musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

The temple in which we live


I realize I’ve been obsessing about this for quite a while now, but my progress has been slow, and the chances of resolution seem to recede further and further each time I make the attempt. It’s easier, of course, to analyze it, measure it, and categorize it in someone else, but for this… for this, I am too close. How can an eye see itself, if not by reflection; how can a voice hear itself except in an echo?

If I can only know myself through others, then what, exactly am I -where do I stop…? Am I –are we– simply Venn diagrams, overlapping here, and realizing some autonomy there? Who, or what, is on on the boundaries then, or is the interweaving so dynamic and the concept of borders so ephemeral as to be meaningless? Am I am more of a process than a substantial entity?

Perhaps you can see why I am confused. Quite obviously, I am neither a philosopher, nor a neuroscientist; my credentials, albethey old and perhaps outdated ones, are in Medicine -Obstetrics and Gynaecology, to be specific. In the first few years after I qualified, I think I viewed my professional world as largely binary: us (doctors) and them (patients). Now I am quite certain I had it wrong: we had been interlinked all along; it was just the names and the issues that, although gendered, and no doubt filled with power-dynamics, were tissue thin. I was, in a very real sense, my patient when I learned of her problem and offered to help.

Although I would not have known the word in those days, I now realize from an article I happened upon in my retirement, that I was enmeshed in what has been termed enactivism. This is a concept which acknowledges that to study the self is also to experience ourselves with others.[i] There is a dynamic interaction between an acting organism and its environment; between oneself and the others with whom one interacts. Put another way, to practice medicine I had to experience the patient as much as she experienced me; we were codependents, as it were: sine qua nons, I suppose.

And yet, I’m not sure how much that realization helps me in my protracted quest for self-knowledge, for understanding where in the outside world I am no longer me -or if there really are functional boundaries. I wondered if, perhaps, my mother’s advice had been wiser than I’d suspected and I simply needed to pretend that part of me was a separate, not-me person who was able to observe my interactions with others to gain some insight.

Even though many Covid restrictions have been relaxed, they still live on with many passengers on a bus -especially a crowded bus. Public transportation seems to be more popular nowadays, perhaps because of the price of gas, or maybe the adventure of leaving home, but nevertheless, however convenient, it makes it harder for an elder like me carrying a heavy backpack. I was readily identifiable as an older man, with my white beard, clearly dated clothes, and the awkward momentum shifts from my pack whenever the bus moved; but despite that, there were no volunteers to vacate their seats -or worse, no efforts to move from the aisle seat to the empty window seat beside them to provide a refuge for a hapless elder. Of course, perhaps it’s up to me to point to the emptiness of the window space, or to the seat only occupied by a shopping bag; but I will not ask, to beg I am too proud. I mean, it should be up to them, eh?

Still, when a thin, older lady wearing a light-red sari who had been staring at her lap to ignore the crowd, slid partway over to the empty window space to rummage in her purse, I could see sunshine on the seat she had inadvertently relinquished and slipped into it like a car into a parking space. The ‘outside-me’ -as my mother used to call the etiquette of interacting with someone you didn’t know- watched all this with astonishment. I had not been invited to the seat, and I had not asked permission to occupy it. My mother would have been horrified.

I tried not to touch the woman as I settled in -that would have been beyond the pale, I think- but nevertheless she turned her head, surprised at the sudden warmth alongside her, and scowled in surprise.

It was difficult for me to pretend objectivity and observe the situation as if I were merely a person watching the interaction from the aisle; I was so embarrassed at her obvious censure I was drawn back into myself like a genie disappearing into its bottle.

At first, she merely strafed me with her eyes, no doubt deciding whether to scold me, or try to move back into the space I now occupied; but I could see she noticed my discomfort, my reddened face, and my readiness to cede the space to her once more should she complain loudly enough for others standing in the aisle to notice. Her eyes suddenly softened, and she surrendered the rest of the seat to me and my pack as her face brightened.

“Why didn’t just ask me to move over?” she said in a gentle, if somewhat hoarse voice that I could just hear over the noise of the bus. “That pack looks awfully heavy…” she added, her lips blossoming into a smile.

“I…” I was surprised at her reaction, and realized I should answer, but I felt too awkward, I suppose. I fiddled with my pack, trying to liberate it from the straps around my shoulders, and settle it on my lap.

She could tell I was still flustered, and reached over with surprisingly strong arms, to help me dislodge one of the straps from my shoulder. “Four arms are sometimes better than two,” she said, and winked at me.

I smiled and thanked her for her help. “You’re very understanding,” I added, unsure of what else to say.

She sent her eyes to perch on my cheeks for a moment in an exploratory gesture -to see if she could trust me, I think. “You know in one Hindu myth, all humans used to be divine, but we abused our privileges,” she said, still watching me for my reaction. Then, satisfied that I seemed interested, continued. “The ancient gods, decided to take our divinity away from us. They couldn’t decide where best to hide it where we’d never find it, but Brahma, one of the old powerful gods, had an idea: ‘Let’s hide it in the very centre of their being, because they’ll never think to look for it there,’ he said. Over time, though, some of us figured it out…”

“You mean…?” I started, honoured that she’d share this legend with a stranger.

She held her finger to her lips to hush me for a second, and then smiled at me conspiratorially and with a little bow of her head. “I mean because of what we share, we all deserve respect…”

[i] https://psyche.co/ideas/the-philosophy-of-selfhood-became-real-when-my-mother-got-dementia

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gozzter

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