Ask Me About My Uterus

What happens when a person in pain is not believed? The book uses Abby Norman’s story of endometriosis and neurological illness to explore how women’s pain becomes invisible in medicine, history, and culture. The author argues that the healthcare system’s tendency to reduce complex suffering to numbers or stereotypes leads to misdiagnosis, delayed treatment, and deep psychological harm. This is not just a memoir—it’s an anatomy of disbelief, exploring the intersections of biology, psychology, and gender bias.

You follow Abby’s collapse in the shower to her long fight for diagnosis. Her experience reveals medicine’s two blind spots: the historic feminization of pain and the excessive medicalization of fertility. From ancient myths of the “wandering womb” to modern triage scales that demand a number between 0 and 10, the book shows how systems of measurement erase the nuances of anguish and reinforce disbelief, particularly for women.

Pain as Language and Power

When you’re asked to describe pain, you face a translation problem: an inner, private sensation must become a public statement. Medicine’s favorite solution—the 0–10 numeric scale—demands simplicity but strips away texture. Abby’s triage moments expose how these scales encode credibility tests. A calm or quiet woman is interpreted as not suffering enough; an emotional one risks being labeled hysterical. Both fail because the scale prioritizes intensity but ignores duration, quality, and function—the details that actually help clinicians understand what’s happening.

The author compares this to the Beaufort wind scale, which pairs numbers with descriptors (like “stiff breeze” or “gale”) to translate experience into something others can visualize. Pain deserves a similar lexicon. Asking for adjectives—“stabbing, dull, radiating”—can bridge the gap between personal experience and clinical comprehension. Without that richer language, patients like Abby end up invisible within data-driven medicine.

From Hysteria to High Tech: The Historical Echo

The disbelief facing women’s pain is centuries old. Hysteria, once attributed to a “wandering womb,” cast women as unreliable narrators of their own bodies. Charcot’s theatrical “treatments,” Freud’s psychoanalytic interpretations, and 20th-century psychiatric diagnoses all reinforced a pattern: when doctors couldn’t find a lesion, they assumed the problem was psychological. The book vividly connects these legacies to modern clinical habits, showing how diagnostic shortcuts and gendered expectations perpetuate neglect. This history explains why a college-aged woman with stabbing abdominal pain still has to work harder than her male counterparts to be taken seriously.

Pain, Gender, and the Cultural Script

The book situates pain within a gendered cultural script. Women are more likely to be offered sedatives instead of analgesics (“The Girl Who Cried Pain”), to have their symptoms attributed to stress, and to face disbelief when presenting with chronic illnesses that don’t neatly fit textbook descriptions. These biases are compounded by research gaps: women were long excluded from clinical trials until the 1990s, leaving drug responses and disease patterns under-documented. The result is a system where a woman’s suffering is both under-measured and under-studied.

A Narrative of Advocacy and Humanization

Amid this landscape, Abby’s story unfolds as both case study and call to action. Her relentless research, emotional honesty, and patient-led detective work turn personal pain into a social critique. Alongside medical discussions of endometriosis, pelvic surgery, and neurological crises, she examines relationships, sexuality, attachment, and trauma—reminding you that illness is not only physiological but profoundly relational.

Ultimately, the book argues for a more integrated model of care. Pain must be understood through both the body and context: attachment histories, cultural narratives, and institutional structures all leave physiological imprints. You come away with a radical insight—that listening well, documenting clearly, and challenging bias are as clinically valuable as any test. The personal becomes political, and the body becomes both evidence and testimony.

To understand why women’s pain is often dismissed, you have to look at how medicine’s worldview evolved. The historical diagnosis of “hysteria” revealed more about male anxieties than female physiology. Ancient physicians imagined the uterus as mobile, moody, and pathological—literally wandering the body. Jean-Martin Charcot’s nineteenth-century Paris clinics turned female suffering into scientific theater: women’s seizures and cries became data points in a patriarchal show of diagnosis.

Freud’s and Breuer’s work on cases like Anna O. gave hysteria a psychological frame, but it continued to pathologize women’s expression. Even in modern psychiatry, labels like “conversion disorder” and “somatization” function as softer echoes of hysteria—they preserve suspicion toward women’s bodies by placing blame on emotions.

Echoes in Contemporary Clinics

This historical scaffolding shapes present-day encounters. Doctors still reach reflexively for psychological explanations when faced with unexplained pain. In Abby’s experience, this plays out as dismissal—“you’re anxious,” “you’re stressed,” “this is in your head.” Each phrase carries centuries of disbelief. When a test fails to show pathology, the default assumption remains that the patient is dramatizing rather than describing.

