pat willard

When it comes to feeling ill, most people I know fall into one of two behavioral categories which I think of in military tones: they are either soldiers or deserters. In response to experience and wisdom, some people switch from one to the other, depending on their age and circumstances but, in general, our nature dictates the kind of patient we become. Soldiers are the ones who march onward, simply doing what they have to do, ignoring every sign to the contrary that something is not right. Deserters, on the other hand, skip out at the first rumble. And while it’s been my experience that the sexes divide equally among these two categories at any given time, it’s often been popular to think exclusively of men as soldiers and women as deserters.

You would have a hard time convincing me that the first person to voice this opinion was not a man—and probably a doctor, to boot. Early medical textbooks have often portrayed women as owning a delicate constitution, one that would fade at the least disturbance. Most of these illnesses fell under the diagnoses of “Female Complaints,” which seemed to have encompassed everything from menstrual distress to boredom. The biggest category in this broad area were considered “nerve” related, manifesting themselves in headaches, fainting spells and a general, although mysterious, weakness of the body. The literature of the last century is filled with examples of women whittling away at life in service to odd, and frequently not always believed, debilities. In discussing the figure of Eva’s invalid mother, Marie, in Uncle Tom’s Cabin, Harriet Beecher Stowe expressed the popular notion that women “suffer...the sins of the beloved in their own bodies.” A spiritual concept that dove-tailed very nicely into popular medical theories about the weaker sex, women both fought and sanctioned this view, often using their expected weaknesses as a way to opt out of oppressive situations (everything from unhappy marriages and strict social codes to unfulfilled ambitions). Doctors didn’t help a bit when the most widely regarded course of action was to prescribe a bracing doses of powerful narcotics—cocaine, opium and laudanum being among the most favored–which, not infrequently, women became addicted to.

The women who succumbed to this situation were not always what modern sensibilities would suppose to be: naive, or weak-willed, simps. Florence Nightingale is a prime example of the type of woman whose response to a difficult living situation was to take to her bed with what her doctors called “neurasthenic malfunction.” The beautiful, youngest, daughter of extremely wealthy titled landowners, Florence was expected to follow her mother’s course in life, namely to marry well and establish a successful social life. After the age of 16, the most taxing intellectual accomplishment she could look forward to achieving was the planning and execution of a week in the country for an array of prominent friends.

There was no reason to assume she would wish to do otherwise. Aside from her looks, she knew how to dress, danced very well and more than held up her end of a dinner conversation. That she was far more intelligent than most people around her was viewed as a slight inconvenience. Her mother claimed it was something they would have to overlook—not that she wanted Florence to act stupid but, as she told a relative, her daughter would simply have to learn not to discuss so much. And, for awhile, Florence tried. She shopped in Paris, dutifully made the rounds of country homes and spent the London season going to concerts and balls. By the time she was twenty-five, she had been proposed to several times and thought very seriously of marrying one of her suitors. But she longed to do something more, what a voice in her head, which she ascribed to God’s, told her was her duty— to devote her life to caring for the sick. If she heard of a stricken servant or relative, much to the bewilderment of her hostess and family, she would drop whatever engagements she had and tend to the sick room, unbearably happy doing what only women of low-character were suppose to do. When she pleaded with her parents to set her free of social obligations to study nursing at The Institution of Kaiserswerth, one of the best teaching hospitals in Europe, her mother accused her of conducting a secret love affair with a “low vulgar surgeon,” and would not hear of it. Her sister fainted at the mere mention of such a plan (who would marry a sister of a woman like that!). Her father took off to the spas in Baden-Baden and would not even discuss such madness.

At twenty-six, Florence collapsed into hopeless depression. Light gave her headaches, noise made her jumpy, her mind wandered perpetually into what she described as “dreaming.” For eight years she was to all outward appearances a curious invalid and though her family did not wish for her to suffer, they were content enough with Florence’s situation to not look for a real cure. Her headaches were treated with narcotics and calming work about the house (her mother put her in charge of managing the estate’s pantry and linen closets). Long stays in the country away from the excitement of London, slow travel to distant lands were also recommended. Such were the strong restrictions of her class that it took an ill-advised and bloody war to rouse Nightingale from what would otherwise had been a life of quiet desperation.
While it’s true that, if she lived today, Florence would have had a much easier–and straighter–road to travel toward her life’s goal, I sometimes think that certain situations have not changed. Women continue to lead oblique lives, impelled to carry on many different—sometimes warring—obligations between accomplishing their life’s desires and the roles society continues to expect of them. I first became aware of this situation when, shortly out of college and living far away on my own, I came down with a sudden illness whose strongest symptom was periods of debilitating headaches. I could not lift my head, could not move even a toe without a jolt of blinding pain shuddering through my body. There was a very high fever on the first day, then nothing except the headaches. I laid on my narrow bed in my small room watching through slitted eyes as the leaves on the enormous trees outside my windows gradually changed colors through the balmy southern autumn. Friends would drop by to see me, take one look at my pale face, and beg me to see a doctor. I think now that the sight of someone their own age so enfeeble must have frightened them. But I don’t remember being concerned at all—a little annoyed, perhaps, by the constraints on my social life but more often amused by the foolish postures the pain forced me into (I read with my head tilted sideways cradled in a mass of pillows; walked to the bathroom bracing my face between my hands as if I was holding a fragile custard). It was not at all unpleasant to lie in that room which seemed to nestle coolly in the upper canopy of the surrounding oak trees. I was enveloped by time, good books and music, with an excellent excuse to be away from a terrible job. The truth, perhaps, in my convalescent contentment was that I knew I was drifting, using the illness to bide my time while one life blurred and another all too slowly came into focus.

