Watermelon

At 11:29pm, four minutes after the helicopter landed, we knew she was going to die.

She had what most people think of as the “flesh-eating bacteria” infecting her right leg. The tired-sounding surgeon at the community hospital, three hours away, paused for effect after he recited her lab values and vital signs, hearing the incredulity in our silence.

I called the next of kin while my superiors began coordinating the operating room personnel, because even though we knew there was no hope, there is always hope. The phone rang four, five, six times: the community surgeon had told us the family was on their way to our hospital by car, racing against time and the helicopter, but they were very elderly, possibly driving without cell phones. I hoped that I could hang up the phone, say that I tried, and wait for their arrival, when legions of people more experienced and competent than I could explain to them that the only way we would save their daughter’s life was by sawing off her right leg at the hip socket.

The helicopter landed and we went to examine her. She was intubated, sedated, massively obese and edematous from the liters of fluid they had pumped into her. Upon removing the sodden dressing from her right leg, which was filleted down to the spectacularly dusky and engorged muscles from the thigh to the ankle, we put our gloved hands on the exposed muscle and felt the ominous popping, like palpable fireworks. It was the operating room or death, but more likely, the operating room then death. Everyone began to move simultaneously and in various directions, like cars at a busy roundabout; I dialed the family’s phone number again, wedging the portable ICU phone between my ear and shoulder as I unlocked the bed and began wheeling her towards the elevator. Nurses unplugged various IV pumps, draping the cords methodically and storing portable monitors unceremoniously between her feet, where I could keep my eyes on her heartbeat and blood pressure as we traversed the long limbo between the ICU and the operating room.

A voice answered the phone on the fourth ring. It sounded shockingly calm. I gulped once, twice, introduced myself as Doctor So-and-So, gulped again, and asked with whom I was speaking. It was her 80-something-year-old mother.

I’m afraid we are taking her emergently to the operating room right now, I said gently.

Long pause. I still had both hands on the bed rails, helping the nurses steer the bed down the interminable hallway, and I briefly wondered if I had accidentally hung up the phone by shifting my shoulder the wrong way.

So you think you can save her?  

She’s very sick. The only chance she has is if we remove the infection completely, which will most likely mean that we will have to disarticulate her hip. I explained that this meant that the entire right leg would be removed from where the hip attaches to its socket on the pelvis. The mother emitted a muffled, horrified cry, as if she had a crumpled tissue handy for quickly stifling her sobs.

I’m very sorry. We are going to do everything we can.

I know you will. I trust you.

I nearly dropped the phone. Had she spontaneously begun speaking in Elvish, I might have been less flummoxed. I had just told a complete stranger that I was about to remove her 59-year-old daughter’s leg—a daughter who had been in perfectly good health 24 hours earlier—and her response was to reassure me that she knew we were making the right decision. What had I ever done to earn such profound trust? Obtain a degree that allows me to introduce myself as Doctor So-and-So? Be fortunate enough to have worked at a prestigious, well-known, highly reputable hospital? Use medical lingo that sounds impressive?

The authority that people grant you for being a physician is something for which nobody can really prepare you, something that I will never believe I deserve. Families, lives, entire worlds can be torn asunder and put back together at the word of one human being in a white coat. Such power is awe-inspiring, humbling, and terrifying. I accept and respect the trust that complete strangers place in me and in my colleagues, but I also fear it. I fear how natural it feels to comply with the convincing edicts of an authority figure, who you believe has your best interests at heart. I fear how trusting we are as a species, how enticing it is to succumb to someone else’s plan when you are suffering and afraid. I fear how easily we could be controlled.

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It is not just the suffering of illness or the fear of impending death that makes people vulnerable to manipulation. Complacence, apathy, and the urge to conform to widely held values system are everyday driving forces that passively enable manipulation. People actively seek a knowledgeable and capable individual who will tell them what to do during times of duress; during times of quiescence, not resisting is simply easier.

