Abstract
Ask any woman- they will be able to recount a particularly uncomfortable visit to the doctors. ‘I was not offered pain relief’ or ‘I was dismissed due to my weight despite my legitimate concerns’. Why is this shared experience for women accepted?
In this dissertation, I explore how women are impacted by medical practices by analysing my first-hand account of a vaginal examination as well as Martha Rosler’s Vital Statistics Of A Citizen, Simply Obtained. Both of these approaches allow me to draw wider conclusions about society's attitude to women and how female bodies are consistently seen as unusual when compared to the male standard. The shared experiences of women are systematically being dismissed not only in the medical sphere but in other aspects of life.
While reflecting on my first-hand account of the examination, I was able to thoroughly understand my body but also how, in oppressive spaces, I become more malleable. Through publishing the writing, I hope that it provides insight for other women about how they can have autonomy over their bodies.
“We are allowed to say, That hurts, we are allowed to demand that it doesn’t hurt.” (Enright, 2019).
List of Figures
Figure 1: Wilke, H. (1992) Intra-Venus Series No. 4, July 26 and February 19, 1992 (detail) [Photograph] Available at: https://feldmangallery.com/exhibition/164-intra-venus-wilke-1-8-2-19-1994 (Accessed 20 December 2021)
Title and figure 2: Rosler, M. (1977) Vital Statistics Of A Citizen, Simply Obtained [Performance]
Available at: https://www.moma.org/collection/works/118563 (Accessed 31 March 2020)
Figure 3: Rosler, M. (1977) Vital Statistics Of A Citizen, Simply Obtained [Performance]
Available at: https://vimeo.com/195328460 (Accessed 7 January 2020)
Figure 4: Wybrant, C. (2020) Ectropion [Photograph] (Accessed 24 September 2020)
Acknowledgements
Firstly, I would like to thank Lina Hakim for inspiring me throughout the entirety of my time at Kingston University. Without your guidance, my dissertation would not have been so enjoyable to write. Thank you for encouraging and understanding me.
I would also like to thank Will for everything. More specifically, for the continuous rereads on a subject that is completely out of your remit and always being my biggest fan.
Thank you to Megan and Kirsty for going on this journey with me. This dissertation has been shaped by our conversations attempting to put the world to rights.
Finally, I would like to thank my mum and dad. Thanks, mum for answering all the questions I have (you know the ones). And thank you dad for providing the comic relief. I have really appreciated both of your support and understanding along the way.
Introduction
Figure 1: Still image taken from !Women Art Revolution documentary depicting Hannah Wilke
Hannah Wilke’s deep brown eyes bore out of the photograph. Her expression alludes to a terrible happening however she does not look sad. Rather, she expected that outcome all along. Her gaze is bewitching and when my eyes meet hers a special connection is formed. It seems that I have entered a pact to be authentic and bold; to break our eye contact is to be cowardly and immoral. Her eyes settle beneath skin which has a paper-like quality. While her features are steely, there is a sense that her physical body is weak. The thin wires of hair that cover the top of her head, like delicate veins, also indicate her declining health. Wilke appears completely unclothed, except for the medical tape which covers the back of her right hand. The nakedness of her body is paralleled by the nakedness of her gaze.
Within the documentary !Women Art Revolution, this image of Hannah Wilke’s is used to demonstrate the paradigm shift that occurred after the “long tradition of the woman being looked upon. When feminist performance began it literally was the looking back” (Roth, 2005). Referring to women as being looked upon describes how women are rendered powerless within a patriarchal society. It positions women as voiceless and passive. However, introducing the idea of looking back demonstrates how female performance artists began aggressively challenging the societal norm. Performance artists believed “a live element reflected the modern condition better than static painting or sculpture” (Tate, 2017) and this is especially true of feminist performance art. Poetically, the artists use their bodies “to comment on how the female body is always a spectacle” (Wybrant, 2020) allowing an audience, under the artist’s conditions, into a private sphere to communicate their perspectives.
The metaphor of looking back was used to establish the theme of body politics, which “refers to the practises and policies through which powers of society regulate the human body” (Martin Shaw, n.d) and, in particular, how body politics infiltrates the medical system. These politics are deeply embedded into our lives. At first, invisible but once we become aware of them, call them by their name and acknowledge their shape we see that they are surrounding us. They push and pull against us. Bend our bodies into uncomfortable positions and ultimately shape our world experience.
In this dissertation, I will explore how Martha Rosler’s Vital Statistics Of A Citizen, Simply Obtained (Rosler, 1977), hereafter VSOACSO, addresses the impact of medical practises on the female body. In the opening monologue, the performance is described as “an opera in three acts” although I will mostly reflect on Act One. The performance exhibits a woman being physically examined, for over thirty minutes, by two male examiners who are eventually joined by three female examiners. Often, the piece is interjected by a female commentator and finally, with the assistance of the female examiners, the examination concludes with the woman being redressed. The photomontage is also examined which displays various images of women and girls while a female voice defines the acts committed on them. Act One parallels the experience I describe within the autoethnography.