I would have happily loitered in my bed for some time if a rather imperious man I still can’t believe I got myself involved with didn’t take hold of the situation and make an appointment to what he assured me was one of the best doctors in Atlanta. The doctor was associated with the government and since my job was under contract with the state, all his enormous bills would be duly paid without question. The next day, my friend drove me to the office in a fashionable suburb and sat with me in the waiting room. When it came my turn to see the doctor, I forced him to remain behind and walked in to meet a nice looking, middle-aged man with courtly manners. He listened to my story, took a few notes, then outlined a battery of tests for the next few days that would leave no part of my body untouched. I meekly submitted to a few that day in his office that didn’t seem too bad—a thorough examination and a complete recording of my vital signs. The next day I endured a C.A.T. scan, some kind of eye test involving a laser and, toward the end of the day when I truly had a headache, a couple of psychological tests that were beginning to raise a warning nerve. But at a time when I was still in awe of anyone who was suppose to be my superior, it did not occur to me to protest at all. Back in his office, after I listened to the next day’s program which involved inserting tubes in places I knew had nothing to do with my head, I asked the doctor what he thought the results of all this would be. He smiled rather patiently at me from across his desk and said, “It’s hard to tell. With women and Negroes, you have to take into account other things.”

Like what, I inquired, really curious—if not down right obtuse—about what he could be getting at.

“Well,” he sighed. “Sometimes, unfortunately, it’s a lack of formal education but mostly it’s just the general weakness in inferior constitutions.”

I didn’t even thank him for his time. I banged open the office door, sailed past my friend and never went back again, the doctor’s exorbitant bill for services rendered never submitted for payment. The headaches slowly disappeared—what I am convinced now were the product of a low-grade infection that would have been properly considered if I was a man. Soon afterwards, at our last meeting when I was breaking things off with him, my friend informed me that the doctor had warned him I was a classic hysteric and advised him not to become seriously involved with me.

“Then you shouldn’t mind,” I replied and, not so casually as I had wished, walked away.

I never met another doctor quiet so blatant as this one in his prejudices and yet I remain a little skeptical about all doctors in general (though I have nothing but strong faith in our current doctor who has seen my family through various crises in fine, intelligent comfort). I have heard enough tales from other women that convinces me women are still viewed somewhat differently than men when it comes to their aches. The stories women tell about their experiences with doctors are usually related with real indignation, even horror, yet they continue to chalk up these transgressions to a lot of things that should never be forgiven.

I don’t see any reason in the world to suffer a fool, especially when my health is at stake. Yet, as I think about the matter, I am not unwilling to consider the fact that the situation may have something to do with the intricacies of a woman’s body. Without the complications associated with reproduction, men’s operating systems are, by comparison, straight-forward. What goes wrong with them is usually clearer than what can go haywire in women. And because men have this soldier-like reputations their complaints are often considered to be founded in reality. As a result, I have very rarely heard anything but praise from men about their doctors and the cures they prescribed for them. (Now, you ask any woman who’s ever lived with a man if this is true or not in an informal, away-from-the-doctor’s-office way, and she’ll just laugh at you. The term “baby,” often with the adjective “big” before it, is not an uncommon opinion about the supposed stoicism of men.)

But for everyone–male and female, alike–(and I suspect this has always been so, even in the paternalistic shelter of the 19th century), it is often the case that what really ails us is only remotely related to anything a doctor may have studied in school. This is no more truer than when a good old-fashion headache, whose source is not remotely physiological, strikes.

In my case, I know it’s often because my days start early and go on sometimes to midnight, followed frequently by fitful sleep. I deal with a job that is always nerve-wracking, navigate my children through dangerous periods in their lives, strive with all my heart to continue a marriage that is like most—almost always a passionate refuge but not infrequently a maddening entanglement. In between all this there are warring forces of good and evil—ill-tempered bosses, aggravating parents, unpaid bills, leaking roofs, neighbors with stupendous stereo speakers. No wonder, then, that during some part of these many hours, I develop a headache or, on really bad days, feel like pulling a Nightingale and giving up the ghost entirely. The only thing that has stopped me from this course is the realization that, as a member of a poorer class, I would not have the luxury of being tended as Florence was. No one would coddle me. No one would whisk me away to a villa on the Grand Canal.

What I end up doing, instead, is looking for the cause and try to alleviate it as best I can, helping it along with a little medicinal sustenance. The most common causes of headaches are stress—in daily life or from the wear of illnesses; from environmental factors (like pollen and pollution resulting in allergies and sinus pressure); or as a by-product of something else going on with the body (fevers, menstruation, hunger, hangovers, fatigue). If headaches become frequent or are debilitating they should be carefully explored. Migraines are in a class by themselves and must be treated under a competent doctor’s directions.

But simple headaches can be easily managed, especially these days, with the miracle of aspirin and their kind. For added potency, I combine two aspirins with one of the following old remedies. Teas, in particular, were a favorite cure, perhaps because the directions are always emphatic about sipping them while lying down. I brew the potion, carry the cup to the sofa or, if the headache is really bad, to my bedroom where I close the door. Propped up among the pillows on the bed, I swallow the aspirins and begin to slowly drink at the brew I made for myself—sometimes falling off into a refreshing sleep, but most times just benefitting from the exquisite pause in the day.