Karen Havelin Dead Ink, 2019, PB, 320pp, £9.83, 978-1911585541
It would be impossible to read this book and not have gained insight into the physical, mental, and emotional pain of endometriosis. Please Read This Leaflet Carefully graphically depicts the suffering caused by endometriosis and sections leave the reader exhausted.
Starting with her character Laura’s life as a single mother in New York, relishing some of the freedom it brings, Havelin traces her past back to her childhood in Norway where she endured multiple allergies and, despite this, was a keen and accomplished figure skater. She describes Laura’s ambivalent relationship with her parents, especially her mother, and about her sexuality. There is a page-turning quality in her description of the challenges of her relationships and the love story element of it is compelling. Her dilemma, as a woman with a debilitating illness, about the ethics of bringing a child into the world will resonate with the equivalent dilemma being faced by many people contemplating pregnancy but concerned about the effects of climate change.
The detailed and harrowing descriptions of the effects of endometriosis mean that the book is not a comfortable read and her reference to the lack of listening and understanding of various health professionals (‘Doctors barely hear what you say’) make it even less comfortable: ‘If you’re too hysterical, they write you off. If you’re too calm, they do the same.’ The book chronicles Laura’s coming to terms with her body and some of the psychological journey could be applied to anyone living, or trying to live, with any chronic, debilitating illness.
Work done by Dr Kate Young, public health researcher at Monash University in Australia, has uncovered how doctors can fill knowledge gaps with ‘hysteria narratives’, and she has found that this is especially likely to happen with endometriosis. Prior to the 1990s women were routinely excluded from clinical trials and, even now, based on unbiased assumptions about risk, women are often misdiagnosed, for example, in cardiac disease.
This book joins several others highlighting the biases and prejudicial attitudes afflicting many women’s health problems. Because this is such an important subject and because this book is such a good read, it richly deserves to be included in GP teaching reading lists.
- © British Journal of General Practice 2020