Today, I was riding the bus from the office at twilight. In New England, the sun sets by 4:30 p.m. at this time of the year; as the bus rounded a corner heading East, the moon was suddenly straight ahead. It was the largest, fullest, brightest moon I had ever seen in person. Looming above the spire of the Prudential Center, which was sparkling with the first lights of evening, the moon gleamed bright white against the deep purple sky. There were no clouds, no wind.

The sight was so strikingly beautiful that I looked around the crowded bus to see who else had noticed it. Everyone was bundled up in puffy black winter coats, knit scarves around necks and heavy-duty winter boots on feet. Every single head was bent, the dull glow of cell phone screens staining every face.

The bus turned a corner and the moon disappeared behind a block of tall buildings. No one else had seen the moon.

We are blinded by the mundane, seduced by the routine of our lives. Someone goes on a TV show and talks about climate change and how human beings are destroying the Earth, and someone else goes on a different TV show and says that this is all a vicious rumor propagated by China. Which is easier: attempting to see the truth for yourself and understand the science that irrevocably proves that humans are actively wreaking havoc on the environment, or choosing to believe a person on a TV show? And if you choose to believe the person who shouts that climate change is a lie concocted by enemies of the United States, doesn’t that make you feel better about driving your gas-guzzling SUV to work and dumping hundreds of tons of non-biodegradables on landfills? Why disrupt your routine in the name of truth? If someone in a newspaper insists that unarmed Black men being shot when fleeing from the police did something to deserve it, might that validate your own prejudices against non-whites, justifying your urge to cross the street when you see a Black man in a hoodie walking towards you?

This is how we ended up with Donald Trump.

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Everyone—the media, pundits, commentators, politicians, family members, etc.—seems fond of saying that, in retrospect, we should have seen this coming. And perhaps we should have. After years of vicious rumor-mongering and the systematic construction of a narrative that portrayed Hillary Rodham Clinton as a perfidious, shrill, unfeminine, unpatriotic, nefarious crook—a narrative that was aided and abetted by the purported “liberal media”--it was simply easier for people to conclude that they shouldn’t vote for her, rather than try to understand why Donald Trump could not be allowed to win the election, for the sake of humanity. If every major news outlet is telling you that Mrs. Clinton’s emails probably contained something shady, do you choose to interrupt the flow of your daily routine by taking the time to research the veracity of these speculations, or do you parrot the buzzwords (“Scandal!” “Political insider!” “Benghazi!”) that you keep hearing as evidence that there’s something inherently and profoundly wrong with electing Mrs. Clinton?

I know what that something is. I understand now. The “it” that we all should have seen coming is actually this: the election of President Barack Obama challenged the white male power structure, the structure that human civilization has fought to maintain for centuries throughout the world. The people who voted for Donald Trump—white, non-white, male, and female--understand their role in a society dominated by a white, wealthy man. The fact that this white, wealthy man cares nothing about the working class, women’s rights, or “cleaning up the inner cities” is seemingly immaterial; these people know where they fit into a wealthy white man’s world, and, for better or for worse, wherever they fit into that world seems preferable to an uncertain position in a non-white man or woman’s world.

And the people who didn’t vote for Trump, but who are now attempting to grovel at his altar, are staring at their phones, refusing to see the moon. These people will not be rewarded for their conciliatory pleas to “give him a chance”. They will not be spared from the carnage of whatever terrible international conflict awaits us simply because they implored people to “wait and see what happens”.  Strangers place their trust in physicians like myself because, for centuries, the profession has demanded a standard of ethics to which we all must strictly adhere lest we be stripped of our privileges; Trump’s well-documented behavior over the years adheres to no such standard whatsoever. In fact, the words that have come out of his own mouth and the numerous destructive and immoral decisions he has already made in the four weeks since he was elected are more than enough to reject him entirely as an authority figure. Blindly placing your trust in such a person is irresponsible and cowardly. No one could make the excuse for you that you are suffering or in pain or terrified, like the patients who blindly trust doctors to make the right decision on their behalf. You are simply being complacent and apathetic. You are being lured into the trap of relentless optimism that seems to plague modern American society.

