Woman: An Intimate Geography (23 page)

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Authors: Natalie Angier

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BOOK: Woman: An Intimate Geography
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for anymore?" Yet they do. All the recent emphasis on bedside manners, and still the clichés and witlessisms fly. One woman described to me the miserable time she had with her gynecologist. She was fifty-eight years old, and her uterus was prolapsing into her vagina. The doctor told her, Have a hysterectomy.
I don't want a hysterectomy, she said. I don't want to go into early menopause. I'm not ready for that. Isn't there some alternative?
Early menopause? the doctor said in disbelief. You're fifty-eight years old. You're
post
menopausal.
Believe it or not, she said, I'm still having my periods.
Oh, I see, he replied. So what do you want for that, a medal?
That man should take out malpractice insurance on his mouth. The woman had her hysterectomy. Now she is having other problems. Instead of a prolapsed uterus, she has a prolapsed bladder. Let's learn at least one thing from her misfortune. If a doctor says something inane, callous, or excessively light during a consultation for gynecological problems, find another doctor. Do not trust him, or her, to give you sound advice. Leave the punchlines to sitcoms and Muhammad Ali.
To make a truly informed choice, we need information. Part of that information cannot yet be had, for as we have seen, the uterus is still terra in need of investigative cognition. Much information exists right now but takes work to gather, metabolize, and personalize. A woman must know the particulars of her sexual and emotional demesne. If her erotic life is important to her, for example, and her orgasms tend to be deep and pulsating, she should try anything before relinquishing her uterus. We have been schooled in the primacy of the clitoris to female sexuality, but it is the contractions of the uterus and cervix that lend a climax its subterranean vibrato. A woman should realize that some consequences of a hysterectomy cannot be predicted, no matter how well she prepares herself. She may have decided on a "conservative" operation that removes the uterus while leaving the ovaries in place. By saving her ovaries, she thinks, her biochemical status will remain stable and she will avoid the threats to heart, bone, and brain that come with an abrupt cessation of ovarian hormones. Unfortunately, there are no guarantees; it turns out that a third of the time the ovaries never recover from the physical trauma of the hysterectomy, and they end up
in vivo
but inert. Moreover, even when the ovaries survive, a heightened risk of

 

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high blood pressure and heart disease remains, possibly because the extraction of the uterus eliminates one source of prostaglandins that help protect blood vessels.
The aftermath of a hysterectomy can be terrible or wonderful or banal, and there are plenty of women out there who will testify for each possibility (or shall we say ovarify, given the origins of
testify
in the word
testis
, a reference to the male practice of swearing by something while gripping his most sacred possessions?). Some women say they became depressed and fatigued after a hysterectomy and have never recovered. Some say that their feelings for their children are diminished, as though they lost with the uterus a kind of emotional bas-relief of the babies the organ once carried. There are women who say they feel great and wish they had done it sooner. There are women who say they aren't about to celebrate the surgery, but they didn't have much of a choice and they're doing fine. Beth Tiner, of Los Angeles, started a support group on the Internet called Sans Uteri for women who have had hysterectomies or are considering a hysterectomy. The group doesn't judge. It doesn't have a position for or against. Tiner herself had a hysterectomy at the age of twenty-five to treat endometriosis that had tormented her with pain since she was seventeen. She doesn't regret having had the surgery. She doesn't have the pain anymore. Nonetheless, she anticipates that other problems in her life will arise as a result of having lost her uterus and ovaries at such a young age. Some women teach themselves to become strong and libidinous again after a hysterectomy. In a tart and moving fictionalized account of her hysterectomy called ''So You're Going to Have a New Body!" the novelist Lynne Sharon Schwartz describes her attempts to recover after the surgery, an ad-lib program that included dumping her insipid male gynecologist, having a brief affair with an old and reliably dexterous lover, and running ever faster around the Central Park reservoir. A year after the operation, she felt much better, fond of her new body, "accepting its hollowness with, if not equanimity, at least tolerance." Still, she retained the "tenuous sense of waiting," like a woman who has come to the edge of a cliff and lingers there too long. What she was waiting for, she had no idea.
Eighteen months after her hysterectomy, Hope Phillips also is fine not exhilarated, just fine. She is glad she had the hysterectomy rather than trying a myomectomy for the simple reason that she's terrified of

 

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surgery and was not willing to risk needing more later. The hysterectomy initially left her with stomach muscles so weakened that during a three-month trip to Africa, she could barely sit up as she jostled along the dirt roads in a putative all-terrain vehicle, and at one point her back gave out. Returning home, she started a vigorous exercise program, and the pain and numbness in her belly gradually disappeared. The loss of her uterus has not affected her erotic life. Her relationship with the man she was seeing survived the spinning teacup of gynecological surgery, of her becoming, for at least a moment in his mind, akin to his mother's friends. They were married in 1997, and I mean married, holding one wedding in California and another in Zimbabwe. Hope Phillips once again feels at home on the road, now that her suitcase carries what it was meant to which for her, the practiced wanderer, means almost nothing at all.

