Opinion: Are you prepared to be naked? The societal and feministic perspective of urology
they are concerned with their own wellbeing, and often – though not always – they are male. I think men are better at lobbying and networking. I’m definitely no good at it. At the University where I was teaching I stopped attending meetings for it was a total waste of time. Everything had already been settled and decided. We had to attend to uphold the pretence of democracy and transparency. I didn’t know how to fight this, to resist it. "A diverse team may inspire people to seek professions or careers that otherwise they might feel excluded from." So if you ask me what organisations and institutions should do, I would say: start by being honest. Don’t fool yourself and don’t fool others. When you use the word ‘diversity’, have you stopped to think what it means? Do you realise that it may entail a code of practice that is unfamiliar to you, and therefore potentially scary? To what extent are you willing to have your way of doing things challenged? To what extent are you willing to relinquish some of your power? Of your status? Of your privileges? To what extent are you willing to admit that you have power, status, privileges? I once attended open heart surgery for the purpose of writing about it. It started early in the morning and went on for quite a while. At a certain moment the surgeon, who had made a name for himself by fixing the heart of our then king, suggested we take a break for coffee. As I remember there were some five people in attendance; they had to watch as part of their training.
A young woman writer recently told me she did not want to have her picture taken for professional purposes by a man. She felt it would be wrong for a newspaper to send a male photographer to her house. I was stunned. I’ve had my picture taken by many male photographers. Once by an Italian, he kept shouting: Bella! Bella! I was wondering whether all Italian photographers were like that. I’ve also had my picture taken by women, but never by a black photographer. Recently the paper has sent a photographer who had been born in China and had been adopted by Belgian people. Her pictures were very good. You’d be surprised what difference a photographer can make. Same is true of urologists, of course. Not to forget the hairdressers. My guess is that the photographer with Chinese roots was sent as part of a drive to have a more diverse team. For the arts I’m all in favour of diversity. The more diversity, the more ideas, the more perspectives, the more wealth. To what extent does this also hold for the world of medicine? The western – scientific – way of practising medicine has been dominant and has yielded tremendous successes. It has also led to the sense of it being the right, the enlightened way, and all other ways being considered backward and primitive, though occasionally their benefits are acknowledged as in the case of acupuncture. There are a number of very good reasons to strive for diversity in your team. For a start, a lot of talent goes untapped if you exclude certain groups. Intelligence, ability and talent are not the privilege of a specific category. Moreover a diverse team may inspire people to seek professions or careers that otherwise they might feel excluded from. I can remember the first time I was treated by a doctor who was not white. He was a dentist, and without me asking for it, he whitened my teeth. And another slightly related memory: I had given birth to my son, and I was wheeled on a bed to a room. Before entering I was asked whether I objected to sharing with a black woman. I was shocked, not because of her, but because of the question. You don’t have to tell me the colour of your skin doesn’t matter, because it does. And exactly for that reason it is crucial to demonstrate the opposite. And how can you demonstrate the opposite? By having as diverse a team as possible. But then there is the final hurdle: to what extent do you expect everybody on your team to conform to the established code of conduct? To what extent will they only be professionally successful, to what extent will they only come up for promotion if they play it by the written and especially the unwritten rules? How much space is there for members of the team to be different? "The more diversity, the
‘What about them?’ I asked pointing to the people who stood there motionless and stiff, like guards of a royal coffin. ‘Won’t they have coffee?’ For a second he seemed puzzled, almost as if he was not aware of the presence of these underlings. As far as he was concerned they did not exist, and they certainly had no need for coffee. It was clear that in that hospital you had to submit to this surgeon, you had to pay him respect as if he were some tribal leader. It was take it or leave it. I have no way of assessing whether this is typical of hospitals, whether such hierarchies are established everywhere, but I’m sure it is fairly general, and I’m equally sure it will be vehemently denied. It takes a lot of courage to look critically at your own behaviour, and to allow junior people to express criticism. In my experience the criticism will inevitably lead to retaliation. And thus so many people shut up and feel quietly miserable at work. And possibly they take it out on their inferiors and patients. There are two options: you play the game according to the rules or you quit. And a third option: you have a burn-out. A Dutch poet once wrote: to be naked and to begin. So my question to you is: are you prepared to be naked? Are you prepared to lay off the signs of your status and achievements, and to listen, to really listen, even when what you hear will not be to your liking?
