By Krista Christensen
Featured Art: Abstract — Woman by Carl Newman
It is out of a need for precision that I search for words, wading through thesauri and dictionaries and -pedias, crawling into the tunnels of -ologies and -onomies and -ectomies, mining deep for a more accurate reflection of self than dry medical terms like bilateral salpingo-oophorectomy.
I’m not even sure how to pronounce that last word, though it’s a thing that’s been done to me. Perhaps the two o’s bleed together into one sound, like the two o’s in moon, my two ovaries like white orbs hovering in one sky: oophorectomy. Or possibly the two o’s mirror the guttural softness of the pair in brook, like the one tinkling through the lot behind my home: oophorectomy.
When I look it up, I find that both o’s get equal play. Medical dictionaries give the pronunciation oh-uh-for-ec-toh-mee. A perfect irony that even in sound, the two o’s are piled on top of one another in the beginning of the word, as if there are more than enough to go around. There’s a sense of excess, of plenty and abundance, when really the word is all about what’s missing, about evacuation, about empty space. An O, a zero, the absence of value.
Nothing is ever straightforward in female anatomy. Even using the term hysterectomy, a casual term in comparison, brings up more questions than it answers. Repercussions of this surgery are nebulous, confounding: it could mean that a woman has lost just her uterus, but kept her ovaries, and so would not need to make the choice between synthetic hormone therapy or instant menopause. Even if a woman loses just her uterus, it’s possible she’d keep her cervix, that her vagina wouldn’t be sewn shut at the top, that she wouldn’t become a dead-end, a U-turn, closed for business.
For me, the word hysterectomy doesn’t begin to cover it.
The first word is cancer: a disease caused by the unchecked reproduction of cells, which spreads through invasion and metastasis. There are other words, too, that buddy up to this one, binaries like malignant and benign, like healthy and diseased. I need to know this word cancer, need to lie with it, let it penetrate me, wash over me like pounding surf. I need to steep in it like tea, for without it, my organs are gone for no reason. If I did not have actual cancer, if borderline tumors don’t count, then I’m empty for nothing.
While I lay unconscious on a cold steel table in a white tile room brightly illuminated by industrial halogen bulbs, a man—a pair of eyes beneath his scrub cap and above his face mask—excised a softball-sized mass of cells from my abdomen. The mass included my ovary, the left one, overtaken by the grapefruit- sized anomaly my confused body had sprouted, unknown to me. While I lay, the skin of my belly pried open like a spreading maw, arterial surgical clamps protruding from it like teeth, my face soft and jaw slack from hours under anesthesia, the softball/grapefruit was sent to Pathology, and the man in the mask waited. Maybe he tapped his toe impatiently, chatting with technicians about his golf game. Perhaps I give him too little credit.
The pathology report upgraded the cyst to a “serous tumor of low malignant potential,” and it is this phrase that drives me to consume medical research papers on PubMed the way I might inhale salts in the wake of fainting. I am desperate to understand because, as I lay flayed before this man—a gynecologic oncologist I had known no more than forty minutes total—he extracted my entire reproductive tract: uterus, ovaries, cervix, Fallopian tubes, omentum, lymph nodes. More. When I woke, rising through the haze of anesthesia like a drowned woman, my thiry-two-years-young body bloated by irreversibility, they told me I’d had borderline ovarian cancer, a relatively rare disease in which the multiplying cells are not actually carcinomas, in which metastasis is rare, in which chemotherapy is not necessary, and which has a relatively low recurrence rate.
They called me lucky.
In the weeks and months following the surgery, I won’t use the c-word, won’t own it as my reality, will insist, instead, on using the medical term for what’s happened to me: total abdominal hysterectomy. Of course, afterward I’ll add that my ovaries are gone too since, inconveniently, there’s a separate, unpronounceable word for that. Glib well-wishers will echo my nurses, congratulate me—because it could have been worse, right? Because I don’t need chemo. Because I “really dodged a bullet there, huh?” In the grocery, at the office, by my front door, on the phone, people will ask if I am healing okay, referring, of course, to the incision. To the surgery itself. And yes, the incision is fine. But I will not be. I will respond to these questions factually: “Yes, I can walk and talk and lift my toddler. The bleeding has subsided. But I don’t know if I’ll ever be fine,” I will sigh. “Sometimes I can’t make it eight hours without weeping. I miss my uterus. I miss my ovaries,” I will report, welling up, squeezing my fist against my lips to stop their quivering.
