The Blue Cotton Gown: A Midwife’s Memoir

admin — Wed, 17 Jun 2009 09:10:00 +0000

By the time Patricia Harman finished writing The Blue Cotton Gown, she was no longer working as a midwife. Instead, soaring malpractice fees had caused The Women’s Health Clinic of Torrington, West Virginia, a practice Harman runs with her husband, Dr. Tom Harman, to provide only general obstetrical and gynecological care to the patients it serves.

Harman is a nurse-practitioner and her memoir tracks a handful of women for approximately a year, zeroing in on the many variables that impact their health and well being: rampant drug and alcohol abuse, poverty, violence, mental illness, and inadequate information about staying healthy, among them. It’s a gripping account. At the same time, the book is as much a meditation on aging, marriage, and parenthood as it is a look at the obstacles and challenges endemic to the provision of healthcare in the U.S. This makes it both intensely moving and intensely, if obliquely, political.

Harman describes herself and her spouse as former hippies, people who found their professional calling in their thirties, after years of organic farming and communal living. Their countercultural impulses have made them compassionate, and their work is motivated by love of medicine, not love of the dollar. Not surprisingly, these tendencies have led to managerial problems. To whit, an inattention to finances—and way too much trust in accountants who could care less about the Harman’s ethos of providing the best care for the best price—led to monetary miscalculations that threatened to shutter the practice. When the IRS came calling, tensions built and the Harmans and their ten-person staff had to work tirelessly to forge a survival strategy. They did—the practice was saved—but not without both dents and dings to numerous personal relationships.

Meanwhile, they had patients to deal with and their own personal crises to address. Harman calls it “running in front of a plague of locusts.” There is Nila, pregnant for the eighth time, who fears that her ex-husband is molesting her four-year-old. There is Heather, a teenager pregnant by a nineteen-year-old drug addict, and Holly, a forty-five-year-old menopausal realtor whose bulimic daughter is perched on death’s window ledge. And there’s Rebba, worried because she has never had an orgasm, and Shiana, a college student who needs to have a condom extracted from behind her cervix.

Closer to home, the elderly parents of staff get sick and Harman, herself, becomes ill. Within the span of a few months she needs to have a gangrenous gall bladder removed and has a complete hysterectomy.

Throughout, there are constant money troubles—big ones—and the tension and stress are palpably presented. To her credit, Harman is not looking for either sympathy or accolades but her matter-of-fact descriptions of how difficult it is to provide high quality, patient-centered care is simultaneously enraging and shocking. While she never discusses the need for a national health plan—she also barely mentions abortion as an option for her oft-pregnant patients—her chronicle of the trials and tribulations of one nurse practitioner is riveting.

Yes, The Blue Cotton Gown could have been more politically prescriptive. Nonetheless, readers will find their immersion in the daily affairs of this off-the-beaten-track health center emotionally engaging, engrossing, and inspiring. Indeed, in an era of rampant medical discontent, the determination and persistence of Harman and her Torrington colleagues seems almost miraculous.

Written by: Eleanor J. Bader, June 17th 2009

Body Panic: Gender, Health, and the Selling of Fitness

admin — Tue, 26 May 2009 00:21:00 +0000

By Shari L. Dworkin, Faye Linda Wachs

New York University Press

Much has been made of representations of bodies, women’s bodies especially, in the media; this terrain is heavily traversed, particularly in feminist discourse. Magazines can be particularly insidious culprits of spreading rigid body doctrines, and for this they have been criticized and pulled apart in many ways. What makes Body Panic: Gender, Health, and the Selling of Fitness different is that Shari L. Dworkin and Faye Linda Wachs are relentless in their pursuit of a comprehensive, empirical study of the ways in which both women’s and men’s bodies are represented in mainstream fitness magazines.

Smiling and posing from the racks as mainstream America waits in line at the grocery store, male and female fitness models shine as beacons of wellness. Oiled, buffed, flexed, but above all sexy, these men and women represent a promise of a better life within the covers. Fitness magazines preach a doctrine no less rigid or demanding than the imperatives of the fashion industry to be thin or the cosmetic industry to be beautiful; however, they do so behind the shield of “health” that so often keeps them from harsher criticism. Dworkin and Wachs dismantle the concept of “healthism” in Body Panic, exposing the ways in which the fitness industry packages and sells a narrow and constrictive version of wellness as a one-size-fits-all prescription to happiness, sex appeal, a long life, and more.

If one only works hard enough, and wants it badly enough, the magazines preach, dreams of “health” and “fitness” can be realized. Based on gender, however, one’s goals should be different. Dworkin and Wachs examined a cross-section of mainstream magazines for both men and women over a span of about ten years, and used a detailed rubric to break down the differences and similarities between them, particularly the cover photographs. The discrepancies, while not surprising, are nonetheless indicative of the unequal ways women’s and men’s bodies are displayed and consumed.

Body Panic takes a fresh look at the diet and exercise industries; Dworkin and Wachs show us that no one, woman or man, young or old, is safe from the pervasiveness and influence of these powerful money-making machines. By no means suggesting that individuals ignore or disregard their “health,” they rather implore us to be critical of media sources we consume, particularly when it comes to our bodies. It is no surprise that the diet and exercise industries consistently make top dollar in the United States—by creating morally superior imperatives and edicts of fitness, and by repackaging the health of our bodies into something that can be bought, these industries ensure that their customers will continue to chase, and pay for, through money or social capital, the health ideal they have fabricated. An ideal so strictly policed is always worth dissecting, and Shari L. Dworkin and Faye Linda Wachs have done this in top form in Body Panic.

Written by: Kelly Moritz, May 25th 2009

health industry

The Blue Cotton Gown: A Midwife’s Memoir

Body Panic: Gender, Health, and the Selling of Fitness