To further enrich this dissertation, I will also use autoethnography as a research method that displays “the researcher’s own experience a[s] [a] topic of investigation in its own right” (Bochner, Ellis, and Adams, 2011). I will detail my personal account of a medical examination and use this to draw wider conclusions about the impact of medical practices on women. This method is appropriate as it is able “to get across the personal, emotional and embodied experiences” (Van Amsterdam, 2014) of women setting their humanity aside to become a patient, observed as purely biological. This is my personal way of looking back at how I have been treated and how women are continuously treated in the medical system.
Similar to VSOACSO, this dissertation is divided into three parts: before, during and after my examination. Part One largely addresses tone of voice within the performance, Part Two considers how women’s bodies are deemed public spaces and Part Three interrogates the significance of the statistics extracted from the woman. In addition, these sections include a reflection of the autoethnography.
Finally, the analysis in this dissertation derives from my personal experience of being a cis-gendered, heterosexual woman. Therefore I use woman and female interchangeably, though I am aware that these words are not always synonymous.
Figure 2: Still image from Vital Statistics Of A Citizen, Simply Obtained
Part One
It is impossible to observe Martha Rosler’s VSOACSO without considering how medical practices affect the female body. Rosler includes a photomontage of women and children being examined which contextualises the performance and demonstrates “the truth known to women” (Rosler and Weinstock, 1981). The truth known to women is widely unheard as “pain is to be expected, to be endured, to be borne- with discretion and even good cheer” (Enright, 2019), and so pursues a culture of women being misrepresented and mistreated. These conditions have serious implications for women in medicine as well as in other areas of their living as “women see their bodies as part of their whole lives” (B Sri, 2010). Unlike men, women experience life accompanied by the unavoidable sensation of the female body. Every patronising conversation is instigated with the presumption that a woman does not know correctly or working a shift with debilitating period pain or being touched on the waist to be moved out of the way like an out of place chair. With the “prevailing norm of the male body” (Van Amsterdam, 2014) the female body is considered taboo and “marked ‘other’ devalued as feminine” (Morris, 1998). VSOACSO is not a piece of fiction nor a self-indulgent whim but a commentary on how women are consistently unacknowledged and therefore harmed by medical bias.
The waiting room is silent aside from the television which quietly murmurs, mounted high on the wall before me. I attempt to focus on the words the news person is speaking yet I soon move my attention to the person sitting two chairs over. Distractedly, I chew my lip while considering their ailments until the taste of blood reminds me to stop.
Over the past three months, I had noticed more spotting than usual. Each time I saw the sprinkling of blood a dark cloud rested around my shoulders. The first month I could convince myself it was a one-off because I had been stressed at work. The second I was sure it was due to my contraception. But by the third, I had run out of excuses and I was feeling uneasy.
“Chloe?” An unfamiliar voice calls.
I stand quickly but falter when I recognise the voice of a man. Internally, I scold myself for the rush of anxiety which follows the sound of his voice. “He is a professional, Chloe, stop being so narrow-minded”.
I walk after him and into a wide room. Meekly, I stare about the room, taking a seat and folding my hands into my lap.
“How can I help?” He says, his eyes unmoving from the computer screen he has seated himself in front of.
I pause before answering, waiting to see if his eyes will move from the screen. After a few moments, I describe my symptoms, ending with a short, sharp, anxious laugh.
“Oh, and I wanted to let you know that I’m not very good with pain. I’m really prone to passing out”, punctuating the sentence, again, with a laugh.
It is standard routine, for me, to let the doctor or nurse know about my tendency to faint. The many occasions where I have been woken up following an injection, blood test or piercing has taught me that it is better, to be honest because then I am treated with a bit more caution.
His eyes swivel to meet mine as he decides, “you will not pass out”.
A surprised laugh escapes my mouth as I nod feverishly. In response the doctor shakes his head, returning his eyes slowly to the screen.
The anxiety returns but this time I struggle to fight against it. My eyes land on the examination table.
VSOACSO opens with a female voice which I immediately assumed to be the voice of Martha Rosler, who is the subject of the medical examination. Understanding that Rosler is also the director impacted my initial interpretation of the performance as her voice is authoritative and objective, reflecting the process of the examination. Rosler is the expert, regardless of her role as the subject, as she describes symptoms of the female condition. Her voice positions the performance as a scientific “metacommentary” (Rosler and Weinstock, 1981) of the medical field itself. Women are extremely familiar with these uncomfortable experiences and are conditioned to believe this is normal. However, allowing the performance to become a scientific examination of the examination itself enables the viewer to critically observe through a third-person perspective how insensitively the female body is treated. This performance might seem like an exaggerated version of the truth but it is not too dissimilar from reality as “she’s measured ruthlessly but it made you think of how women are measured ruthlessly” (Roth, 2005). Rosler encourages the viewer to consider the significance and implications of these “medical measurements” (MACBA, 2008).
