May 2008

The 15th Annual Carol A. Bowman Creative Writing Contest for Medical Students

About the judges:

Janeta Tansey, MD, holds an undergraduate degree in philosophy from Creighton University and is currently a PhD candidate at the University of Iowa Department of Religious Studies. She completed her MD at Loyola Stritch School of Medicine and psychiatry residency at the University of Iowa. Dr. Tansey currently works with the Holden Comprehensive Cancer Care Center to provide and improve psychosocial care and serves as director of medical student education in psychiatry. She is a recipient of the 2007-2008 UI Collegiate Teaching Award.

Hugh Ferrer, MFA, is the associate director of the International Writing Program and the fiction editor of the Iowa Review. He holds an undergraduate degree from Princeton University and an MFA from the Iowa Writers’ Workshop. His course, “Readings for Writers,” introduces UI undergraduates to the literary culture of Iowa City.

Sponsored by the UI Carver College of Medicine Program in Biomedical Ethics and Medical Humanities

Co-sponsored by the UI Carver College of Medicine's Writing Program.

Created by Richard Caplan, M.D.


The Position of the Uterus

by Micheil Cannistra, '11

Traditional medical illustrations depict the uterus as a front-facing, upright, pink triangle balancing on the snail foot of the vagina, its fallopian tubes bent at awkward angles as they protrude to the sides, eagerly extended to catch the monthly ovum. These pictures of the hemisected uterus make it look like some sort of fertile, cherry-filled pastry or, worse, a really enthusiastic cheerleader. "Gimme a B, gimme an A, gimme a B, gimme a Y! GoooOO BABY," these versions of the uterus yell, pom-pom fimbrae waving.

In medical gross anatomy, my professors—one a stylish, witty homosexual, the other a short, earnest Canadian—corrected this traditional, mistaken view. "The uterus," Dr. Hoffman explained, "is positioned in the body like a ski jumper. It's sort of tipped forward, with the fallopian tubes extended behind it, the ovaries at the end of the fimbrae." Standing in front of the classroom, he illustrated this posture, leaning forward, an eager and flamboyant ski jumper, his calves straining, his arms reaching out behind him. The class laughed at the demonstration and at Dr. Pizzimenti's similar, later depiction, which featured some Nurf football "ovaries" and a bat-winged lab coat as the protective broad ligament.

Later, in the laboratory, I saw the uterus first-hand. Slumped over the urinary bladder, the fallopian tubes stretched behind it, it looked similar to the happy, energetic athletes imitated by my teachers. Yes, their forward-moving, wind-in-their-hair depictions of the uterus were closer to reality than those found in traditional textbooks, but they still failed to capture the posture, the attitude, or the experience of the real uterus as it sits in the body. I'd seen the correct position once before. It was a scene I will never forget and a moment that will prevent me from ever idealizing motherhood.

My maternal grandmother died of breast cancer when my mother was seven. The fact that she is a motherless child has been central to my mother's identity her entire life. Inspired by the looming shadow of this emptiness, my mother became a school teacher and, later, stayed home with my older sister, Kieran, and me in the early days of the feminist '70s when other women rushed to work outside the home. Wanting to be the best parent possible, my mother applied her considerable intellect and talents to this difficult role. Raised on a farm and an amazing cook, she shunned jarred baby food, blending her own fruits and vegetables and mixing them with whole grains or her own homemade, naturally sweetened yogurt. Moreover, after Rachel Carson's Silent Spring was published, my mother fed us only organically grown produce, a practice that was unheard of in those days.

Without her own maternal example to follow, my mother took child development and parenting classes at the local night school, employing many Dr. Spock-, B.F. Skinner-, and Ashley Montagu-inspired child rearing techniques. She sent away for dolls from Europe so our psyches wouldn't be damaged by Barbie and Skipper's unrealistic examples of the female form. She bought us almost every toy manufactured with the U.N. label, including my favorite, Miss Many Faces, a doll whose cloth flap clothes could be repeatedly flipped to uncover many little girls of different races. My favorite books were the feminist tomes Girls Can Do Anything and The Little Red Hen; my favorite record was Free to Be You and Me.

My sister and I attended preschool at Vassar College. As study subjects in the child psychology department, we had a fleet of tenured professors and Ph.D. candidates available to teach us about the classroom gerbils, draw our numbers and the alphabet, help us build block towers, or lie on the floor and sing us the effort-affirming anthem, "The Itsy-Bitsy Spider," complete with the spidery hand-dance, for hours at a time. My sister and I had sleep schedules and play schedules and positive female role models and gender-neutral clothes and simple, wash-and-wear haircuts. T.V. was restricted; chores were mandatory. My mother worked like hell to give us Health and Character and Intellect and Self-Esteem. No wonder she was always exhausted.

