The Feast of Fools

It’s hard to switch sides, isn’t it? Hard to cross the tracks. And even if you do, does welcome await, or merely sidelong glances and mistrust -or as Macbeth feared, curses not loud but deep, mouth honour, breath which the poor heart would fain deny and dare not…?

It’s a brave person who crosses over –who dares to live the other life. But can one ever feel what one has only watched from afar? Would the experience be real, or only a tawdry simulacrum? A Halloween costume? True, only we know for sure how we perceive something, but we can intuit how someone else might feel –and realize that they might also have a different understanding of what happened. A different reality. So, are we unalterably barred from that room?

I ask this as a man peering over the fence and wondering about what I see. It always seems so… so like my side –so like the cover of the book I’m reading. I suppose that’s where it gets confusing. I know the story is different, and yet I don’t really understand why. But then again, perhaps I’m as naïve a reader as I am a contributor –or is that merely a pretence of innocence? An expected social conceit?

And if I were to attempt a disguise in a situation that even I could see might be demeaning for a woman, would that help me understand? Or would it merely seem weird, and elicit the confused and embarrassed reactions that cross-dressing usually does? Would it take me closer to the lived experience? Or would it be yet another variation of the male Weltanschauung?

An article in the CBC news on sexual discrimination in the workplace made me wonder: http://www.cbc.ca/news/canada/ottawa/workplace-sexual-discrimination-men-heels-union-613-1.3483305 ‘The male staff decided to dress up after a CBC Marketplace story  […] on restaurant dress codes and found that many women felt compelled to wear sexy outfits —including high heels, tight skirts and heavy makeup — to keep their jobs.’

I have to say that at first glance, I was reminded of the Medieval Feast of Fools. This, as you may recall, was a festival usually held at the beginning of the new year (especially in France) in which a mock bishop or pope was elected, ecclesiastical ritual was parodied, and low and high officials changed places. And, according to the Encyclopedia Britannica, by the 13th century these feasts had become a burlesque of Christian morality and worship. But nobody was fooled; everybody realized it was just a charade…

In the case of the restaurant, ‘The men lasted only an hour or two in the heels, which ran the gamut from red stilettos to cheap, black, strappy numbers. But aside from the physical pain, they also described feeling vulnerable and uncomfortable as they worked.’ And understandably so –they were pretending to be something they most decidedly were not. Everybody –customers and staff- knew it and no doubt played along. ‘”Guys were making comments, jokingly of course, because that’s what we were going for — to show light to it — but even those jokes that they were making were, after a while, still very uncomfortable to be faced with,”’ said one of the servers.

A few of the customers were women who also worked as servers at other restaurants with similar dress codes where they were told to look like they were going to a party, not coming home from it. One of them, who had recently quit one of those places after being sent home for not wearing enough jewellery on her shift, said: ‘”I came here tonight because I love the idea of reversing sexist dress codes required in some restaurants to male colleagues. Seeing them wearing heels and short skirts is really something. I wanted to come down and be a part of it,” she said.

‘”It reinforces how ridiculous it is. Seeing men walk by in tight miniskirts and heels really just hits it home how crazy it is to ask women to do that.”’

The consensus among the women servers watching was that within limits, dress should be about choice. If they felt comfortable with dressing like what they were seeing, that was fine. But many of them didn’t. The doctrine of contra proferentem might apply, perhaps, but I doubt that many of them would go so far as to hire a lawyer to press their cases.

So, apart from some interesting publicity and a bit of teasing, what did the cross-dressing actually accomplish? For guys, dressing like women and trying to balance on high heels they’d never been acculturated to wear -and never had the opportunity to practice on- can only give them the barest whiff of what many women have to endure on an ongoing basis. They weren’t women that night, just actors rehearsing a drama they would never get to play.

Clearly, what the article was pointing out was the tip of a very large iceberg. Highlighting this form of sexual exploitation was merely a way of hinting at the way women in general are regarded in our society –and maybe not just ours… You can legislate fair hiring practices, but it is far more difficult –impossible, actually- to legislate attitude.

It is true, however, that unless the issue is publicized in a manner that shocks people into seeing it, there is unlikely to be any change. Some are hoping the protest might go national, with similar events taking place in various cities across the country. But I worry that, although the cause is worthwhile, too frequent repetition of the burlesque, is also a way of making it seem just confrontational -turning a good idea into a parody, and losing the point it was originally intended to make.

