I had a doctor’s appointment a couple months ago, and my doctor asked me if it was OK for a student to do the prep work, you know, the usual: height, weight, temperature, blood pressure, the like. I said sure.
What I didn’t expect though, was that the student intern was going to read through a list of health questions to try to find out if I was menopausal. Nothing against menopause – it’s a natural thing and I think some women even look forward to it. But I just turned 42, and no, I’m not having hot flashes quite yet.
I suppose it’s some kind of mandatory thing to ask a woman who is in her 40s a series of questions like that. And to be honest, I probably wouldn’t have minded if it had been my doctor asking me. I’ve been seeing her for years now, she knows me, and she knows how to ask questions in the right way. I trust her.
But sitting up on an examination table in a sterile room, clothes off save for an oversized paper gown that keeps falling off my shoulder, with a 20-something I’ve never met sitting in front of me asking if I’m incontinent, suffer from bouts of depression, and have loss of libido was a bit off putting.
It made me want to lie to her. To not reveal any sign of potential menopausal weakness. To tell her that I never feel fatigued. That I never, ever forget anything, and that I am never ever ever distracted or unfocused. I secretly shunned all her suggestions. Calcium? nope, not taking it. Multi vitamins, pah, I feel fine. Let’s get this interview over with STAT.
It felt disempowering to have this young woman, who I don’t know and haven’t developed any trust in, asking me very personal questions about myself and my life and offering scripted solutions to something she imagined I might have, and that she’d obviously never experienced herself. Since then, I’ve been thinking about it off and on, and related life stories come to mind.
Julia*, someone I was very close to in my Barrio in El Salvador (where I lived for most of the 90s) had a long history of domestic abuse. She would talk to me about it all the time – she still lived with the man, who had tapered off a bit as he got older but who was still not entirely pleasant to her. She would get depressed sometimes and talk about leaving, but she never did. As I got to know her better, I realized my role in the relationship was not trying to find solutions, or criticizing the man, or feeling enraged. It was listening and not judging. An older woman, with a small pension. Where would she go? She believed that she would be seen by the neighbors as weak, and that people would lose respect for her. She really didn’t have a lot of options. So she’d tell me and I’d listen, and that was enough. I’d tell her my work troubles too, and she’d listen, and that was also enough for me. I realize as I write this how much I miss her.
About 15 years ago at work, while still in El Salvador, I was responsible for overseeing a study on gender violence that a partner organization was carrying out and that we were funding. It was going to be a door-to-door survey mixed with some focus group discussions. I immediately thought of Julia; of all the women in the Barrio. I thought ‘Julia would never tell anyone the truth if they came knocking on her door to interview her about domestic violence.’ She would say no, that doesn’t happen here, and close the door until they went away. I doubt any of the other women in the Barrio would have acted any differently.
I felt pretty sure that the information that was produced in that study on domestic violence was not going to be valid, even though it was being managed by a group of well-known, well-educated Salvadoran feminists. But I felt like I couldn’t say anything, because I wasn’t a well known local feminist. And after all, they’d often imply, what did I know about El Salvador? I was a foreigner. What I did feel certain about was that no one in the Barrios where they wanted to do their study was going to tell them the truth.
And somehow related to that, I started thinking about the time I went to the doctor’s office with my mother-in-law, a brilliant, strong and upright woman from the Barrio, with a 6th grade education, who would be considered ‘impoverished’ by most standards. I remember vividly a young male doctor who addressed her using the familiar form of ‘you’ (vos) instead of using the respectful form of ‘you’ (Usted). I remember being furious. I don’t even use vos with my mother-in-law, out of respect. What was this young, wealthy doctor doing using it? I hated seeing her stripped of her well-earned Barrio respect once she entered the doctor’s office, just because she was poor.
What am I trying to say here? I’m not entirely sure, but I guess I’m thinking about respect and the hierarchies of information and education and offices, and the importance of developing a rapport with people before you go prying around in their personal lives and offering solutions.
I’m relating that to ‘aid’ and ‘development’ work, which in my world, is an intensely personal thing. I try to work from the heart, and I hope I’m never making people feel belittled, judged, or like they need to lie to me or conceal things from me because I haven’t taken the time to get to know them. I hope I’m not disrespecting anyone, knowingly or unknowingly, and that I’m not messing around in things that are none of my business or where I haven’t got an invitation. I hope I’m not always trying to offer solutions, but rather listening and supporting people to come to their own conclusions. I hope I don’t make people feel like they are sitting, half naked on an examination table, while someone who knows nothing about them or their life politely asks them some standard questions and comes up with some generic recommendations for how to prevent or cure something they may or may not have or may not think is an illness.
*Not her real name
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