It is powerful listening to Rosler’s voice as this demonstrates that she is taking ownership of her body. Even when it becomes distressing to observe, the viewer acknowledges that Rosler situated herself in this performance. However, the viewer is then provoked to ask why “it was necessary for [her] to do this in the first place” (Hershman Leeson, 2011) in such a vulnerable and raw manner. Exhibiting her body contributes to the idea that “self-inflicted wounds and exposed vulnerability reflect a culture of rage and aggression” (Hershman Leeson, 2011). Rosler’s honest depiction represents the experience of real women.
A second interpretation of the voice is that, rather than it being Martha Rosler’s, it is the voice of a nameless woman who is interchangeable. Thus demonstrating that all women are in the same position. The voice is “very personal… spoken by a real, not an idealized, voice” (Rosler and Weinstock, 1981) which is relatable and accessible to the majority of women. The tone of voice is informal which juxtaposes the exceedingly formal visual of the examination. To a female viewer, it is invigorating to observe the power being taken from the situation and this is furthered by the use of dark humour. The voice states, “this is a lesson in sinking or swimming when sinking and swimming have a lot in common” indicating how humour is interwoven seamlessly through vivid language which describes the scene but also removes the seriousness from it. While the overall message is alarming, the line is produced ironically with an attempt to make the female audience feel more comfortable and relaxed. Arguably, the performance becomes a more satirical scientific metacommentary with this understanding of the voice.
Additionally, the voice seems real as though it might occur within a conversation. The message is developed naturally and gradually with the confidence that the audience will remain to hear the end. It is relatively neutral, not commercialised or intent on persuading an audience one way or another. With this interpretation, there is the impression that the words are spoken nonchalantly and however they are interpreted is a legitimate interpretation. Consequently, the commentary is perceived as honest, raw and trustworthy.
By using the word “she”, rather than speaking in first or second person, Rosler can communicate to women without directly converting them into active participants. This creates a sense that the piece is addressed to women but is distanced enough that they can reflect. Therefore, observing the examination becomes a space for women to consider what is being done to them and why. Next, as a sign of acknowledgement, Rosler presents images of women and children, offering the names of the crimes committed to them. These photographs are also displayed at a distance, “you see them framed and reframed; within the frame of the screen… distanced, rather than presented as visual truth” (Rosler and Weinstock, 1981). Providing distance offers an elevated sense of importance. The frame of the screen forces the audience to view the entirety of the image and to do so means to truly appreciate the message. While the images cannot be the entire truth as they portray one still moment, they speak boldly about that moment. Rosler does not attempt to tell the audience what to think about the images but encourages them to consider the commonality between the examination and the crimes. The audience is compelled to consider how structures, such as science and medicine are used to normalise and justify these actions. The interpretation of the examination could be considered subjective yet the names of the “crimes are definitive words, though- femicide is a meaningful term, as are childbirth torture, wage slavery. They allow for no argument” (Rosler and Weinstock, 1981). This evidence consolidates VSOACSO as it demonstrates that this truth is real for women. These terms exist due to the issues of discrimination within the space of science and medicine derived from “the acceptance of the male norm” (Criado Perez, 2019) as the baseline. The one-size-fits-all approach has been consequently normalised, which leaves any individual who does not identify as male vulnerable.
The female voice can be interpreted in several different ways. It could be the voice of Martha Rosler or another anonymous woman; the importance of the voice is not who it belongs to, but that “it’s the voice of the argument” (Rosler and Weinstock, 1981).
Within the autoethnography, the first speaking voice belongs to the male doctor who interrupts my thoughts to begin the appointment. While minor, this interruption represents how harsh I find the methods of the doctor and the examination itself. This initial interaction establishes how the appointment will proceed; too clinical and direct. Throughout the appointment, his dialogue is efficient, only speaking when necessary. It becomes clear that he understands this appointment as an aspect of his job and as such, I am just a task to be completed. He views me as a “[person] without personhood” (B Sri, 2010), an empty vessel that he can examine without considering what the person inside might think.
At the prospect of the intrusive examination, I emit signals, like laughing excessively, to exhibit the anxiety I am feeling. On one hand, these signals are expressed to directly translate my nerves to the doctor. On the other, even if he does not understand this manifestation as nerves, he will at least perceive me as friendly and therefore take better care throughout the appointment. Laughing has become a form of protection for women as it is safer to be viewed as harmless and docile than to challenge a man. This laughter is also a response to the structure of power exerted on me by the doctor. I attempt to ease the formality of the situation and align us as equals yet the doctor stands firm in his superior position. Such formality is observed within VSOACSO but it is combated by the satirical commentary. There is a parallel between the use of dark humour and my laughter, contributing to the idea that women do rely on humour as a self-defence mechanism.
