Part 17 (1/2)
One source of trouble in the menopause is that it comes at a time in a woman's life when she is likely to have too much leisure. In no way can a woman so easily handicap her body at this time as by stopping work and being afraid. Those women who have to go on as usual find themselves past the change almost before they know it,-unless they consider themselves abused, and worry over the necessity for working through such a ”critical time.”
Three Rules. Here are a few pointers which have have been of help to a number of women:
1 Remember that this is a physiological process and therefore abundantly safeguarded by Nature. If you don't expect trouble you will not be likely to find it.
2 Remember that the sweating and flus.h.i.+ng are made worse by notice.
3 Do everything in your power to keep from the public the knowledge that you are no longer a potential mother. If you are past forty, do not mop your face or gasp for breath or carry a fan to the theater! Shun attention and fear, and you will be surprised at the ease with which the ”change” is effected.
Nature's Last Chance. While we are on the subject of the middle-aged woman, it may be well to mention a phenomenon sometimes noticed in the early forties. Often an ”old maid” who has considered herself settled for life in her bachelor estate, suddenly takes to herself a husband. (I use the verb advisedly!) Mothers who have thought their child-bearing days long past sometimes find themselves pregnant. ”The child of her old age” is not an uncommon occurrence. Unmarried women who have ”kept straight” all their lives sometimes go down before temptation at this late time. There is a reason. It is as though Nature were making a last desperate attempt to produce another life before it is too late, speeding up all the internal secretions and flas.h.i.+ng insistent messages throughout the whole organism.
It may help some woman who feels herself inexplicably impelled toward the male s.e.x to know that she is not being ”tempted by the devil” but merely driven by the insistent chemicals within her body. She is likely to rationalize and tell herself that it is too bad for a worth-while person like herself to leave no progeny behind her; or she may say, as one of my patients did when contemplating running away with another woman's husband,-that she could make that man so much happier than his wife did, and that she really owed it to him as well as to herself. When a woman knows what is the matter with her, it makes it easier to bide her time and wait for the demands of Nature to subside. Chemicals may not be so romantic as love, but neither are they so melodramatic!
Other Troubles
”Speaking of Operations.” Physicians are often called upon to diagnose some such vague symptom as pain in the abdomen, back and head; ache in the legs; constipation, or loss of appet.i.te. Since the patient is very insistent that something shall be done, the physician may be driven to operate, even when he has an uneasy feeling that the trouble is ”merely nervous.” Sixty per cent. of the operations on women are necessitated by the results of gonorrheal infection. Next in frequency up to recent date, have been operations for nervous symptoms which could in no way be reached by the knife. Only too often a nerve-specialist hears the tale of an operation which was supposed to cure a certain pain but which left it worse rather than better. It is a pleasure to see some of these pains disappear under a little re-education, but one cannot help wis.h.i.+ng that the re-education had come before the knife instead of after it.
A skilled surgeon can cut almost anything out of a person's body, but he cannot cut out an instinct. It sometimes takes great skill to determine whether the trouble is an organic affection or a functional disturbance caused by the misdirected instinct of reproduction. Often, however, the clinical pictures are so different as to leave no room for doubt, provided the diagnostician has his eyes open and is not over-persuaded by the importunity of the poor neurotic, who insists that the surgeon shall remove her appendix, her gall-bladder, her genital organs, and her tonsils, and who finally comes back that he may have a whack at the operation scar.
The Bearing of Children. A number of years ago I became acquainted with a charming young married woman who had all her life recoiled with fear from the phenomena of s.e.x. She had been afraid of menstruation and of marriage, and had at this time almost a phobia for pregnancy and childbirth. Before long she came to me in terror, telling me that she had become pregnant. I explained to her that pregnancy is the time when most women are at their best, that the nausea which is often troublesome in the beginning is caused merely by a mixing of messages from the autonomic nerves, which refer new sensations in the womb to the more usual center of activity in the stomach; and that after the body has become accustomed to these sensations, most women experience a greater sense of well-being and peace than at any other time in life. We had a conversation or two on the subject and everything seemed to go well for a while.
