The day I became a feminist

In 1987 I arrived at my new job as the first woman urologist in Seattle (actually the first woman urologist north of Los Angeles and west of the Mississippi). I found a great private practice that wanted me to focus on taking care of women and invested in the specialized equipment to allow me to build my practice. I noticed that the receptionist would say the first available appointment for Dr. G is in 4 weeks but Dr. Bavendam is new to our practice and HER first appointment is later this week. Women were delighted to have a woman urologist and it was a rare men that decided to wait to see a man. Male referring physicians were the most hesitant about their male patients seeing a woman urologist but there were enough women physicians to build my practice quickly.

Many of were initial women patients were incredibly complicated. They had already had all of the standard treatments – the same ones I had to offer and were either not better or worse. The women expected me, as a women to have better treatment options. I had little I could do except take very detailed histories and work to unravel their stories. Many of these women had been told they were hysterical and/or that their symptoms were all in their heads. When a cause for their symptoms can not be found or women do not respond to the usual treatments, the norm at that time was to blame the woman rather than recognize our lack of knowledge about the problems and potential new treatments. Some women were undergoing weekly or monthly painful dilations of the urethra having been told that if they didn’t keep coming in, their urethra would close up. Women had painful, emotionally draining stories that I found distressing to listen to and document. I went through a box of tissues a week. I got a humorous tissue box cover that was prominent on by desk that helped break the tension when emotions took over. With some of the stories, I also needed to use the tissue.

I was angry at my fellow urologists. I looked for any source of information that would help me offer something new. I went to a text book that I had received during residency (perhaps 3 years previously) and found a chapter on Female Urology. I started reading until I found this section:

My world stopped for a few seconds and I became a feminist in those moments. You might have thought I considered myself a feminist during medical school and residency but I hadn’t really taken time to think about it. I was in rural Iowa in the 60’s as feminism emerged. There was little discussion on the topic. No one ever told me I shouldn’t go to medical school. Becoming a urologist was novel. I had 3 brothers so it was easy to be one “of the boys” at the beginning. I had an unplanned pregnancy during my first year of residency. I spent the rest of residency feeling guilty and trying not make waves. I was grateful that I was allowed to finished residency on time in spite of taking 6 weeks off after delivery with some additional time later for postpartum depression. I did not have the capacity to consider feminist principles until the day I read this statement.

That statement provided the context for me to better understand the experiences the women were reporting. Hurting women with dilation of the urethra and putting liquid silver nitrate in the bladder was what many urologists had been trained to do. In the absence of any other options, the practice persisted. My plan to find a better way to care for women with urologic problems went into overdrive. I started practicing patient-centered, individualized care before those concepts existed. Each woman became her own puzzle to solve and together we developed an approach to care that was based on education, behavioral change and rehabilitative strategies. I used medication and surgery when I thought there would help. First and foremost, I did my best to explain why I was recommending treatments and what aspect of their condition I thought each treatment would help. I did everything that I could to “not hurt them”.

From that point forward, I have never passed up an opportunity to act like a feminist because I finally understood I was one.