For what its worth, I reject your apathy. I reject your dogged optimism. When complete strangers trust me with their bodies and lives, and the bodies and lives of their most treasured loved ones, I choose to take this as seriously as Trump is choosing to be flippant about dodging the daily intelligence briefings that are offered to him in order to enable him to make the decisions that will keep all of us safe. It is your refusal and to see what is in front of you, in plain sight, looming overhead in the night sky and shining brighter than day, that will make it possible for an egomaniacal, malicious amateur to control you. Because it’s easier to be controlled by the soothing narrative that Trump is going to miraculously transform the second he gets inaugurated into a competent, conscientious, unifying leader who will elevate the working class and restore some long-forgotten illusion of our former glory than it is to face the reality: that this is the end of America as we know it.

_____________________________________________________________

She did die, as we knew she would. Not right away. It actually took her six-and-a-half months to die.

We removed the entire right leg, leaving a gaping mess of tissue where the right hip should have been attached to her pelvis. Eventually, she woke up, the breathing tube was transferred from her mouth to a hole in her neck, a feeding tube was placed, and she was set on the slow journey towards some semblance of recovery. We knew she would never recover, though. It was the listless optimism of her family that compelled us to keep putting the antibiotics on and off, keep doing more surgeries, and keep devising ideas as to how a critically ill woman could someday live outside the hospital with half her lower body missing, unable to even sit up in a wheelchair.

I remember one time, towards the end, when she looked me straight in the eyes. Hair face was huge, flabby, and swollen, but her eyes were always wide with what I can only describe as abject horror. She could not yet speak around the tracheostomy tube in her neck. Sparse gray hairs had spouted on her chin. Countless machines and monitors beeped and hummed around her. We had just found out that she had cancer, of which a rare complication had led to the devastation of her right leg. She knew about it, as did her family, but their optimism prevailed even in the face of inevitability.

We had all assumed that she was delirious and had permanent brain damage from the many cardiac arrests she suffered throughout her long stay in the ICU, so I had never had an actual conversation with her. But this time, she stared me down and very clearly mouthed, come here.

I came close to her, held her hand, addressed her by her first name, and asked her what I could do for her.

Her eyes widened, and she mouthed, watermelon.

Of course, the only food she was able to have was a liquefied nutritional compound pumped into her gastrointestinal tract through a tube. Eating anything by mouth was not an option, which I attempted to explain to her as clearly and compassionately as I could.

She shook her head, grimaced slightly, and mouthed again: watermelon.

Weeks later, when I read her obituary, I understood.

She had known.

On Identity: Race, Individuality, Donald Trump, and Flesh-Eating Bacteria

This summer, Donald Trump (who, just in case you needed additional proof that American politics is merely a farcical tableau vivant rather than a functional institution, has decided to actually run for president) voiced his opinion on immigration the only way he seems to know: through racism. He stated, “The U.S. has become a dumping ground for everybody else’s problems…When Mexico sends its people, they’re not sending their best…They’re sending people that have lots of problems, and they’re bringing those problems to us. They’re bringing drugs. They’re bringing crime. They’re rapists. And some, I assume, are good people." Not only is this an absurd generalization devoid of statistical evidence, it’s a testament to Trump’s belief in the inherent superiority of those who are like him (wealthy, fortunate, and white) over those who immigrate to the U.S. (who may be any number of things other than drug addicts, rapists, and criminals). And while Trump is one of the more verbal holders of this opinion, he is by no means the only one. Has there ever been a time in all of human civilization when our societal infrastructure hasn’t depended on the presence of a power gradient?

Perhaps it is a curse of the human condition, this need to emphasize what makes us different from one another. Or perhaps it’s just easier to try to understand our environment in terms of the “other”, native and foreign, friend and enemy. After all, our own bodies segregate cells and proteins into self and non-self on a molecular level in order to defend itself; this is the foundation of immunity and the reason why we don’t succumb to overwhelming infections. Unfortunately, human beings are too crude to understand that, while this molecular war against outsiders is adaptive and necessary, the macroscopic insistence on enmity among individuals is both counterproductive and intellectually lazy. I wonder if Trump knows that race is merely a social construct (I’m guessing that he doesn’t), or that his assertion that some Mexicans are maybe “good people” is dependent on an arbitrary definition of good and evil. One might imagine how such nuances could have escaped Trump.

