I Knew a Woman: The Experience of the Female Body

I Knew a Woman: The Experience of the Female Body

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by Cortney Davis
     
 

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"I cannot ignore the reality of the body, its glorious beginnings and its subtle endings," writes Cortney Davis in this intimate and startlingly original account of her work at a women's clinic. A poet and nurse-practitioner with twenty five years' experience, Davis reveals the beauty of the body's workings by unfolding the lives of four patients who struggle with

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Overview

"I cannot ignore the reality of the body, its glorious beginnings and its subtle endings," writes Cortney Davis in this intimate and startlingly original account of her work at a women's clinic. A poet and nurse-practitioner with twenty five years' experience, Davis reveals the beauty of the body's workings by unfolding the lives of four patients who struggle with its natural cycles and unexpected surprises: pregnancy and childbirth, illness and recovery, sexual dysfunction and sexual joy. An abundance of solid medical information imbues every graceful line. Davis's eternal question to herself is: How do you help someone to not merely survive but flourish? In this compassionate and expansive book, she provides a template. I Knew a Woman will alter your perception of the humanity of medicine and the ordinary miracle of our physical selves.

Editorial Reviews

Publishers Weekly
In this compelling look at how women's bodies influence, and sometimes dramatically alter, their lives, readers become intimately acquainted not only with women's body parts, but also with several specific women Lila, Eleanor, Joanna and Ren e, composites of the many patients Davis has treated as a nurse practitioner in a women's health clinic in suburban Connecticut. But while the characters are fictionalized, the drama, pathos and heartache in these pages ring true. Lila, who is 15, has had 10 sexual partners and is living in a car with her boyfriend when she first comes to the clinic. Two months later, she's pregnant. Eleanor, a 49-year-old math teacher who comes in for a routine exam, finds that irregular bleeding is just the beginning of her problems. Joanna, a 32-year-old graphic artist with a loving boyfriend, experiences pain every time she has intercourse. Ren e, a drug addict with three children in foster care, is pregnant again. Davis, a poet (Details of Flesh) and NEA grant winner, sugarcoats neither the harsh realities of their lives nor her own responses to them. Some days she feels maternal toward Lila, other days she'd like to clobber her. She's "convinced that the cause of Joanna's pelvic pain has more to do with a bruise in her soul than with an abnormality in her body." Occasionally, Davis tells us, she holds up a mirror so a patient can see her cervix. In this book, reflecting on her patients' health and histories, Davis holds up a mirror to the whole woman, letting us see inside and out. She provides a fascinating look not only at how women's bodies work, but also at a medical professional's emotions. Readers may find themselves wishing the perceptive Davis were theirown nurse practitioner. Agent, Sanford Greenberger. (On-sale date: Aug. 21) Forecast: This will appeal to all who enjoyed Natalie Angier's Woman: An Intimate Geography and should sell very well, boosted by the author's three-city tour. Copyright 2001 Cahners Business Information.
Kirkus Reviews
A nurse practitioner's exploration of women's health and treatment through the prism of four composite characters who represent some of the many types she's encountered in 25 years of practice. Davis is fascinated by women's health, and how the spirit inhabits the flesh. By creating four case studies, she is able to focus on four issues that are quite common and unique to female health: teen pregnancy, cervical cancer, drug-addiction, and child abuse. Despite the fact that the four women she uses as examples are fabrications, the author's emotional response to her "patients" feels very honest. She does her best to be helpful to Lila, a pregnant 15-year-old who lives with a man 13 years her senior. Davis's resources are nearly tapped out when dealing with Renee, a drug addict who is doing her best to kick the habit in order not to lose yet another child to foster care. A favorite patient's unexpected cervical cancer affects Davis more than anticipated, and an attempt to help a patient face emotionally painful truths about her past leads the author to divulge her own bit of uncomfortable history. The author's account is equal parts medical text and good storytelling; as their tales unfold, the patients' bodies and maladies are at all times explicitly discussed, with specula and vaginas appearing on page after page. These are, after all, the stock in trade of a nurse practitioner at an OB-GYN clinic. And though her prose can veer towards the purple, Davis's respect for women's particular physical makeup allows the reader to be drawn into the viscera and mundanities of common afflictions. A particularly graphic description of a hysterectomy nicely illustrates the author's mastery of hertopic, as she transforms what might normally be an episode that would try the squeamish into an entirely absorbing account that insists on being read. Informative, honest, engrossing.

