“You’re bringing up that again?!?”
The husband of my patient Bella* came to her five years ago and confessed he was having an affair. Although he swears that he has been faithful since, that long-ago infidelity still pollutes every moment of her waking life. There’s no pleasant afternoon spent together that isn’t colored for her by the memory, and in every quarrel about unrelated issues, she manages to remind him of his perfidy.
I know why Bella is still so angry. She feels the betrayal as viscerally as she did when he told her about it. For him, it’s over; for her, it’s an ever-present specter spoiling their marriage. In some ways, the culture supports the “female” point of view on the subject: Currently held common wisdom tells us that talking is good, while silence equals denial, and is therefore bad. Everything we read or see on television reassures us of how good it will feel to get things out in the open, to pursue closure, to remember always.
But is this really the best thing for us?
A fascinating article published in the Journal of the American Medical Association suggest that Post-Traumatic Stress Disorder, a psychiatric disorder that occurs after experiencing life-threatening events, is “just as much a problem in forgetting as remembering.”
The researchers concluded that “it’s important for people to have privacy, to forget and not have to talk”. In a 2004 article in the New Yorker, Jerome Groopman, MD, explored whether recalling the details of a traumatic incidents actually helps. Recent data – regretfully available to us in the wake of the events of September 11, 2001 – shows that forgetting or repressing the memory of the experiences might be much more helpful and conductive to real healing.
This may be an area in which women, with their tendency to return over and over to the scene of the crime, can learn from men. I might suggest that Bella take a page from her husband’s book – for the sake of her mental health, not simply her marriage. Nothing will erase the fact that he was unfaithful to her, but for both of their sakes, she must make the decision to move on.
When she told me about the affair and its effects on her, I naturally asked her why she stayed in the marriage at all. She immediately gave me five excellent reasons the relationship was still positive for her (incidentally, just doing that exercise alone can be very helpful indeed). I gently pointed out that since she had decided to stay, she needed to do her part to allow the marriage to heal, and they have since begun counseling.
Marianne J. Legato, MD, Ph. D. (hon. c.), FACP is an internationally renowned academic, physician, author, lecturer, and pioneer in the field of gender-specific medicine. She is a Professor Emerita of Clinical Medicine at Columbia University College of Physicians & Surgeons and an Adjunct Professor of Medicine at Johns Hopkins Medical School. Dr. Legato is also the Director of the Foundation for Gender-Specific Medicine, which she founded in 2006 as a continuation of her work with The Partnership for Gender-Specific Medicine at Columbia University. She received an honorary PhD from the University of Panama in 2015 for her work on the differences between men and women.
At its core, gender-specific medicine is the science of how normal human biology differs between men and women and how the diagnosis and treatment of disease differs as a function of gender. Dr. Legato’s discoveries and those of her colleagues have led to a personalization of medicine that assists doctors worldwide in understanding the difference in normal function of men and women and in their sex-specific experiences of the same diseases.
She began her work in gender-specific medicine by authoring the first book on women and heart disease, The Female Heart: The Truth About Women and Coronary Artery Disease, which won the Blakeslee Award of the American Heart Association in 1992. Because of this research, the cardiovascular community began to include women in clinical trials affirming the fact that the risk factors, symptoms, and treatment of the same disease can be significantly different between the sexes. Convinced that the sex-specific differences in coronary artery disease were not unique, Dr. Legato began a wide-ranging survey of all medical specialties and in 2004, published the first textbook on gender-specific medicine, The Principles of Gender-Specific Medicine. The second edition appeared in 2010 and the third edition, dedicated to explaining how gender impacts biomedical investigation in the genomic era, won the PROSE Award in Clinical Medicine from the Association of American Publishers in 2018. A fourth edition is forthcoming.
She also founded the first scientific journals publishing new studies in the field, The Journal of Gender-Specific Medicine, and a newer version, Gender Medicine, both listed in the Index Medicus of the National Library of Medicine. She has founded a third peer-reviewed, open access journal, Gender and the Genome, which focuses on the impact of biological sex on technology and its effects on human life.
Dr. Legato is the author of multiple works, including: What Women Need to Know (Simon & Schuster, 1997), Eve’s Rib (Harmony Books, 2002), Why Men Never Remember and Women Never Forget (Rodale, 2005), Why Men Die First (Palgrave, 2008), The International Society for Gender Medicine: History and Highlights (Academic Press, 2017), and most recently, The Plasticity of Sex (Academic Press, 2020). Her books have been translated into 28 languages to date.
As an internationally respected authority on gender medicine, Dr. Legato has chaired symposia and made keynote addresses to world congresses in gender-specific medicine in Berlin, Israel, Italy, Japan, Panama, South Korea, Stockholm, and Vienna. In collaboration with the Menarini Foundation, she is co-chairing a symposium on epigenetics, Sex, Gender and Epigenetics: From Molecule to Bedside, to be held in Spring 2021 in Italy. She maintains one of the only gender-specific private practice in New York City, and she has earned recognition as one of the “Top Doctors in New York.”
