Two women in denial. One wanted a daughter from her second husband after 11 pregnancies – two deaths and six abortions. Belonging to Tajikistan, she donned a hijab but talked of intimate things through a male interpreter. The second woman was the mother of a daughter with Turner Syndrome. Her concern was the marriage of a daughter, when she should have been concerned about the health of the girl – her life was at great risk. Tripti, a New Delhi-based practicing gynaecologist, discusses real life incidents and wonders what it is to be a woman. Here’s a fictionalised account, exclusively in Different Truths.
Being a woman was almost vital today. While all creativity was sacrificed at the altar of this new pride in that something called ‘womanhood’ the celebrations were just as superficial, the emotions, as virtual, as was the space, which bore the rantings of a world that suddenly completed correcting the misdeeds of past. Even the most notorious and the most cynical ones joined in the glorification of womanhood for once.
A medical representative stood with a bouquet and a card along with her product monogram. Any other day I wouldn’t have liked this intrusion but in this new found spirit of sisterhood, I indulged her. She was doing her job. I smiled at her. Well, she was a woman too.
As she left, I noticed a familiar face peering through the half closed door. I recognised him immediately. He was an interpreter to patients from Tajikistan and he stammered very badly. He had my sympathies but when pitted against a foreigner whose language I had no means of understanding and a medium who stammered so hard that it made everything impossible to comprehend, I could only brace myself for a difficult time ahead. If he was not my best friend, I was not his favorite doctor either. He rather made no bones about it. Once when I had asked him to be a little quick, he had grumbled about me being a little impatience. I could recognise the same impatience creeping once again.
A tall bulky woman followed him. She greeted me before sitting on a stool near me. I looked at the interpreter warily as he once again broke into a stammer. Trying hard not to look exasperated I smiled encouragingly at him. There was no point being at loggerheads with the only help I had. Lot many hurdles remained to be cleared. Moreover, there was no point having a repeat stand-off with him.
At times, it zapped me that these women, who were otherwise covered from head to tail in their trademark black hijab, chose to share with these strangers (interpreters) their most intricate and intimate details, sometimes even in the absence of their husbands. Well, necessity remains the mother of all inventions.
From what I gathered from him, this woman wanted help in conceiving.
‘No children?’ She looked a little older. Her papers mentioned that she was actually thirty-eight.
‘No ma’am she has three!’
‘Actually, she had five.’ This is where it got stuck. The moment you wanted a detailed history, it got really difficult as you had no inkling as to what she was saying. One had to depend upon the interpreter’s intelligence. And in this case, it was so difficult to trust that.
‘Well, she had five children, of whom only three survived, all of them males. Rest died within five days.
‘Hmm, so she had five pregnancies.’
The interpreter translated it to the women. She shook her head vigorously and broke into an incoherent language again
‘She’s saying she had six more.’
‘Six what!
Did he seriously mean 11 pregnancies? She was only 38 years old and just about two short of Mumtaz Mahal’s record.
‘Actually, she had six abortions after her deliveries.’
‘She has spent almost all her life in pregnancies and still, she wants more’ I seriously appreciated some people’s zeal to procreate.
The doctor inside struggled to decide the tests she needed to undergo when I was bombed with another piece of information
‘Ma’am, actually all the abortions are with the second husband.’
‘Second!’ I stared at the expectant smile on the woman’s face.
‘So get her present husband tested.’ It was getting simpler.
‘But, he has eight children from another wife, youngest less than a year back.’
My ambitions to test him quietly walked out of the window in face of such a daring proof.
It never was easy for a doctor.
‘Why should he want more now?’ They were not a very rich country.
“Actually he wants a daughter from her.’ He spoke indulgently at the woman.
Trust me for not understanding such obvious emotions. Shaking my head I set out to write a battery of tests to evaluate her continuous and persistent efforts at motherhood.
‘I could go far for that someone I loved if only I knew how far….’
Men in that part of that country were allowed many wives. A harem! I scoffed. Yet I was amazed to see a surreal acceptance amongst the wives for each other.