It will be here, in the discomfort of sorrow, that I lose these well-wishers. They will have hoped, of course, that I am truly fine—all fixed up and grateful, as I’m supposed to be. So this will be what they choose to hear. It’s so much simpler to ignore pain, after all, to hide in blissful oblivion. Howyadoin? Finethanksandyou? No one expects another person to actually tell the truth. We prefer, instead, to anticipate—to demand, even—that others will mask their pain for our comfort, just as we do for them. This is called being polite. And so I will receive, over and over, polite responses.
“It’s good you’re healing up.”
“So lucky you didn’t need chemo, right?”
“Glad you’re doing better.”
A swift, awkward pat on the arm, and they will be off, leaving me bobbing in a hollow wake.
The first time I use the c-word to refer to my own situation is in conversation with a student of mine in my Developmental English class, three and a half months after the surgery. I use it not because I truly believe that I had cancer. It’s just an easier, less awkward discussion than what usually follows when I use the word hysterectomy. In that word, of course, my vagina is silently implicated, in that it becomes obvious to the listener that I have one. It’s not something people like to talk about: vaginas are not the subject of polite conversation. And yet, the student has asked a question. I need to answer somehow. So I tell her I had benign ovarian cancer. This seems the best compromise: the word benign balancing out the c-word, keeping me honest, tipping scales both toward and away from me. It doesn’t seem fair to all the women suffering through real ovarian cancer, women who occupy no borderlands, balding women with chemo ports threading beneath their skin, to say that I, too, had the same disease: port-less me.
Nonetheless, my student’s reaction is instant and wide-eyed. “I’m so sorry.” Tongue clucking, she shakes her head. “Jeez. And you got two little kids . . . ” She’s implying, of course, an awful future in which they—my beautiful children, so young, one barely out of diapers—are left motherless in the wake of ovarian cancer. A disease that, honestly, I don’t believe I had.
“It’s okay, really.” Hands out protectively, as if to shield her from what now feels like a lie, I reiterate my spontaneously selected safety word. “It was benign. Really, everything’s fine now. I don’t have cancer . . . uh, anymore.”
Her sympathy still doesn’t flag. “But still, cancer, that’s so scary. I’m so sorry,” she repeats, face long and serious.
Folding into the olive overstuffed chair, I stare down a large concrete Buddha statue, which Andrea has seated peacefully on a zafu beneath an open window that frames a steel sky. Here, in my therapist’s office, I confess my lie. “I’ve started calling it ovarian cancer, instead of a hysterectomy.” I steel myself against a lecture on dishonesty, a lesson about purporting something to be true which I know is not.
Andrea cocks her head, the way therapists do. “Why do you think you changed what you say to people?”
This question catches me off guard, so prepared am I to defend myself against an imagined accusation. I meet her eyes and mumble a weak “Because . . . ” and shift my gaze. I resort to addressing Buddha, and begin anew with “Because . . . ” before faltering again. Andrea waits patiently, and I mount a silent interrogation of the statue, memorizing his folded hands, his square shoulders, the carved folds of his stone robe, his placid half-smile, before inhaling.
“Because when I call it cancer, people give a shit.” My voice is flat; I picture my student’s ready concern. “When I tell someone I had cancer, they are so sorry for me. They want to know about my loss, want to make me feel better, all the right responses for someone who’s, I don’t know, hurt, damaged . . . broken.” I sigh. “But when I tell someone I had a hysterectomy, they just say, ‘Oh, that’s too bad. Can you please pass the ketchup?’ They don’t conceive of it as the loss it is. They call me lucky.” I lift my eyes from Buddha, and through the window, leafless tree branches waver in autumn winds. “I fucking hate when people say that.”
The next word is castration: the removal of gonads, the testicles in males, and the ovaries in females. I dig it up because I want to know if castration includes the removal of the penis as well. It doesn’t. I want to know if it’s a word I can apply to myself, or if it is a word that, like so many things, belongs to men only. It doesn’t.