Long have I struggled with things like race, patriotism, and organized religion—any classification system that is based on nonspecific features other than character, ideas, and choices. I was fortunate enough to have grown up in an environment in which I scarcely thought about my ethnicity and the fact that it rendered me a part of a “minority” group; certainly, if I had been raised in a community fraught with racial tension, I might have felt differently. It wasn’t until I moved to North Carolina that I remembered that I have brown skin (on the inside, I feel exactly like Queen Elizabeth the First), as I found myself fielding frequent and mostly benign “what are you?” questions. I have no problem with my ethnicity, I simply don’t think much about it. I never felt marginalized by the mostly white Barbie dolls I played with as a child because they didn’t look anything like me, nor did I ever daydream about marrying a dashing brown prince. My self-actualization was cultivated on a foundation of my passions, my talents, and the people and things that I’ve loved--not on the color of my skin, the country I was born in, or the God my parents taught me to worship.

It is odd to me that we all cherish our individuality so closely, yet have this natural propensity to fall in line with regard to race and religion, which seem to be the enemy of individualism. How is it that people feel so comfortable with defining their entire identity by something as insignificant as the rate of melanin degradation in their skin cells? I understand that people don’t necessarily conceptualize race strictly in terms of skin color, that culture, history, and traditions factor in as well. This makes sense to me. Culture is sturdy, durable, and substantial; I can comprehend how culture dictates identity very well. But culture and race are two very different things. Culture and religion are two very different things, in fact. I have tried to understand why this distinction is so often ignored, and have yet to come across a satisfactory answer.   

Being a surgeon only emphasizes the irrelevance of these arbitrary distinctions that we designate amongst ourselves. On the inside, everyone looks more or less the same. I can’t tell the different between a white person’s pancreas and a black person’s pancreas. Your left gastric artery is located in more or less the same place, whether you’re a Muslim or a Christian. The blood flow to your heart depends less on your skin color than it does on your dietary and lifestyle choices. The inside of the human body is unfazed by thing like citizenship, tax brackets, and church attendance. I’ve seen necrotizing fasciitis (what’s colloquially known as the flesh-eating bacteria) kill African Americans, Chinese Americans, and Caucasians in less than twelve hours—rich or poor, religious or atheist, legal or illegal, death came for them all.

We as a civilization have made race more important than it is, and we have chosen to wage war in the name of religion and territory. What would we be without those things? How would we make sense of one another? I too am guilty of my own non-hateful prejudice; assumptions are pervasive in medicine and very few are able to look at the young, Black, heavily tattooed male smelling strongly of weed in the trauma bay with a gunshot wound to the chest and not think “gang member”.  Are we all hateful for making these assumptions, or have we been so heavily influenced by the importance that society has placed on race as an indicator of character that we are powerless to resist even the most subtle of prejudices?

My point is, there are forces greater and more powerful than you, I, or Donald Trump could possibly understand that are directing the course of humanity. And there should be zero tolerance for blind hatred and xenophobia. Life is hard enough, what with mass shootings, climate change, nuclear weapons, and flesh-eating bacteria. Is it possible that maybe—just maybe—we are actually all from the same tribe, whether we believe in Jesus, Moses, Allah, Buddha, or the tooth fairy? (I personally believe in unicorns, but that may be beside the point.) On a fundamental, anatomical and structural level, we are no different. And Mr. Trump, for all his billions of dollars and his skyscrapers and his perpetually younger trophy wives, is no better than the Mexican immigrant trying to cross the border to seek a better life for his family. Sooner or later, both will turn to dust, and Trump’s dust won’t sparkle any brighter.

