Michael Abrahams | Looking beyond physical manifestations

I am an obstetrician and gynaecologist. Many people are fascinated by my profession. Some men say they would love my job. Others say they would not want to “work where other men play”. I find that when people hear the word ‘gynaecologist’, there is a tendency to immediately think not only of the vagina, but of the organ in purely sexual terms.

But obstetrics and gynaecology is way more than that. My job involves managing disorders of not just the vagina, but the entire female reproductive system. More importantly, I have found that in order to manage my patients with the greatest degree of efficiency, looking after not just their physical, but also their mental and social well-being, it is imperative that I create a safe space in my office, one in which they can share their deepest and darkest secrets and their greatest fears without fear of judgement and condemnation.

It has been a long journey for me. As humans, it is natural for us to judge, and even without saying a word, our facial expressions, body language and energy can betray us. As physicians, in order for us to maximise the care we give to those who present themselves to us, we must create an environment in which they can be honest. Sometimes, withholding important information can be to the person’s detriment. For example, if someone is diagnosed with a sexually transmitted infection, and they decline to admit that they have more than one partner, failure to treat all their partners may allow the infection to continue to spread.

In this space, people should feel free to speak about their issues, including their mistakes, errors of judgement, weaknesses and traumatic experiences. It is in the confines of this safe space that I have learnt much about not only issues that affect women, but also human behaviour in general. It is not uncommon for mature women to share information and experiences with me that they have never shared before the door to my office was closed behind them. On several occasions, my shirt has been soaked with the tears of women I have hugged and comforted while they wept and shared stories of their traumas or confessed to transgressions they are now remorseful for.

CARRY BURDENS

Many of us carry around burdens with us without having a clue how or where to unload them. The list of women I have come across who suffer from depression and have even been suicidal, but have never been seen by a mental health professional is, unfortunately, not a short one. My referrals to psychologists and psychiatrists occur probably every week.

But there are some who will not go when referred and will admit that they would rather just talk to me. In my office, behaviours that would be met with scorn by the society, such as adultery, being in sexual relationships with more than one partner, having abortions, engaging in intimate relationships with other women and performing sex work, are not met with condemnation or raised eyebrows. I have learnt that in this life, everybody has a story, and some of the stories are horrific. I have learnt that, as a wise man once told me, people do the best they know how, in the situations they are in, with the resources they are given. Some people lack adequate mental and emotional resources to deal with the situations they face in a functional manner. We all have our dysfunctions and ought to be mindful of judging those in situations we have never been in, or have been in without experiencing the ways others were socialised, or the childhood and other traumas they have survived.

My journey as a physician has been a long one and as I progress, I continue to learn. Recently a patient who visited me for a simple gynaecological complaint spent over an hour in my office speaking about her traumatic childhood, abusive marriage, depression and suicidal thoughts. She unloaded her heavy heart. She reflected. She cried. At the end of the visit, she expressed gratitude for my concern and my listening ear and confessed that, on leaving my office, she felt “much lighter”.

In creating this safe space, childhood traumas, sexual assaults, abortion regrets, abusive relationships and sexual dysfunctions affecting women or their partners come to light. If they are not mentioned they cannot be addressed. Sometimes the issues that create the greatest discomfort and misery are those that the persons affected by them fear talking about. By keeping these inside, they can literally make us not just mentally, but physically unwell.

As far as I have come, I am still learning, and as I learn, I try my best to make the space an even more comfortable and welcoming one. In this regard, I express gratitude to the women who have confided in me and shared their experiences. Every story has been a lesson for me, increasing my empathy and providing me with material to maximise the comfort of the space.

The journey continues.

Michael Abrahams is an obstetrician and gynaecologist, social commentator and human rights advocate. Email feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or tweet @mikeyabrahams.