As long as shareholders and owners of companies see profit in sexualizing young women –and men, for that matter- the battle for change will be an uphill one. We are already seeing a backlash against ‘political correctness’, to the extent that many of the gains made in the past few decades are being sidetracked, or even eroded. I suppose it was inevitable that direct confrontation with the status quo would be resisted as would any threat.

But the solution, it seems to me, lies not in confrontation, but in changing what we accept as normal –as proper. And it is already being done with some success nowadays through both social media and advertising strategies. Just look at the change in attitudes about, say, smoking in restaurants, or driving home after a night at the pub. There are already recent, albeit tentative steps in various TV and internet-streamed programs –sitcoms and the like- to portray women less as sexual objects, and more as equal partners in their dealings with men. Some episodes have even attempted, as did those male servers in that Ottawa restaurant, to depict the humiliation that men would experience were the roles reversed. And people are watching and getting used to the idea because the characters on the screen are making it seem, well, normal. Accepted, not contentious. And certainly not antagonistic.

Nothing happens overnight, of course, and although we are understandably impatient for more progress, change that is too rapid often leads to rebellion -especially if that change is precipitate. Unexpected -or worse, abnormal!

“How poor are they that have not patience!” says Iago in Shakespeare’s Othello. “What wound did ever heal but by degrees?”

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An Unfamiliar Worry (for some)

I don’t know how the world used to manage with just men at the helm. There are so many things –obvious things- that simply pass by us uncharted. I don’t think its intentional; it’s more likely that those things just do not affect us in the same way. They have different consequences; we assign them different priorities –if we assign them at all…

There are, of course, some issues at which men seem relatively proficient at first glance- such as dealing with the needs of refugees arriving in Europe or wherever, from war torn areas of the world. When they arrive, attempts are made to provide for their health and safety while they are being processed. Because of the large numbers arriving, this often means settling them temporarily in camps where the basic needs of shelter, food, and medical care can be provided.

But those are relatively easy things to plan for -easy things to discuss at any  rate. Add in education for the children, maybe phone service so they can communicate with their families back home, and perhaps even, as icing on their cakes, leisure activities, and… Well, apart from a chance of permanent resettlement or, of course, improving the chaos in their home countries so they could return, what else could refugees possibly need? Or want?

Full disclosure: I am a man, and despite my forty-plus years as a gynaecologist, I’m afraid my brain is still sometimes stuck in Y mode. One would have thought that if anyone could transcend gender –wear other shoes- a gynaecologist might be in the running. But I missed this one: ‘About one in four of Zaatari’s [Jordan’s largest refugee camp] residents need sanitary pads. The UN does distribute them now and again to women aged 14 to 45, but there are never enough to go round.’ Sanitary products, even if they are available, can be expensive; the temptation is probably to use whatever personal money is available for other, more survival-oriented necessities. I learned this from an insightful article in BBC News: http://www.bbc.com/news/magazine-34925238  A British woman named Amy Peake not only discovered the need, but found a simple machine in India that would allow women  to make sanitary pads cheaply and on site. ‘On top of that, Peake discovered, there is a desperate need for incontinence pads for the many wounded, elderly and disabled people – and traumatised children. “The children are really suffering,” says Peake. “The problem is that the mothers have been trying to cope for so long that basically they’ve given up. Night after night of urine and they can’t keep them clean.’

There are so many things in everyday life that most of us take for granted until they are not available –things like a clean and timely change of clothes, the ability to maintain personal cleanliness in a culturally sensitive manner, and in private if desired. Although necessary, it is simply not sufficient to provide only the obvious -food, shelter, and so on- and then assume normalcy will ensue; we are all products of societies laden with traditions and expectations –this is what it is to be human. To strip these away is not only cruel, and disrespectful, it is also degrading. Inhuman. After all, they were living lives much like us until forced by war and unspeakable danger to flee from their homes for the sake of their families. For the sake of their futures… They are not merely bodies in need of sustenance, they are mothers and fathers… children… and so are we. So the question we must continue to ask ourselves is whether we would be comfortable treating our own families in the same way as these refugees. Would we feel that we have been sensitive to their needs?