Please Stop Misquoting Marilyn Monroe

I don't enjoy social media. I never have, and I likely never will. Admittedly, I inexplicably continue to partake in social media, a fact which certainly warrants some careful self-examination, but I heartily dislike it, for three very discrete reasons:

1. The desperately misinformed plebes who regurgitate ignorant and hateful remarks about religion, politics, human rights, and current events. I've learned to shake my head and move on, but the temptation to publicly ridicule these simpletons is ever present, waiting to rear its ugly head and inspire a fruitless rant that falls on deaf ears.
2. The predictable, generic, poorly-lit, bouquet-of-red-roses-and-box-of-candy photos that are posted en masse on Valentine's Day. I'm sorry, ladies, but Valentine's Day is an anti-feminist corporate-fueled joke of a holiday that infantilizes grown women and reinforces the childish notion that a man must prove his love for us by buying us things--completely unoriginal things, I might add, that the industry has arbitrarily designated as universal symbols of love. I'll tell you something: everybody's love is entirely original and no one symbol works for everyone. Flowers are pretty and I'm happy for anyone who receives flowers for any reason, but receiving a bouquet of flowers on a phony Hallmark holiday is not definitive proof that somebody loves you (nor should anyone feel compelled to prove that they are loved to a cyber-group of friends and distant acquaintances).
3. The rampant epidemic of Marilyn Monroe misquotes, the most egregious of which appears on many a profile belonging to many a prepubescent/pubescent/college-age/twenty-something young lady:

"I'm selfish, impatient, and a little insecure. I make mistakes, I am out of control, and at times hard to handle. But if you can't handle me at my worst, then you sure as hell don't deserve me at my best."

This is a highly disturbing quotation that makes the speaker sound like a petulant circus monkey. "Out of control"? "Hard to handle"? Worse, this statement has the dubious distinction of being simultaneously misandrist and misogynist: it insinuates that men should simply accept bad behavior from women because all they really want out of women is their "best" parts.

(I doubt that I need to explain why this quote is misogynist; the word "handle" alone says it all.)

The ongoing popularity of this rubbish quotation in social media is not that mystifying, if you think about it. It serves as a cutesy justification statement for immature, entitled women who truly believe that being in possession of lady parts renders them exempt from the usual consequences of being an asshole. It also makes women feel sexy and glamorous to try to associate themselves with Marilyn Monroe.

But wait. You guys...you guys...Marilyn Monroe never said this.

There is absolutely no proof that these words came out of Norma Jeane's mouth. Yet somewhere along the tortuous lines of print journalism and social media, this idiotic quotation became attached to Marilyn Monroe. But I assure you, there is nothing to suggest that Monroe said this. For all we know, Jay Leno said it.

What's gotten my knickers in a twist about this whole quote debacle is not even the content of the quote (although it is undeniably asinine), it's the fact that social media requires no proofreading or editing for accuracy; people can put literally anything out there without any need for accountability. You can attribute words to people who never said them, because nobody is doing any fact-checking on your Facebook profile. Whatever you put into cyberspace can be misinterpreted as fact by an unsuspecting follower. Rumors are perpetuated and misinformation is accepted; the lines between fact and falsehoods are progressively blurred. Having your words printed used to be a privilege. Now any irresponsible nincompoop can post an infinite amount of unreliable data through social media, and, unless you have the werewithal to do your own research, you can easily find yourself accepting assertions that are blatantly incorrect.

Poor Norma Jeane had enough trauma in her life. She was a survivor of childhood sexual abuse and struggled with mental illness, which culminated in her suicide at the age of 36. While she may very well have described herself as "out of control" and "hard to handle", it still isn't fair to assign words to her that she never said in order for modern-day girls and women to attempt to justify their own bad behavior.

The lesson here is this: try not to perpetuate misinformation. This example is, of course, relatively harmless (a dumb quote is falsely attributed to a deceased movie star), but misinformation can have dire consequences (for example, the attacks on Sikh Americans after 9/11 because social media helped foster a belief amongs ignorant yokels that all turban-wearing individuals are terrorists). So please, be thoughtful about what you post on social media. One of the unfortunate side effects of the digital age is that literally anyone can be a quasi-"journalist", and your words--whether they deserve to or not--matter.

