The science of Anthropology can be described as the study of social relationships and cultures. An examination of the Anthropology of fandom ought to show that fan writers and writing played at least as important role as fanzines in the shaping of today's fandom, and in how today's fandom will be remembered in the future. Definitions aside, it's quite likely that Sharon Farber will be remembered decades from now as one of our best fanwriters; here's the latest installment of her "Tales of Adventure and Medical Life" series.

'Tales of Adventure and Medical Life #14' 
  by Sharon Farber; illo by Kip Williams
 Astute readers will notice that I've been promising the continuation of the story of my third year of medical school, but I come up with other things to write about. Like last issue's ruminations on the sex life of Vulcans... Do you get the idea I'm avoiding something?

 It's true. I've been putting off the story of the end of third year, my ob-gyn rotation. Not because it was particularly more painful than the rest of third year -- in a way it was, but not only is it ancient history now, by the time it all happened I was so numb I barely noticed that things had just kept getting worse.

 No, it's because it just doesn't really lend itself to brief humorous anecdotes. I like to pride myself in my ability to drag humor out of misery -- my dentist had to tell me to stop giggling during my wisdom tooth extraction -- but this just didn't seem to foster quite the humor of previous rotations.


# # # #

 One evening during my first year of medical school, as we were waiting outside a movie theater, another first year student came up to me, looked around furtively, and asked an urgent question. I was five years older than the other students and had been out in the real world, sort of, and was also a California weirdo. All that had transformed me into a mommy equivalent, able to answer practical and philosophical queries from classmates who had generally gone from college prep high school to prestigious university to med school without Passing Go or Going To Jail.

 "Sharon," the young man said, "Do women enjoy pelvic exams?"

 My jaw dropped. Had he been raised in a glass bubble? Had he never overheard his mother or sisters or even strangers on a bus dreading their trip to the gynecologist? Or was he simply hoping to hear good news that would set him on the path to a career that would be salacious as well as bringing pleasure to thousands of eager souls?

 "For god's sake," I replied, annoyed. "Would you enjoy a refrigerated metal object shoved up your ass?"

 His eager little puppy dog face fell, and he subsequently chose a career in pathology. I don't know how much I had to do with that.

# # # #

 Whether or not women enjoy or dread or simply tolerate pelvics seems to have a lot to do with who goes into gynecology. I've met male gynecologists who honestly like to help women, and others who just go all gushy when they get to escort a new life into the world.

 Unfortunately, those guys weren't teaching us. Our faculty seemed to be composed entirely of Grade A porkers, the sort of autocratic chauvinists who enjoyed seeing women helpless and uncomfortable. I leave it as an exercise to the reader to decide if their need for power was political or sexual or simply the mark of inadequate personalities. (I will, though, note that the chief of the beer-guzzling sexually obsessed frat boys whom we called Neanderthals, until my friend Lorraine pointed out that the analogy was insulting to proto-hominids, wound up on the gynecology faculty. Now isn't that amazing.)

 A typical lecture from the chairman of the department began: "Little Suzy Brown comes in, a bleedin' down the block." It wasn't long before every woman in the class who was not either clueless or teflon started skipping lecture.

# # # #

 I finished off my third year of medicine with the clerkship of ob-gyn. I started at the University hospital, where I was mostly astonished by the sheer, well, boredom of the subject. Let's face it, gynecology deals with a single organ system, and not the most complex. Clinic consisted of pelvics, one after another, often just healthy women needing pap smears. Maybe a bit of a discharge, so you checked a slide and either treated for yeast or bacteria. Maybe some pelvic inflammatory disease or a case of clap to liven things up. A few cases of herpes -- always prefaced by the comment, "I got it from my ex-husband," the hurt in their voices explaining that this disease was the final confirmation of their spouses' infidelity. Maybe a case of dyspareunia (painful intercourse), but the warm and sensitive chief resident was apparently of the 'dyspareunia is better than no pareunia' school of thought. And prenatal visits, measuring the belly, listening for heart tones... Frankly, I found it about as intellectually stimulating as making toast.

 Even the surgeries were boring. Hysterectomies varied only in how you went in and how much you took. They lacked finesse -- general surgeons tended to call gyn work 'meatball surgery' -- except for the occasional case of cancer, which was depressing but at least different. And dilation and curettage was, well, messy and unchallenging.

illo by Kip Williams  It might have been a bit more interesting if we'd been allowed to do some cutting or sewing, but there was a hierarchy at the university, and medical students were at the bottom. The attending might let the chief do something, or the more senior residents, but medical students just stood and watched, like worshipful little robots. (Some surgeons in academic centers find having an audience necessary. I remember one who loudly refused to yank a gallbladder until someone found him a student. I finally volunteered, figuring this guy was hot to teach. No. Another silent surgery, in which I saw and did nothing, though the surgeon did smugly inform me that the muzak was playing Mozart's fortieth. But as the same tape played in all the operating theatres, and a number of surgeons had already and just as smugly identified the symphony for me, I was unimpressed.)