When my subtle message is not grasped, I directly communicate my worries to the doctor. However, even when the point is exceedingly clear, the doctor ignores my concerns. In response to my attempt at levelling the dynamic, he further redefines the hierarchy to demonstrate that he is the “expert” (Enrght, 2019) and I am beneath that, not a person but a patient. By referencing Lynn Enright in this instance is to acknowledge that others have experienced this unsettling dynamic too. Enright proceeds to state “the doctor had been nice but he had also been patronizing and dismissive” (Enright, 2019). Rosler consolidates this idea by describing that “for an institution to be evil it need not be run by Hitler… it need only be run by heartless people sometimes called intellectuals or scientists”. An individual does not need to be evil to their core when the structure they operate within justifies harmful practices. He is the medical expert but I am the expert of my body and so to disregard my perspective is irresponsible and demeaning.
Arguably, an unequal power dynamic could result in a lack of respect for the patient. This could be an explanation for why the doctor did not feel compelled to communicate the circumstances of the procedure to me. Even now, I am unsure whether I experienced a typical smear test or a unique test due to my symptoms. Providing me with any knowledge about the examination would have reassured and prepared me, while also including me in the process. Generally, women “find the knowledge of their bodies empowering and liberating” (B Sri, 2010) which increases the feelings of “self-control, independence and confidence” (Rosler and Weinstock, 1981). Providing women with knowledge about their bodies would have positive implications as they would know what their rights are, as well as what is to be expected and how to recognise if something is wrong. Potentially the doctor presumed that I would not understand, or that I would not want to know, or that knowing would not make a difference. Regardless, this enhances the strange dynamic where I am at his mercy, unknowing what will happen and when.
When in the context of the doctor’s office, I am a reflection of the woman in VSOACSO as “she is made malleable” (Gennard, 2017). In the confines of the examination, I am also made malleable, willing to sacrifice my comfort for the sake of the convenience of the doctor. Within the autoethnography, my internal voice is distressed while being aware that I am treated badly. In contrast, the female narrator in VSOACSO is authoritative and clear. Powerful while I am powerless. Even throughout the process of writing my autoethnography, “I seem[ed] to be endlessly engaging in practices of self-surveillance” (Van Amsterdam, 2014), feeling urged to remove words like vagina, discharge and speculum. Whispering and hesitating when verbally retelling the story, following apparently vulgar words or situations with a lighthearted laugh. I felt inclined to use poetic and abstract metaphors instead of vividly describing what had happened. In engaging in self-surveillance, I become the doctor who attempts to silence or dismiss me. However, when I can critically analyse the autoethnography my voice mirrors the voice of the female narrator. Within this space, I am authoritative and can take back the control that was taken from me.
Figure 3: Still image taken from https://vimeo.com/195328460 of photomontage in Vital Statistics Of A Citizen, Simply Obtained
Part Two
Shakily, I move behind the blue curtain which now halves the room. The space feels new, more intimate now and foreboding. I tiptoe towards a chair and let my fingers drag across the rough, grey, perforated paper which lines the examination table.
Sheepishly, I peel my trousers from my body and fold them into a neat square. Observing my naked lower body, I consider my spotty socks but removing them feels a bit too naked, so I opt to keep them. The linoleum flooring is cold on my feet as I return to the table and perch awkwardly, awaiting the doctor.
When the doctor returns, he is accompanied by a female nurse who collects items. While she glides about the room, the doctor instructs me to lay back on the table and position my legs into the stirrups. I focus my eyes on the squares of the ceiling while reflecting on my previous examination. I think about the woman’s kind voice as she reassured me that she would use a smaller speculum and encouraged me to breathe deeply as it was inserted. A warm feeling settles on my chest thinking of her. I felt like an active participant in the experience rather than being done to.
While still trying to recall “do I breathe in or out when it is inserted?” the doctor blankly says, “wider”. Uneasily, I widen my legs, battling against the urge to clamp them tightly shut. Then, I feel the speculum push inside my vagina which immediately causes my body to tense. It isn’t extremely painful but it is uncomfortable which intensifies as he begins to swab. After a few minutes, I become familiar with the proceedings of the examination and focus on breathing rhythmically.
Sharply, his chair jerks away from the table as he stands.
“This is something unusual!”
With his words, the anxiety I have been feeling the last few months crashes down onto my abdomen. My breathing becomes accelerated and my mind begins to race. “Why didn’t I come sooner?!” I scold myself, imagining my mum’s teary face and countless hospital visits.
The nurse quickly appears by my side as the doctor hurriedly blows out of the room. He leaves while my legs are still in the stirrups and the speculum inside my vagina.
“What is happening?” I squeak.
But the nurse evades my question, instead answering “you’re bleeding”.
Blood. I imagine the irrefutable liquid seeping through the sheet beneath my skin and slowly pooling on the floor, staining the clinically clean office.
