Peer Review Comments:
Libby:
“Hi Delaney,
I don’t have many comments regarding the finer points of this yet since I know this is still a broad editing process for you right now, given your recent change in the direction for the project. Instead, I propose some challenges for you:
1. Maybe work to shorten these quotes you’ve selected. I remember in Professor Tuttle’s class, that she would really try to narrow down what we wanted to focus on, even to the point of just looking as a single piece of punctuation. Some of these quotes are fairly long and I worry that your annotations may try to cram too much.
2. Give an introduction to the story you are annotating. I was a bit confused since I didn’t know the context of the story. If you did give a summary and I missed it, I apologize, but maybe it should be its own paragraph since I may have mixed it in with other information.
Overall, I enjoy this journalistic tone you’ve taken on and look forward to seeing where the project goes.” (Overall comment)
“This may be a good point to add in the actual DSM-5 entry for context” (Comment on specific point in forward)
“Maybe try to challenge yourself to make this one concise thesis sentence?” (Comment on thesis)
Mikayla:
“For only “half done” I think you have a great direction/plan!” (Overall Comment)
“You introduce a lot of questions here, which is interesting, but I am not sure which ones you are trying to answer. All of them? If so, that might be a lot to take on. I would suggest just making the distinction somewhere in the intro about which ones you are specifically going to be focusing on in this project”
“this is all great context to provide readers” (Comment on the Forward)
“is this going to be your introduction? The second halves seems to lend itself to this more while the beginning sections where you are speaking in first person would fit into a framing statement” (Comment on the critical introduction)
“I know that this is a working draft still but I agree that it might be beneficial to look at smaller sections of the text for your annotations. However, these passages look great in terms of finding relevant evidence to support your thesis” (Comment on Quotes)
Title: Sex and the Clinic
Writer’s Memo: https://dcollins11.uneportfolio.org/2021/04/14/writers-memo/
Topic: Bioethics of Patient Provider Relationships and Gender in The Bell Jar by Sylvia Plath
Forward: I recently had to find a new Primary Care Provider. I didn’t need one for anything in particular, just insurance purposes, really, so I found a convenient group of physicians and gave the organization a call. After the formalities— patient name and birthdate etc— I was met with the question: “Do you prefer a male or female provider?.” While, perhaps, this question doesn’t come across as particularly remarkable, it indicates a cogent implication in the treatment of gender by the medical community, specifically regarding patient-provider relationships. First, it indicates that the patient notices a marked difference in their treatment from a male provider and a female provider (and vice versa). Second, the question implies that these are the only options for providers: Male or female. This indicates that the patient-provider relationship is, by this question alone, defined by the gender binary. For those (both patient and provider) who fall outside of this binary, the process of receiving healthcare is initiated with a question that may not have a clear answer, or more importantly, a comfortable one.
This question, “Do you prefer a male or female provider?” implicates a broader point that needs to be analyzed: how do medical bioethics and gender intersect? And perhaps, an even deeper question— how might gender contribute to medical specialties that deal less with our anatomy, or more with our psyche? One can understand, for instance, cultural and personal motivations for a heterosexual, cisgendered woman preferring a female obstetrician. However, how do these preferences, and the resulting implications, translate into the vulnerable lobes of the brain? Who do we prefer to lay our souls bare to, and moreover, who do we trust to sew together our fragmented emotions and personalities? A plethora of scientific articles arise in considering the physiological differences in neuroanatomy between male and female born persons. However, there is less scientifically efficacious information on how these differences manifest in the forms of psychiatric illness. Moreover, there is even less information regarding the psychiatric experience of transgendered, nonbinary, or intersex individuals. In fact, the diagnoses in the psychiatric manual (the DSM-5) pathologize non-conforming gender identities.
The pervasive concomitance of transgressive gender expression and its association with mental illness originates in the hallowed origin of western, industrial medicine. As class systems arose, germ theory appeared, and medicine became a regulated community of shared academic research, gender and medicine became inextricably wound through academic, societal, and cultural influences. Most notably, was the association between women’s ‘fragility, delicacy, and femininity’ and a predisposition to ‘nervousness’. Furthermore, as the subjugation of women was a common practice in society, this translated to patient-provider relationships. It was impossible for women to be empowered by their male physicians because they were societally subordinate to them, and had obtained a role off limits to women. This implicated the patient-provider relationship between male physicians and female patients to become hierarchical— where the male physician was the authority over the female patient’s body on a basis of access to knowledge, alone. Furthermore, as women were unable to access healthcare professionalism, the medical community was dominated by male physicians. This meant that all opinions, research, and medical knowledge originated from the understandings of men— even that knowledge regarding things uniquely female.