 

On Crazy Women: Iggy Azalea, Gone Girl, Fatal Attraction, and How Insanity Became Synonymous With A Lot of Other Things

Whilst cruising down the Durham freeway with a car full of fresh produce, I happened upon a local Top 40 radio station, from which the harsh, manufactured tones of Iggy Azalea were emanating. I was detachedly intrigued. I am more out of touch than ever with the pop music genre that I so vehemently despise, given that I no longer even have the occasional night out at a bar to expose me, however transiently, to the Hits of Today. Despite being perfectly content with my iPod full of Led Zeppelin, Tchaikovsky, Sondheim, Bartok, and myriad other works of High Quality Music (insert the raised eyebrows and pursed lips of a Bona Fide Music Snob here), I listen with amused curiosity to this sample of vacuous, soulless, talentless modern music, a song called “Black Widow”.

The song tells the tale of a spurned woman who threatens to take vengeance on her careless former beau. I’m pretty sure she’s implying that she is either planning to kill him, or has already killed him. The lyrics are not terribly subtle. Here are some examples, for your consideration:

“I’m gonna love ya

Until you hate me

And I’m gonna show ya

What’s really crazy”

I know what you’re thinking. You’re thinking, “Whoa, that sounds kind of nuts. Who can possibly relate to lyrics like that?”

It gets worse. Iggy Azalea (whose Gestalt I will document here for posterity, since she will surely fade into unrecognizable anonymity quite soon: an innocent-looking, attractive white girl who has a throaty, guttural, Lil Kim-esque rapping style) continues with the following:

“I'm gonna l-l-l-love you until it hurts
Just to get you I'm doing whatever works
You've never met nobody
That'll do you how I do ya
That will bring you to your knees”

What you’re supposed to extrapolate from this verse is that this woman is genuinely “crazy”: irrational, illogical, unreasonable, and hyper-sexually conniving. This is a song about a mentally ill woman—not person, woman—who gets dumped, tries to win the guy back through sexual tactics, fails, and then kills him.

This is TOP 40 MUSIC???

Okay, I know what you’re thinking again. You’re thinking, “Come on, Rhea, it’s not that serious. It’s just a dumb pop song. Besides, women can be crazy sometimes, amiright?”

I don’t blame you, if that truly is what you’re thinking; we’re bombarded by images in the media of women behaving irrationally and emotionally. It’s a stereotype so well-worn that we’re hardly even cognizant of its stereotypy: the Crazy Wife. The Crazy Ex-Girlfriend. Don’t piss her off, That Bitch Is Crazy. Whenever a woman’s behavior bothers us, we designate her as Crazy. We are comfortable with varying degrees of Crazy Women, a spectrum of hypersensitivity, jealousy, insecurity, and shrill rage that we’ve somehow come to accept as a universal truth of womanhood: Women Are Crazy.

There are so many issues with this stereotype that I scarcely know where to begin dissecting it (and if you know anything about me, you’ll know that I adore stereotypes; thus, a stereotype has to be truly offensive for it to disturb me so).  But let me start by attempting to prove to you that this glibly accepted notion of Crazy Women is so pervasive that a reference to another notorious Crazy Woman popped up in Iggy Azalea’s song about a Crazy Woman:

“I can't fall back go quick
Cause this here a fatal attraction so I take it all or I don't want shit”

I presume you all remember Glenn Close’s character in the 1987 film Fatal Attraction. Close portrayed a jilted mistress of a Manhattan attorney (played by a buoyantly bumbling Michael Douglas) who proceeds to Ruin The Man’s Life with her Excessively Emotional Behavior. The caveat here is that the character is truly mentally ill, and even goes so far as to slit her own wrists and boil Douglas’s kid’s bunny. She then gets shot to death (spoiler alert!) by Douglas’s wife, who Stands By Her Man and does the totally not-crazy thing by killing his Crazy Ex-Mistress. Good for her! Is this an anti-feminist film? Probably. But what film isn’t? (Not many.)