Admittedly, in times of crisis and overwhelming numbers, some things must be prioritized, while others, perhaps less important to survival, need to be relegated to the background. But not neglected. Not forgotten. The refugees, already traumatized and exhausted by the hardships of their journeys and often bewildered by the contrasts with their previous lives, are ill equipped to complain. They are initially powerless, and confused, but very soon understand that once the basics have been provided, once the threat to life and limb has receded, there is another thing they desperately require: dignity. If they are ever to be assimilated into another country, another culture, another life, they must regain their self-esteem. Their pride.

We must not forget that different societies may view the world in different ways. Things to which we in the West have long since been accustomed are sometimes still problems elsewhere. Attitudes about the management of menstruation is one such problem. In many traditions, it is not only a secretive event that must be concealed from others for fear of ridicule, but also dealt with by whatever is at hand. The stigma around menstrual periods is complicated and culturally sensitive as I have already discussed in several other blogs:

https://musingsonwomenshealth.wordpress.com/2014/11/26/menstrual-taboos/, https://musingsonwomenshealth.wordpress.com/2015/04/01/menstruation-and-sports/, and even: https://musingsonwomenshealth.wordpress.com/2015/03/13/the-tampon-tax/

So I’m not sure why this article came as such a revelation. Maybe it was a reminder that we all see the world from our own perspectives: two people crossing one bridge is really two people crossing two bridges… And yet, to a third who is watching from the edge, it’s still the same bridge.

I should have known!  ‘But every little difference may become a big one if it is insisted on.’ as Lenin said.’ so I suppose I’ll have to accept that Time is a series of tests, and you only get marked at the end… I hope.

I can only offer the words of Iago in Shakespeare’s Othello:

I will wear my heart upon my sleeve
For daws to peck at…

 

 

 

What’s in a Word?

Alexithymia. Ever heard of it? Me neither. It sounds like one of those words you’d get in a national spelling bee when they’re trying to off you. Fortunately it has a rather pedestrian etymology: ‘a’ meaning ‘without’; ‘lexis’ –speech, or words; and ‘thymos’ – soul, or emotions. In other words: no words for feelings. Hmm… Who would have thought it was a condition? Mind you, since there’s one called anhedonia, the gloves are off.

I’m fairly certain that its shadow would never have darkened my office door, had not a patient pulled it deliberately from her purse while reaching for her phone. Pandora comes immediately to mind, but this lady’s name was Alexis – or, rather, Alexisse as she quickly corrected me- with the accent on the last syllable would you believe? She seemed innocent enough sitting in the waiting room, but in retrospect, she was more a pier in the currents of a hectic room than a middle aged lady. The usual waves of noise and confusion seemed to break over and around her with as little effect as a storm on a breakwater. Throughout the maelstrom, she maintained a smile on her face, but she later admitted to me that it was a well-practiced artifice –a mask that she would always carry with her to help her to blend in.

Her clothes certainly helped as well –a grey skirt worn just below the knees, white blouse buttoned tight around her neck, but loose at the wrist, and black shoes with just a hint of a raised heel. Her light brown hair was short and tidy and her nails long and uncoloured. An average height, she would have melted into any crowd without a trace. Indeed, she followed behind me to my office like a shadow.

I’m describing her like this in the full light of retrospect, however. We always tend to remember things in ways that make sense to us I suspect, although at the time, only the word stood out. She presented as a model patient, and was not at all upset that I was running behind time and was almost an hour late before I was able to see her. “These things happen,” she said with the same smile she’d worn through the whirlwind out front. “I carried a book with me, just in case.”

I brought up her file on the computer as she sat contentedly across the desk inspecting the art work on the walls. I’d not seen her before, but the only thing the family doctor had sent me was the result of a pap smear she’d done recently. Alexisse was a new patient for her as well, and apparently had not had a pap done for over ten years. But worse, the smear was read as showing some malignant cells.

“Did you find the pap smear results?” she suddenly asked, the smile still on her face.

I nodded and looked at her for a moment before speaking. She didn’t seem at all upset so I assumed her GP hadn’t discussed the results with her. Of course the diagnosis was unlikely to be firm until a biopsy of her cervix had been done, so perhaps she had decided to wait until I did that before discussing it with Alexisse.

“Dr. Mandel said you’d be able to confirm the diagnosis with a biopsy.”

