musingsonwomenshealth.com

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

To be, or not to be, is that the question…?


‘To be, or not to be…’ The timeless soliloquy by Shakespeare’s Hamlet still provokes a shiver. I don’t hear it as much now that I’m retired from my Obstetrical practice and contraception (or pregnancy termination) is so readily available; it occasionally surfaces from time to time in my social interactions, however. The problem is often labelled a little differently nowadays, and seems to slip into conversations about the state of the world, and whether it is a good idea to bring a new life into it.

But it is not Hamlet’s quandary; asking whether it would be better never to have been born is not the same as asking whether it would be better to die. The question is not even one of reproductive rights -of choosing pro-life or pro-choice; it is profoundly more existential than that. The question may not so much address a woman’s right to decide the fate of what may exist in her womb, but whether or not she should be able to decide whether or not to use her womb in the first place.

Of course the option still remains open, but the choice often involves a lengthy prologue and justification of whether bringing a new life into an increasingly overpopulated and polluted world is ever justified; whether having children is simply selfish. These are different times…

I met Sandi at a large celebratory dinner at a wealthy friend’s place. Perhaps I should say I met her again that evening: her mother had been a patient of mine twenty or so years before, and Sandi was the baby I’d delivered; it’s a jarring reminder that I am getting old…

Before the dinner, we all mingled in my friend’s enormous living room talking and introducing ourselves. “You don’t recognize me, do you doctor?” a young woman with long curly auburn hair said as she sat down beside me on the couch.

I suppose I looked surprised and a little embarrassed, because she quickly reached over and touched my hand. “You were the first person ever to see me, actually,” she said with an enchanting little giggle. “I’ve changed a lot since then, I imagine,” she added, her eyes twinkling at my reaction.

I didn’t have enough time to mount the smile I’d perfected over the years for use when accosted by mothers on the street I’d seen as patients in the past. A busy obstetrical practice and equally busy call schedule made it difficult to remember all the faces as the years rolled by; even those people I was sure I’d never forget, gradually merged into the melange of similar memories after I retired.

“It’s okay, doctor, my mother hoped you’d surface sometime in my life.” Sandi continued to examine my expression. “Her name is Sandra as well -Sandra Stevenson… She decided to spell Sandi with an ‘i’ to differentiate us, I suppose…” she added as she shrugged and grinned mischievously.

I smiled as the memory slowly solidified in my mind. I remembered when her mother showed up for her first postnatal visit and tried to justify calling her daughter Sandi with an ‘i’.

“Please call me ‘G’, Sandi; everybody calls me that now.” ‘Doctor’ seemed out of place after six years of retirement.

A dimple appeared in her cheek as she smiled; she was certainly as beautiful as I remembered her mother had been. “Okay, G. My mother warned me you were probably the type that would drop the honorific when you retired.”

I shrugged; I didn’t think I was so predictable to my patients. “And how about you, Sandi? You probably have a family by now, I guess, eh? Your mom was quite young when she had you…”

Sandi stared at her lap for a moment before she answered. “Well, that’s something I wanted to ask you about.” She saw my face change and she quickly smiled. “No, I wasn’t going to ask you for advice. I don’t think I’m infertile or anything; I mean, I know you’re retired, but… Well my mom actually knew you were going to be at this dinner and she said I should speak to you.”

“Where’s…?”

“She and dad are in Florida for the winter,” she explained, rolling her deep blue eyes with an obviously practiced skill. “They’re old friends of Jeff and Linda,” she added, nodding towards the hosts.

I smiled and stayed silent while she decided how to phrase her question.

“I… I don’t think I want to have children.” She sent her eyes to perch on my cheeks briefly before they took flight again. “I mean the world is not a welcoming place now: nasty politics, pollution, climate change, wars, global overpopulation…” She shook her head sadly. “The list goes on…” She glanced at the milling crowd in the room, most of them laughing and talking loudly to be heard. “I mean look at them, G. All of them trying to distract themselves… all of them attempting to rationalize their existence…”

I tried not to seem surprised. “A bit harsh, don’t you think?”

She shrugged and attempted a little sigh. “I get carried away sometimes…”

I softened my expression and glanced at a young man standing across the room who had been looking at us with a worried expression on his face. “Is that your partner over there, Sandi?”

She flicked her eyes at him and then nodded. “I told him I was going to talk to you.”

“About having children…?”

She stared at her lap again for a moment but her eyes soon flew to my cheeks once more. “He doesn’t understand…” Another sigh. “We’ve been having little blow-ups about it.” She took a deep breath. “He said a child would be good for us: a common bond; I told him that we should just get a rescue-dog instead; we had a big fight about that, let me tell you.” She glanced around the room to make sure nobody else was listening to us. “I think having a child would be selfish, but he can’t see that. He thinks we could provide a good life for a child and so not having a baby would be depriving it -and us– of an opportunity.” She struggled to put her concerns into words.

“But we can think of what non-existence would be like only by comparing it with what it would mean for us who already exist… A non-existent baby cannot possibly care whether or not it is born; only once it exists might it have an interest in continuing to exist…

“What do you think, G?”

I understood what she was trying to say but, perhaps because of my life as an obstetrician and a father, I was not sure I agreed with her. For the binary problem as she had formulated it, there was only a binary answer: baby, or no baby. I couldn’t think of any response that might help her to discuss it with her partner.

But then Sandi said something interesting. “A good friend of mine tried to help me: ‘If someone recommended a play at the theatre, you could always walk out during intermission if you didn’t enjoy it; but if you’d known that, why would you have gone in the first place?”

I smiled at the clever argument. “But if you never experienced the play, how would you ever know what to think about it…?”

She looked troubled and then glanced at her partner watching anxiously from across the room.

I studied her face for a moment. “Your mother was a professor of English literature at the university, I seem to remember.” I chuckled at a memory of her mother during her prenatal visits; she always quoted something just before she left the room. Tennyson seemed to be a favourite poet of hers… “Did she ever quote Tennyson to you, Sandi?”

She nodded tentatively, no doubt wondering where this was going.

“Remember his elegy, In Memoriam­ –it had a longer title I think. She usually only quoted its first verse and then the last few famous lines: ‘I envy not in any moods, the captive void of noble rage, the linnet born within the cage, that never knew the summer woods.’ And then she’d say, ‘Tis better to have loved and lost than never to have loved at all’.

Sandi’s eyes softened at the probably inaccurate quote that she no doubt knew by heart. She glanced at her anxious partner and smiled, then reached for my hand and squeezed it. “Thank you G… Thank you!” she said, as she rose from the couch and walked over to him, arms outstretched.

I don’t think they were arguing…

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gozzter

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