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 Feminism in India. In this piece, a senior gynaecologist who is associated with the campaign reflects on being a feminist gynaecologist in a patriarchal medical universe.

As a woman and a feminist I am beyond delighted to see this 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.

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.

And as a practicing gynaecologist I wanted to just offer a glimpse of what this world looks like from the other side of the consulting table/ examination bed.

Here is a short outline of what makes a gynaecologist in our country: what information is taught, what values are inculcated, what kind of a work environment one has to survive and what happens next.

We start off as 18 year olds who have managed to get into a medical college after two years of intense back-breaking studies and classes. Then follow 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. 

It is a lot like Sherlock Holmes and House MD combined. We are trained to solve puzzles and mysteries, not hand hold and coddle. 

Yes many of us do join it because we want to help people, because we have romantic notions of being like Dr. Livingstone and change the world with our innovations and cure cancer and all that. 

Like any other 18 year old we have our dreams and desires.

But like any other 18 year olds we are also impressionable, insecure, ambitious, lonely, anxious, with feelings, desires, prejudices, ignorance, ideologies, families, friends, obligations, limitations.

We learn from what we see, hear, are told is right. We accept as truth what is taught to us by seniors and experts.

Ward rounds would be 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.

When we were 19 and doing the Paediatric wards rotation, some of us fall in love with a 5 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 OT 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.

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 regular mainstreaming of gender and rights and a connecting to medicine as a healing art. 

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 un-useable, rats came into the rooms at night. 

Until you have ever 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 ObGyn 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 they may be judgemental and patronizing and even uncooperative and that sucks. 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. 

https://www.ted.com/talks/philip_zimbardo_on_the_psychology_of_evil/transcript?language=en

Remember that modern medicine emerged from a strong patriarchal uprising which resulted in the witch hunts. It was never a women- centered touchy-feely happiness- and- joy 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 Gather of Radiology 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 or anything 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, over worked 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.

Of course it is now the VERY 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.”

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.