Women Asking Women: Tracey Lindeman and Margaret Nowaczyk

In honour of Women’s History Month, we asked women writers from across the country to pair up and interview each other on all kinds of things: their processes, their inspirations, their thoughts on WWW (writing while women). We can’t wait to share these conversations with you.

Interview: Tracey Lindeman (BLEED, ECW Press) and Margaret Nowaczyk (Chasing Zebras, Wolsak & Wynn)

Margaret Nowaczyk: I remember learning about endometriosis in medical school – at the time, it was presented as an ailment that affects only a tiny proportion of women with chronic pain and I never learned how extensive and debilitating it could be. We weren’t educated about that, more about its rarity and its nefarious, so to speak, character that almost mimicked cancer. Also at that time, the majority of my teachers in gynecology were men who seemed not to take it too seriously – would you say that things haven’t changed that much in 30 years? Are there more women physicians currently involved in the care of these patients and do you think that it has made a difference in the approach and attitudes?

Tracey Lindeman: Modern gynecology was defined by men. In the mid-1800s, doctors like James Marion Sims forcibly and repeatedly operated on enslaved Black women in the US to “perfect” surgery techniques. When John A. Sampson defined and named endometriosis in the early 1920s, “hysteria” was still very much a medical term actively used to describe women in pain. Medical education is largely based on texts written, and practices defined, by men.

So the fact that endometriosis was poorly taught — or, not taught at all — in medical schools is no surprise. In 2023, medical schools are still largely very socially conservative and slow to change, meaning that even today medical students are likely not receiving accurate or complete information about endometriosis, either.

I’d love to be able to say that women’s larger presence in medicine is helpful to people with endometriosis, but I’ve been gaslit and discredited by as many female doctors as male ones. One female doctor essentially forced me to get an IUD before she would “even consider” talking about surgery for my endometriosis and adenomyosis. As I describe in BLEED, I think this is owed to the fact that even if these women are given agency over their careers, they are still trained and conditioned to operate within a patriarchal system.

Tracey Lindeman: How did your peers and superiors at medical school treat you, as a woman? Were there any particular experiences that still stand out to you now?

Margaret Nowaczyk: I did not perceive any difference in how I was treated. Now, that might just be a case of not being perceptive enough or, alternatively, of feeling so sure that I belonged there that I would not entertain any doubts. Looking back, I realize that there were assh*les with a big dose of misogyny, but at that time I just took them as garden-variety assh*les. Also, I trained in specialities – pediatrics and clinical genetics – where there are many female physicians and being a woman was not out of the ordinary. It might have been different if I were training to be a surgeon or a cardiologist, I don’t know.

Margaret Nowaczyk: In the 20th and 21st century, endometriosis seems to have taken the place of the “hysteria” of Victorian times as a dismissive explanation for women’s health issues. Did you discover any indicators in the attitudes of physicians that hearken back to those times? Were you able to discuss it with them or were they defensive?

Tracey Lindeman: Interestingly, in the Victorian era, endometriosis was viewed by some as a physical manifestation of hysteria.

A lot of people attribute “hysteria” to Freud, but Sabina Arnaud’s book On Hysteria explains that the term predates him by decades. Arnaud writes that the way we see hysteria today was defined in the late 1700s and early 1800s when a bunch of conditions got thrown under the banner of hysteria — conditions that were mainly associated with women or feminized traits, such as painful periods. It wasn’t long before “hysteria” became a shorthand term to describe and dismiss various physical and mental aspects of the “female condition.” (Freud certainly did not help on that front!)

The rise of hysteria was also tightly tied to modernization, in the sense that social progress movements that sought to improve women’s lives, like suffrage, were thought to cause needless suffering. We saw this replicated in the post-war era, when millions of women ended up on minor tranquilizers like Valium. In that era, hysteria got a makeover; people called it “psychic tension” or “nervousness” instead.

Now, I think, we just call it depression. So many people with chronic pain conditions are given depression or anxiety diagnoses and meds to match — and like, yes, being in constant pain is depressing. But so is going to see doctor after doctor who says your pain isn’t real and that perhaps you should just try being positive. So the short answer is, “hysteria” is still prevalent in medicine; we’ve just professionalized it and made it more insidious.

