Our Bodies Ourselves

The classic women’s health book. Our Bodies, Ourselves, now in its 35th anniversary edition, has gotten into the hands—and minds—of millions of women. The book, which has sold four million copies and been translated into 18 languages and Braille, is a very old friend of mine. OBOS has been a lively, wise mentor through the curiosity of my adolescence, a confidante during my first anticipations and experiences of sex, and a spur for my earliest twinges of feminist consciousness. OBOS was the source of ideas I found myself latching onto in medical school, and the litmus test for good docs in my own experiences as a patient. This book, originally emblazoned with the subtitle “by and for women,” has felt like a whole community at my side, connecting my personal pleasures, angers, and questions with the lives of other women, and giving them a larger social and political context.

With its clear medical information, anatomical illustrations, bold photos of real-life people (not generic line drawings), and frank first-person accounts, this landmark book takes as its terrain body image, our intimate relationships and sexuality, birth control, abortion, the decision to have children, infertility, rape, aging, “some common and uncommon” health problems, and the politics of women and medical care. OBOS was one of the first modern health references written for the lay person, and for quite a while was the only one focusing reliably on women. In the pre-Internet age, it was the first, and by far the best, place to learn the facts (accompanied by a lucid feminist critique of modern American medicine) and to hear the voices of other women—kind of a combination of Google and blogs, but with the heft and comfort that I still draw from an actual book I can clutch in my hands.

The book’s strengths include its earnest, impassioned, tell-it- like-it-is approach and its bedrock reliability. But what has most powerfully sustained my love for the book is its use of first-person stories that have stuck with me for years and its photos of charmingly, certifiably real people exploring and enjoying their bodies. Many of these strengths have been preserved in the most recent edition; some, sadly, have not. Raw health information is now widely available, in print and online, but informed alchemy is still needed to turn this lead into gold. I worry that this new edition, entitled Our Bodies, Ourselves: A New Edition for a New Era (Simon & Schuster, 2005, $24.95), will fail the next generation of young women looking for an approach that honors their everyday strengths and beauty, together with the particular quirks, hair, blood, fat, and other realities of living in our individual female bodies.

Our Bodies, Ourselves and I are the same age—both arriving in 1970—but we didn’t meet until 1 was 14 and read the 1984 New Our Bodies, Ourselves up in my family’s third-floor attic, stretched out on my belly, hip bones pressed into the fuzzy beige carpet. I’d found the book while grazing my family’s haphazardly organized bookshelves looking for something juicy to read.

I stuck ardently to the chapters on relationships and sexuality, taking in all the pictures and falling in love with the italicized first-person stories that illuminated each section. My parents talked to me and my siblings about sex and reproduction early and often. But it was one thing to hear at the dinner table, through our eye-rolling, that “making love is a beautiful thing,” and another to hear women’s voices reporting the ups and downs of masturbation and orgasms (or lack thereof). I listened in on all the power struggles, inner demons, flames of emotion and sensation, joy, satisfactions, and the spoken and unspoken, explicit and dreamy connections involved in sex with another person. I’d searched for years for non-parental confirmation that adults not only had sex (of which they gave very little indication) but possibly also enjoyed it (even less information here). 1 hadn’t come up with very many clues other than continued population growth and my parents’ copies of The Joy of Sex and Peyton Place. Except for exploring my own body pleasurably since childhood, and a little teenage kissing, I didn’t get to “actual sex” until after high school. Would I like sex when the time came, 1 remember wondering.

Reading OBOS was like gaining entry to an all-ages slumber party. The women’s voices reassured me that sex is real, complex, commonplace, and extraordinary. One of the best things about sex, aside from the sheer physical pleasure, is how it is an oasis among other experiences: the tender, green discovery that it is possible, permissible, to be so intimate with another person. The open, friendly discussions in OBOS, a secret garden in print, shared something in common with the intimacy of sex itself, and gave me a similar feeling of exhilaration and acceptance. My favorite bio-snippet from that period was from the section on sex and physical disabilities:

I persist in feeling that my body is ugly when I’m naked. Yet my husband clearly loves making love with me. I asked him one day if I made love with a limp. “Yes,” he said, “you make love with a rhythm like your walking rhythm. It’s nice.”