 My friend Jon did get to do part of a D&C once, to his future benefit. The next year he did an away rotation in a religious hospital in the African bush. It was the second largest hospital in the country, but still had only three doctors. One had left and not yet been replaced, one was on vacation, and the third had just been summoned by the President of the country. So when Jon arrived, he was greeted at the landing strip by a couple of senior medical students from various countries.

 How nice of them to come down and meet me, he thought. "Hello!"

 They cut off the introduction. "Can you do a D&C?"

 "Well, yeah, sort of..."

 So within an hour of arriving he was in an operating theatre with a bleeding woman. "What anesthesia do you want?" asked the nurse anesthetist.

 He had no clue, but he said what turned out to be the right thing: "Uh, the usual."

 And then, as he stood there wondering what he was going to do, his hand fell open and the scrub nurse, who spoke only Swahili, slapped an instrument into it. He found that, in this way, the surgery went rather smoothly, as every time he wasn't quite sure how to proceed the appropriate tool would strike his palm.

 But, as usual, I digress. One of the 'treats' of being a medical student on the ob-gyn service was a certain venal private doctor. The residents hated him, and as someone had to scrub with him, that fell to those at the bottom of the pecking order -- the students and interns. One day I watched him do something I didn't understand. I asked him about it.

 "Just killing time til the bleeding stopped," he said, or some such. The intern looked panicked. Afterwards she explained to me that I had just witnessed conscious fraud and malpractice. I was horrified. How could such unethical and illegal behavior occur at one of the top ten medical schools in the country?

 The residents told me not to make waves.

 Maybe I misunderstood the entire thing. Maybe I was simply clueless. But a friend later told me he had witnessed the same doctor do the same thing.

# # # #

 Well okay, but there was still that 'helping new life into the world' bit. That was fun, right?

 Wrong. Maybe I just don't have the temperament for it. Having a kid seemed to take a long time, and be associated with a lot of pain. And it meant not one pelvic but a bunch, checking the amount of dilation constantly. Watching largely irrelevant squiggles on the monitor. And finally going into the labor room for a long screamfest followed by the arrival of a slimy conehead, much rejoicing, and then repairs.

 I'd guess that most of the deliveries I saw there, at least of the private patients, were of planned or at least wanted pregnancies. But I remember one, a young woman who'd been raped. She began flashing back to the assault during delivery, meaning we were dealing with hysterics as well as the ordinary shrieking. Her boyfriend was with her, a scuzzy disreputable-appearing dude -- if I'd seen him on the sidewalk, I'd have crossed the street, he was that bad. But there in L&D he surprised me by his support. I wish that every anti-abortion zealot could have been in that delivery room...but on the other hand, they probably think rape is punishment for uppity behavior and that this suffering was deserved. (There was an abortion clinic down the street from the hospital. Pickets always came out on weekends with good weather. My classmate Kathy liked to stop and chat with them. She claimed that if you kept them talking for more than ten minutes, every one would eventually admit to really being against abortion because sex was a sin and deserved to be punished.)

 Another bad day: a woman was having complications, and the intern ordered an X-ray that showed the infant had hydrocephalus and other deformities. As is usually the case in a hierarchy, everyone responded to the incipient tragedy by blaming the intern.

 One of my classmates told me the chief resident kept making passes at her. She was worried about her grade. I didn't care by then -- I was spending the next three weeks at County Hospital. I'd been told ob-gyn was more fun there, that medical students uniformly had a great time.

 I wasn't about to go to County Hospital. I was about to enter Kafka General.

# # # #

illo by Kip Williams  Three students went to County: me, my friend the Ace, and the Little Rich Girl. The Little Rich Girl was some sort of idealist. One day she stopped me in the hall and gushed, "Don't you just love the dignity of the poor?" Since I had just spent several weeks delivering babies to impoverished people who hadn't planned them, often didn't want them, and were usually condemning them to a life of equally hopeless poverty, I wasn't so sure.

 Our first residents, who were there only for one week, were the most cynical individuals I'd ever met. And lazy. They sent us to the emergency room to evaluate patients, to labor and delivery to check the patients, and in general just showed up, like the Lone Ranger, to rescue things at the last minute. If they could have figured a way to have the students breathe for them, they'd have ordered it.

 Another bad thing about ob-gyn was that any pregnant woman, no matter what her presenting complaint, automatically belonged to ob. And the minute we showed up, every doctor and nurse in the ER evaporated into thin air, leaving the students alone and baffled. Usually it was something you could deal with, like the woman who showed up hysterically screaming that her water had broken. I did a pelvic, got a sample of the fluid to check under the microscope -- it certainly wasn't amniotic fluid. I had a slide full of anxious sperm, all swimming about wondering where they were supposed to be. I never had the guts to say, look, it's semen, didn't you sort of notice how it got there? I just reassured her and sent her home.

 And the minute you decided someone had to go to labor and delivery, the nurses would help you push the stretcher as far as the elevator. But once inside the elevator you were on your own...hoping it moved fast and didn't get stuck.