While, thankfully, the glass ceiling of the medical field has been broken by women physicians for a significant amount of time, the knowledge base and bioethical origins of the western medical community still has deep roots in its original male-dominated propriety. The same is true for physicians and patients of color as well as those with indigenous heritage— they are deeply disenfranchised because of the disproportionate and unjust discrimination of the medical community against them. While the topics of race and gender in bioethics are not mutually exclusive, they cannot be summatively discussed
It should be noted that stereotypical gendering of medical professionals has another origin within the community of healthcare regarding the clinical and practical difference between doctors and nurses. Outside of religious institutions, nursing’s origins are in acute crisis care— in times of war, when men were recruited to fight against enemy troops, nurses were young women who were called upon to undergo training in order to care for wounded soldiers. While this relationship— between patient and provider— is unique in its lack of male medical authority, it is based on the need for women to serve men. Additionally, at the advent of secular nursing, physicians were still predominantly male and had medical authority over nurses. Interestingly, nursing is still predominantly female. However, male nurses tend to gain promotions and raises more quickly than their female counterparts.
NEED TO:
- Add conclusion
- Add citations
- Add supporting quotes from historical articles
- Especially regarding nursing and origins of medicine
- Add supporting quotes from historical articles
- Refer to Dr. Zay
- Include paragraph about freud and psychiatry
- Include paragraph about ECT
- Refer to the yellow Wallpaper
- And supporting document about “The Rest Cure”
THEN:
- Edit grammar
- Edit punctuation
Critical Introduction:
P1: The Bell Jar, by Sylvia Plath is often referred to by literary critics as a “roman à clef”, meaning that the story acts as a key to the door of Plath’s existence (Fernandez 163; Taylor Kober and Ross e23 ). Many believe the novel helps readers to understand the many years of suffering leading up to Plath’s taking her own life— despite the relatively positive ending assumed by The Bell Jar where the main character, Esther, is ultimately discharged from the hospital, and she finally feels “…perfectly free” (Plath 242). The difference between the end of the novel and the end of Plath’s life provides both important information about the limit of reasonable literary extrapolation from a roman à clef as well as the potential idealization of Esther’s experience with psychiatric treatment.
P2: The Bell Jar functions as a commentary on the perpetuation of gender oppression through psychiatric treatment. Plath depicts and characterizes the systematic enmeshing of both societal gender ideals and mentally un-wellness through the main character of Esther Greenwood (Fernandez 164-165). Moreover, Esther’s mental health treatment is received from two healthcare providers: one is a woman (Doctor Nolan) and one is a man (Doctor Gordon). The difference in care and treatment between the two providers illuminates a more clear representation of how gender infiltrates mental illness through both patient and patient-provider experiences.
THESIS: Through the strategic juxtaposition of two providers and the explication of their differing genders, The Bell Jar by Sylvia Plath examines how psychiatric healthcare and gender interpolate. Additionally, The Bell Jar by Sylvia Plath utilizes narrative and linguistic differences to indicate the impact of gender on psychiatric patient-provider relationships.
Quote 1: ”’A few more shock treatments, Mrs Greenwood,’ I heard Doctor Gordon say, ‘and I think you’ll notice a wonderful improvement.’ The girl was still sitting on the piano stool, the torn sheet of music splayed at her feet like a dead bird. She stared at me, and I stared back. Her eyes narrowed. She stuck out her tongue. My mother was following Doctor Gordon to the door. I lingered behind, and when their backs were turned, I rounded on the girl and thumbed both ears at her. She pulled her tongue in, and her face went stony.” (Plath 143-144).
Sitting in the front seat, between Dodo and my mother, I felt dumb and subdued. Every time I tried to concentrate, my mind glided off, like a skater, into a large empty space, and pirouetted there, absently. ‘I’m through with that Doctor Gordon,’ I said, after we had left Dodo and her black wagon behind the pines. ‘You can call him up and tell him I’m not coming next week.’ My mother smiled. ‘I knew my baby wasn’t like that.’ I looked at her. ‘Like what?’ ‘Like those awful people. Those awful dead people at that hospital.’ She paused. ‘I knew you’d decide to be all right again.’ (Plath 144).
Annotation 1: (Part of final draft, hasn’t changed)
Quote 2: “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.Doctor Gordon was fitting two metal plates on either side of my head. He buckled them into place with a strap that dented my forehead, and gave me a wire to bite. I shut my eyes. There was a brief silence, like an indrawn breath. Then something bent down and took hold of me and shook me like the end of the world. Whee-ee-ee-ee-ee, it shrilled, through an air crackling with blue light, and with each flash a great jolt drubbed me till I thought my bones would break and the sap fly out of me like a split plant. I wondered what terrible thing it was that I had done. Sylvia Plath. The Bell Jar (p. 142). Delhi Open Books. Kindle Edition. ” (Plath 141-142).
‘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?’