This woman, and the book as a whole, did not gloss over how challenging it could be to feel good about your body. Her story said that your sexual expression was of a piece with the rest of you, not something isolated and exotic. I learned from her that I might hold big or small grudges against my body based on big or small reasons, but my body and my personality, with all their idiosyncrasies and flaws, could form a lovely whole. And it was quite possible I would find someone who would love making love with me, drawn by the way all my personal elements fit together. One of the larger messages of the book came through clearly here: self-knowledge that included your physical self was a form of realism, confidence, and power. I credit OBOS as one of the influences that helped me, from my teen years on, cultivate interest, ease and pleasure in my body, in and out of sex.

In college, I found a way, in that strange bouquet of If classes—classical Greek, Virginia Woolf, developmental  biology—to make contact with my old friend by writing  a paper on OBOS for a class on the history of American medicine. I read the book’s original preface, entitled “A Good Story,” about how a group of women in 1969, galvanized by frustration at their own lack of health information and bad experiences with doctors, embarked on a project to educate themselves about their bodies, and then share their knowledge, forming the Boston Women’s Health Book Collective, and producing the earliest, mimeographed versions of OBOS. Now I could see the book’s historical context: its roots in the feminist movement, the consumer rights movement, and an anti-authoritarian Zeitgeist triggered by the Vietnam War. It was fun to revisit the sex chapters, now that I could connect them with my own experiences (and there was the additional thrill of reading and writing about sex and bodies for an academic paper in that atmosphere where, as a rule, one snootily divorced the pursuits of the mind from those of the body), but now I could also relate to the anger and activism driving the book. Twenty years after it first appeared, I found I could barely turn around without encountering attitudes the book’s founding mothers noted in the original preface, doctors “who were condescending, paternalistic, judgmental, and non-informative.”

My first year of college, I’d gone to the student health center for information on birth control, especially non-hormonal methods (I am a D.E.S. daughter—another complicated, sordid tale of medical ignorance and malfeasance), but the portly old doctor behind his desk would talk to me only about the Pill, “because we don’t want to get pregnant, do we?”

Then, the spring after I wrote my OBOS paper, I found a lump in my breast. My mother had been treated for breast cancer four years before. I knew the lump was unlikely to be anything serious, but knew it needed medical evaluation. I couldn’t get an appointment with my nurse practitioner, so I went to see an unfamiliar doctor, a young guy who examined my breasts and referred me straight to the surgery center on the floor below. “It’s probably nothing,” he said, “but they can always just scoop it out.”

In the stairwell, I kept picturing my mother’s melon-baller, and contemplated continuing down and out of the building. But my sense of duty to myself won out. I approached the surgery floor and got the earliest possible appointment—for one month later.

I called my nurse practitioner, who said, “What nonsense! I’ll get you an ultrasound and we’ll figure out if this is a cyst, which is very common and benign.” At my ultrasound appointment at the hospital, the technician ran her probe over my jellied breast and kept furrowing her brow at the monitor, positioned so I couldn’t see it. She was having some problem visualizing the deepest part of my lump and called in a team of doctors to consult. Finally, after a good 10 minutes without addressing a word to me, the senior doctor turned and said to me, in a crisp British accent, “It’s a cyst. Completely benign, dear, but you can have it out, if you want to be neurotic about it.”

From the depths of a turbulent silence, I felt glad to have read so recently in OBOS that this kind of treatment was not due to a defect in my own actions, body, or sanity.

A short time later I could credit OBOS as a major influence in my decision to pursue a medical career. I went to medical school with a mix of motivations: I was interested in weaving together the biological and human narratives about our bodies. I wanted to gain access to medical knowledge and language, a bit the way I chose to study French because my parents used it to talk about things they didn’t want us kids to understand. And I had a burning certainty that there had to be a better way to treat and talk to patients than what I had experienced.

Immersed in medical texts and medical ways, I didn’t read OBOS again for several years, though its lessons stayed in my thoughts. Although 1 met many lovely human beings in medicine, people who work with grace and dedication, I also learned that the system as a whole exerts dehumanizing pressures. Among them: a tradition of gamesmanship and competition, showing off knowledge while bluffing about one’s lack of it; pressure to hide emotion, doubt, or ignorance; constant bribery by the drug companies and a lack of skepticism or restraint about using medication; self-important, belittling jargon (“incompetent cervix,” “the patient failed chemotherapy”); the low value (literally and figuratively) placed on talking to patients compared to everything else you might do for or to them. And always my amazement and outrage at how little most people have been taught about our bodies (women’s alienation from our own reproductive anatomy is only one of the most striking examples of the larger problem) and how that ignorance adds to the fear and discomfort of medical experiences.