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Product Details

ISBN-13:
9780375504181
Publisher:
Random House Publishing Group
Publication date:
08/01/1901
Edition description:
1 ED
Pages:
288
Product dimensions:
6.49(w) x 9.61(h) x 1.00(d)

Read an Excerpt

Chapter 1

Dr. William Riley’s office was five blocks from our suburban Connecticut home. It was 1962, several years before my mother would finally learn to drive, so she and I set off on foot, the form for my college physical folded in her pocketbook. Dr. Riley’s office was the first floor of his home, a tidy two-story box just like the other wooden houses along Prosper Street—a name that surely reflected the aspirations of the town’s founding fathers. A tinkling bell announced our arrival. Mother and I joined the handful of people waiting in straight-backed chairs around the edge of the room. Some patients were sniffling or coughing, others just stared at the floral carpet. Glass-front cabinets held a dusty array of fraying medical books, and the worn rugs and heavy curtains smelled like an old grandmother’s apron. It was early summer.

In September, I would be a college woman. Almost eighteen, I was already convinced I knew more than my parents, certainly more than my mother. I had a boyfriend, and we’d had sex, an occasional slippery fumbling in the back of his Dodge that left me feeling powerful but not breathless and tingly. I was formulating a shaky theory: We women, I decided, had a magical, potent allure, as if we gave off some invisible chemical like the lovely nocturnal moths that cling to a screen door, driving the male moths mad. Men, for all their position in the world, were like these beating moths, humbled before us. Once a woman became a sexual being, I reasoned, she would always have the upper hand.

When my turn came, the doctor himself waved us in. He was short and partially bald, his few remaining hairs the colorof old sand. Silver wire glasses sat halfway down his nose, and his cheeks were tight puffs of flesh, as if he held seeds inside or notes that he’d squirreled away in medical school for future reference.

I changed into my white gown (it smelled of Ivory detergent, and I imagined his wife as she washed a pile of gowns every day, holding her breath against whatever contagion clung to them), and Dr. Riley asked my mother the required questions about my immunizations and illnesses. Then he told her to sit in the wooden chair far across the room. As he examined me, I focused on Mother’s thin, upright posture, her white gloves and unscuffed shoes, her splashy Lily shift aglow in the dim light. The doctor kept his blinds closed, creating a strange hermetically sealed dungeon, within which, I realized, a patient could lose orientation. I concentrated on my mother’s bright image and the comforting hum of traffic outside the window, as if such human details could hold me to the real world.

I hadn’t seen a line requesting “pelvic exam” on my college form, but Dr. Riley told my mother it was time to do one anyway. She nodded, and I suddenly wondered if he might discover I wasn’t a virgin. Smug and well versed in street knowledge, I instantly planned to blame any lack of a proper hymen on horseback riding. Although I had no idea what a pelvic exam was, I assumed that once a woman experienced sex, she could endure anything. Mother sat, hands folded in her lap, and watched as the doctor extended the metal stirrups from his table and motioned me down. I was suddenly anxious about the exam and embarrassed by my mother’s presence. Sitting to my left, she saw me slide to the end of the leather table, how the white paper stuck and bunched under me. Surely she saw how plaintively my bare knees stuck out, how the skimpy sheet was pushed back over my pubic hair. She saw the doctor bend slightly as he inserted first the metal speculum, then his fingers, into my vagina.

“She has a tipped uterus,” he intoned to Mother, ignoring me as if I were simply the plastic model he used for demonstration. “I’ll try to tip it forward again.”

Mother nodded once more, asking something about difficult childbearing, and the doctor furrowed his brow. Small drops of sweat beaded in the waxy ruts of his forehead as he pushed another finger into me, wiggling it, leaning over until his cheek hovered above my pelvis. Once in a while he grunted something about my case being difficult.

This was before patients demanded explanations, before they asked questions, before there was any voice in the room other than the physician’s. There was no nurse; my mother served as the only distant chaperone. She lowered her eyes and allowed the doctor to do what he thought best.

Dr. Riley continued twisting his fingers as he stroked my belly softly with his other hand, a mockery of the normal pelvic exam. I felt my limbs turn to stone. The control and the worldliness I felt with my boyfriend fell away like an old carapace I was forced to shed. “Hold still” was never said but certainly implied. The doctor in his white coat, my mother in her white pumps, the dark mahogany bookshelves and desk—everything in the quiet room whispered to me to be good, to endure. Outside was a different world: green buds unfurling, children in strollers. Me and my boyfriend, the car windows open and summer pouring in.