Once a woman suffering from a bad genital infection wanted to take medicines for the other wife too. Laughing at my raised eyebrows she said, ‘If she doesn’t get treated, this husband would again transmit the infection. I once heard her over the telephone. She was asking him to get me treated.’
I guess it was allowed in their religion so they accept them.
‘My religion allows too but Indian woman not so accommodating.’ The interpreter bent forward to give his best smile. I didn’t realise I had spoken out aloud. Well, I was neither impressed by him nor did I want to be part of any slapstick humour and looked blankly at him. Embarrassed he fell back on his chair.
I was not really convinced about the tests I wrote, yet I didn’t want to disappoint someone who had travelled miles just for this. Throwing a grateful smile at me, which I felt I somehow didn’t deserve, I watched her leave my clinic.
Women! How boundaries changed our perceptions, behaviour, and ambitions too.
I was not left with much time to brood.
A small plump dark girl had been just waiting for her turn and rushed inside, followed by another older woman who appeared to be her mother.
They were carrying a pile of papers, some yellow ones on the verge of a massive breakdown peeping through the files. The government gives them poor quality papers, and they keep their tiffin over them and yes, we still talk about maintaining records. No point getting sarcastic over a piece of paper, smelling of pickles. But then there was so much more stored in those weathering ones!
The elderly lady sat on the stool in front of me, and the younger one who appeared to be her daughter sat at the corner.
I looked at them questioningly but the lady had too much on her head to look at my questioning eyes.
‘I have to get her married.’
‘Ok!’
‘You know how important it is for a girl to get married.’
It was debatable but I guess from her viewpoint she appeared justified. I waited patiently, just to see where I came in her plans of marriage.
‘I guess, I do.’
And it was still not clear to me who was the patient. The one who sat near me was usually the patient but I guess, here the one who sat near me was the one who was troubled more.
‘So what brings you here? Not a marriage proposal for sure.’
She laughed.
‘Actually, at AIIMS, they gave her a medicine and she started having regular cycles. Then one day when we went to them, they changed the medicine. Now she has no periods. Your hospital is on my panel. So please write the earlier medicines so that I can get it from the dispensary.’
Her problem didn’t make my diagnosis and much as I wanted I couldn’t write a prescription without one.
People sometimes like to tell their problems in their own way but we doctors have this habit of extracting information in our own ways.
At least it was clear who the patient was, now.
‘Can you please change places with the girl?’
She looked a little embarrassed but obliged.
‘Madam, she can have children, no.’
‘I know it’s important for you.’
‘Yes ma’am, very much!’ She interrupted me.
‘But can I please understand what’s going on?’
‘At AIIMS, they told me it’s a Turner Syndrome.’
A Turner! With a start, I looked at her. It was a condition where the person had XO chromosome rather than XY or XX. The absence of Y chromosome made her a woman, yet the presence of just a single X made her at most ‘not a man’, genetically speaking.
I looked closely at her. She was short-necked but otherwise, she carried all the feminine traits. They carried no papers but she told me that she was not suffering from any heart defects so characteristic of a Turner syndrome.
‘When did you realise you had a problem?’
‘Madam, she didn’t start menstruating so we had to see the doctors. At AIIMS, they gave us some medicines and she was alright, even without medicines. It was only when they changed her medicine that her periods stopped. You please write down the ones she was taking earlier.
‘Do you know what being a Turner means?’
The girl lowered her eyes.
‘Madam, she has to marry.’
‘You might have to remove her ovaries. They get cancerous.’
I didn’t have the papers but I was sure she must have been told about this.
‘Madam, how will she marry then?’
‘I am telling you about cancer and you are talking about marriage? I think it’s the only thing important to you’ I couldn’t hold back the sarcasm.
‘It is!’ She failed to understand it
‘Why don’t you start searching right now?’
‘Yes ma’am, we have already done so. You just write her previous medicines so that she starts having periods.’ She still didn’t get it.
