August 28, 2016

Packing Up Brain's Diseases of The Nervous System

My essays on gender bias in medicine are finished for the time being, as I pack up Donaghy’s Brain’s Diseases of the Nervous System and prepare canvases for painting. It may seem odd that an artist would read neurological textbooks, books on medical history and articles in law journals. But few people seemed to be questioning what appeared to me to be a basic misunderstanding of women’s health, and there seemed to be little to no redress for the resulting injuries and injustices. So I thought to squeak about it a bit.

Before putting these findings to rest, at least for now, I would like to make it clear that sexism, like racism, is an evil institution. As an evil institution it is not necessarily the struggle of man against woman per se. I can attest to this because in my research thus far, most proponents of equal treatment in health care for women were men, and I dutifully included their books and articles in my bibliography upon my last writing. A PDF file that was the most short sighted, and most potentially destructive to the health of women was in fact authored by a woman. Fortunately, woman on woman crime was not always the case as evinced by Professor Diane O’Leary’s scholarly articles and popular webinars on the role of misdianosis of somatoform disorders in diagnostic delay and denial of care:

The struggle for equal rights and fair treatment is a fight against a destructive ideology that may be shared across gender lines.

The text book that I found to be the most problematic for women with initially unexplained, and sometimes even explained neurological disease was, however, written by men. I had read Brain’s Diseases of the Nervous System back in 2013 and noted that the chapter on Psychologically Determined Illnesses was gender discriminatory and laced with a veritable plethora of antiquated pejoratives against women. The book was otherwise a rich tome of historical and scientific information. The chapter on reflexes was particularly fascinating and I had written about this subject at the time. As to the sexism expressed in the book, I did not attend to that back in 2013 because it came to my attention that I did not have the latest edition of Brain’s Diseases of the Nervous System. Times change and textbooks become updated with new information, and new evaluations. I will wait, I thought at the time, to obtain the later edition of Brain’s Diseases of the Nervous System, in order to check and see if the misogynous chapter is removed.

Three years later this giant textbook arrived through inter-library loan. It arrived in poor condition. The spine had been broken and was held together by rubber bands. I wondered to myself if this was perhaps an indication that the sexism remained intrenched in this heavy book. Had an irate nurse read Donaghy’s comments on "hysterical nurses," and reacted to it by stomping on the book? After checking out of the library and taking the injured textbook home, I immediately turned to the chapter in question. It had not been altered. It had just as many misogynist references as before. Oh well. He had his chance to rectify, tone down the rhetoric, make amends, and failed to do so. In this way Brain’s Diseases of the Nervous System became added fodder for my satirical drawings and wry writing. (I am at work now on a drawing depicting how a gender -biased medical professional might conceptually view a woman’s brain. )

How does sexism insinuate itself into mainstream medical literature and remain there unchallenged? And can it be changed? As usual, I looked to precedent to find an instance where a sexist remark in a medical text book was changed and how this was accomplished. A good case study here is Campbell’s Urology. In the 1978 -1985 editions, Interstitial Cystitis is included in a chapter entitled "Psychosomatic Conditions in Urology." Women were most likely to suffer from this disease which was described as follows:

"Interstitial Cystitis may present the end stage in a bladder that has been made irritable by emotional disturbance...a pathology for the discharge of unconscious hatreds."

Through extensive patient advocacy work and the Interstitial Cystitis Association, founded by Dr. Vicki Ratner, the description was eliminated from the 1986 edition of Campbell’s Urology.

It took many dedicated, rational men and women to get the emotional spontaneous generation theory of medicine for women removed from Campbell’s Urology. That was one comment removed with great effort. How much effort would it take to for the nineteen similar comments with regard to women removed from Donaghy’s Brains Diseases of the Nervous System.? It would depend upon good patient advocacy and some common sense neurologists.


Stan said...

Did you tell the author of "Brain's Diseases of the Nervous System" of your objections and ask that he make changes?

kozachekart said...

This is an excellent idea. I did some research earlier and could find no contact information for this author. Thank you for reminding me that I should try again. Any other thoughts are greatly appreciated.