Laura: Sophia, here's a wild statistic for you. A 2001 study found that after major surgery, men were more likely to be prescribed actual pain medication, while women were more likely to be given... sedatives. Sophia: Wait, what? So, 'You're not in pain, you're just hysterical. Go to sleep.' Is that the message? Laura: That's the chilling subtext. And it's the exact reality at the heart of the book we're discussing today. We are diving into Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain by Abby Norman. Sophia: And Abby Norman isn't just a patient; she's a science writer. She brings this incredible dual perspective of being both a meticulous researcher and someone living through the very nightmare she's investigating. Laura: Exactly. The book was widely acclaimed, with publications like the New York Times calling it an 'alarming story' that galvanizes you. It really struck a nerve because it’s not just her story; it’s the story of millions. And Norman’s own story begins with a scene that is just terrifyingly normal, until it isn't.

Laura: Picture this: Abby is a sophomore at Sarah Lawrence College. It's a crisp autumn morning. She’s living in a little house on campus, life is good. She decides to take a shower before class, a completely mundane, everyday act. Sophia: Right, something we all do without a second thought. Laura: She steps into the warm water, and then it happens. A sudden, stabbing pain in her abdomen. It's not a cramp; it's something alien and violent. She describes it as a sharp, insistent presence. The pain intensifies, spreading through her, bringing on a wave of nausea and dizziness. Sophia: Oh my god, that's terrifying. Just out of nowhere? Laura: Completely out of nowhere. She's struggling to even stand. She fumbles to turn off the shower and collapses onto the cold tile floor of the bathroom, gasping. In that moment of intense physical agony, she looks up at the steamy mirror and sees a reflection. But it's not her own face she sees; it's a haunting image of her mother. Sophia: Whoa. That's... a lot to process. Physical agony and a psychological gut punch all at once. So at this point, she has no idea what's happening to her body? Laura: None. And this is the moment that kicks off her years-long quest for a diagnosis. This is where her journey into what she calls the 'kingdom of the sick' begins. And her first encounters with the medical system are, frankly, infuriating. She goes to the hospital, and they ask her the question we've all been asked: "On a scale of one to ten, how would you rate your pain?" Sophia: Ugh, the pain scale. I've always found that question impossible. How do you even rate a pain you've never felt before? What does an '8' even mean? Is my 8 the same as your 8? Laura: That’s precisely the problem the book exposes. Pain is deeply subjective, but the medical system demands an objective number. Abby struggles to answer. She’s a stoic person, raised in Maine with a "grin and bear it" mentality. She says a '7'. And because she's not screaming or writhing, the doctors seem to mentally downgrade her report. They run some basic tests, find nothing obvious, and essentially send her home with a diagnosis of a urinary tract infection, handing her antibiotics and cranberry juice. Sophia: Cranberry juice? For a pain that made her collapse? That feels so dismissive. It’s like they weren’t listening to the story, just checking boxes. Laura: They weren't. And this is the first major theme of the book: the profound, systemic disbelief of women's pain. The book cites a study by Diane Hoffmann and Anita Tarzian called "The Girl Who Cried Pain," which found that women are more likely to have their pain reported as "emotional" or "psychosomatic" in origin. Sophia: So, the modern-day version of hysteria. It’s not a real physical problem, it's just your lady-emotions acting up. Laura: Exactly. The book even references these bizarre experiments from the 1940s at Cornell, where researchers tried to create an objective pain scale called the 'dol' scale. To do this, they needed a source of extreme, observable pain. Sophia: Okay, I'm almost afraid to ask what they chose. Laura: They chose women in active labor. They used a thermal device to burn the hands of these laboring women, asking them to compare the pain of the burn to the pain of their contractions. Sophia: Hold on. They were burning women in labor to measure pain? That sounds barbaric. What did they even learn from that? Laura: They learned that childbirth can exceed the human pain threshold, which, you know, any woman could have told them for free. But more importantly, the experiment failed to create an objective scale. The women themselves pointed out the absurdity of it, saying the quality of the pain was completely different. A burn is not a contraction. They couldn't equate them. It just proved that pain is a complex, personal experience that can't be boiled down to a simple number. Sophia: And yet, here we are, decades later, still using a 1-10 scale and telling women their '7' is probably just anxiety. It's one thing for a college student to be dismissed, but this happens to famous, powerful women too, right? I was stunned by the story of Gilda Radner in the book.

