Popping the Question

Last week it happened again. It starts with a hesitant smile, a subtle pause, eyes looking me up and down, and a gaze that tentatively rests at my stomach. I sense what is about to occur, and I wait like the proverbial deer in the headlights. Then comes the timid question: “Are you expecting?”

I pause awkwardly and briefly contemplate my response. Because my patient is inquiring out of love and genuine curiosity, I tamp down my sarcasm and mumble, “It’s my pants style.” The patient lowers their eyes and murmurs something apologetic.In the provider room, I share this latest interaction with my colleagues. Their outrage assuages me. We brainstorm alternative responses to the pregnancy question. “Wow! I’m fifty-one years old! Thank you for the compliment about how young I look!” Or “No! My kids are 17 and 20! No babies for me!” Or “No, it’s my full bladder.” Or, worse yet, “It’s my abdominal mass.”

I do appreciate the fact that my patients think I appear youthful enough to conceive. I understand that they are not trying to be nosy and inappropriate, but to connect in our shared humanity. But the question about pregnancy is only the tip of the iceberg. Patients have commented about my weight loss, weight gain, gray hair, haircuts, wedding rings, clothing style, pimples, bags under eyes, looking good, looking tired, looking young, looking older, and more. They ask if I have gone through menopause (which directly conflicts with the pregnancy question, by the way) and what my experience has been with aging. They inquire whether I exercise and eat well (I do) and whether I’ve had the preventive medical services that I suggest to them (I have).

Patients notice everything about their medical provider. My style of practice often leads to less rigid patient-physician boundaries. Perhaps these relaxed boundaries convey a permission to ask these questions. For me, this tradeoff is worth it, yet sometimes I feel exposed and vulnerable when patients ask these questions and make such comments. At other times, I sympathize with them—after all, I get to ask them endless questions about intimate matters. Is it too disquieting for these inquiries to be unilateral?

And yet, time and time again, I ask myself: If I were not a woman, would such questions be asked of me? If I were a man, how would this all be different?

Pamela Adelstein
Newton, Massachusetts