Now I am teaching and writing about medicine, not practicing it. I teach undergraduate nursing students and graduate nurse-practitioner students, almost all women. And in the spirit of teaching people outside of the health care professions about our bodies, I’ve been developing workshops on anatomy and physiology at my yoga studio. During my training, I loved creating rapport with patients, figuring out the puzzle of their problems, and explaining what I thought was happening and what it meant in plain language. I am glad to have escaped the Scylla and Charybdis of emotional distancing and all-consuming empathy, and the strange combination of hypervigilance and tedium I felt when treating patients. The same OBOS-inspired idealism, passion for emotional honesty and plainspokenness, and fascination with the known-facts and subjective mysteries of bodies that helped draw me to medicine is also what took me out of it.

Revisiting OBOS in my mid-thirties, I’ m struck by how much more of the life cycle resonates with me. I’m married, I’ve had a baby, my mother is in her sixties, I’ve grieved the deaths of my grandmothers, and gone through medical training. Now, looking at this fancy new 35th anniversary edition of the book, it’s not just the sex chapters that interest me.

This edition was made possible by support from Harvard’s Brigham and Women’s Hospital and the Boston University School of Public Health, and the list of contributors is a sparkling array of women working in medicine, public health, education and journalism. But it’s hard to relate to my friend’s twenty-first century, professionalized, highly groomed appearance. She’s certainly doing a lot more shaving and plucking these days (so, okay,  I’ m not in one of my hairier phases either), but I suspect her of resorting to cosmetic surgery. The updated medical information is just as clear and sound as ever, supplemented by a companion website (www.ourbodicsourselves.org). And I’m pleased to see the first-person passages still there, including ones of early vintage. But the photographs are very disappointing. Some examples?

Disabilities and sex. While the original negative-image photo of a softly rounded woman in a wheel chair passionately kissing a person of indeterminate (I always thought female) gender is, admittedly, dated, did it have to be replaced by the model-skinny woman in movie-poster embrace in the surf with her soft-focus wheelchair in the background?

Masturbation: The exuberant, fuzzy-legged, post-orgasmic, lovely nude woman on a friendly living room couch has been replaced by a stick-like woman in a tank top with her hand in her underwear, her face turned away, her legs, couch, and impersonal setting cropped so that she looks, all in all, very much like the model in the blandly “provocative and quasi-pornographic” Calvin Klein ad that the book critiques in its chapter on body image.

Self-examination: The latest edition includes a photo of one woman helping another woman look at her cervix in a mirror, but while it obviously comes from the original roll of 1970s film (was this the last time a woman looked at her own cervix?), the editors have chosen a photo—unlike the one in earlier editions—that leaves out the face of the woman-with the- cervix and the smile and eye-contact of her assistant. Bearing the most symbolic weight are the changes in the cover photography. The image of a white-haired woman and a beaming Nice Jewish Girl marching with a huge “WOMEN UNITE” placard has shrunk with each edition (from 7 inches across in 1971 to an inch and a half in 1998), but the current edition is the first one to get rid of it entirely. Instead, we have a tableau of five airbrushed women. In the center, two blue-eyed, bleached and highlighted blondes who (despite the lesbian-identifying necklace on one) look like they were extruded from the same plastic tube that produces everyone on TV. At the periphery, the token chubby woman on one side and, on the other, the elegant African-American and Asian women, neither of whom looks more than 60. In general, the older editions’ photos looked endearingly like they came straight out of the family albums of the Boston Women’s Health Book Collective. They were charming snapshots of people who could be your cousins (among other losses, the photo of the Jewish wedding couple up on chairs is gone). This edition’s photos tend toward the posed, the bland, and the slick, to the point of being inexplicable; the chapter on gender identity displays an unironic photo of a college-aged woman focused on the task of painting her nails, and the chapter on infertility shows a creepily angelic, side-lit blond nurse comforting an African-American woman who looks like she’s in her late 40s. I do not think it is only my nostalgia for the au naturel innocence of the seventies that makes me find these photos so artificial and colorless. I’m additionally disappointed because I always loved the book— beyond its value as a practical reference—for its literary power (like my love for Jane Eyre or Little Women), which it largely retains, and also for the veracity of its images, the loss of which feels like a betrayal.

Shala Erlich lives in Seattle with her husband and her two and- a-half-year-old daughter, who asks a lot of questions about her body.