by Joan Arakkal
The co-educational schools I attended had craft classes that were compulsory for boys and girls. When I see my brother darn his own socks, I am not surprised. He continues to reap the benefit of those early skills. I tried to explain this to my children as they watched with disbelief their uncle deftly covering up a hole with a needle and thread. There is merit in not just adding another sock to the landfill. I told them the meditative side of the darning is just another advantage. I usually fail to convince them and I am sad that I have not succeeded in passing on these skills to my children. They have grown up in a disposable society
In my early years in medical school, I began hearing about feminism. Being equal to a man appeared to be its objective. The first wave of feminism did not quite resonate with me. I wanted to be who I was – a woman. I saw no contradiction in having a fulfilling life and being a woman. I loved dressing in beautiful clothes and wearing saris that made me feel feminine. I loved wearing jasmine in my long hair and I had no desire to dress in monotonous outfits to succeed in a man’s world. I certainly did not feel that being a woman should limit me in what I wanted to achieve.
However, I was not blind to my own privilege. What was true for me was not true for all women, especially not those living in poverty or who had been deprived of education. Young female babies were lamented at birth. Domestic duties were handled by young girls who were kept out of school. Educational disparities were rife and matrimony further enslaved women to their lesser status. The abuse of women was contradictory to the ethos of a nation that worshipped the feminine and where there were more female goddesses than male ones.
Some negative gender stereotypes also persisted in wealthy households. It was not hard to see the common denominator – a lack of education. When men did not see the value of education and stymied women’s progress, women continued to be treated poorly. When these attitudes were combined with poverty, the plight of women was even more dismal.
There was a great need to emancipate women who were mired in these situations. The Indian government’s efforts to alleviate poverty, illiteracy and inequality continues to empower women in very tangible ways. Now, as literacy increases, women are slowly finding their rightful place in society.
In 1972, when Indira Gandhi was democratically appointed as the first female prime minister, the country was well ahead of its Western counterparts. Sri Lanka, Indonesia and Pakistan also had strong female leaders. Women in these nations can achieve their potential once they have broken free of the shackles of poverty and poor education. There are few cultural barriers that prevent them from rising and there are certainly no glass ceilings.
I look at the women in my adopted country and wonder if women’s liberation has come far enough. As I matured, so did feminism. Now in its third wave, the movement urges women to be their true selves. Unlike the first wave, the current feminist culture tries to preserve the feminine. It appeared to me that previously, when we fought for equal rights, we were fighting to be more like men. Today we are coming into our own. Masculine qualities of aggressiveness are being discarded along with dark corporate clothes; families and children are being prioritised along with traditionally understood feminine values of emotional and social skills. Recognising the power of both genders without devaluing feminine qualities will empower our society. However, embracing our differences should not impact on the opportunities available to us. On a level playing field, women may well outperform their male counterparts. Equity, not equality, is what we should strive for.
Some women who were successful in climbing the corporate ladder in the past, embraced the role wholeheartedly. These women competed to be like men, rather than competing with them. To remain in coveted positions, they sacrificed their femaleness and took on a male persona. Many also felt they had to hang on to their hard-won positions by ensuring other women did not ascend to their level. Often they became the worst enemies of other women. Today, the feminist movement operates under a banner of sisterhood.
Over the centuries, women have been healers in many societies. Yet, despite half the entrants into the medical schools now being female, the number of women entering surgery still does not reflect these proportions. The rigorous training, which interferes with a woman’s attempt to combine career with family, is usually cited as one of the reasons for this trend.
But the elephant in the room is the attitude of men. Women’s entry into the hallowed grounds of surgery is closely monitored. Lately, many surgical conferences have programmed a session dedicated to ‘women in surgery’. I went to one of these recently.
Our research grounded in basic science and using theoretical methods was going well. We had received two grants and I had presented the paper at two international conferences. Unable to present the paper at an AOA forum, as I was not a member, I was pleased to deliver the paper at the scientific meeting of the Royal Australasian College of Surgeons in Brisbane. Afterwards, one orthopaedic surgeon came up to me and said the paper had blown his socks off.