Of course, nearly all words unfold into sub-categories, origami cranes of meaning creased with connotation. Because functional sex organs are binary, there are two types of castration, one each for males and females. Here, though, the words sort themselves into categories of population control: the animal terms of spay and neuter. These words swell with a sense of domination, of disempowerment, and I shy from them, lifting them with my fingertips, pinching my nose and shaking my head. These words carry the unpleasant odors of true excess, of humane societies and no-kill shelters. It’s an unfortunate reality that spayed is precisely the term for my biological status; if I am hunting for a word that defines an ovary-less, uterus-free situation, this is the one. And yet to call me spayed is to make me a bitch.
It comes down to intent, really: spay and neuter programs sterilize, but my castration was performed out of a perceived need to save me from a tumor that might never recur as actual carcinoma. And though castration is performed on animals for the purpose of sterility, it’s not the human go-to for men and women who desire permanent birth control. Instead, those respective highways, either tubes or deferens, are merely interrupted. This is because there are serious hormonal consequences to impaired gonadal function for adults. Gonads, indeed, are the dispatchers of adulthood. And though I’m no castrato, being both post-pubescent and a mother, I still struggle in this no-man’s-land. My exterior announces my sexual maturity, and yet I am unwhole, incomplete, a crone before my time, an empty space that once incubated new life.
What my therapist tells me is true. That kind of thinking, that morose meditation on the absence, will drive one mad with longing.
“Castration, or removal of the testes, usually early enough in life to have hormonal consequences on normal maturation.” I’m combing web pages, the OED, Merriam-Webster, Wikipedia. We’re in our talking chairs, matching modern spring-rockers from Ikea, his beer and my wine partnering on the small oval table beneath them. These are still our habits, after eleven years together, after two cross-country moves, after three career changes and four degree programs and two children. We sit on our couch to not talk; we sit in our chairs to talk.
“What’s that?” He tips his head back to drain his beer, shifting awkwardly in his chair.
He shudders, then cups his crotch gingerly in his hand. “Ugh. Do we have to talk about this right now?”
I shoot him an oh-no-you-didn’t face, and he blanches. “I’m not saying I don’t want to talk,” he begins, backpedaling now, palms up and out to highlight his non-intention to offend, his reluctance to step on any of his wife’s many fresh tendernesses—not only her physical wounds, but the scars etched inside her, her eroded sense of self, all magnified by the menopausal roller coaster which she is now bound to ride. “Baby, please. Remember that Eddie Murphy joke? You don’t even need to get kicked in the nuts for them to hurt. Just grazing them is . . . ” At the look in my eyes he falls silent. I know he’s reminding me how it was possible for me to laugh earlier, how he’s done nothing but cultivate my smile in the weeks since the surgery. But it doesn’t matter; there is only now. Fuck Eddie Murphy and his fully functional gonads.
“Hold on just a minute,” I say, eyes wide and lips tight. “So we can talk all night about the words hysterectomy, ovaries, and cervix, but we can’t discuss the tantamount experience for a man?”
“No, baby, that’s not what I meant.” He’s reaching for me, face soft and eyes now as wide as mine.
“As if it’s somehow worse if it happens to a man instead of a woman?” My voice is gaining octaves. I am dripping with defensiveness.
“No, baby, no it isn’t. I’m sorry.” Out of his seat and kneeling before me, and though I’ve cupped my face in my hands to hide my now-leaking eyes, he folds me into his chest. “Listen,” he says, tucking my forehead between his collarbone and chin, “let’s talk. Tell me. Tell me about your words.”
According to Freud, a boy child at the genital stage of development experiences “castration anxiety,” which in theory results from a suspicion that, because his mother lacks external genitalia, she must have been castrated. Girl children at the same stage have a similar suspicion: because they lack a penis and testicles, they must have, in fact, been castrated already. Troubling emotions arise from this, the theory goes: fear of emasculation on the part of the boy/man, and disempowerment on the part of the girl/woman.
