woman as patient

Woman as Patient

by Laura Green (1971) Women faced deepseated and often outrageous discrimination both as patients and as healthcare providers. by Laura Green excerpted from Health Rights News September 1971 -- final paragraph by Womankind. 

(Editors Note: Prejudice against women both as patients and has healthcare providers was very strong in 1971.)

What really happens when we menstruate? Can't anything be done to end menstrual cramps? Why isn't there a safe and effective means of birth control?

Most of us don't know the answers to these questions, or to many other questions concerning our bodies and how they work. When we are ill, get pregnant, or want birth control, we have to rely on the doctor's advice without really knowing what it is that is happening to our bodies, why the doctor is saying what he (generally) is saying, or, in fact, whether what the doctor is saying is safe or effective. And this is true for virtually all women, even the rich. The American medical profession is based on keeping the patient ignorant -ignorant of her own body, ignorant of how normal, healthy bodies work, or what happens when we are sick, or of ways to know when an illness is serious or minor.

This built-in ignorance starts when doctors fail to explain how our bodies work when we are kids. It continues as our breasts develop and we begin to menstruate without ever having any sympathetic, clear explanation of what is going on, either from our mothers (who probably don't know themselves), our doctors (if we are rich enough to have a regular family doctor), or our schools (which don't begin to know how to deal with the subject of sex). It is reinforced if, as young women, we become pregnant, and deal (if we are lucky) with an obstretician who, though competent, plays the "father role" to us. He will try to "reassure" us about the fears which it is assumed that we have without ever giving us enough real knowledge about the exciting process of growth and birth to give us a clear understanding of what is going on.

This built-in ignorance results in two things. One is money for doctors whom we are forced to turn to and whose judgments we are forced to accept unquestioningly because we don't know enough to be able to challenge them. The second is our own sense of helplessness about our own bodies, which we ought, ideally, to know and understand very well. These two things work to reinforce each other; the more helpless we feel, the more we rely on doctors to tell us exactly what to do.

Good health care would be different. It would start with teaching us all, from infancy, what our bodies are like and how they work. We would each know enough to be able to care for our bodies wisely, and can care for ourselves, rather than making us into helpless, ignorant-feeling to be able to work with persons trained in medicine in finding out if our bodies are working as they ought to, and in deciding what to do if they are not. It would work to make each of us feel that we understand women, who must look to the doctor to make basic decisions affecting our lives.

woman as doctor

When Elizabeth Blackwell tried to become this country's first woman doctor over a century ago, children mocked her in the streets, landladies refused to rent her a room, and her teachers tried to prevent her from watching surgery. Woman doctors have come a long way since then, but the fight for equal admission and treatment in medical schools in hardly over.

Although the percentage of women in medical schools has risen from 9 to 11 percent in the last year, it hasn't changed significantly from the beginning of this century when four per cent of all medical students were women. The U.S. compares poorly with the rest of the world -three out of every four Russian doctors are women, and nearly one in three English doctors and one-quarter of the doctors in France are women. Only Spain, Madagascar and South Vietnam have a smaller proportion of woman physicians than the United States.

American medical schools don't seem troubled by this state of affairs. A seven-year study by Dr. Harold I. Kaplan, a psychiatrist at New York Medical College, revealed the deep-seated prejudices of medical school administrators toward female medical students. Dr. Kaplan's questionnaire provoked some responses he calls "too outrageous to publish." The answers he did print, in an article in The Woman Physician, dismally confirm the conservatism, indifference and callousness that American medical schools show women applicants and students - particularly those who try to complete their medical training while raising children.

One dean wrote: "I just don't like women -as people or doctors - they belong at home cooking and cleaning. Certainly not as medical colleagues who are at best dilettantes in our field." Another said: "We have not been overly impressed with the women that have been admitted to medicine even though academically they are entirely satisfactory. I think they ordinarily have so many emotional problems that we have not been particularly happy with their performance." A third dean complained: "I have enough trouble understanding my wife and daughters without attempting to explain the questions in this paragraph."

The study indicates that women who do get into medical schools are at least as well qualified, if not better, than their male counterparts. Marquette University wrote: "Those we admit must present excellent college records and Medical College Admission Tests scores, and must furnish evidence of emotional stability and of sincere motivation for medicine as a career."

Dr. Marvin Dunn, assistant dean at the Medical College of Pennsylvania in 1969, who interviewed admissions officers at 25 Northwestern medical schools, discovered that 19 schools admitted men in preference to women unless the women were demonstrably superior. He found women were not judged on an equal basis but required special justification for acceptance.

Most medical schools allow pregnant students to continue their studies so long as they do not miss too much time. However, most students resume their full school schedules within three days to two weeks after giving birth, hardly an adequate recovery period. Students return to class because they fear they will lose the year's credit if they stay out longer. In contrast, several schools in the Kaplan study said a student with hepatitis or mononucleosis might be given up to two months leave with full academic credit.

Most other countries provide a longer post-partum recovery period for both students and working women. Russian women are given 56 days paid leave before delivery and 56 days after. A woman is exempted from night duty until her child is one year old. In Sweden, a pregnant woman physician may take as much as six months leave around the time of her delivery. Polish women students are granted three months leave and lose no academic credit.

All of this is doubly interesting in view of the fact that the United States needs about 50,000 more doctors. All those who control admissions to medical schools - the American Medical Association, medical school administrators - are guilty both of blatant discrimination against women and of carrying out policies detrimental to the health of all Americans.

original editor's note: the Liberation School offers courses in natural childbirth nutrition, women and their bodies, and high school women and their bodies to help combat the type of ignorance discussed in this article. Call the Liberation School in care of the Chicago Women's Liberation Union, for information about these courses.