The smile never left her face but I was drawn instead to her eyes –they were totally neutral. Cool, if anything. “What did Dr. Mandel say about the pap smear?”

Alexisse shrugged. “Well, for a start, she tried to downplay everything. She said that pap smears are only screening tests and so sometimes they are mistaken…” She stopped for a moment and stared at me with an unchanged expression. “But even when somebody goes to great lengths to paint a black paper white, you know it still ends up looking grey.” Her eyes sought mine to see if I understood.

I approached the topic carefully. “So… What do you think she was trying to tell you?”

Another shrug. “That I have cancer of the cervix.” She said it as if I had asked her about her last period.

I was speechless for a moment. There was no sign that she was upset. No tears. No tightening of her facial muscles. Just the smile –the mask. “You don’t seem very upset. Your family doctor must have done a good job of discussing it with you.”

Alexisse shook her head. “She seemed a little confused about what to say. She asked me if I had any questions, and when I didn’t, said she’d send me to see you.” She stared at me for a while and when she saw that I looked puzzled as well, sat back in her chair.

“I have alexithymia,” she said as she reached nonchalantly into her purse to turn off a phone that was ringing. I must have cocked my head, because her expression intensified. “It’s a condition that makes it difficult to feel emotions –even identify them as such. I’ve learned to put a smile on my face along with my makeup in the morning.”

I started to ask if it was a type of autism, but she saw the word forming in my mouth and waved it away. “Only half of us with the condition are autistic, if that’s what you’re going to ask…” She took a deep breath and let it out slowly. “I’m sure it’s a spectrum disorder –worse in some, less in others.” The smile appeared again. “And the next question you’re going to ask is about my name. Isn’t it a little suspicious that my name is almost the same as the condition? I mean I can almost see everybody thinking it. Go online and you’ll see the community calls its members ‘Alexes’. It’s why I’ve started pronouncing my first name differently…” She sighed briefly. “I don’t think the condition is even accepted by mainstream psychiatrists yet. It wasn’t in the DSM IV at any rate… But I have to admit I haven’t looked lately.”

“So…”

She crossed her arms and stared out the window. “I’ve always wondered about why everybody except me seemed to get excited about things. I can’t remember ever being angry, or crying at a movie. People thought I was weird.” She shifted her position on the chair. “Anyway, I looked up the etymology of Alexis –which is how my parents spelled the name- and realized it came from the Greek for ‘without speech’. It didn’t take Dr. Google very long after that to introduce me to alexithymia.

“And no, I haven’t had a formal diagnosis. Dr. Mandel asked me about that.”

I sat back slightly on my chair to get the computer screen out of the way. “Well, frankly I’m more concerned with doing a biopsy as soon as possible than with any personality disorder you might have…” I wanted her to know that the most important thing to think about at that moment was her health. I meant well, but her facial expression changed immediately. She looked almost angry –hurt, at the very least.

“Personality disorder? And that I might have?” Her whole body tensed at the perceived insult. “I think you’re being entirely too insensitive, doctor!” She shook her head slowly. “Just like my family doctor. Now you see why I don’t go to doctors very often.” She started to get up from her seat. “Your secretary can let me know when you’re going to do the biopsy,” she said, still shaking her head in disbelief. “You all seem to ignore who I am for what I have…” She fixed me with a glare that almost pinned me to my seat then left the room with a toss of her head… Anger?

She never showed up for any of the biopsy appointments despite multiple phone calls from both our office and her family doctor’s. I can only hope she sought help from someone who listened to her pleas for understanding. I don’t know whether she actually had alexithymia or some other mental issue such as schizophrenia, but it clearly seemed to interfere with her ability to process information appropriately. I’ve since learned that alexithymia is often associated with other psychiatric disorders, so perhaps she had decided to fixate on a more acceptable but obscure variation. Maybe she’d been wearing another mask -one that even she had not suspected. Or one that she found too difficult to acknowledge…

I also Googled the word and discovered that the BBC had an article on it that was dated a month or so prior to her visit: http://www.bbc.com/future/story/20150818-what-is-it-like-to-have-never-felt-an-emotion I remain open to convincing, but I keep remembering what Iago said in Shakespeare’s Othello: ‘I will wear my heart upon my sleeve for daws to peck at. I am not what I am.