Iggy Azalea’s reference to the film is not so much a self-aware nod to the caricature she is depicting in “Black Widow” as it is a tacit acknowledgement that the archetype of the Crazy Woman is permanent, affixed, and rarely questioned. Harris O’Malley wrote a stereotype-damning article for The Huffington Post called “On Labeling Women Crazy” that I thought was excellent; it was triumphantly quoted throughout social media platforms for about two-point-five days and then it was scarcely mentioned again. In the interim, songs like “Black Widow” have come out. Tabloids have relentlessly mocked Taylor Swift for having a lot of boyfriends and writing mean songs when they break up with her. Gillian Flynn’s novel Gone Girl, about a woman who clearly has a whiff of Antisocial Personality Disorder, has rocketed to cataclysmic levels of popularity. We’ve all comfortably settled back in to the idea that women, when they behave in a way that’s objectionable in some way, are Just Being Crazy.

O’Malley admits in his article that, when he used the “C” word, “for the most part, crazy meant ‘acting in a way I didn't like.’”.  But why is it so tempting to chalk up unpleasant behavior in women to something essentially unrelated to unpleasantness, like mental illness? Is it because we as a society tend not to use “crazy” and “mentally ill” as mutually exclusive, interchangeable terms? Colloquially, “crazy” can be used as a synonym for “irrational”, “erratic”, “emotional”, “angry”, “shocking”, and any number of adjectives that are independent of mental illness.  Interestingly, there is no catch-all adjective for men when they act in a way that others don’t like.

But let’s return to Gone Girl for a moment. Truly, I found this book exquisite. I did, however, take issue with the fact that Amy had to be The Crazy One.  Do we really need another example in popular culture of a woman who is genuinely nuts, to provide additional fodder to the already crackling bonfire of anti-feminism? Why couldn’t pathetic, ineffectual, unlikable, insecure Nick be the mentally ill person, instead of the victim that we’re all forced to feel sorry for in the end? (Because, admit it, you did feel a little bit of righteous pity for the poor sucker, taking one for the team and sticking it out for his kid. I, on the other hand, momentarily hated the author for letting Nick be a martyr.)

But it’s not just the fact that Amy is “crazy” that bothers me: it’s the fact that her love for Nick tips her over the edge. In every form of media, women and love are inextricably intertwined. The default for a main character is Male and White; the only time a non-Male is needed is when there needs to be a romantic subplot, and the only time a non-White is needed is when there is a racially-specific subplot. (I’m sure you can think of an isolated example that deviates from this formula, but an isolated example does not a pattern make.) Why was Arwen even included in the Lord of the Rings Trilogy? To provide a romantic subplot. What was Hermione’s ultimate purpose in the Harry Potter series? To have Ron’s babies. How does Katniss end up, after all that revolution-leading? Married with babies. That’s the ultimate goal for women, isn’t it? Love, romance, babies? “It is a truth universally acknowledged that a single man in possession of a good fortune must be in want of a wife”?

That fantasy is the root of Amy’s insanity in Gone Girl. According to the media, power drives men and love drives women Crazy. It’s that simple.

All that Men Are From Mars, Women Are From Venus bullshit was supposed to be humorous and harmless: the woman wanting to lock a man down in order to best her biological clock and procreate, the man hilariously fighting tooth-and-nail to preserve bachelorhood and independence. A comical tug-of-war between the sexes that somehow ends in happily-ever-after. Romantic comedy garbage. What we subversively ended up with was yet another facile, palatable, culturally accepted strategy for subjugating women.

Don’t hire her, women are too emotional for that kind of job!

You better get a pre-nup; otherwise, your wife may go crazy and try to take half.

My girlfriend won’t let me do that. She’s crazy.

I just don’t think a woman can be President. A President has to be logical and level-headed…

In most Western societies like the United States, institutionalized subjugation of women has more or less fallen by the wayside; necessity in turn demands that there be another way of dismissing women and ensuring that, despite the fact that women can technically pursue the same career opportunities and function independently of men, the superiority of men is maintained. Instead of taking away a woman’s right to vote or her physical safety or her right to wear whatever she wants to wear in public, we take away a woman’s sanity. We rupture her image so that she’ll toe the line—because what sane person wants to be labeled “Crazy”?