The author contrasts this with legitimate psychosomatic interplay: stress does modulate pain perception, but that doesn’t invalidate physical disease. The ethical task is diagnostic humility—ruling out physiological causes with rigor before labeling distress psychological. Without that humility, clinicians reproduce the damage of Charcot’s amphitheater in quieter, bureaucratic form.

Fertility and the Politics of the Womb

Bias in care extends to how fertility dominates treatment decisions. Gynecology’s paternalistic roots mean clinicians often act as stewards of women’s reproductive potential rather than advocates for their quality of life. Abby’s surgeon preserved her ovary “for fertility’s sake,” even when that meant leaving potential sources of pain unremoved. Others advised pregnancy as treatment, echoing Joe Vincent Meigs’s claim that endometriosis afflicted women who delayed childbirth—a moralization of disease that persists.

Medical training and institutional incentives perpetuate this bias: fertility outcomes are more measurable than daily pain, and preserving reproductive organs feels safer legally. The result is clinical tunnel vision—one that values potential motherhood more than the woman in pain. The author makes clear that healing requires dismantling these inherited hierarchies between reproductive capacity and suffering.

Endometriosis sits at the center of Abby’s story, symbolizing what medicine still struggles to define. It’s a disease both common and mysterious: tissue similar to the uterine lining grows elsewhere—on ovaries, bowels, diaphragm—but the mechanism is still debated. The standard theory by John Sampson (retrograde menstruation) explains tissue migration through menstrual backflow but cannot account for cases found in fetuses or lungs. Alternative models, such as David Redwine’s embryonic stem cell hypothesis, suggest a developmental misplacement at birth.

Clinical Confusion and Research Scarcity

Diagnosis usually requires surgical visualization, meaning many sufferers go years without confirmation. Staging systems quantify lesions but poorly correlate with pain. That dissonance reinforces disbelief: when pathology doesn’t match suffering, doctors assume exaggeration, not measurement failure. Research gaps compound the issue—funding for endometriosis lags far behind diseases of similar prevalence. PubMed hosts tens of thousands of liver disease papers but only a fraction for endo, despite its widespread impact.

Faced with such neglect, patients become their own scientists. Abby compiled binders of research and connected with surgeons like Redwine and Reich, who specialize in full excision. This grassroots knowledge-building parallels other patient-led movements—HIV activism or rare-disease advocacy—revealing how citizenship extends into scientific contribution when institutions fall short.

The Invisible Illness

Physically, endometriosis often hides in plain sight. Symptoms—crippling cramps, bowel distress, fatigue—are misread as normal periods. Abby’s episodes (collapsing in a shower, vomiting from pain, bleeding through clothes) illustrate how an invisible illness can demand constant adaptation. Socially, invisibility shields disbelief; externally functional women are seen as exaggerating, while their private lives disintegrate under cyclical agony. Dr. Melanie Marin’s advice to suppress menstruation with hormones reframes the idea of “normal” cycles—not as moral obligation but medical choice.

Endometriosis thus becomes emblematic: a medical riddle wrapped in moral history, demanding that modern medicine finally listen and investigate with open-minded precision.

Pain is not a data point—it’s a biography. In clinics, though, it becomes a number. The 0–10 scale and similar tools emerged as quick triage aids, but in practice they enforce emotional conformity: patients must present “appropriately” for their pain score. Abby’s quiet endurance read as insincerity, while her contextual storytelling seemed like dramatization. This disconnect highlights how pain scales shape not only documentation but belief.

The book exposes how disbelief operates as structural gaslighting—a blend of skepticism, bias, and bureaucracy that convinces patients to doubt their own sensations. Cumulative microaggressions (“you’re too young,” “it’s stress”) become a second wound. Research confirms the gendered divide: women wait longer for analgesics, receive milder medications, and are more likely to be told their symptoms are psychiatric.

The Consequences of Dismissal

Disbelief leads to diagnostic drift: real pathology goes untreated while emotional resilience erodes. Abby’s later neurological episode—numbness, cognitive haze, shingles flare—illustrates how systemic inattention can worsen disease trajectories. A neurologist’s dismissive “all in your head” echoes the historical hysteria label, showing how easily complex presentation becomes moralized. When care fragments across specialties, patients must coordinate their own cases or fall through cracks.

