Oct 102017
 
 October 10, 2017

Last week Pratt professor and women’s global health advocate Dr. Nimmi Ramanujam, gave a talk on her recent invention: the pocket colposcope, expected to be a breakthrough tool in the fight against cervical cancer, making screenings more accessible and affordable.  But for Ramanujam, that there is an ongoing fight against cervical cancer is frustrating. Despite the HPV vaccine and early detection mechanism, cervical cancer remains common. According to the most-recent National Institute of Health data, there are 8.1 cases per 100,000 women in the United States. It is the fourth most common cancer for women world-wide.

Like many diseases that afflict only women, there are significant ethical and logistical challenges to overcoming them. Ramanujam attributed some of this gender gap to the nature of medical research. There is far less drug testing on women and female cadavers are used less frequently. Paradoxically these differences emerged as way to protect women (and their biological children) but are not clearly having unanticipated consequences.

Ramanujam’s argument is based in themes also present in the work of Colombian surgeon and artist, Dr. Libia Posada.  The doctors noted the importance of listening to the population that they would be assisting.  While developing the pocket colposcope, Ramanujam explained that she consulted physicians and patients in countries, such as Peru and India, whom she stated would be the primary beneficiaries of her invention. Posada believed that the Hippocratic oath entails not only going through the motions of examination and treatment, but also engaging with the patient. While I had contemplated this relationship in the context of service work, I had not realized that it may also act as a guiding principle for medicine.

I wondered if a motivating factor in the design of the pocket colposcope and Posada’s artwork was to emphasize compassion in the physician-patient relationship.  Indeed, Ramanujam explained that the pocket colposcope would eliminate the use of uncomfortable tools and the physical space that occurs between a physician and patient during a traditional colposcopy.  I questioned if the physical distance between the bodies of the physician and patient may be conducive to an emotional distance as well.

Intentionally using the white coloration throughout her artwork, Posada explained that for her this color symbolized the sterility of medicine.  I wondered if Posada also used this color to criticize the stoic relationship that can occur between physician and patient.

While listening to both female doctors describe their work, I thought they embodied what feminist theorist Carol Gilligan describes as an “ethic of care”.  Gilligan argues that women gravitate towards forming lateral relationships and that women are inclined to find strength in “nurture” and “interdependence”.  Prior to hearing these lectures, I was not as aware of the role that ethical concepts may play in shaping the medical field.