Tracey Lindeman: How did it feel to talk/write openly about your mental illness?

Margaret Nowaczyk: Freeing. I have never had any problems discussing my diagnosis. Having bipolar disorder is the same as having diabetes – it wasn’t my fault, it was a result of a biological predisposition, and I took it as such. It was a relief to receive this diagnosis so that I could stop worrying and wondering what was wrong with me and thinking that I was a “bad” person with a “bad” attitude and “anger issues”.

Margaret Nowaczyk: What made you interested in writing on this topic? Was it difficult to research such an emotionally-laden topic and how did you deal with these difficulties?

Tracey Lindeman: Endometriosis was something I dealt with in private for most of my life. I tried really, really hard to persevere and accomplish things in my career and my life despite the pain. I wrote about all kinds of things as a journalist, but never my own health — it felt like if I came out about it, that my credibility as a journalist would take a hit. I’d just be another “hysterical female” on the internet.

My mind started to change when I learned that I was not alone. I mean, I always knew other people had endometriosis, but I thought the reason I was so routinely gaslit and discriminated against was because I was somehow defective — that I had done something to deserve the bad treatment. When I realized that most people with endometriosis also feel this way, it clicked: this is systemic. And so, although I may not have written much about health in my journalism career, I have always gravitated toward covering systemic injustice and inequality. I wrote BLEED from that perspective — to be intentionally confrontational, or as they say in journalism: to comfort the afflicted and afflict the comfortable.

Tracey Lindeman: What pushed you to take Chasing Zebras out of your head and onto the page?

Margaret Nowaczyk: There were two reasons: one, to show what clinical genetics is all about. Many people assume that a geneticist works in a lab and has no contact with patients. While this is true of researchers, a clinical geneticist is a physician who everyday sees very difficult problems and patients in life-changing situations. This specialty is emotionally demanding and quite draining and I wanted a bit more understanding and, possibly, sympathy from my peers and from the patients.

The second reason was to show how writing can be instrumental in maintaining emotional health and well-being in physicians and other healthcare workers and how, when I started writing about my emotions and professional demands, I was able to make better sense of them and cope better.

Margaret Nowaczyk: Was it difficult to write on the personal aspects in this book? How did you take care of the emotional burden that this engendered? What I am asking is do you have any strategies for writing about emotionally difficult subjects?

Tracey Lindeman: There are no quick-and-dirty tips here. I have complex PTSD (C-PTSD) caused by childhood and medical traumas. Like a lot of people with endometriosis, I’ve wrestled with complex feelings about my self-worth and value to the world.

But I also dislike confessional-style writing — the kinds of articles where people lay all their traumas bare, unprocessed and raw, for onlookers to gawk at. I needed a reason to write BLEED, which is why instead of writing a misery memoir, I used this as an opportunity to call the system and its supporters out.

I was able to get into that mindset largely because I’ve been talking to a therapist regularly for nearly two decades, and have been doing EMDR for the past couple years. The process of healing myself makes me better able to articulate the pain and the consequences I endured — physically and mentally — because of endometriosis, and helps me to understand that I genuinely deserve better.

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Tracey Lindeman is a longtime freelance journalist whose work has appeared in The Guardian, The Atlantic, Al Jazeera, Maclean’s, The Walrus, the Globe and Mail, and many other publications. She is from Montreal and is currently based in western Quebec.

Born in Poland, Margaret Nowaczyk is a pediatric clinical geneticist and a professor at McMaster University and DeGroote School of Medicine. Her short stories and essays have appeared in Canadian, Polish and American literary magazines and anthologies. She lives in Hamilton, ON, with her husband and two sons.

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Many thanks to Tracey and Margaret for digging into each other’s books and sharing this medically-informed talk!

Catch up on the Women Asking Women series so far:

• Judy LeBlanc and Sarah Ens
• Tracey Lindeman and Margaret Nowaczyk