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Review: Ask Me About My Uterus

CW: child abuse, bulimia (affecting the narrator’s mother), medical mistreatment, chronic pain, sexism/misogyny

Earlier this year, I was talking to a friend who was very certain that she had endometriosis, who was having trouble getting her doctors to diagnose her condition and/or treat it effectively. Some of the details of her conversations with these doctors sounded absolutely unreal to me, and I became aware of this problem in the medical community: female patients with “female” complaints are treated dismissively. Even by female doctors. So when I heard about Abby Norman’s  Ask Me About My Uterus a few weeks ago, I ordered a copy immediately, wanting to better understand this insane phenomenon.

askmeaboutmyuterusIn the book, Norman opens her story on the day she first felt the pain that would come to define the rest of her life (so far). What begins as a few days of skipping class in hopes of recovering from her strange sickness leads to hospital visits, a surgery, a recommendation that she leave school altogether, and growing concerns as her diagnosis and treatment does little to combat her chronic pain. She takes the reader back through a childhood of abuse and perseverance, back further into a general history of female pain, and forward along the trajectory of her medical issues up to the date of publication.

I’ll warn you now, in case you haven’t surmised already: this is not a story that ends with a cure, with doctors being penalized for their failure to listen to women in pain, or with the resumption of Norman’s life and goals pre-symptoms. Ask Me About My Uterus contains its share of victories, but the problems it highlights are serious, numerous, and ongoing.

“If I, or any other woman whose gynecologic cancers or pathologies had gone undiagnosed, had just been sick in some other part of the body, in some other way, would it have been any different? Or would it not have mattered? Was the underlying preexisting condition being female? Does the congenital lack of a Y chromosome predispose a patient to worse outcomes regardless of what condition or disease they present with?”

If you’re thinking this book sounds too medical for your taste, never fear. Though Norman did work in a hospital for a time (and was able to access medical journals and see records that aided her personal research), this is not the writing of a doctor using impenetrable jargon to explore a niche condition. You come for an exploration of women’s pain, but you stay for a very readable memoir-style tale of one young woman’s eventful life. Norman begins to feel like a friend, whether any part of her experience is relatable to the reader or not.

“Of course, people lie to their doctors, too, but they usually lie to themselves first.”

Though Norman’s account is a very specific rendering of her own unique lifelong struggle with chronic pain (not limited to her endometriosis), perhaps the most shocking realization comes later in the book as we begin to see how very many women have been dealing with similar unresolved symptoms. There are plenty of infuriating moments when the reader sees how much of Norman’s unsatisfactory experience with the doctors who treat her (or refuse to) is a larger gender problem. Though endometriosis is not restricted to female bodies, the care that women receive for this condition is undeniably subpar. Furthermore, this indifferent attitude toward female pain extends well beyond endometriosis, and can be traced back hundreds of years. It’s hard to say whether Norman’s doctor paying more attention to her boyfriend’s concerns about his sex life than Norman’s reports of pain is more or less disturbing than accompanying historical factoids like this:

“It’s not uncommon to read old patient charts in which sexual relations- consensual or not- between patients and physicians were noted simply as a matter of fact, implying that such a relationship was not thought to violate ethical standards. It helped that, during the mid-nineteenth century, sedation was becoming increasingly popular as a first line of treatment for women for just about anything- particularly ether, which was highly addictive. Women who were in a semiconscious state were obviously particularly vulnerable to physicians who wanted to exploit them.”

I had only a few small obstacles between me and a 5-star read here, the first (due to no fault of the book) being that it simply wasn’t entirely what I had expected to be reading. From the title and subtitle (Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain), I expected this book to be… informational. Persuasive. And it is informational, but Norman’s personal life is the main focus. Her story is certainly persuasive and engaging, but it seems aimed at women experiencing a similar struggle with chronic pain who are looking for solidarity, and at the doctors that are being appealed to in hopes of initiating a change. I fit neither category. Though I did find it worthwhile to encounter a new-to-me perspective, the amount that I learned about the endometriosis struggle in general (especially after hearing about it from a close friend already) can be summed up in a few sentences; Norman’s life is a very interesting one that I appreciate having read about, but it left me wanting to know more about endometriosis than this book ultimately has to offer. And to an extent, I think that’s going to be an unavoidable reaction to any book currently available on the subject, as endometriosis is still a very nebulous disease with a lot of unanswered questions. I only wish I had known I was in for a mix of memoir and mystery when I picked this book up.

My other slight hangup had to do with the way Norman’s narrative skips through time. Though her chronology is clear enough that I followed the broad strokes just fine, there are some layers between her points that I found harder to place. For example, she mentions a specific job she had, or a person she lived with, or a period of time when she experienced a particular brand of pain, and uses each of those eras of her life to explore certain concepts or experiences. When it becomes confusing is when she references the same job/relationship/pain in a different context, leaving the reader wondering which events overlap and how they fit into the overall timeline. I think this confusion would’ve been completely resolved if Norman had used a linear chronology, but real life isn’t always structured in a convenient way for narration and skipping around allows her to keep the focus on women’s pain even in moments that aren’t strictly related to her endometriosis. There are also a few instances of past and present tense confusion within sentences and paragraphs, though generally what is meant is clear.

Aside from a bit of timeline confusion, Norman is a fantastic writer. She weaves real events, her own ruminations, and moments of humor and horror into her story, always circling back at the end of each chapter to drive every new element she’s introduced toward a common underlying purpose. We see bits of human history, her family history, and anecdotes from Norman’s friends alongside her own account, all centered around some aspect of female pain. She never looses a thread. Her perspective is one that every reader- nay, every person- should be aware of. I’m eager to spread the word.

“Even now, it’s been so many years since I’ve lived in a pain-free body that I don’t really remember what it feels like.”

My reaction: 4 out of 5 stars. I think anyone who has suffered from chronic pain or treated anyone for chronic pain is going to get a little more out of this book than I did, but I’m glad I picked it up nonetheless, and highly recommend it to anyone particularly interested in feminist and/or medical memoirs. Since the story is left open-ended, as Norman’s experience with chronic pain continues uncured, I would love to see a follow-up from her someday, and I sincerely hope the medical profession improves in the meantime. It was also very fascinating to be reading this so soon after The Handmaid’s Tale and The Testaments; I didn’t plan to focus so heavily on injustice relating to the female reproductive system this month, but they turned out to be excellent companion pieces. If you’ve also been reading Margaret Atwood lately… it might be time to pick up Norman’s book as well!

 

The Literary Elephant