“The wall-eyed nurse came back. She unclasped my watch and dropped it in her pocket. Then she started tweaking the hairpins from my hair. Doctor Gordon was unlocking the closet. He dragged out a table on wheels with a machine on it and rolled it behind the head of the bed. The nurse started swabbing my temples with a smelly grease. As she leaned over to reach the side of my head nearest the wall, her fat breast muffled my face like a cloud or a pillow. A vague, medicinal stench emanated from her flesh. ‘Don’t worry,’ the nurse grinned down at me. ‘Their first time everybody’s scared to death.’ I tried to smile, but my skin had gone stiff, like parchment.”
Dr. Gordon bedside manner during the set up of Esther’s ECT treatment. (Plath 141-142).
“Doctor Nolan put her arm around me and hugged me like a mother. ‘You said you’d tell me!’ I shouted at her through the dishevelled blanket. ‘But I am telling you,’ Doctor Nolan said. ‘I’ve come specially early to tell you, and I’m taking you over myself.’ I peered at her through swollen lids. ‘Why didn’t you tell me last night?’ ‘I only thought it would keep you awake. If I’d known…’ ‘You said you’d tell me.’ ‘Listen, Esther,’ Doctor Nolan said. ‘I’m going over with you. I’ll be there the whole time, so everything will happen right, the way I promised. I’ll be there when you wake up, and I’ll bring you back again.’ I looked at her. She seemed very upset. I waited a minute. Then I said, ‘Promise you’ll be there.’ ‘I promise.’ Doctor Nolan took out a white handkerchief and wiped my face. Then she hooked her arm in my arm, like an old friend, and helped me up, and we started down the hall. My blanket tangled about my feet, so I let it drop, but Doctor Nolan didn’t seem to notice.”
Dr. Nolan’s bedside manner prior to Esther’s ECT treatment. (Plath 213).
These quoted sections of Sylvia Plath’s The Bell Jar entail the bedside manner of Dr. Gordon and Dr. Nolan prior to the administration Esther’s ECT treatment under their respective care. The comparison of these sections demonstrates the ethical importance of informed consent, and the power of patient-provider rapport. In the first section. Dr. Gordon delegates his nurse to prepare Esther for the treatment. Without asking her for how she feels, or performing any type of nursing assessment, Dr. Gordon’s nurse both assumes how Esther is feeling and concomitantly invalidates the significance of her fear. This, again, removes the power from Esther, and encourages an environment of psychiatric treatment that is not focused on Esthers well-being, but rather on the administration of ECT and practice of psychiatry. To summarize, Dr. Gordon provides either profit or protocol-driven care, that values medicine over patient health. Dr. Gordon, at no point, asks Esther for her consent nor explains the procedure. The inability of Dr. Gordon to provide effective care is related to Dr. Gordon’s gender, as he is unable to provide effective care based on the societal conditioning and internalized sexism that has taught him that he has unrestricted access to women’s bodies. Societally, Dr. Gordon has been told, as a male, that he has authority over female bodies and therefore he would not have to ask if it is okay to administer ECT to Esther. This violates the basic ethical principle in medicine and patient-centered care that allows patients to be informed participants in their treatment and maintain ownership of their body. Alternately, Dr. Nolan is perceived “like a mother” and her request for consent to bring Esther to ECT is emotionally charged. While Dr. Nolan doesn’t fully allow Esther to participate in her ECT treatment— she gives her very late notice— she provides emotional support. This emotional support clarifies that Dr. Nolan is there to treat Esther’s emotions. This is especially clear when Dr. Nolan is shown feeling negatviely in response to Esther’s negative emotions. This empathy is related to gender as it is representative of feminine tenderness that is brought up throughout the novel. In their article “Stones, Turkey Necks, and Gizzards: Grotesque Humor and Metaphors of Masculinity in Sylvia Plath’s The Bell Jar”, Donnie Seacreast explains the pervasive themes of feminine and masculine metaphor throughout the novel, writing:
“In contrast to all of the morbidly hard manifestations of masculinity that are forbidden to women, the images of soft masculinity are more closely related to the type of female success or agency that Esther envisions for herself. According to Plath’s metaphorical language, successful female agency will be soft, thus harkening back to Dr. Nolan’s comment about the “tenderness” (219) women provide.”
(Seacreast 72)
Ultimately, Dr. Nolan offers Esther tenderness that is built off of the empathy of existing in a similar human form. Dr. Gordon is incapable of offering this degree of care, because he is a male provider who cannot understand this empathy. Dr. Nolan’s own experience as a female causes her to humanize Esther’s experience, and her connection to Esther through their shared anatomical experience prevent her from claiming ownership over Esther’s body. Ultimately, Dr. Nolan’s shared experience of being a female— like her patient, Esther— allows her to connect with her emotionally in a way that allows her to provide ethical, patient-centered care.