I wandered through the foyer of the Brisbane Convention Centre. Posters of the College’s president and his colleagues studded the area, with slogans condemning discrimination, bullying and sexual harassment. This virtuous signalling rang hollow. Clearly the actions of the Colleges did not match the rhetoric. The crowd was overwhelmingly made up of white men, although the number of women attendees had no doubt increased over the years. Even the orthopaedic fraternity had increased their intake of women, though the ratio was still below five per cent – even less than the ratio for women train drivers.
In a darkened hall, a session for ‘women in surgery’ was underway. I sat in the all-female audience and watched the slides display the statistics. They were shameful. The prospect and merits of mentoring were discussed. One woman brought up the issue of being careful not to discriminate against men, triggering some laughter. Bullying victims often feel the need to appease the perpetrators and I wondered if this was the case here. It was 2016, and women were still discussing issues of male domination. Images of the suffragette movements of the late nineteenth century flashed through my mind.
Women have travelled a long way, but have we come far enough or fast enough? Why do we need mentors? Would we not do well enough if we were left to work unimpeded by sexist attitudes? We would not have to gather in cloistered spaces if men entered the twenty-first century and embraced modernity, celebrated science and included women.
Isobel could well have been on a feminist ‘We can do it’ poster in 1943. She would wish to see us equally at home today with a scalpel in the theatre and knives in the kitchen.
A NEW STAGE
My back began to hurt every time I had to deal with AHPRA. Stress-related back pains are a common presentation to back clinics. I followed the advice that I gave my patients – exercise, meditation and yoga – but the pain appeared more frequently and spread to my rib cage and neck. I was annoyed at what I presumed was a psychosomatic response to the upheaval in my career.
When I couldn’t handle the pain any more, I went to the emergency department. Lying on the narrow table, chugging into the tunnel of the scanning machine, I closed my eyes to avoid the claustrophobia.
There is no gentle way to tell a patient that her cancer has returned after twelve years. The consultant delivered the news with as much sympathy as he could muster for a patient he had never met before. The previously cheerful nurse returned to my cubicle looking chastened. Tears escaped from my eyes and found their way slowly to the white pillow on which my head rested. The nurse held my hand and apologised. It was not his fault, I wanted to say. Nor was it mine. The cells that had been waiting patiently, biding their time, had found their playground.
As for my T cells, B cells and lymphocytes – all those sentinels had dropped their guard. They did not say, ‘Halt, who goes there,’ as my nineteen-year-old father had when he stood in the darkness with his loaded gun. Stress had gripped me in its vices and released a stew of chemicals. Cortisol, prolactin, epinephri
ne … the list went on. This useful brew would have lent wings to my feet if I had ventured into the forest at night and encountered a ‘tyger tyger burning bright’, but for the last few months, I had been living in a jungle where the tigers never slept. The chemicals that had come to my rescue had also devoured and weakened my body. And the bad guys had marched in and staked their claim.
Twelve years after my primary diagnosis I was back in the oncologist’s office. Scans, blood tests, prayers, hope – the stage IV drama unfolded. The oncologist said she wanted to see me in the chair across from her in another fourteen years and I grabbed onto her veiled optimism. ‘Targeted therapy’ was the buzz word in oncology, as was ‘immunotherapy’. I went on a clinical trial where the experimental drug arrested the cell cycle and stopped the cells from replicating. The cancer cells thrived on my female hormones, so they were zapped with a daily dose of letrozole. The combination of the two drugs alleviated the need for full-blown chemotherapy, with all its attendant side effects. As the months passed the disease stabilised. My hair thinned, and fatigue set in, but I celebrated every scan that reported ‘stable disease’.