It is impotence, ultimately, that all people fear, for why else would such a word stand in for erectile dysfunction? People fear being denied any worldly influence, that which they might wield from a position of power. Even little children sense that their genitals are special, a source of power. The fool Freud linked this power with the penis, but he was off the mark: his theory says more about parental discipline in Victorian-era Austria than it does about child development. No, it’s the balls, the cojones, which are the stand-ins for bravery, for assertiveness, for a capacity to act, to impact. Perhaps my ovaries were a source of my own power—only I didn’t know it. And I let that man take them away. I didn’t protect them the way men protect their testicles. I didn’t question the doctor, didn’t refuse to sign any paperwork, didn’t demand a second opinion. That might have shown how little trust I had in them—and it would have been impolite, after all, to question their authority.
This—the evaporation of my power and my pathological dissociation, a loss of self resulting from castration, a severance of self—this is what happens when the integral nature of sexual identity is divided from the self. Sex, power, and selfhood all swirl in a frothy vat of permanent loss. My loss of agency, and not my ovaries, is my true castration.
Unlike the word castrated, which divides neatly into male and female versions, there is only one kind of eunuch: a castrated male, specifically one whose castration preceded puberty. Castration of males before sexual maturity, in animals and in humans, is done for a variety of reasons. Timing is everything. This isn’t just about sterility, not just about the inability to fertilize an ovum. Men castrated before puberty have significantly lower testosterone levels as adults, resulting in less aggressive behavior, more docility, more logical decision- making. Eunuchs, the theory goes, are more reasonable, more agreeable—more serviceable—people.
Eunuchs held positions of significant privilege in their respective societies, but they were deeply limited in the scope of their lives, and because they were assigned a singular job, they were essentially public servants or private slaves. Their curtailed powers of reproduction rendered them somewhat expendable, and they did not hold positions of absolute power. Instead, they held positions of absolute trust.
It’s on the sofa during my recuperation from the surgery, watching a cartoon about American history with my older boy—the second grader—that I learn about James Armistead, a black slave during the American Revolutionary period who served the Continental Army as a spy, first providing his services against the double-crossing Benedict Arnold, and then contributing, significantly, to the downfall of Cornwallis at Yorktown. Because he was a slave (as so many eunuchs historically were), he was impotent beneath the gaze of his white oppressors, and so was figuratively, rather than literally, castrated. He faded into the wallpaper, invisible in his darkness, and because of his invisibility, because of his metaphorical castration, he was able to traffic, repeatedly, key facts and information to General Washington. Armistead is an unwritten lynchpin in our history, a history that may not have happened without his services, and yet it is not simply his bravery that we should hail. In fact, we should also note his figurative castration, be willing to see—to witness—his presumed impotence, which cloaked him in an unthreatening powerlessness, so that his loyalist owners never saw fit to hide information from him. As a metaphorical eunuch, Armistead commanded access to a place of deep secrets, a place of revelation. A place where most do not tread.
Eunuchs held the keys to the kingdom, were charged with care of the most precious items a society had, in spite of—or because of—their supposedly impotent status. They were allowed into their society’s inner workings, lubricating its wheels and cogs as powerful generals, harem guards, chamberlains for kings. Their different sexual status afforded them access and knowledge beyond that of the average person. The word eunuch is defined by disempowerment, and yet it creates a power all its own.
In this word, eunuch, perhaps I may reclaim some of the power I have lost through castration. Perhaps there is a way to mold my invisible suffering into a force for good. Does my vacant belly hold, too, an invitation to an inner sanctum? Is it possible that the violation of my castration provides me a chance to call to account those who mutilate in the guise of salvation, those wholly indifferent to the aftermath of their decisions? The opportunity to reveal our medical heroes as monsters, or worse, as humans, capable of shame and blame and error, as, really, we all are? Is this the moment in which I finally see that I, though emptied, may be as much agent as I am victim?
Each day, I live my reply. There can be no other.
Krista Christensen was an Artist-in-Residence for the Alaska State Parks in 2019, and a Denali National Park Artist-in-Residence for Winter 2018. Her essays have been nominated for Pushcart Prizes and named Notable in Best American Essays. Her work has appeared Potomac Review, New Ohio Review, Waxwing, Booth, Riverteeth, Alaska Airlines Magazine, and more. She got an MFA a few years back, and calls Interior Alaska home for now, where she teaches high school and college English.
Originally published in Issue 19.