“‘How do you feel?’ ‘All right.’ But I didn’t. I felt terrible. ‘Which college did you say you went to?’ I said what college it was. ‘Ah!’ Doctor Gordon’s face lighted with a slow, almost tropical smile. ‘They had a WAC station up there, didn’t they, during the war?'”
Dr. Gordon’s clinical assessment of Esther following her first ECT treatment. (Plath 143)
Dr. Nolan: “I woke out of a deep, drenched sleep, and the first thing I saw was Doctor Nolan’s face swimming in front of me and saying, ‘Esther, Esther.’ I rubbed my eyes with an awkward hand. Behind Doctor Nolan I could see the body of a woman wearing a rumpled black-and-white checked robe and flung out on a cot as if dropped from a great height. But before I could take in any more, Doctor Nolan led me through a door into fresh, blue-skied air. All the heat and fear had purged itself. I felt surprisingly at peace. The bell jar hung, suspended, a few feet above my head. I was open to the circulating air. ‘It was like I told you it would be, wasn’t it?’ said Doctor Nolan, as we walked back to Belsize together through the crunch of brown leaves. ‘Yes.’ ‘Well it will always be like that,’ she said firmly. ‘You will be having shock treatments three times a week—Tuesday, Thursday and Saturday.’ I gulped in a long draught of air. ‘For how long?’ ‘That depends,’ Doctor Nolan said, ‘on you and me.’”
Dr. Nolan’s clinical assessment of Esther following her ECT treatment. (Plath 215- 216)
In these two passages, Esther is assessed by each of the doctors after receiving ECT. Through comparing the responses of the two physicians after Esther’s ECT treatment, it can be noted that Dr. Gordon’s clinical assessment of Esther is much less effective and Ethical than Dr. Nolan’s. To begin, there is an obvious difference in the length of clinical assessment that each doctor performs. Dr. Gordon has not gained the trust of Esther, as he is not depicted to do the work to counteract the internalized sexism that has blocked his ability to understand his female patient. This lack of trust has translated to Esther’s unwillingness to become vulnerable by being honest about how her treatment felt. Instead of focusing on Esther further, Dr. Gordon choses to focus on the one thing that Esther does that is not transgressive— her attendance of college— and that he can relate to. This also happens to be entirely unrelated to her care. Ultimately, Dr. Gordon is unable to gain full access to Esther’s psyche because he only occupies the patient-provider relationship as an authoritarian role which lacks empathy and prioritizes control. Thus, Dr. Gordon’s treatment is ineffective and does more harm than good. Contrastingly, Dr. Nolan has been able to do the work to connect with Esther and is therefore able to provide her with ethical and effective care through accessing empathy. At the end of Esther’s ECT treatment under Dr. Nolan’s care, she reports being free of the bell jar that has contained her since she has begun feeling mentally unwell. Stephanie De Villiers, in their article “Metaphors of Madness: Sylvia Plath’s Rejection of Patriarchal Language in The Bell Jar” writes the significance of this moment:
“If Esther is depicted as living underneath a bell jar, then, not only has ‘all the life-giving air
(de Villiers 8)
[been sucked] out of her environment’ (Gill 108), leaving her with stale, ‘sour’ air, but also no
fresh air can enter. This image relates the experience of madness to death: cut off from reality,
Esther feels as though she has died… More significantly, perhaps, is the function of the domestic bell jar, which is used to display objects of beauty – often food such as pastries in pastry shops… If Esther is depicted as living underneath a bell jar, the metaphor of the domestic bell jar implies an invitation of the male gaze as well as pointing to Esther’s function as a woman in patriarchal society. She must be beautified and put on display in order to attract the attention of a man who would choose her as a wife and mother to his children. What is significant about this metaphor is that it points to the relatively passive role of the woman, while the man takes on the role of active agent. This view of gender roles, shared by the majority of American society in the mid-twentieth century, is an assertion of males as active and progressive, and of women as passive nurturers and caregivers. Moreover, women are defined as relative creatures as well, with their duties and their use to society arising from the needs of men. Despite this passive role, however, the burden of becoming a wife-and-mother still falls on the woman, who must embody societal notions of feminine beauty to attract a mate and is deemed as a failure if she does not marry.”
Ultimately, the bell jar and Esther’s depression represented her subjugation and relegation as a woman who was subservient to men. Dr. Gordon’s incapability to remove the bell jar did not just point to the exten of Esther’s mental illness, but rather the gendered implications of his care— which more likely put further pressure on the bell jar. Dr. Nolan’s care existed outside of the patriarchy, and therefore was able to work against the oppression that was symbolically manifesting Esther’s depression. Ultimately, Dr. Nolan was able to provide better psychiatric care to Esther because she was a female provider, and Dr. Gordon provided worse care to Esther, in part, because he was a male provider.