One day, because Kieran was off playing at a friend's house and I was bored with whatever healthy, little kid thing I was doing in our playroom, I wandered to the kitchen to go bother my mother. I don't know how old I was, but I was little enough that I could walk under the kitchen table without bending my knees or ducking my head. In fact, I was so young it was still developmentally appropriate for me to be oblivious to the fact that I could ever be a bother to my mother. I mean, what else did she have to do but address my many dull questions and attend to my constant stream of requests? (Seriously, think back to how you thought as a little kid and admit it—you, too, were a selfish asshole.)

My mother was cleaning the kitchen—wiping the table, filling the dishwasher. I didn't like the dishwasher. It was much taller than me with lots of sharp edges and pointy spikes. Worse, very recently, just as my mother was starting to teach me to drink from grown-up glasses, every last one of my bottles and sippy cups had mysteriously melted in the hot, steaming jaws of that harvest gold death trap of a kitchen appliance. After this tragedy occurred, my mother had carefully taken each cracked ball of twisted plastic out of the dishwasher and showed them to me, one by one. She said, “I’m sorry, Baby Micheily, but isn’t it great that you can drink from big glasses now? You really don’t need baby bottles or little kid sippy cups.” I listened as I clutched my blanket in nervous frustration, determined to drink like a grownup from my Care Bear-, and Superfriends-decorated glasses.

Anyway, that morning I was bored and thirsty and I wanted a glass of chocolate milk. Normally chocolate milk was offered as a very occasional dessert. (The fact that I was even asking for it was a little like walking into a bank at which you don't have an account and asking for a free $20. Sure, it's only 20 bucks and there's, like, 20 million in the vault, but is the teller going to give it to you?) I knew my odds of getting a glass of delicious chocolately frothiness weren't good, so, looking up at my mother as she stood at the sink, I was ready for her quick "No." Much to my surprise, she paused, looked out the window, allowed her gaze to linger on the branches of the tree outside, turned to me, and, smiling, said, "Sure." When my jaw dropped open in surprise, she smiled wider, drying her hands on a towel as she walked to grab the milk from the fridge and the organic cocoa powder from the cupboard.

I can still feel the prickly waves of anticipation that ran through my body as I watched her pour the milk into the blender. My mother was a chocolate milk maestro. All my little kid friends loved the way she made this special treat because she doubled the required cocoa and mixed it in the blender, which (better than just stirring with a spoon) made the milk go all frothy with the extra sweetness. Standing on tiptoe, I gripped the kitchen counter and peered over the edge to observe this symphony of snack preparation. My mom added ice cubes and then, with one hand on the blender cover and one hand on the buttons, punched the machine to 'pulverize.' I listened to the scream of the blender and watched the shadows of the ice cubes as they danced to their death against the crushing blades. I trembled with anticipation. "Chocolate milk before Daddy comes home," I thought, "and Kieran isn't here to get any!"

When the drink was done, my mother turned off the blender, removed the cover, and reached into the dishwasher to get my new favorite, extra-tall, Wonder Woman drinking glass. She poured the chocolate milk and set it on the table within my reach. My eager, little hands shot out to grab my unexpected treat, but I misjudged the distance of my target. Instead of seizing my sweet prize, lifting it to my greedy lips, and drinking deep, I knocked over my Wonder Woman-decorated glass of chocolate milk.

Waves and waves of sticky, chocolate-infused dairy ran off the edges of the table onto the kitchen chairs, the floor, me, and my mother. Time went into slow motion, and it seemed like the glass was bottomless. The milk just kept pouring out of the glass, on and on and on, until the furniture, my mother, and me stood like isolated islands in the Great Lakes of chocolate milk. And still the milk kept coming. My mother stared down at me in shock, her mouth open, the blender cover still clutched in her left hand. She said nothing; she barely breathed.

And here, Reader, is where I broke my mother's spirit all by my little kid self: Before she had a chance to get the sponge or the mop, before she had a chance to strip me of my chocolate-covered clothes and throw them in the washer, before she'd even reached to pick up the Wonder Woman glass and set it upright, I peeped, "Um… Mommy? May I please have a new one?"

My mother dropped the blender lid like it was an electric eel, staggered backward, and clutched the counter behind her for support. I didn't understand what was happening; I had made sure to say 'please' and 'may,' but it was too late. I watched as my mother toppled forward in slow motion and fell with a splat onto the table before her, right into the pool of chocolate milk.

She lay there, unmoving, slumped on the urinary bladder of the kitchen table, her fallopian tube arms extended behind her, akimbo, her reflexively clawed fimbrae fingers clutching the supportive counter in agonized frustration. My mother lay in the position of perfect defeat. Years later, as I peered into my cadaver in the gross anatomy lab to observe the reproductive organs at the bottom of the pelvis, I realized that, in that long ago chocolate milk moment, my mother had assumed perfectly the position of the uterus.