Just the thought of it makes cold shivers climb my spine. Thick grey splodges begin dabbing out my vision. I’m feeling lightheaded. The speculum is embedded into my pelvis. Anchoring me to the table. It hurts more intensely now.
“I think I’m going to pass out.”
Anxiously, the nurse reassures me that I am okay. But I don’t feel okay. I feel hysterical.
“I am going to pass out,” I repeat as liquid leaks down my cheeks. “can I take my mask off?”
The nurse seems relieved that she can console me in a small way and allows me to tug down my mask. I gulp in the stale air, hoping each mouthful will bring the colour back to my vision.
A few minutes trawl by before the door to the office jerks open again. I am visible and exposed to whoever might enter the office but I observe as a female doctor dramatically enters, followed quickly by the previous male doctor.
“Oh my god!” She angrily exclaims while yanking on her gloves and seamlessly positioning herself between my legs.
Gently, she removes the speculum and relief floods through my entire body. Her presence immediately brings me comfort.
“I’m really sorry.” I murmur to the nurse and then louder “I’m sorry, I don’t feel very well.”
“Don’t apologise. Feeling lightheaded is a completely natural physiological reaction to having something pressed against your cervix. Don’t worry.”, responds the female doctor, pointedly.
The interactions between the woman in VSOACSO and the doctor are revealing as they directly indicate how women experience the world from within a female body. It also indicates the consensus within society that it is appropriate to touch and control the body of a woman without regard for the woman herself. The female form is observed as a public space and as such, individuals do not need permission to gain access. This is exemplified, frequently, when women are in a public space. Suddenly, somebody wants to pass between the woman and another person, or an object. Instead of simply saying “excuse me” the person feels justified to place their hands on the waist of the woman and slightly shift her out of the way. Maybe, allowing their body to press closer than necessary against her before disappearing into the distance. Immediately, the woman is jerked out of her reality. There is no evidence to explain what happened but there is an unsettling feeling that she has been used. Eventually, she decides to try and shake this feeling away but for the rest of the time, she peers over her shoulder whenever someone draws close. Alas, women and their bodies are observed and disrupted. However, this is not a phenomenon that is confined to public leisure activities; it also occurs within professional settings and, as Martha Rosler demonstrates, within medical spaces too.
In VSOACSO, each time the doctor calls out a measurement of the woman’s body, one of three female examiners produces a corresponding noise. The sounds they emit are distinct, “one rings a bell when she meets the standard measurement, another blows a whistle when she exceeds the measurement, the third blows a kazoo when she falls below” (Gennard, 2017). These noises are clear and easily distinguishable however the resulting chorus of sounds are unsettling. Their qualities, so unlike any other sounds in the performance, penetrate confidently through the scene, chiming abruptly like subconscious thoughts. The sharp sound of the whistle is like a derogatory remark, “that dress is not flattering” about a woman’s body which does not fit the required societal metric. Interpreting these sounds as instinctive thoughts about women’s bodies, therefore, illustrates how it has become a reflex to evaluate her physicality to determine her value as an individual. While this is a patriarchal notion, women are engaged in this process as much as men are. Women are encouraged to consider such insights as significant and representative of their whole selves. Consequently, there is a pressure to compete with other women to be viewed as superior and so continues the cycle of oppression. Rosler implies the importance of the measurements by differentiating between the different sounds. If the measurement had no implications, Rosler might use only one sound or none at all. Announcing to the room where she falls demonstrates the significance of the number to the individual or society. By comparing the woman to a standard measurement Rosler encourages the viewer to consider the pressure of traditional western beauty standards.
All three examiners producing the sounds are female and observing them react to the measurements calmly is unsettling as the audience might expect them to be more protective. However, this demonstrates how this seemingly unusual situation is, in fact, normal. It could also show that when acting on behalf of science anything is excusable. The dynamic is further altered when the women begin responding to the measurements, each sound directing attention towards their bodies; “the whistleblower is tall and thin, the kazoo player short and a little plump, and the bell ringer somewhere in between the two” (Gennard, 2017). This encourages the viewer to consider how the female examiners and the woman are all being compared and arguably, in competition. Paradoxically, the women who represent falling below and exceeding the standard measurement could be said to physically exemplify both these states. The taller, thinner woman might weigh less however her height sets her above the standard while the smaller, plumper woman might weigh more yet her height positions her below. This shows the viewer that the standard measurement is an ambiguous concept and belittles the many forms and functions of the human body.
Therefore, all of the women become positioned in an impossible cycle of how to become the standard as they understand that “when people look at her, they do not distinguish her from her appearance: she is judged, respected or desired in relation to how she looks” (Beauvoir, Border, Malovany-Chevallier, Reid and Haynes, 2015). This is especially true for the female examiners. While the women are titled examiners, which is the title of the men also, their sole purpose within the examination is to present their physicality. The viewer is encouraged to consider the female body while the male body remains respectfully professional. This illustrates that regardless of how intelligent the female examiners might be, or how far she has progressed in her career, her physicality is what remains important. Their female bodies are also included in the examination, alongside the woman.
