The Woman in the Surgeon's Body (review)

Joan Cassell. The Woman in the Surgeon's Body. Cambridge: Harvard University Press, 1998. vii + 267 pp. $35.00.

About a decade ago Joan Cassell published an anthropological study of surgeons that, among other things, beautifully captured their masculine subculture. ¹ When she first began to observe them at work in 1983, there were only a handful of women in the field. Since then, however, those numbers have increased tenfold and are still rising. Such an extraordinary change in a specialty so long a bastion of male privilege has enabled Cassell to return to the subject of surgeons for a fascinating second look. This time around she is interested in gender, wanting to know whether and in what ways women practitioners differ from men. The result is a complex but readable account that will appeal not only to historians of medicine but also to theorists and scholars of difference. Unlike her research for the previous book, where Cassell could observe the entire surgical staff in depth at only a few hospitals, she has struggled this time with more daunting logistics: since there were rarely more than one or two women surgeons at any institution, she had to visit a large number of cities and sites to observe and interview the thirty-three women who eventually became the subjects of her study. We are all the richer for her efforts.

The stories Cassell selects from her fieldwork are compelling, but even more illuminating is her theoretical framework. She argues that the alien, male-dominated world of surgery is as ritualized as are the separate male spaces that orchestrated coming-of-age ceremonies for young men in the premodern tribal cultures studied by previous generations of anthropologists. Moreover, surgeons, like modern-day test pilots, race-car drivers, and career military men, inhabit a death-haunted world not merely closed to women, but in which the female body is powerfully out of place. As women's bodies threatened to pollute the primordial notions of maleness projected in ancient tribal ceremonies, men's houses, and secret male activities, so too do surgeons' sacred undertakings lose their potency when women come to understand their mysteries. Cassell notes that in both settings, men conceive of doing things to and for women, but never with them.

What better site for posing the questions that Cassell wants to answer: What does it mean when the surgeon is a woman? Does she relate to patients in the same way as a man would? Do her superiors and subordinates treat her equally? How can the scholar begin to sort out the meanings of both differences and similarities? Not surprisingly, the evidence she has gathered is contradictory, and it challenged her to find a theoretical framework that can illuminate its complexity. Unsatisfied with scholarship that emphasizes the essential differences between men and women, Cassell is equally mistrustful of social constructionist theory that views gender as a negotiated performance generated by the exigencies of social interaction. Especially troubling was how little the notion of "doing" gender could account for the ambiguous gender-related behavior that kept cropping up in her fieldnotes. How could she explain the intensity and persistence of difference?

Eventually, Cassell came to believe that something else was going on in her subjects' behavior--something nonlogical and nonverbal--which she captures best in an elaboration of the notion of "embodiment" and "habitus" derived from the theories of Pierre Bourdieu. What she describes is a world in which learning is achieved through the body, and knowledge is passed on in nonverbal ways. Habitus is a distinct environment that molds individuals, who can then embody the dominant social arrangements, social experience, and social thought of that world. Thus, much of the hostility that women surgeons encounter can be explained by the fact that they have the wrong body in the wrong place. Since women are feminine and not dominating in the way of surgeons, a...