Hektoen International

A Journal of Medical Humanities

In sickness and in health: misogyny in medicine

Shreya Sharma
Ontario, Canada

 

Woman yelling while holding yellow curtain
Image by Rene Asmussen from Pixabay

“You see, he does not believe I am sick! And what can one do?”1

These words, spoken by the unnamed narrator of Charlotte Perkin Gilman’s 1892 short story The Yellow Wallpaper, could have been articulated by many women about their medical experiences. Women have long had to navigate a healthcare system designed primarily by men for men. Instead of addressing the limitations of their knowledge, many doctors throughout history expected women to accept their condition gracefully and make lifestyle changes to cope. The Yellow Wallpaper has long been revered as a feminist tale, with the garish yellow paper serving as a symbol of how domestic life ensnares women. A more literal approach makes it a clear story of how gender disparities disproportionately harm females when accessing medical treatment.

The Yellow Wallpaper is written as a composition of diary entries, sharing the tale of a woman brought to a countryside home by her husband to rest and recover from her “nervous troubles.”1 She stays in a room with barred windows, a scratched floor, and yellow wallpaper that appears to transform as time goes on. All the while, she struggles to convince the men in her life that she is ill and suffering.

The story stems from Gilman’s own experience with “nervous prostration.” Today, she would likely have been diagnosed as having post-partum depression. She sought treatment from Dr. S. Weir Mitchell and went through his controversial “rest cure.” Mitchell’s interest was in observable physical symptoms and he maintained a flippant attitude towards the patient’s emotional experience. Gilman at first appeared to improve after a month of bed rest, massage, electrotherapy, and a meat-rich diet. She was instructed to rest after each meal, never write again, and live an ideal domestic life. Unsurprisingly, her depression and melancholy resurfaced. Not long after, Gilman chose to take her daughter and separate from her husband, a scandalous decision at the time.2

The narrator of The Yellow Wallpaper was also diagnosed as having a “temporary nervous depression—a slight hysterical tendency,”1 characterized by melancholy and unease. She is told to rest, exercise, and avoid writing and work at all costs. While Gilman’s story is one of the better-known narratives, it is not the first to highlight the historical association between women and a state of being “dreadfully fretful and querulous.”1 The concepts of nervousness and female hysteria were dominant medical theories for centuries.

In the eighteenth century, a “nervous disease” was named for its connection to the nerves, which referred to emotions. Most patients diagnosed as such were women. Women were considered to be sensitive, delicate, and particularly susceptible to any illness arising from an imbalance in their emotional state.3

Nervous diseases were characterized by many physical and emotional symptoms. Abdominal swelling, fainting, heart palpitations, and headaches were some of the main physical symptoms, while emotional symptoms included excitement, continual sighing, intense laughter, gazing, distress, and desolation. In medical practice, any evidence of personal discontentment was considered a possible indicator of a nervous disease. Men could also display the same signs, but women received these diagnoses because of their presumed mental and physical inferiority.3

In the nineteenth century, the concept of “nervous diseases” became known as “hysteria.” With the root word hystera—Greek for “uterus”—this new disease was a strictly feminine affliction. Hysterical episodes were recognized by a rapid transition between symptoms such as laughing, fainting, crying, irritability, and fatigue. It was believed that any activity related to the uterus, especially sexual intercourse, menstruation, and childbirth, triggered hysteria in much the same way as emotional imbalance had served as a sign of a nervous disease.4

In The Yellow Wallpaper, the narrator’s distressing emotional and mental states could have led a physician at the time to diagnose a nervous disease. Meanwhile, her mental instability induced by childbirth lends itself as a symptom of hysteria. However, at the start of the story, she does not seem to suffer from anything more than mild depression, presumably post-partum in nature, and a strong desire to explore and write.

Whether ill or not, she is forced into a diagnosis, with her husband confident that her discontentment and restlessness are due to her feminine, emotional tendencies. The narrator goes through a treatment that highlights her position of inferiority and dampens her creativity. Evidenced by the narrator’s resentment of her brother and husband, both male physicians, she is a victim of misguided medical perceptions of female sexuality and emotions. The Yellow Wallpaper illustrates the inherently oppressive and misogynistic history of nervous diseases and hysteria.

Gilman’s short story puts the reader into the mind of someone who is being failed by the healthcare system of her time. The narrator’s deteriorating condition serves as a lesson even today, even if one is “a physician of high standing.”1 Experience and familiarity can lead to stagnation and resistance to adopting new methods of care. The Yellow Wallpaper is a study in the efficacy and implementation of therapeutic processes and a reminder that illnesses and their treatments do not exist in isolation from a person’s environment. Diagnosis and treatment should be holistic, compassionate, and free of bias.

Today we might scoff at the premise of something like the “rest cure.” Yet it is a humbling reality that our current diagnoses and treatments might be met in the future with the same bewilderment and disdain. Maybe the narrator was diagnosed with hysteria and a nervous disease simply because she had a uterus. Or maybe she was forced to take the “rest cure” to focus on being an attentive wife without the distraction of an adventurous spirit. Regardless, it is difficult not to wonder what other “hysterical,” “nervous” women had to go through.

 

References

  1. Gilman, Charlotte Perkins. The Yellow Wallpaper. The New England Journal, 1892.
  2. Gagnon A. Charlotte Perkins Gilman: Connecticut history: A cthumanities project. Connecticut History. CTHumanities. https://connecticuthistory.org/charlotte-perkins-gilman/. Published March 5, 2020. Accessed August 10, 2021.
  3. Schuster DG. Neurasthenia and a Modernizing America. JAMA. https://jamanetwork.com/journals/jama/fullarticle/197572. Published November 5, 2003. Accessed August 10, 2021.
  4. The History of Hysteria. Office for Science and Society. https://www.mcgill.ca/oss/article/history-quackery/history-hysteria. Published July 31, 2019. Accessed August 10, 2021.

 


 

SHREYA SHARMA is a second-year undergraduate student at Western University (London, Ontario). She is passionate about preventative healthcare and has an interest in examining how ethical issues in medicine are conveyed in literature.

 

Summer 2021  |  Sections  |  Doctors, Patients, & Diseases

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