A year passed with regular scans and blood tests, providing the drug company with more data and me with short periods of reassurance. Suddenly the skin on my face went lighter. Puzzled, I read through the expected side effects of the medications. This was not a noted adverse reaction. My skin got paler and areas of depigmentation set in on the exposed areas of my body. As it spread, forming irregular, map-like borders, I entered a new country called disfigurement. Comments likening me to Michael Jackson and being called ‘whitey’ sent me scrambling in search of my fast-retreating sense of humour. Beauty is but skin deep. I looked for traces of the old me in the mirror and was disappointed.
A colleague at the practice where I continued to see patients requiring an independent assessment of their injuries for medico-legal purposes said, ‘Joan, you’re becoming one of us.’ He was, of course, referring to my new skin colour, not my professional progress. This throwaway comment reinforced the ‘them’ and ‘us’ attitude that still prevailed, despite me having worked with him for two decades. He just could not look past my skin.
I replied laughing, ‘Well, maybe the AOA will view me a little more kindly now.’
His reply was deadpan. ‘Don’t hold your breath.’
A gulf of otherness set me apart.
The monsoons were on their way to Kerala and so were we. Every year we swapped the cold wintry rain of Perth for a few weeks in the warmer rains of Kerala.
The pilot guiding the plane over the Western Ghats asked us to keep the window shutters open. The only joy I had ever felt in geography classes was when I coloured in the maps. Gazing out of the tiny, oval windows, I saw green mountains where I had once ignorantly coloured them brown. I remembered the white, fluffy cartoon-like clouds I had drawn to the west of the mountain ranges and the slanting hyphenated rain that was not allowed to cross eastwards. I looked out now and saw that the cloud had hit the mountain peaks and shed its might on the windward side. While the green covered the west with abandon, mottled specks of verdure studded the eastern side. The mountain range, also known as the Benevolent Mountains, was a study in antonyms: wet–dry, windward–leeward, fertile–arid. The contrast could not have been starker.
It was mid-June and as the plane descended into an air pocket we briefly entered a grey cloud capsule. I held Francis’s hand as he leaned across and pointed out the peaks and water bodies that studded the mountains that had once been part of Gondwana. Floating over the green undulated folds of the mountain, an unbidden feeling of airy lightness pervaded me and I felt like Princess Jasmine may have on her magic carpet with Aladdin by her side. We landed smoothly on the Cochin tarmac and green paddy fields, coconut trees and a pale-green sign welcomed us to the world’s first fully solar-powered airport.
Legend has it that the current airport in Nedumbassery resides in an area named after a low-caste man called Nedumban. The local chieftain took pity on Nedumban, who was a refugee, and offered him a large piece of land. The external architecture of the airport belies the modern facilities inside. After a quick immigration process, we wheeled our cases out into the humid bustle of organised chaos and the warmth of my waiting parents. Sitting in the back of the car, with the windscreen wipers furiously wiping away the pelting rain, I felt a sense of homecoming.
Thoughts of Perth were quickly washed away as mugs of soft sweet water hit my travel-worn body. The immersion was quick. Warm jackets were relegated to the back of the cupboard, and soft light cotton and linen kept us cool. The practical sarongs and loose kurtas looked and felt right. The smell of sardines fried in coconut oil, the hot unpolished large rice, the early morning aroma of puttu – layered rice flour and grated coconut pushed out of its long cylindrical steamer – the tropical vegetables and heady fruits – all played havoc with my taste buds. Early morning walks to the stream, lazy days, reading, talking, being – the days rolled into nights as we tried to make time stand still.
Weddings, housewarmings, deaths, births, naming ceremonies: every one of life’s events calls for a celebration. I attended the wedding of a young Catholic relative who would soon travel to Washington to pursue his studies in robotic technology. Unlike his parents’ marriage, his was not arranged. Romance had blossomed between him and a non-Catholic fellow student. The wedding, held in a cathedral, was blessed by a singing Catholic priest and a silent orthodox clergy. Hundreds of guests – a modest wedding by Indian standards – partook of a sumptuous feast generously provided by the young couple’s parents. The bride’s white veil trailed the old church floor as she left her groom’s side. Returning in a resplendent red sari speckled with gold threads worked into an intricate embroidery, she looked every bit the radiant Indian bride.
