An Open Letter to Women Medical Students in the United States — On Use of the Word “Hyster-ectomy” in Women’s Health.
Today, more than in any recent era, it is clear that the words and symbols we use to describe the world we live in matter — existentially.
Our words and symbols, especially those uttered by leaders and experts, shape our attitudes, our policies and our practices — and as such, they also dictate the health, wealth and survival of our democracy and the world’s future.
I write this open letter, today, to all women medical students in the United States — and to all of their friends and partners in work and life.
Because I know that you can bring ethics and safety to the specialty of Gynecology, where it is seriously lacking in the year 2020.
In recent days, it has been alleged that some women in ICE custody in the United States may have undergone the Gynecological operations known as “Hyster-ectomy’.
You may read about this allegation against ICE HERE.
As I’ve been reading the headlines blaring the word “hyster-ectomy” the past few days, it has brought back to me all the memories attached to the death of my late-wife, Dr. Amy Josephine Reed, following her complication from this operation, this “hyster-ectomy”, at a Harvard Medical School associated Hospital — the Brigham and Women’s Hospital.
You may read about Dr. Amy Josephine Reed and her “hyster-ectomy” related complication and death HERE — and in many other articles in the general and professional press.
I will only state that Amy’s complication at one of the most prestigious Gynecological surgery programs in the world demonstrated a severe defect in, both, the ethics and practice of uterine surgery by Gynecologists — as her activism on behalf of women’s health will demonstrate to any reasonable citizen observer.
The error that led to Dr. Reed’s death was not only a clear bellwether case of individual and systemic negligence in the clinical treatment of uterine fibroid tumors by Gynecologists — it more broadly highlighted a deviance in ethical consideration and handling of uterine disease by Gynecologists.
Not the least of the unacceptable and dangerous gynecological error committed in the care of uterine disease, is the very term the specialty uses to describe the surgical removal of the uterus: “hyster-ectomy”.
The “hyster-ectomy” operation is one of the most common, if not the most common, operation performed on women in the US, and across the world, annually.
But, what is the origin of this eerie medical word, “hyster-ectomy”?
It is an historic fact that, in a not so distant past, male dominated society and medical institutions, operated on the prejudice that women are more prone to “hysteria” than their male counterparts.
It is also verifiable that many prominent medical men successfully promoted the notion that the uterus is the seat of this “hysteria” in women — the “moving uterus”, they called it in these “hysterical” women they treated as patients.
Of course, this man-made construct about the uterus is an historic falsehood, based in an atrocious prejudice against women: first that they are more prone to “hysterics” than men and, then, that this “hysteria” stems from the female reproductive organ we know as the uterus. These are egregious historic falsehoods and prejudices, which harmed many women — the history is, of course, verifiable.
Fast forward to today, in 2020, the word “hyster-ectomy”, conceived in the disturbed prejudice and ignorance of the past, continues to be used by physicians, regulators and the laity. In fact, most Gynecologists are aware of and will acknowledge the facts I’ve stated above about the origins of a word they each use thousands of time every day of the week.
Millions of federal and state tax dollars are used daily to support research on various aspects of the “hyster-ectomy” operation.
Millions, if not billions, of Medicare and Medicaid dollars are authorized to fund the “hyster-ectomy” operation in millions of American women each year.
Yet, not one professional or government agency, not one leader in medicine or government, has yet had the courage to ask two simple and self evident questions:
Is it appropriate for the English lexicon to retain an historically incorrect and prejudiced term, “hyster-ectomy” to describe the most commonly performed surgical operation on women?
What are the functional and safety implications of commonly using such a diminutive and offensive term, “hyster-ectomy” to describe surgical resection of a woman’s uterus?
It is a simple matter of reasonable ethical and civil conduct that the word “hyster-ectomy” be replaced by the medically accurate and appropriate descriptors “uterine resection” or “removal of the uterus”.
In the year 2020, it is not too much to ask for well-educated and moral professionals and regulators to cease using a misogynistic and prejudiced term in their professional jargon.
To be very clear for the record, the death of Dr. Amy Josephine Reed and the many thousands of other women similarly fallen, resulted from a systemic error in Gynecology resulting from an “Assumption of Benignity” about symptomatic uterine Fibroid tumors.
You may read more about this “Assumption of Benignity, HERE, in a letter I recently sent to US senator Kamala Harris.
Dr. Amy Reed and I are convinced that the incorrect and negligent assumption of benignity about her uterine fibroid tumors, which ultimately caused her death, was directly linked to a nonchalant orientation of the Gynecology specialty towards diseased uteri, as expendable organs.
“Hyster-ectomy”, indeed!
The prejudiced and misogynistic symbolism encoded in the word “hyster-ectomy” ought not be ignored by any woman, any ethical physician or any cogent regulator.
We live in an era when the living symbols of America’s prejudiced past are being evaluated and eliminated from the public square. This, so that these symbols are not used to cause injustice and do harm to the subsets of the citizenry these emblems target anymore.
For physicians, and Gynecologists in particular, it’s time to honestly assess their use of the word “hyster-ectomy” in our professional jargon. It is not a justified word and it never was. Simply stated, “hyster-ectomy” is a prejudiced and misogynistic word that downplays the stringent care every physician must deliver to the diseases that afflict that complex reproductive organ.
As medical students, you the readers, have the power and responsibility, now, to demand accuracy and appropriateness in the vernacular of your profession — irrespective of whether you are a rising gynecologist or not.
You, as rising woman physicians or friends/colleagues to them, have the power and responsibility to demand that the word “hyster-ectomy” be eliminated from the living language of medicine - and for it to be consigned to the history books in which our profession acknowledges that the words we use to describe the conditions of the human body, if inaccurate or prejudiced, can taint our attitudes and approaches to disease and do harm.
This act of integrity, I ask of you in the name of Amy Josephine Reed MD, PhD a graduate of the University of Pennsylvania’s School of Medicine and a member of the Harvard Medical School faculty — and all the other women harmed by the “prejudiced” handling of uterine diseases by the specialty of Gynecology in the United States.
“Hyster-ectomy” is not a justified living term in the working jargon of medicine in the year 2020.
Yours Sincerely,
Hooman Noorchashm MD, PhD.
