Literary Review, September 2018
Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain, Abby Norman (Nation Books, £20)
No matter how hard doctors try to measure it, pain is a subjective experience. None of us really knows what someone means when they say they’re in pain, given that what is agony for one person might be bearable for another. But it is clear from this memoir that Abby Norman has endured extraordinary levels of pain, forcing her to become an expert on a subject many people would shy away from.
The subtitle talks about trying to get doctors to believe in women’s pain but the book leaves no doubt that Norman’s own experience is real, long-lasting and excruciating. The book opens in 2010 when Norman was in her second year at Sarah Lawrence, the prestigious liberal arts college 15 miles north of New York City. She is from Maine and a family so dysfunctional that getting a place at Sarah Lawrence was a major achievement. Norman’s mother was anorexic, so absorbed in and ravaged by her own illness that she couldn’t care for her daughter; what she did do was impose draconian rules about food, leaving Norman perpetually hungry and forced to forage for scraps from other children’s lunches at school. She went to stay with her grandmother at the age of 12 but that didn’t work out either and she eventually moved in with a sympathetic teacher.
I hadn’t heard the phrase ‘legally emancipated’ until I read this book but it refers to a minor who has in effect divorced her parents, which is what Norman did in court at the age of 16. It isn’t a step many teenage girls would know how to take, let alone ask a judge to sanction, but it is clear from the early pages that Norman has a rare degree of intelligence and determination. After such a struggle to get to college, the fact that she was struck down with a mysterious and devastating illness during her second year, putting an end to her hopes of graduating, is nothing less than tragic.
Everything about her backstory is heroic but it worked against Norman when she became ill with endometriosis – a condition usually defined as tissue from the uterus growing in other parts of the body, principally the ovaries and fallopian tubes, and causing agonising pain. But it is clear from Norman’s own experience, and the mass of research she has done, that much about it remains mysterious. Endometriosis wasn’t even talked about much until fairly recently when a handful of well-known women, including the novelist Hilary Mantel and the actress Padma Lakshmi, began to speak and write about their own experiences.
Because it is poorly understood – and, as the books reveals in excruciating detail, doctors don’t always listen to their patients – some of the health professionals who treated Norman looked for other explanations of her pain. Hence the book’s title, which emerged from the frustration of being treated for psychological problems while she sometimes felt so physically ill that she thought she might die. At the same time, in the absence of a unified public health care system, she had to look for doctors who would accept her as a patient on Medicaid. Casual references in the book to threats from debt collection agencies speak volumes about living in a country where access to cutting-edge medical treatment depends entirely on money.
It’s understandable that Norman is interested in the history of medical neglect of women, although some readers might find that passages in the book about Freud’s theory of hysteria cover well-worn territory. But she writes about the experience of pain more vividly than anyone I’ve previously come across, so much so that there were times when I had to put the book down. ‘Bodily agonies that do not end beget a kind of forced intimacy with pain,’ she says at one point. Her book is unusually candid, giving readers a sense of what that terrifying and unsought intimacy might be like.