Kristien Hemmerechts (BE) Author
k.hemmerechts@ skynet.be
The 7th International Congress on the History of Urology takes place on Friday 10 March, during EAU23. A number of speakers will cover a diverse range of topics, including the political and sociological drivers of the history of urology and the developments over the 50 years since the EAU was established. In this article, well-known author Kristien Hemmerechts shares her perspective on diversity, which she will present on Friday, 10 March. Hemmerechts: I have a problem with gynaecologists and also with hairdressers. I know I’m supposed to talk about urologists, but I don’t have any experience with them yet, in spite of having suffered multiple bladder infections, but it never crossed my mind to consult a urologist. Maybe I should have done, maybe my life would have taken an entirely different direction had I done so. I like a hairdresser to focus on my hair, to get on with it, and to definitely not expect small talk – or even any talk – from me. For years now I’ve had my hair trimmed by my daughter, she’s no professional but she has a professional attitude. Likewise I want my gynaecologist to be professional: to know what he or she is up to, to get on with it, to be business-like and to know their business. And again, no small talk, please. "So if you ask me what the world needs right now, I would say we need efficient and professional practitioners of medicine with lots of experience and expertise." For a long time I changed gynaecologists every couple of years and then at one point I stopped making appointments, I just couldn’t take it anymore. Then one day I felt a lump in my breast, and I realised at once it was no good. My stepdaughter recommended the nephew of her mum’s boyfriend. She had his mobile number sitting in her phone, so I could see him the next day. Was I impressed with this man! He managed to examine my breasts and my private parts with me barely noticing. I love that expression: ‘private parts’. We don’t say it that way in my mother tongue, which is Dutch, but it’s an ace expression, for those parts are private and should be treated as such. I doubt whether there is one single woman on this planet who doesn’t hate that device to open you up, the duckbill speculum. With him it was over and done before I had time to even think how I disliked it. So if you ask me what the world needs right now, I would say we need efficient and professional practitioners of medicine with lots of experience and expertise. That is the first and foremost requirement, also of hairdressers by the way. It doesn’t matter what gender or race they are, of how they define their sexuality, as long as they are efficient. Having said that I would find it odd if the person handling the mammography machine were a man. They have to take hold of your breasts and push them between those plates. It’s unpleasant enough when a woman does it. I guess I’m a bit old-fashioned in this respect. I must confess e.g. to preferring gendered toilets. I know I will have to get used to gender neutral ones – the world has decided that it is the way forward, and who am I to argue with the world.
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more ideas, the more perspectives, the more
wealth. To what extent does this also hold for the world of medicine?" It’s extremely nice and energising to work in an environment where you feel you fit in, where you feel you can be yourself. Everybody benefits, including the patients who are treated by happy and relaxed doctors. Unfortunately such work environments are rare. Many organisations – hospitals, universities, companies, banks – will claim they invite discussion, that they are open to disagreement, that they encourage the debate, that they strive for transparency. In most cases this is nothing but window dressing. The power is usually in the hands of a very limited group of people. This group has only one aim: to keep this power, by whatever means. They don’t have the well-being of the organisation at heart,
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Historia Urologiae Europaeae series is addressed to all European urologists. Its aim is to make known the ideas and the work of our predeces- sors, and to help us understand the current trends in the development of our speciality. Unfortunately, the treatises written in Sanskrit, ancient Chinese, Greek and Latin are both difficult to find and difficult to understand, and should, therefore, be translated into English. The same applies to more recent books pub- lished in various languages. Most of the treatises produced before the 17 th century, even the legendary ones, have gaps, mis- takes and inconsistencies. Modern scientific research allows us to re-evaluate this ancient knowledge and examine it from new perspectives. The History Office of the EAU in collaboration with internationally based urologists, historians, philologists and other experts, conducts research, accumulates and shares this fasci- nating information in their annual publication, Historia Urologiae Europaeae.
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