 We did get to do more in deliveries than at the University. I even delivered a baby myself. Sort of. What really happened was that a young woman came in, unmarried, first pregnancy. She evidently hailed from a long line of relatively intelligent and educated women without husbands or active fathers, and the man she had chosen to perpetuate the line (he bopped in briefly, strutted and left, realizing his lack of importance in the overall scheme) looked like he'd been picked for availability rather than any outstanding personal qualities. And the whole time I was examining her she kept repeating, "I won't keep it if it's a boy."

 That made me a little nervous, since we were talking fifty-fifty chance or better there'd be an unwanted infant. She was so definite about it. I looked questioningly over at her mother, who just nodded and smiled.

 A few hours later I was checking her when she began to scream, "I need to go to the bathroom! I need to go to the bathroom!" I, still somewhat clueless to the entire childbirth thing, started to help her onto the bedpan and noticed scalp appearing between her legs.

 So I delivered the kid, no gloves, ruined my watch (well, it was almost gone anyway), an incredible mess, and the whole time she's digging nails into my arm and screaming "I don't want it if it's a boy!!"

 Was I ever relieved when it turned out female.

 Clinic was even more depressing than at the University. My favorite case was when I noticed that a pregnant woman wasn't putting on weight. "Morning sickness?" I asked.

 "No." She didn't want to talk, but I was eventually able to dig out the story. She wasn't hungry...

 That seemed odd. Was she sleeping? No. Was she crying? Yes.

 Within a few minutes of speaking to her I'd formed a diagnosis of severe depression with psychotic features. I went out and found the chief.

 "She's not putting on weight because she's suicidally depressed. I'm worried about her. We need to call psych and get her some help."

 The chief glared at me, exasperated. He walked in, looked at the woman and asked casually, "Everything okay?" His tone of voice clearly demanded she agree.

 "Yes," she said, and he turned to me with a look of triumph: This is how it's done. I was allowed to give her the number to call to make an appointment at psych clinic, but she never did. She did call a week later, at 3:00 a.m., crying in a phone booth. "Call psych clinic," I told her. My sympathy was less by the end of a rotation, especially at 3:00 a.m.

# # # #

 The residents were replaced by new ones: a chief, a woman I shall call 'The Evil One', and an intern. The Little Rich Girl hit it off immediately with The Evil One. They'd sit giggling together like junior-high-schoolers. I should have suspected that this meant trouble for me and the Ace. The Little Rich Girl was mad at us.

illo by Kip Williams  On our first day she had come to us with a list of days when she absolutely did not want to be on call, because she had parties or committee meetings or political rallies. We said sure, and allowed her to arrange the call schedule. Then we learned the clinic routine -- it seemed that, on days when there was no clinic, you might be able to leave early if you weren't on call. The Little Rich Girl's schedule gave her fewer light days than we got -- so she wanted to switch things around so she would get all her chosen nights off and also a goodly share of easy days. We pointed out that we'd already bent over backwards, and would stick with what we had.

illo by Kip Williams  There was another resident. He'd decided to leave the program, or been fired, and he'd spent every moment when he wasn't absolutely essential hiding in a call room. It was intimidating and disheartening, a little like having Mrs. Rochester locked in the attic, and made a weird rotation even weirder. When the guy did emerge from the call room and walk silently past, I was always tempted to start quoting the first scene of Hamlet.

 At rounds he was totally quiet. Even the day when the other residents were explaining about a patient who was in the ICU, probably not planning to survive. They were painting a grim yet inevitable story for the boss...

 And then my friend Ace, the A student, who just last year won a national award in her chosen profession -- my friend the hopeless naif chipped in with a fact that the residents had left out their history, the one fact that let the attending know just how bad the entire case had been screwed up and what a disservice had been done the patient. The Ace sat back, proud to have contributed, unaware of the evil stares the residents were fixing upon us.

 I should not have been surprised to hear my course evaluation, a litany of character assassination, cheap psychological assumptions, and falsehoods. It seemed like the perfect cap to a rotten year.

# # # #

 Of course, no one could expect us to ever get an internship with such a horrible evaluation on record. All that ultimately saved me -- and it took the better part of a year to accomplish -- was that the Ace got an equally rotten grade, and the faculty knew she was okay.

 It seemed that the chief had walked into the clinic back room one day, carrying our evaluation sheets, and said, "I don't feel like doing the grades. Anyone want to?"

 The Evil One said, "Yeah... I don't like Sharon and Ace."

 The intern told us this, but didn't agree to tell the ob-gyn course supervisor. She didn't want to rock the boat.

 Ace and I went to complain to the course supervisor. She explained that we were stuck in a Catch-22 situation -- the only person who could change the grade was the one who had given it to us! It didn't matter that that person hated us and was acting out of personal spleen, it didn't matter that she had no business grading us in the first place. We had to convince her to change the grade.

 So we dutifully made appointments to talk to her one evening. She took me into another room first and indulged in vicious insults. I told her that it was clear she was incapable of reason, and left. Ace stuck it out for a couple hours of invective, with as much success. As I said, it was just luck that I was stuck in a hopeless situation with an A student who had friends in important places. Things eventually got straightened out and we got grades that, if not exactly making us look like Albert Schweitzer, at least didn't make us Hannibal Lector. 

All illustrations by Kip Williams

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