The women forgotten by gynecology

Joyce Carol Oates, Macellaio
The figure of Silas Aloysius Weir, the “red-handed butcher” who gives his name to the latest novel by Joyce Carol Oates (La nave di Teseo, 2024, translated by Chiara Spaziani), is based on three different American doctors who, between the second half of the nineteenth century and the early twentieth century, became known for the innovations they introduced in their respective fields: Henry Cotton, director of the New Jersey State Hospital for the Insane; Silas Weir Mitchell, the so-called “father of medical neurology”; and above all James Marion Sims, considered the “father of modern gynecology” and author of an autobiography, The Story of My Life, from which various episodes in the book are drawn.

Of course, it comes as no surprise that gynecology—a discipline by definition concerning women—has always been the domain of male (and white) doctors, the only ones granted access to education. What is striking, however, is how little these so-called “luminaries” actually knew about the subject in which they were regarded as top experts. The female body, in fact, was not considered a legitimate object of study, both for moral reasons and because of the little importance Western society attached to the so-called “weaker sex.” At the time, it was still widely believed that female illness, whether physical or mental, was due to a displacement of the uterus (from the Greek hystera, the root of the word “hysteria”), and the only childbirth experiences future doctors had were with stiff, immobile mannequins, as pregnant women were assisted almost exclusively by midwives.

So how, then, were these much-vaunted innovations achieved? What path led to the development of a treatment for vesicovaginal fistula, a common affliction among women who had undergone complicated deliveries? Where did the idea for the speculum (originally a simple spoon) come from? These are all milestones reached through the suffering of an unknown number of women—unwilling guinea pigs in experiments that were pioneering, yes, but also cruel—women who could not resist because they were powerless, submissive, and without rights. In the novel, Silas Weir operates on patients locked inside the asylum he directs; in reality, Sims experimented on enslaved African women held on plantations. These procedures were carried out without anesthesia (it was commonly believed that women from the lower social classes did not feel pain, as they were supposedly hardened by a life of hardship), or, conversely, involved reckless use of chloroform to test dosages that would later be administered to paying, middle-class patients.

Some still argue that all innovation must come through trial and error, and that it is naive to expect the sensitivities of the past to match those of today. But one cannot ignore the fact that when progress occurs within a system based on oppressors and the oppressed (in this case, oppressed women), it becomes exploitation.

In any case, the great strength of the novel lies in its ability to convey the full scope of man’s gaze upon the female body (and, by extension, the female universe): on the one hand, a source of disgust; on the other, an object of desire. Dr. Weir is horrified by his patients’ reproductive organs, but despises them even more for not being beautiful—showing that, whether loved or hated, the female body is always seen as a tool in the service of male ambition.