling effects of the accident on all dimensions of Grace’s life—personal, professional, psychological, spiritual, and economic—focusing especially on how Grace’s disability turns the family dynamic on its head. Fu becomes the primary caregiver to both Grace and Sabrina, Grace becomes a care-receiver, and as Grace describes “Sabrina’s position in the family [is] radically upgraded by the accident. She is so much more able-bodied than I am.” We witness her frustrations with the limitations of her paralyzed body and see her, at one point, arguing with Fu about her right to die if she continues to be so impaired. Some of Grace’s ultimate goals (to walk again, to dance again, to surf again) remain unattainable at the film's conclusion, but she sets and exceeds new ones. Grace “comes out” as a disabled person in medicine, returning to Laguna Honda Hospital as its first wheelchair-bound physician, where she is appointed Medical Director of the Pain Clinic. She resumes the caregiver role, but with an intimate knowledge of the lived experience of pain, suffering, and disability.

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At the Heart of the Universe

Shem, Samuel (Stephen Bergman)

Last Updated: Nov-23-2016

Carter, III, Albert Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This ambitious novel presents unusual events ten years after an international adoption. Because of the Chinese one-child policy, Chinese peasant woman Xiao Lu abandons her second daughter Chun in a rural market, knowing that the child will be sent to an orphanage. An American couple adopt the child, calling her Katie. As a celebration for Katie’s tenth birthday, they return to southwest China, hoping to meet the birth mother.

In a series of unusual events, they find Xiao Lu, and it is, at first, a joyous event. Troubles mount, however, as the birth mother wants Katie to stay with her, and Katie feels a mystical bond between them. Xiao Lu, having left her husband, now lives as a hermit in a hut on the slopes of The One Hundred Mile Mountain. She sweeps the 100 steps of The Elephant Temple daily and practices calligraphy in her hut.

Pep and Clio Macy, having married late, could not get pregnant. The novel satirizes them as aging Yuppies, spoiled and materialistic. Clio wears a Movado watch worth hundreds if not thousands of dollars. The family’s cockerpoo has been boarded at home. Katie dislikes being the only Chinese American in her private school.

After the birth mother has been found, the mood of the book changes. Xiao Lu wants her child returned, and the Macys fear that they are in danger. In the last 100 pages, nature itself attacks the Americans with snakes, monkeys, bats, a huge millipede, and even the weather. Pep is injured and receives rough, traditional medical treatment from a monk; it appears to be effective, however, in healing his heart physically and spiritually—a resonance with the book’s title. Katie becomes more and more like Xiao, learning calligraphy and some Chinese language. When Xiao is grievously injured by the monkeys, the Macys effectively care for her, and previous conflicts are resolved.

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Side Effects May Vary

Murphy, Julie

Last Updated: Jan-07-2016

McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Call the Midwife

Worth, Jennifer

Last Updated: Dec-15-2015

McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Fracture

Miranda, Megan

Last Updated: Dec-08-2015

McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

After eleven minutes underwater at near-freezing temperature, Delaney Maxwell, who appeared dead upon rescue, is revived. Unlikely as her survival seems, the return of apparently normal brain function seems even more unlikely, yet after a few days she is allowed to go home with medications and resume a near-normal life. But after-effects of her trauma linger, the most dramatic of which is that she develops a sixth sense about impending death. She hides this recurrent sensation from her parents, and from her best friend, Decker, who rescued her, but finds that she shares the experience with a hospital aide who, like her, suffered a coma after a car accident that killed his family members. Like her, he senses death in others. Gradually Delaney realizes that “normal” isn’t a place she’s likely to return to, and that Troy, the aide whose life has been a kind of “hell” since his own trauma, is even further from normal than she. Troy seems to feel that it is his mission to help hasten death for those who are dying, to prevent prolonged suffering. The story follows her efforts to stop him, and to communicate with close friends, especially Decker, in spite of the secret she carries about her own altered awareness. When her efforts to save a friend who is dying of a seizure fail, Delaney faces another moment of crisis, compounded by Troy’s own suicidal desire to end his own suffering and hers with it. In the midst of these new traumas a clarity she has lost about what it means to choose life returns to her, and with it the possibility of a loving openness with parents and friends about the mysteries of her own brain and heart.

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Next To Normal

Kitt, Tom; Yorkey, Brian

Last Updated: Nov-18-2015

Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

Next to Normal is a musical, composed in a rock idiom.

Meet the Goodmans, (father Dan, mother Diana, daughter Natalie) who on the surface resemble a “perfect loving family” like any one of millions. However, from the outset we see that they are, in fact, a hair’s breadth from collapse: Diana’s long-term struggle with bipolar disorder leaves her suffering uncontrollable mood swings. Her illness fuels the chronic tension in her relationships with husband and daughter. In addition, we learn that a son (Gabe), whom we initially believe to be an active family member, actually died years ago and his appearances represent Diana’s hallucination.

As the show begins, Diana is undergoing a hypomanic episode that is resistant to treatment by her psychopharmacologist. Discouraged by side effects and egged on by her phantom son, Diana flushes her pills down the toilet. As she deteriorates, she visits a new psychiatrist who agrees at first to treat her without medication. As she begins in psychotherapy, for the first time, to accept the loss of her son, she descends to a new clinical low. At the close of the first act, after making a suicide attempt, she is hospitalized and agrees to be treated with ECT.

By Act II, the ECT has effected great clinical improvement, with stabilization of Diana’s mood and no further hallucinations. All this, however, has come at the expense of her memory. As it returns, she becomes aware that what she most needs to remember, and process, are her feelings about losing a child. In fact, we learn that she was kept from expressing them at the time because of concerns she might decompensate. She struggles to make sense of all of this while remaining stable. When she confronts Dan about Gabe, it is he who appears unable to discuss their loss. She suddenly becomes aware that Dan has been enabling her in an unhealthy way. She reconciles with her daughter, but realizes that in order to move forward she needs to get out of her dysfunctional marriage. However, the door is left open on this relationship, for at the recommendation of her psychiatrist Dan enters psychotherapy.

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