Probably she had closed the doors to any rational thinking and no voice of reason could reach her now.
I turned to the girl
‘Listen, I hope you know what you are dealing with. Please bring your old papers next time so that we clearly know where we stand. I hope you have been told that one needs to remove the streak gonad (ovary/testis) inside the abdomen else they get cancerous. That’s a huge risk.’
‘I understand ma’am. They asked me to remove that about four years back but ….’ Her voice trailed off
‘I am studying. Soon I will be in the final year of graduation.’ She was like any other chirpy girl of her age and I sincerely wished her parents didn’t impose so much upon her.
Conventions were important but what did one do when it was ‘nature’ that became so unconventional. In a world were even altered sexual preferences were gradually getting accepted, what standing such people had, socially as well as legally?
It felt almost cruel to explain her intersex status to her. Her mother’s ambition to get her married off was soon going to expose her to this ruthless world where such deviations from the norm were not taken kindly.
She lingered in my thoughts long after she had gone.
She was back in my clinic two days later with all her papers
Her papers confirmed that she was not just a simple Turner but a little complicated done. Her karyotype revealed that 40 % of her chromosomes were XY and 60 % were XO. Fate is indeed funny especially when it shapes our destiny.
If I thought it was tough explaining her genetic setup, her mother was proving me wrong. There were more pertinent matters that needed to be discussed.
‘Ma’am she can have children, no?’
I stared at her.
‘You just write the medicines she was taking earlier.’
If only she understood that having menses and having children didn’t go together.
Exasperated, I once again turned to the daughter.
‘You need to have an ovary and a genetic set up to pass on to and make babies. Yours is dysfunctional. Having a menses a few times was just an aberration from may be a sporadic production of hormones.’
‘Ma’am, why don’t you understand?’
It was clear who was not ready to understand. Her mother was now bugging me.
‘Listen. Do you realise you are 40% a man, 60 % a woman, whatever that makes you? I hope you know that the society has a word for such people. Yet your secret is under the blanket. What happens when your mother gets you married? You won’t have a baby and your husband is going to take you to a doctor and then all hell will break lose. How would they feel? Your marriage gets null and void and your reputation tarnished. It’s a very cruel word that we live in.’
She could still marry and enjoy a normal physical relationship. At least God had been kind enough and she was normal in other places. Adoption, donor eggs, and IVF were other options for her. But she needed a very well understanding life partner for that. It sounded highly improbable but then life was pregnant with possibilities.
I knew I was being a little blunt and felt a trifle ashamed when I saw tears in her mother’s eyes. Strangely my words still didn’t register with her.
Her daughter needed to be on hormones all her life to substitute for the ones her dysmorphic glands were not making. But then that still didn’t take away from the danger of cancer that was lurking beneath. She looked at my worried eyes and glanced away.
I looked at her daughter. This was her life. Was she such a baggage to her parents? Or was it just a social responsibility that compelled them? Probably they were doing it just to escape alienation in a society that frowned upon parents not able to get their daughters married off.
‘I know ma’am. I will get it removed.’ The girl lowered her face.
‘But how will she have kids?’ Her mother interrupted and I ignored her.
Her daughter passed her a warning look.
‘I hope you understand your health, happiness, and dignity is more important than marriage any day.’
She nodded. Her mother kept her tearful eyes averted.
I knew it wouldn’t be so easy to get rid of that potentially malignant streak gonad for that is where her mother’s dreams of her happy future lay buried.
A strange world we lived in. I couldn’t help feeling sad for her.
She left along with her mother towing behind who kept her eyes downcast. I had not heeded to her demands to write the old drugs. It was irrelevant and didn’t make any difference. What was the point of fueling unrealistic dreams, anyway?
The irony called nature rattled.
Just last month we had so much going in the name of International Women’s Day. So what made a woman? A pair of X chromosomes or was it something beyond that?
My brooding eyes caught at the bouquet and a card at the corner of my table. It read in pink ’Be the woman, you want to be’. Indeed…
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