Ten minutes seemed like sixty, and I floated in time’s unreal bubble. Surely what this doctor was doing was wrong, not the standard medical exam. I knew it, he knew it—come on, someone speak up and tell him—enough! When he finished, my insides throbbed and I thought my uterus must have burst. My inner thighs burned when I tried to stand.

Mother paid the bill (my poor mother, the obedient well-intentioned woman who would die at age seventy-eight, her last pelvic exam the one following my birth!), and we left, walked back down the tree-lined street to our white Colonial house with turquoise shutters, my college exam form folded in my pocket. I checked more than once, but nowhere did the words “tipped uterus” appear in the doctor’s fountain pen scratchings. Nor did Mother and I talk about my exam. We only nodded in unison when she said, “I’ve heard that a tipped uterus makes it difficult for a woman to get pregnant. It’s a good thing he could fix it.”

Then I only suspected, but now I know. You can’t rearrange a tipped uterus as if it were a piece of furniture in some tiny apartment. A “tipped” uterus is simply one of many variations of normal. Some uteruses are anteverted, curled over the cervix; some are midplane, extending straight out from the cervical neck; some are retroverted, tipped back beneath the cervix.

My encounter with Dr. Riley remained a foggy but persistent memory, like a book read and half remembered, until I was a student nurse practitioner learning to do pelvic exams in 1978. First we learned on hard plastic models, then on one another, then on patients.

“Here,” the instructor said to me, “feel the uterus? Slide your fingers under the neck of the cervix and follow it until you feel the bulge of the fundus beneath. This uterus is retroverted.” A nurse stood by the patient, one hand resting on the patient’s arm. I had already explained the exam carefully and clearly, and after I inserted the speculum, the instructor and I positioned a mirror so the patient could view her own cervix. When I did the internal exam I didn’t shove or wiggle my fingers, and I never said “Hold still.” Then I felt it, the firm globular uterus, tipped back, like mine.

I caught my breath. The image of Dr. Riley, the light reflecting from his glasses and his moist forehead as he moved his fingers inside me, welled up in my mind’s eye. Now I was the examiner, the one in control, yet I felt as vulnerable as I had that day in his office. I realized that I knew, viscerally and personally, how invasive this procedure is and how important it is that a woman trust her examiner. In the worst scenario, the exam room becomes the microcosm of a world in which a woman cannot be heard. In the best, the exam room is a privileged territory in which a woman learns how to be her own best advocate.

Sometimes I wonder if Dr. Riley’s exam was simply a distressing experience and not the misuse of power it seemed. After all, I do “first” pelvic exams almost every day, and I know how embarrassing and uncomfortable they can be. Or is it possible that Dr. Riley was trained to believe he could alter my pelvic anatomy, tip my uterus forward, and, as he said then, move my intestines to hold the uterus in place? Somewhere inside I want to believe that caregivers are above reproach, that none of us would dare take advantage of a patient.

But whenever I doubt my memories of that hot summer day, I remind myself of my final meeting with Dr. Riley. Right before I left for college, I developed a chest cold, and Mother suggested I go alone for a checkup. He took me into his exam room, told me to sit on that same massive old wood and metal table, and asked me to take off my shirt and bra. No drape or johnny coat this time. Still, no nurse. I sat with my young breasts pointing straight toward the buttons on his white lab coat, a line of small plastic disks that strained over the paunch of his belly as he leaned in to examine me. His stethoscope lingered on my breast, and I could feel his breath on my skin.

“You’re a lucky young lady,” he chuckled. “Look what you’ve got here.” A touch, a brush of his finger as it circled my nipple. “Don’t ever wear a bra, it’ll ruin you.” A squeeze of my thigh. A prescription for penicillin. Another squeeze.

Again and again, I review my impressions of my visits to Dr. Riley, because those moments taught me a valuable lesson and they continue to influence my own practice in women’s health. I try always to take care, explaining every step, draping my patients to preserve modesty, minimizing my touch and my movements unless that touch is a hug or a firm grasp of a patient’s hand. I can never forget my own helplessness, so I don’t lose patience with women who giggle inappropriately or cry out, who temporarily become too demanding or too frail. In Dr. Riley’s musty office, I learned an emotional truth about the misuse of power and the importance of dignity and control, even for the youngest patient. Most of all, I’ll never forget how swiftly and completely that first rush of self-esteem, that initial bounty of womanly grit, can be whisked away.


From the Trade Paperback edition.

Copyright 2001 by Cortney Davis

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