Laura: Yes, the Gilda Radner story is absolutely heartbreaking, and it's a cornerstone of the book's argument. We're talking about one of the most beloved comedians of her time, an original Saturday Night Live cast member. She was vibrant, successful, and deeply loved. In the 1980s, she started experiencing debilitating fatigue, fevers, and severe pain in her abdomen and legs. Sophia: So she goes to the doctor, and with her resources, you'd think she'd get the best care imaginable. Laura: You would think. But for ten agonizing months, she was shuttled between specialists who dismissed her symptoms. One doctor told her it was just stress. Another suggested it was "mittelschmerz"—mid-cycle ovulation pain. They ran blood tests that came back normal and essentially patted her on the head. Her husband, Gene Wilder, wrote that she was constantly told her problems were psychological. Sophia: They told Gilda Radner it was all in her head? That's infuriating! It’s the same pattern. If the answer isn't immediately obvious on a test, the problem must be the woman herself. Laura: Precisely. After ten months of being ignored, a doctor finally took her seriously and found she had Stage IV ovarian cancer. Gene Wilder recalled that when she finally got the diagnosis, Gilda cried, but then she turned to him and said, "Thank God, finally someone believes me!" Sophia: Wow. To be relieved to hear you have late-stage cancer, just because it means you weren't crazy. That says everything. Laura: It really does. And Norman uses this story to trace the historical roots of this disbelief. It goes back centuries, to the ancient Greek concept of 'hysteria,' which comes from the Greek word for uterus, hystera. They literally believed the uterus could become dislodged and wander around a woman's body, causing all sorts of ailments, from anxiety to fainting spells. Sophia: The 'wandering uterus' theory. This feels like the modern version of that, doesn't it? Just with different words. Instead of a wandering uterus, it's 'anxiety' or 'stress' or 'hormones.' The blame is still placed on some mysterious, uncontrollable part of being female. Laura: That's the book's core argument. The ghost of the wandering uterus still haunts modern examination rooms. The book quotes a 19th-century physician, Mary Putnam Jacobi, who wryly observed the double standard: "If this be a female, and notably selfish, the case is pronounced hysteria. If a man, or though a woman, amiable and unselfish, the case is called neurasthenia." Sophia: So a difficult woman is hysterical, but a nice man is just overworked. The bias is baked right into the diagnosis. And this directly impacts conditions like endometriosis, right? What exactly is endometriosis, and why is it so central to this story? Laura: Endometriosis is a condition where tissue similar to the lining of the uterus—the endometrium—grows outside the uterus. It can grow on the ovaries, fallopian tubes, bladder, and in severe cases, even the diaphragm or lungs. This tissue acts like uterine tissue—it thickens, breaks down, and bleeds with each menstrual cycle. But because it's outside the uterus, the blood has nowhere to go. Sophia: Oh, I see. So it causes internal bleeding and inflammation every single month. That sounds incredibly painful. Laura: It is. It causes chronic pain, scarring, and adhesions that can fuse organs together. It's also a leading cause of infertility. And yet, it takes an average of seven to ten years to get a diagnosis. Sophia: Seven to ten years? Why so long? Laura: For all the reasons we've been discussing. The primary symptom is pain, especially severe period pain, which for generations has been normalized. Girls are told, "It's just part of being a woman." Doctors dismiss it. And the only definitive way to diagnose it is through laparoscopic surgery. There's no simple blood test or scan. So you have this perfect storm of a subjective primary symptom, a culture of normalizing female pain, and an invasive diagnostic procedure. Sophia: A system perfectly designed to fail patients. So when you're faced with a system that's historically designed to disbelieve you, what do you do? Laura: Well, as Abby Norman argues, you become a detective.

Laura: After years of being dismissed and misdiagnosed, Abby Norman realizes that no one is coming to save her. The system isn't working for her. So she takes matters into her own hands. Remember, she's a science writer. She has research skills. She dives headfirst into medical journals, PubMed, and clinical studies. Sophia: She starts investigating her own case. Laura: Exactly. She teaches herself the complex language of gynecology and immunology. She creates her own comprehensive medical history, charting her symptoms, treatments, and test results as if she were her own physician. She becomes the world's leading expert on one subject: her own body. Sophia: That's incredible. The amount of work and determination that must have taken, all while being in chronic pain. Laura: It's immense. And it culminates in this incredibly powerful scene. A year after her first surgery for endometriosis, she's still having this specific, debilitating pain in her lower right side, near her appendix. Her doctor, Dr. Wagstaff, is skeptical. He's already done one surgery. He thinks it's just residual endo pain. But Abby has done the research. She's found obscure case studies linking endometriosis to chronic appendicitis. Sophia: So she's coming to him not just with a feeling, but with data. Laura: With a full-blown medical thesis. She presents her findings to him, laying out the evidence. Dr. Wagstaff is taken aback. He looks at her and says something that perfectly captures the doctor-patient divide: "You’re either brilliant or the most well-educated hypochondriac I’ve ever met." Sophia: Wow. That's so backhanded! It's still couched in disbelief. But he listened? Laura: He did. Reluctantly, he agreed to do another laparoscopy to check her appendix. And when she wakes up from the surgery, he's there. He tells her, "You were right." They found a chronically inflamed appendix, likely irritated by the nearby endometriosis. They removed it, and that specific pain was gone. Sophia: She had to solve her own case. That's an amazing moment of vindication. But it's also deeply unfair, isn't it? You shouldn't need to basically get a medical degree to receive proper care. Laura: That's the social justice heart of the book. Abby Norman's story is one of triumph, but she's clear that it shouldn't be this hard. What about the women who don't have the time, the education, or the resources to do this level of research? What about women of color, who face even greater levels of medical bias? The book argues that while individual self-advocacy is necessary right now, it's not the final answer. The system itself has to change. Sophia: It's a call for a revolution in how we see and treat women's health. It’s not just about finding a cure for endometriosis; it’s about curing the medical system of its own deep-seated biases.

Laura: Exactly. So you have this journey that starts with a terrifying, personal experience of pain and disbelief. That personal story then opens up into this vast, dark history of medical misogyny. And that historical understanding ultimately fuels this powerful, modern act of self-advocacy. It all connects. Sophia: The book is a powerful and infuriating read. It leaves you asking: How many women are out there right now, being told their pain isn't real? How many are suffering in silence because they've been conditioned to believe it's normal? Laura: It's a staggering thought. And that's why this conversation is so important. Ask Me About My Uterus is more than a memoir; it's a manifesto. It's a call to listen—to patients, to our own bodies, and to the stories that have been silenced for far too long. The author's final message isn't one of despair, but of defiant hope. She writes, "I had never wanted to be right; I had only wanted to be well." Sophia: That line is so powerful. It’s not about winning an argument with a doctor. It’s about the fundamental right to a life free from debilitating, ignored pain. We'd love to hear from our listeners on this. Have you ever felt dismissed by a doctor, or had to fight to be heard? Share your story with us on our social channels. Let's keep this conversation going. Laura: This is Aibrary, signing off.