As established within Part One of this dissertation, women’s bodies are intrinsically tied to events they experience. It is therefore plausible to suggest that, in some instances, women begin to compartmentalise and “treat [their] bod[ies] as a separate entity” (Van Amsterdam, 2014) to handle particularly difficult situations. To disengage one’s mind and create distance between what is happening to the body allows the individual to process what is being done to them or avoid processing it entirely. The female narrator verbalises “her mind learns to think of her body as something different from herself” and this compartmentalisation is further suggested as Rosler creates distance between the viewer and what is being done to the woman’s body, by employing a third-person narrative amongst other techniques. Arguably, the woman herself compartmentalises her body; she makes herself “available for these men to perform their labour” (Gennard, 2017) without the interference of the actual person.
The incentive a woman might need to disengage from her body is demonstrated immediately as “the woman’s consent [is] never asked” (B Sri, 2010) which reveals that everything done to the woman is completed without the knowledge that she is safe and comfortable. This is mirrored within reality too. Asking for the consent of a woman is not commonly practised within medicine and one would be inclined to suggest it is because medical professionals take for granted that the woman is willing. However, it might be more likely to suggest that her consent is not taken for granted- more disregarded. The woman could feel pressured to open herself up while the medical professionals plough on regardless of any signs of discomfort. The power dynamic that exists between the doctor and the patient allows for the doctor to conduct their work regardless of the experience of the woman. The doctor observes their work as objective whereas the experience of the woman is completely subjective, “and thus subjective issues like emotions, contexts [are] not important” (B Sri, 2010). Such an objective approach allows “the human body [to be] transformed into something which could be explored at will, in the name of science” (B Sri, 2010). This experience is reflected within VSOACSO as “the men are polite, professional, a little aloof, and yet something violent appears to be taking place… her limbs are pulled, shoulders pushed down, other inconvenient parts of her body shoved aside” (Gennard, 2017). The violent undertones of the examination are exuded by the doctor’s readiness to investigate the woman’s body. Initially, the doctor records harmless measurements like the length between the top of the head and chin- occasionally adjusting the placement of her arm. However, as the examination continues, the measurements become more arbitrary and invasive which the doctor completes with no reservations. The physical contact increases also, in one instance he assuredly unties her hair and freely touches it whenever it becomes a hindrance. This contact can be interpreted as crossing the boundary into intimacy although oddly it still appears professional because even these personal touches are conducted coldly. All of these actions are accepted by the woman, who remains docile, perhaps mentally overpowered by the presence of two men. She is treated like a tool to aid the examination rather than the centre of it. There is also the sense that she is overpowered by the physical strength of the doctor. Occasionally, her body is rocked by the doctor’s gestures which send her slightly off-balance or she entirely relinquishes control of her body, allowing herself to be manipulated by him. The viewer becomes aware of the power dynamic which is enforced on the woman and consequently, considers at what point would the woman say no or where does the doctor draw the line? Rosler implies that there are no boundaries when the doctor eventually measures the depth of the woman’s vagina. The female body blends into the landscape of the doctor’s office and becomes another item of furniture or a medium through which medicine is practised. Her body is “regarded as communal” (Wybrant, 2020) rather than possessed solely by herself.
As VSOACSO begins, the female narrator explains that “this is a work about being done to” which succinctly encapsulates my experience of my examination. Those words are bittersweet because, on one hand, Martha Rosler acknowledges and validates exactly how I reflect on that experience. However, on the other hand, the phrase is intrusive. It describes a situation of being so thoroughly included while also being totally removed. Within this autoethnography, I continue from Part One describing the limited interactions I have with the doctor. It is clear that he is only concerned with the procedure and therefore engages little in minimising the anxiety that I have verbally expressed. When the examination begins he gives me no other warning that he will insert the speculum other than asking me to part my legs wider. While I am aware that this is a vaginal examination, in what other context is it appropriate to penetrate another person without consent or warning? On reflection, I am more horrified now than I was in the moment. I mirror the woman in VSOACSO; I am attempting to be as agreeable as possible for the sake of the doctor rather than focusing on my comfort. While I know that I am okay and I can understand that this is the way examinations are conducted, it is hard to accept that this is just how it is. It is saddening to learn that even structures designed to help women are innately “tampered by conditioned patriarchal notions'' (B Sri, 2010) which make their bodies a public space.
Blood within the autoethnography is an important representation of my womanhood. Its presence becomes most significant when I begin to imagine it rushing out of my body and staining the floor of the office. By staining the office, I consider how the functions of my female body disrupt the clinical and orderly expectation of the office. This is guided by the “male ‘norm’, with everything that falls outside that designated ‘atypical’ or even ‘abnormal’” (Criado Perez, 2019).