Restoring Credibility to the Body

The remedy begins with listening—but not the perfunctory listening of intake forms. It means contextual listening: hearing how pain changes behavior, identity, and relationships. For clinicians, the task is to ask, “What am I ruling out?”; for patients, to present structured evidence—timelines, symptom logs, and descriptive language beyond numbers. Both sides must resist reductionist shortcuts and treat the story itself as data. Only then can medicine rebuild trust and accuracy together.

The book’s emotional depth lies in connecting psychology with physiology. Abby’s life, shaped by early deprivation and anxiety, demonstrates how the nervous system learns patterns of hypervigilance. Referencing Harry Harlow’s monkey experiments, the narrative shows how disrupted attachment alters later stress responses—affecting pain thresholds, immune activation, and bodily awareness. Trauma doesn’t just echo emotionally; it becomes cellular, influencing how signals are processed in the brain.

The Psychosomatic Border

Clinical categories like somatization or conversion disorder often serve as a repository for the unexplained. Abby’s story insists on diagnostic duality—mind and body collaborate. The same attachment wounds that heighten sensitivity to threat may also amplify pain perception, but this never invalidates the organic cause. The author draws lessons from Karen Armstrong’s misdiagnosed epilepsy: clinicians must explore both dimensions simultaneously, not hierarchically.

Generational Transmission and Healing

Patterns repeat across generations: Abby’s mother’s bulimia and self-soothing through vomiting reappear symbolically when Abby vomits for relief from pain. The behavior’s physiological reinforcement—endorphin release, parasympathetic reset—illustrates how coping can become maladaptive but rational in context. Therapy offers re-patterning, but without medical investigation, psychological care only tells half the story.

The synthesis here is compassionate medicine: doctors must treat the psyche as informant, not suspect. For patients, embracing both dimensions prevents the trap of false dichotomies—neither “all in your head” nor “just physical,” but an integrated portrait of the suffering body.

Pain reaches the most intimate parts of identity. For Abby, sexual activity—once tied to love and curiosity—became a source of dread. Dyspareunia transformed pleasure into trauma, testing both self-worth and relationships. The book treats this not as sensationalism but as anatomy of alienation: how chronic pelvic pain erodes trust between partners, how shame silences conversations, and how the cultural myth that “first time hurts” conceals systemic ignorance of women’s sexual health.

Language and Lived Experience

Clinicians offered mechanical solutions—lubricants, positions, dilators—missing the point that pain had visceral depth. Abby learned to differentiate between superficial vaginismus and the deep, nerve-linked agony of endometriosis. Despite therapy and tenderness from partners like William, pain persisted, showing that intimacy depends on physical safety as much as emotional care. Relationships became spaces of negotiation rather than spontaneity.

Reclaiming the Narrative

The text reframes sexual pain as medical—not moral—evidence. It validates the coexistence of desire and fear, and offers practical counsel: differentiate pain types, seek multidisciplinary care (surgical, physical, therapeutic), and involve partners compassionately. The larger point is sociocultural: sexuality is part of health, and dismissing sexual pain as relational laziness or frigidity perpetuates the same disbelief that haunts women’s clinical encounters.

After years of dismissal, Abby transforms from patient to investigator. Working in hospital records, she learns medical language and begins writing her own “H&P” (History and Physical) to appear credible to doctors. This act of self-advocacy—documenting symptoms formally—becomes a survival strategy within an unresponsive system. Her investigation leads to discoveries overlooked by professionals: an inflamed retrocecal appendix bound by adhesions, only visible during surgery. Her precision and persistence demonstrate that knowing how to speak medicine can be as important as receiving it.

Learning Networks and Citizen Science

Through online networks, Abby connects with experts like Harry Reich and patient-researcher Noémie Elhadad, who created Phendo—a crowdsourced endometriosis database. This collaboration represents a new model of knowledge: distributed, experiential, and accountable to those who live with disease. Patients become scholars, co-creating data where institutions have failed. The democratization of research parallels feminist science movements, arguing that lived experience is data.

From Case Study to Collective Power

Abby’s evolution—from collapsed student to public speaker at Stanford’s Medicine X—shows that advocacy is both intellectual and affective. Her story invites readers to claim medical citizenship: gather records, ask about differential diagnoses, demand clarity about risks and fertility biases, and push for intersectional inclusion. When patients lead, the system learns. The book closes with a resounding lesson: suffering can become a curriculum for systemic transformation.