 

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7
Circular Reasonings: The Story of the Breast
Nancy Burley, a professor of evolution and ecology at the University of California in Irvine, plays Halloween with birds. She takes male zebra finches and she accessorizes them. A normal, pre-Burley finch is a beautiful animal, red of beak and orange of cheek, his chest a zebra print of stripes, his underwings polka-dotted in orange, and his eyes surrounded by vertical streaks of black and white, like the eyes of a mime artist. One thing the zebra finch does not have is a crest, as some species of birds do. So Burley will give a male a crest. She will attach a tall white cap of feathers to his head, turning him into Chef Bird-o-Dee. Or she'll give him a tall red Cat-in-the-Hat cap. His bird legs are normally a neutral shade of grayish beige, so she gives him flashy anklets of red, yellow, lavender, or powder blue. And by altering the visual pith of him, his finchness, Burley alters his life. As she has shown in a series of wonderful, amusing, important experiments, female zebra finches have decided opinions about the various accouterments. They love the tall white chef caps, and they will clamor to mate with a male so haberdashed. Zebra finches ordinarily couple up and abide by a system of shared parental care of nestlings, but if a female is paired with a white-hatted male, she gladly works overtime on child care and allows him to laze though he doesn't laze but spends his free time philandering. Call the benighted wife the bird who mistakes a hat for a mate.
But put a male in a tall red cap, and the females turn up their beaks. No trophy he: you can have him, sister. If a red-capped male manages to obtain a mate, he ends up being so busy taking care of his offspring that he has no time for extramarital affairs, and there are no demands for his moonlighting services anyway.

 

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The opposite holds true for leg bands. Dress a male in white ankle rings and he's of scant appeal. Put him in red and he's a lovebird.
Zebra finches have no good reason for being drawn to white toques and red socks. We cannot look at the results of Burley's costume experiments and say, Ah, yes, the females are using the white crest as an indicator that the male will be a good father, or that his genes are robust and therefore he's a great catch. A zebra finch with a white crest can hardly be said to bear superior finch genes when he's not supposed to have a crest in the first place. Instead, the unexpected findings offer evidence of the so-called sensory exploitation theory of mate choice. By this proposal, the white hat takes advantage of a neurophysiological process in the zebra finch's brain that serves some other, unknown purpose but that is easily coopted and aroused. The hat stimulates an extant neural pathway, and it lures the female, and the female does not know why, but she knows what she likes. We can understand that impulse, the enticement of an object we deem beautiful. "Human beings have an exquisite aesthetic sense that is its own justification," Burley says. "Our ability to appreciate impressionistic painting cannot be called functional. In my mind, that's what we're seeing with the zebra finches. The preferences are aesthetic, not functional. They don't correlate with anything practical."
Nevertheless, the evidence suggests that if a male finch someday were born with a mutation that gives him a touch of a white thatch, the mutation would spread rapidly through finchdom, possibly becoming accentuated over time, until a bird had the toque by nature that Burley loaned by contrivance. No doubt some researchers in that hypothetical future would assume that the finch's white cap had meaning and was an indicator of zebra finch mettle, and they'd speculate about the epistemology of the trait.
A woman's breasts, I argue, are like Burley's white crests. They're pretty, they're flamboyant, they're irresistible. But they are arbitrary, and they signify much less than we think. This is a contrarian view. Evolutionary theorists have proposed many explanations for the existence of the breast, usually according it a symbolic or functional value, as a signal to men of information they need to know about a potential mate. How can we not give the breast its evolutionary due when it is there in our faces, begging for narrative. "Few issues have been the focus for a

 

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wider range of speculation based on fewer facts than the evolutionary origin and physiological function of women's breasts," the biologist Caroline Pond has written. The stories about the breast sound real and persuasive, and they may all have a germ of validity, because we ascribe meaning wherever and however we choose; that is one of the perquisites of being human. As the actress Helen Mirren said in the movie
O Lucky Man
, "All religions are equally true."
Still, I will argue that breasts fundamentally are here by accident. They are sensory exploiters. They say little or nothing about a woman's inherent health, quality, or fecundity. They are accouterments. If we go looking for breasts and for ways to enhance and display our breasts, to make them stand out like unnatural, almost farcical Barbie-doll missile heads, then we are doing what breasts have always done, which is appeal to an irrational aesthetic sense that has no function but that begs to be amused. The ideal breasts are, and always have been, stylized breasts. A woman's breasts welcome illusion and the imaginative opportunities of clothing. They can be enhanced or muted, as a woman chooses, and their very substance suggests as much: they are soft and flexible, clay to play with. They are funny things, really, and we should learn to laugh at them, which may be easier to do if we first take them seriously.
The most obvious point to be made about the human breast is that it is unlike any other bosom in the primate order. The breasts of a female ape or monkey swell only when she is lactating, and the change is usually so modest that it can be hard to see beneath her body hair. Once the mother has weaned her offspring, her breasts flatten back. Only in humans do the breasts inflate at puberty, before the first pregnancy occurs or could even be sustained, and only in humans do they remain engorged throughout life. In fact, the swelling of the breasts in pregnant and lactating women occurs quite independently of pubertal breast development, and in a more uniform manner: a small-breasted woman's breasts grow about as much during pregnancy, in absolute terms, as a busty woman's breasts do, which is why the temporary expansion is comparatively more noticeable on a small-breasted woman. For all women, maternal augmentation results from the proliferation and distention of the cells of the ducts and lobules (the dairy equipment), increased blood flow, water retention, and the milk itself. Small-breasted women have the same amount of lactogenic tissue as

 

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