As it happened, this young woman and her husband came to call on me one afternoon just before the baby was expected. During the visit she began to show signs of being in labor. Again she was in terror. Again I explained the phenomena of labor, telling her that the womb-contractions are caused by the presence in the blood of a chemical secretion (hormone) which continues its good work as long as there is a state of confidence, but which sometimes stops under fear or apprehension. I explained that these womb-efforts are a peristaltic movement, a contraction of the upper muscles and a letting go of the purse-string muscle at the mouth of the womb, and that fear only tends to tie up this purse-string muscle, making a difficult process out of one which was intended by Nature to be much more simple. She seemed to understand and to lose a good deal of her fright.
About six o'clock the couple went home on the street car from the upper end of Pasadena to the far end of Los Angeles. The next morning I had a jubilant telephone message from the happy father, announcing that the boy-baby had arrived at midnight and that, wonderful to relate, he had come without the mother's experiencing any pain whatever.
I give this account for what it is worth, without of course contending that labor could always be as easy as this. It happened that this girl was a normal, healthy woman and that there were no complications of any kind in the process of childbirth. A right att.i.tude of mind could not have corrected any physical difficulty, but it did seem to help her let go of her fear, which would of itself have caused long and painful labor.
A patient once told me that when her first baby came, she happened to be out in the country where she had to call in a doctor whom she did not know. He was an uncouth sort of fellow who inspired fear rather than confidence. She soon found that labor stopped whenever he came into the room, and started again when he went out. She had the good sense to send him out and complete her labor with only the help of her mother. Unfortunate is the obstetrician who does not know how to inspire a feeling of confidence in his patients. Even childbirth may be mightily helped or hindered by the mother's state of mind.
Summary
A woman's body has more stability than she knows. It is sometimes out of order, but it is more often misunderstood; usually it is an un.o.btrusive and satisfactory instrument, quite fit for its daily tasks. The average woman is really well put together. We hear about the ones who have difficulty, but not about the great majority who do not. We notice the few who are upset during the menopause, and forget all the others. To be comfortable and efficient most of the time is, after all, merely to be ”like folks.”
The special functions which Nature has been perfecting in a woman's body are as a rule, easily carried through unless complicated by false ideas or by fear.
If the woman who has no organic difficulty but who still finds herself handicapped by her body, will cease being either resigned to her languis.h.i.+ng lot or envious of her stalwart brothers; if instead she will set out to learn how to be efficient as a woman, she will find that many of her ills are not the blunders of an inefficient Creator, but are home-made products, which quickly vanish in the light of understanding.
CHAPTER XIII
In which we lose our dread of night.
THAT INTERESTING INSOMNIA
The Fear of Staying Awake
To sleep or not to sleep! That is the question. In all the world there is nothing to equal it in importance,-to the man with insomnia. His days are mere interludes between troubled nights spent in restless tossing to and fro and feverish worry over the weary day to come. His mind filled with ideas about the disastrous effects of insomnia, he imagines himself fast sliding down hill toward the grave or the insane-asylum. It is true that his conversation very often politely begins something like this: ”Good morning. Did you sleep well last night?” but if we fail to respond by an equally polite ”and I hope you had a good night?” he seems restless until he has somehow disillusioned us by stating the exact number of hours and minutes during which he was able to lose himself in slumber.
We must not ridicule the man who doesn't sleep. We are all very much alike. If any one of us happens to lie awake for a night or two, he is likely to get into a panic, and if the spell should last a week, he begins looking up steams.h.i.+p agents and talking of voyages to Southern seas. The fact is that most people are dreadfully afraid of insomnia. Knowing the effects of a few nights of enforced wakefulness, and having had a little experience with the f.a.gged feeling after a restless night, they believe themselves only logical when they fall into a panic over the prospect of persistent insomnia.