The lighting of a long brass oil lamp symbolised the union of the two families. The floating wicks threw their light on the bride and groom as they cut a tall cake to the strains of ‘Congratulations and celebrations, when I tell everyone you are in love with me’. By blending the Eastern ceremony with cherry-picked Western traditions, the young couple achieved a rare synthesis, giving the lie to Rudyard Kipling’s belief that ‘East is East, and West is West, and never the twain shall meet’.
The young robot-maker still embraced the rich Indian cultural setting and its traditions, but he was also ready to step unapologetically into a very different future that will play out on a worldwide stage.
After the ceremony, I drove home with my parents. Foggy hills loomed in the distance. Rice paddies shot up from water-logged fields. The green landscape quickly gave way to shopfronts. Restaurants advertised vegetarian and non-vegetarian delights. Handmade furniture, carved out of local teak and rubber wood, sat in chunky silence in open-plan shops. Colourful clothes on hangers festooned shop entrances, gathering both looks and dust. ‘Gift homes’ with useful and not-so-useful items waited for a surprised recipient. People crossed the street with casual aplomb as cars and auto rickshaws threatened to overrun them.
Bearded rambutans hung in bunches over neatly arranged earthy brown sapote fruits. Pink Lady apples sat delicately amongst these tropical delights, protected in netted polystyrene wrapping. Like me, these apples had travelled a long way from Australia and now sat awkwardly among the native fruits – much like the foreigners of the past may have when they arrived on the shores of Kerala with their Bibles, guns and righteousness. Imagine their surprise and disappointment when they discovered that the natives were already worshipping Christ in orthodox churches. With a trade route already in existence, the Jews had frequented the shores of Kerala for millennia. Some even stayed on and built a synagogue to worship the God of the Old Testament.
Doubting Thomas, one of the twelve disciples, is known to have arrived in Kerala carrying the teachings of the most famous Jew in history. His teachings found a fertile ground in a nation that saw Brahman in every creation. The imported message of love did not clash with the spirit
of atman, the spiritual life principle of the universe, and so the Essene man’s face was added to the pantheon of gods. This pantheon included men, women, animals, birds, reptiles, evil spirits, good forces, trees, rivers, stars, sun and moon. The list covers the whole universe.
We stopped by the temple in the land of deer, Ettumanoor. The spotted deer no longer prance through these grounds as they did 1000 years ago. We left our footwear beside the ‘No shoes’ sign and entered the courtyard. To the sound of melodious chants and through a cloud of sandalwood air, we climbed rough-hewn granite steps. The oil used in worship has seeped into the 500-year-old masonry. The temple is dedicated to four deities – two males and two females. Men and women worship together, sitting in silent prayer or chanting mantras and pacing the sanctum. As dusk fell, my brother, my son and I joined the other devotees in lighting the 10,000 oil lamps that stud the outer wall. We lit six wicks each, adding to the beautiful display.
Historically, Kerala was governed matrilineally. Its laws and scriptures pivoted on feminine energy. Centuries of poverty and social upheaval had eroded the place of women, but change is in the wind. India, once derailed, is back on track and chugging in the right direction. Female literacy rates in Kerala now equalled those of males. Women occupying careers of their choice is the rule and not the exception.
My own choice of a career as an orthopaedic surgeon was indeed unusual. When I was a trainee in Kerala in the large Calicut hospital, I was the first woman to make that choice. The hospital wore me like a feather in its hat. I was encouraged and nurtured in every possible way until they proudly birthed their first female orthopaedic surgeon. Few obstacles stood in my way. I wasted no energy overcoming prejudices. I did not have to fight for equal opportunity. I encountered no regulatory barriers, no professional barriers, no gender bullies. When I went overseas to enhance my orthopaedic knowledge, I was totally unprepared for the obstacles and prejudices I would encounter.