In Gone Girl, Nick admits that the thing he fears the most is an angry woman: “I was not good with angry women. They brought something out in me that was unsavory.” Given that this fear is shared by many real-life man, I would ask you to consider that this fear arises from a perceived discord between angry women and gender roles: traditional gender roles demand that men be spitfires—hunters, aggressors, protectors—while women are docile, nurturing, and calming. When a woman is angry, she is by definition not docile, nurturing, and calming. Anger is only acceptable when it is testosterone-fueled. In order to reconcile this perceived disparity with the ostensible modern-day rejection of such arcane gender roles, men must find another justification for why angry women scare them so much: it must be because Women Are Crazy! And an angry woman might prevent a man from doing exactly what he wants to do, which is unpleasant, which means…she must be dismissed.

What better way to dismiss someone than to disparage her very sanity? Brilliant, successful, fascinating Amy is reduced to a pitiable maniac by the end of Gone Girl, just another Crazy Bitch, which is a terrible shame. We don’t remember her witty prose or her ingenuity or the fact that she went to Harvard—all we retain from her character is the psycho way she ruined Nick’s life. If that isn’t anti-feminist, then I don’t know what is.

There are plenty of Internet memes circulating that explore the question, “Why do we need feminism?” I implore you to consider a different, but related, question: “Why do we think we need anti-feminism?” Is it the same reason why white Republicans seem to feel the need to see President Obama as a “nice” Black guy—the kind of Black guy who wears sweaters tied around his neck and goes to Harvard, instead of the kind of Black guy who wears bling and robs liquor stores—the need to see the “other” as something that fits neatly into a carefully shaped mold of acceptability and comfort? Or is it because women, when freed of institutionalized subjugation, possess skills and attributes that are a threat to the long-standing, cross-cultural, and nearly universally accepted dominance of men?

It’s true that the United States has still not seen a female President, but there are plenty of female surgeons, and I would argue that a surgeon, on any given day, wields more power than any Head of State. (Did Dubya ever stand over another human being with a knife in his hand, and then did that human being walk away from him, cured of an illness? Nope.) There have been female surgeons for a long time, and lots of men know this. Perhaps what men are really afraid of is not angry women, but powerful women. Women who may not feel the need to do “crazy” stuff to get their attention.

Because as long as women are the crazy ones, men are the sane ones.

I will complete this thought by explaining that there are two things that bother me the most about the “Crazy Woman” stereotype. Number one: overusing the word “crazy” trivializes mental illness and further marginalizes a group of patients who are afflicted by a genuine medical problem, like bipolar disorder, schizophrenia, and personality disorders. These patients are sick, just like any other patient, and the colloquial use of the word “crazy” only diminishes their suffering. Number two: I don’t like the fact that women sometimes refer to themselves as “crazy”. I hate that Iggy Azalea came out with this dumb “Black Widow” song, which will surely be snickered at by underage frat boys in bars who will nudge each other and guffaw about how this song reminds them of some Crazy Bitch they used to know. I hate the Manic Pixie Dream Girl trope. I hate that Lana Del Rey (one of the only modern-day singers I can even stomach) calls herself “f---ing crazy” at the end of her dreamy, immaculate track “Ride”, opening the door for idiotic, machismo-driven conversations about how “all hot girls are crazy”. The essence of the “Crazy Woman” stereotype is diminishment: diminishing mental illness as a serious medical problem, diminishing women and taking away their individuality—their flaws and quirks and foibles and triumphs—and replacing them with a blanket of Female Hysteria and Craziness.

I do believe that fear is at the root of all this. There are certain men who have seen what certain women can do when unencumbered by certain societal restraints. There are certain men who have seen a female surgeon, for example, operating with her elbows deep in bowels and blood, at the end of her thirteenth hour on her feet, nine months pregnant, when her water breaks and she delivers a screaming infant with no pain medication—and then returns to the operating room to finish the case. (This is a true story.) That is indomitable power. That is a feat that no man will ever say that he did—just a biological disparity, a Darwinian twist that forever leaves man inferior to woman: Man Will Never Bring Forth Life From His Own Body. Anything he can do, I can do better.

Maybe that’s why they’re afraid.

Am I crazy for thinking that?