Sylvia Plath. The Bell Jar (p. 143).
Annotation 2: (Part of final draft, hasn’t changed)
Quote 3: “At the top of the stairs, the garnet-coloured carpet stopped. A plain, brown linoleum, tacked to the floor, took its place, and extended down a corridor lined with shut white doors. As I followed Doctor Gordon, a door opened somewhere in the distance, and I heard a woman shouting. All at once a nurse popped around the corner of the corridor ahead of us leading a woman in a blue bathrobe with shaggy, waist-length hair. Doctor Gordon stepped back, and I flattened against the wall. As the woman was dragged by, waving her arms and struggling in the grip of the nurse, she was saying, ‘I’m going to jump out of the window, I’m going to jump out of the window, I’m going to jump out of the window.’ Dumpy and muscular in her smudge-fronted uniform, the wall-eyed nurse wore such thick spectacles that four eyes peered out at me from behind the round, twin panes of glass. I was trying to tell which eyes were the real eyes and which the false eyes, and which of the real eyes was the wall-eye and which the straight eye, when she brought her face up to mine with a large, conspiratorial grin and hissed, as if to reassure me, ‘She thinks she’s going to jump out the window but she can’t jump out the window because they’re all barred!’” (Plath 140-141).
Annotation 3: (Part of final draft, hasn’t changed)
Quote 4: “’Do you mind if I smoke?’ Doctor Nolan leaned back in the armchair next to my bed. I said no, I liked the smell of smoke. I thought if Doctor Nolan smoked, she might stay longer. This was the first time she had come to talk with me. When she left I would simply lapse into the old blankness. ‘Tell me about Doctor Gordon,’ Doctor Nolan said suddenly. ‘Did you like him?’I gave Doctor Nolan a wary look. I thought the doctors must all be in it together, and that somewhere in this hospital, in a hidden corner, there reposed a machine exactly like Doctor Gordon’s, ready to jolt me out of my skin. ‘No,’ I said. ‘I didn’t like him at all.’ ‘That’s interesting. Why?’ ‘I didn’t like what he did to me,’ ‘Did to you?’ I told Doctor Nolan about the machine, and the blue flashes, and the jolting and the noise. While I was telling her she went very still. ‘That was a mistake,’ she said then. ‘It’s not supposed to be like that.’ I stared at her. ‘If it’s done properly,’ Doctor Nolan said, ‘it’s like going to sleep.’ ‘If anyone does that to me again I’ll kill myself.’ Doctor Nolan said firmly, ‘You won’t have any shock treatments here. Or if you do,’ she amended, ‘I’ll tell you about it beforehand, and I promise you it won’t be anything like what you had before. Why,’ she finished, ‘some people even like them.’ After Doctor Nolan had gone I found a box of matches on the window-sill. It wasn’t an ordinary-size box, but an extremely tiny box. I opened it and exposed a row of little white sticks with pinks tips. I tried to light one, and it crumpled in my hand. I couldn’t think why Doctor Nolan would have left me such a stupid thing. Perhaps she wanted to see if I would give it back. Carefully I stored the toy matches in the hem of my new wool bathrobe. If Doctor Nolan asked me for the matches, I would say I’d thought they were made of candy and had eaten them.” (Plath 189-190).
Annotation 4: (Part of final draft, hasn’t changed)
Quote 5: “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.” (Plath 213)
Annotation 5:
Quote 6: “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.’” (Plath 215- 216)
Annotation 6: (Part of final draft, hasn’t changed)
Quote 7: “At last a tall, cadaverous woman in a white smock entered the room from an inner door. I thought that she would go up and take the man in the maroon bathrobe, as he was first, so I was surprised when she came towards me. ‘Good morning, Doctor Nolan,’ the woman said, putting her arm around my shoulders. ‘Is this Esther?’…Miss Huey helped me climb up and lie down on my back. ‘Talk to me,’ I said. Miss Huey began to talk in a low, soothing voice, smoothing the salve on my temples and fitting the small electric buttons on either side of my head. ‘You’ll be perfectly all right, you won’t feel a thing, just bite down….’ And she set something on my tongue and in panic I bit down, and darkness wiped me out like chalk on a blackboard.”(Plath 214- 215).
Annotation 7: (Part of final draft, hasn’t changed)
Conclusion: Through the interpolation of sex and gender, and the intimate process of psychiatric care, bioethics and gender in psychiatry are unequivocally intertwined. The Bell Jar by Sylvia Plath brings attention to the fact that gender of provider is not only a preference, but a distinct difference in care. Through the societal implications of gender oppression, as well as the societal stigma of psychiatric treatments as patient control instead of patient treatment, gender is a vital aspect of trauma-informed psychiatric care.
Reflection: (Part of final draft, hasn’t changed)
Works Cited
(needed)