When the examination becomes unbearable, I emotionally express that I am uncomfortable although these assertions are followed by apologies. The apologies, much like the laughter in Part One, are also anxiety provoked. I am apologising for not continuing to be the woman within VSOACSO by remaining an object. But by apologising, I continue to make clear that I will not be an object. Instead, I show my humanity and how I have been impacted by this traumatising situation. The intention is that the doctor will acknowledge how he has disregarded me and become my equal by sharing his humanity. Again, he ignores my efforts to neutralise the power difference. Tellingly, the person to respond to my apologies is the female doctor who relieves me of the blame. It could be that, as a woman, she can empathise with my perspective or that she is confident in her role as a doctor to accept blame when the patient is negatively impacted. But, regardless, she is an example that there is space for doctors to be both objective and empathetic- medicine does not need to be inhumane.
Part Three
Again, I am alone behind the blue curtain. I shift my body so that my legs hang alongside the side of the table and, coyly, survey the surrounding area. There is no blood at the base of the table like there is no blood staining the paper either. Sat neatly beside my pile of clothing is a sanitary towel.
A thick silence hangs in the air like smoke in a burning building when I emerge from behind the curtain. Lightheaded, I sit down again and sink lower into my chair while waiting for him to speak, perhaps even scold me.
“Sorry about that.” I breathe out.
He doesn’t respond, continuing to stare intently at the computer screen and loudly clack on the keyboard.
A few more seconds pass before I speak again, “Is it normal to bleed?”
He wavers, for a moment, like he doesn’t understand the question and he meets my eyes. The expression on his face is blank but calm, with a hint of a smile reaching his eyes like I had said “Oh, isn’t the weather nice?”.
I bristle while staring into his face.
“No, it’s not normal.” He states.
Another drop of anxiety slides down my throat and into the pit of my stomach. I am assaulted by a flurry of thoughts. I reflect on the general idea of how unpleasant smear tests are for everyone and how I read Facebook posts about women avoiding their appointments. “No wonder!” I think. Then, I return to the ever-present feeling I have grown up with. That my body is freakish. Too big and too small, too leaky and too dry, definitely broken in some way or another. Finally, I imagine a huge, spongy, ugly tumour sitting deep inside of me, seething and bleeding.
I swallow. “What was it that was… unusual?”
“There was some unusual discharge.” He clears his throat.
I furrow my brow “Discharge!” I feel my inner self yell. “Discharge?”
I should be listening keenly to what the doctor has to say but that is not what is wrong, I feel that deeply. My discharge being unusual could be possible but it is not unhealthy. I live with my discharge. I observe the changes that happen throughout the month- the amount, the texture, the colour.
Even if it did surprise him, he could have asked “does it usually look like this?”- to which I could easily divulge a whole context of what is normal for my body. An open conversation would have shifted the course of the examination. If that was not satisfactory, a second opinion is welcomed. But to abandon me, in the most vulnerable state I can imagine- to assume that I could not possibly provide any insight into my body offends me deeply.
The idea of a grown man, never mind a doctor, darting out of a room at the sight of discharge is laughable. It seems comparable to avoiding a runny nose but, after smirking at this thought, I realise that it is not laughable but deeply upsetting.
Soon after, I return to my previous seat within the now empty waiting room. Staring around the room, I observe that it looks the same as it did twenty minutes prior but it has an eerie quality now like someone had passed away. I sit forward in my seat, itching to escape, though I know I will soon return to complete the examination again as the nurse had gently smiled “It’s probably not a good idea to continue now”.
Down the hall, I can hear people shuffling around loudly but the waiting room is still. Finally, I am completely alone. I don’t want to laugh and apologise anymore. I want to cry. With shaking hands, I open my phone and begin to text my partner, Will, who is waiting outside in the car. “It’s horrible,” I write “I want to leave” and my chest aches expressing the pure sadness I am enveloped in. I truly feel violated. With each character I press, the pain grows deeper and I wish to be in the car, indulging in the tears which I feel are justified.
The shuffling feet eventually turn into the waiting room and I lift my eyes to see the sympathetic smile of the nurse who had been with me earlier.
“Yep… everything seems fine.” The nurse announces cautiously like she is tending to an injured animal. “I can have a look into rescheduling your appointment but it will be sometime next week, if that’s okay, just give us a call.”
Quickly, I nod my head and leave. Once outside of the building I move swiftly across the street allowing the tears to spill freely down my cheeks. When I reach the car I do not attempt to speak but sit in the car with Will sombrely.
The following day I call the doctor’s office again to schedule a new appointment.
“Please can I be seen by a woman?” I ask directly.
Leading up to the appointment, I struggle to eat and sleep. Therefore, when I arrive at my appointment I feel rough around the edges. However, I brighten when my name is called by the female doctor who saw me, briefly, last time.
Diplomatically, she apologises for the previous appointment before asking me to get settled on the examination table. I brace for the insertion of the speculum but the doctor speaks beforehand and encourages me to widen my legs every time I breathe. After a few moments, she is removing her gloves, disappearing behind the curtain.
Sitting across from her, she explains what has been causing the spotting. Neatly, she transcribes the word “Ectropion” on a piece of paper, at my request, so I can research it later. Exiting the building, I fold the paper into a small square and tuck it into my purse. It is a symbol of my independence, my value and my pursuit of the truth about my body.
After experiencing VSOACSO, the audience is aware of how thoroughly women are measured and, consequently, how these measurements are extrapolated. The impact of these measurements take root in all areas of women’s lives and become a tool to govern women in a patriarchal society. This is exemplified towards the end of Act One when, in two scenes cut together, the woman is “seen donning a black cocktail dress… [and] a wedding dress” (Gennard, 2017). The attire the woman wears has implications. One interpretation could be that the woman has to choose which path to follow, when she wears the black cocktail dress she is an unmarried, liberal, independent woman and looked down upon because of it. The black symbolises her impurity and devilishness. However, when she wears the wedding dress she is a wife and mother- everything a woman is expected to be. The white symbolises her purity and virtue. Rosler demonstrates that to be a good woman in society, one needs to be married and therefore tethered to a man. An alternative interpretation could be that in both instances, the woman is embodying a fantasy for men. Adorning the black cocktail dress she is a sexual being, while wearing the wedding dress she becomes a maternal figure. In either form, she is manipulated to become what the man wants or needs. Traces of a patriarchal society are evident in both of these interpretations. By ending the examination this way, Rosler concludes that these measurements are superficial and are not vital for the wellbeing of women. Rather, these statistics are vital in oppressing women.
Researching for this dissertation uncovered a multitude of stories that echoed my autoethnography. Whether written in blogs by strangers or in conversations with family members, I learnt how medical professionals ignored and belittled women. I discovered how women were made to feel uncomfortable within their bodies and observed as “more biological, more corporeal, and more natural than men” (Grosz, 1994). Being viewed as more biological creates a narrative that women are too hormonal, unpredictable, hysterical. In contrast, male bodies are considered stable and their reactions genuine, revered as the “default humans” (Criado Perez, 2019). Therefore, the interaction between myself and the doctor is not unique but demonstrates that he is the “product of a medical system which, from root to tip, is systematically discriminating against women, leaving them chronically misunderstood, mistreated and misdiagnosed” (Criado Perez, 2019). Rosler alludes to this phenomenon, as the male examiner calls “next” before the woman enters the scene. This contextualises the performance to demonstrate that before this examination, there was a previous woman and potentially another before her. An endless cycle of women entering this medical space and leaving with the imprint of the medical system on their subconscious. I am not an anomaly and neither is the woman in VSOACSO.
When considering the term vital statistics, the audience should not reflect on the woman’s physical appearance and how it compares with the standard of society but rather how, within the medical system, few statistics thoroughly represent women independent of men. This oppressive behaviour allows women to slip through the cracks and has wide-ranging consequences. It could mean continuing to stigmatise the female body and spreading misinformation. It could mean being dismissed by a doctor. It could mean having an undiagnosed illness because the symptoms presented are not the same in men as they are in women. It means that women suffer because “the representation of the male body as the human body persists” (Criado Perez, 2019). And so, the vital statistics are those that position women at the forefront of the discussion.
In the closing section of the autoethnography, I become introspective and reflect on the history I have with my body. For many, puberty is an awkward phase and I found myself deeply convinced that there was something wrong. This might be because I received no sexual health education or, perhaps, because “as girls we are told, sensibly of course, that [the vagina] is a private place; we are urged, really, to ignore it” (Enright, 2019). But, the secrecy around my vagina and the abruptness of womanhood shrouded my teenage years in shame and confusion. I became invested in a strange relationship with my body where I was severely distrustful of it but also heavily relied on it to navigate the world. The distrust strengthened when my body changed. I wanted to present to my friends and classmates how appealing I was but my body seemed embarrassing and disgusting. I had discharge and it seemed like my body invented it. Clearly, this was not the case but while boys laughed loudly about penises, girls were encouraged to discuss very little about the vagina. Girls were and are left in the dark. Through my teenage years and into adulthood I have slowly built a rapport with my body. I admire it. Discovering, what is truth and what is fiction. Learning the cycles of my body and the subtle messages it sends me. However, the doctor begins to unravel these threads when he condemns my body as unusual. He falsely states it is not normal to bleed following an examination and suspects my discharge is unusual too. But, of course, women’s bodies seem unusual when society’s template is the male body.
As stated within the autoethnography, the piece of paper transcribed with the word “Ectropion” has become a symbol of my independence, my value and my pursuit of the truth about my body. It is evidence of this experience and my resilience. It is a reminder that information concerning one's body should not be withheld but made accessible. It is a celebration of my womanhood despite the obstacles I face.
Figure 4: Image of transcribed note received from the female doctor
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