Dear, are you hysterical?

by Rosie Audino, expert in philosophy and science and health communication

It's 1875. In the grand amphitheater hall of Salpêtrière – Paris's women's psychiatric hospital – Dr. Jean-Martin Charcot prepares for his Tuesday lecture.Tall, elegant, with a broad forehead and a well-groomed beard, he dominates the scene like an actor on stage. On the bed, lying down, is a young girl: Louise Augustine Gleizes, just fourteen years old. Everyone simply calls her Augustine. In a single day, she had one hundred and fifty-nine convulsions. Around her, the hall is buzzing: doctors, students – including a young Freud – journalists, and photographers. All have flocked to witness a spectacle that fascinates and scandalizes all of Paris: that of the “hysterical women.” During these lectures, the patients are photographed. The images would end up in theIconographie photographique de la Salpêtrière, an illustrated scientific publication, strongly sexist. The images were used to demonstrate medical theories, but in reality, they also reflect male fantasies and projections onto the female body.

In those shots, Augustine appears in delirious poses, beside herself. Only later was it discovered that they were far from spontaneous: the lighting was carefully arranged, the reactions induced by hypnosis. Charcot wasn't trying to cure; he used these women for his “spectacular” experiments. But who was Augustine really? Born in 1861 into a poor Parisian family, she had experienced violence and abuse early on. After those traumas came the seizures, paralysis, and trance states. When she was admitted to Salpêtrière, she complained of severe pain in her right ovary. To Charcot, however, she was just another hysteric.

‍The Cultural Origins of Gender Bias

Do you know where the word hysteria?
From the Greek hystéra, meaning uterus.
As early as the 4th century BC, Plato believed that the uterus, if “unsatisfied,” could move within the body, causing disorders. Later, Galen – a philosopher and anatomist who lived in the 2nd century AD – revived this idea and prescribed as a cure… more frequent sexual intercourse. If you think you've heard it all, well, you're wrong! In the Middle Ages, the symptoms of hysteria were interpreted as signs of demonic possession, and many women ended up burned at the stake as witches. In the 19th century, Charcot attempted to give it a scientific basis, linking hysteria to the brain rather than a person's morality. However, he still ended up reducing the suffering expressed by patients to an emotional, psychological phenomenon, and thus, once again, failed to take physical pain seriously. Freud, Charcot's student, did the same, believing that symptoms were attributable to repressed emotional and sexual conflicts.
If previously the cause of hysteria was to be found in the “unsatisfied” uterus, now the blame was to be sought in the mind of the sufferer. Too bad it was always women's minds. And yes, because hysteria was never diagnosed in a man. Perhaps because men don't have emotional conflicts or repressed sexual desires? Or – who knows – maybe it was just a somewhat patriarchal theory… I'm just putting it out there, don't let Freud's fans get mad at me.
Fortunately, hysteria has disappeared from medical manuals, but its cultural legacy is still alive.

It's not all in your head

Today, certain prejudices persist in other missed diagnoses. Indeed, because underestimating pain, as happened at Salpêtrière, is why some conditions are still difficult to diagnose today. A prime example is endometriosis, a chronic disease affecting millions of women worldwide. Do you know how long it takes on average to get a diagnosis? Seven to ten years. Endometriosis occurs when tissue similar to the lining inside the uterus grows where it shouldn't – on ovaries, intestines, bladder, even in the lungs – causing severe pain during periods, pelvic cramps even on normal days, painful sexual intercourse, abdominal bloating, chronic fatigue, and, in some cases, fertility problems. It can appear from adolescence, even after the first menstrual cycles. If the pain is so intense that it prevents you from studying or working, it might not just be your period. But why is the condition so difficult to identify? Endometriosis symptoms are often mistaken for intestinal colic, premenstrual syndrome, or stress. Furthermore, the disease is not easily visible with routine examinations: an experienced specialist is needed to recognize it. To understand it, the first step is to talk to a specialized gynecologist: it usually starts with a transvaginal ultrasound or an MRI, but the definitive diagnosis only comes with laparoscopy, which also allows for the removal of lesions. 

Probably, if you've made it this far, not only can you maintain attention for more than seven seconds (congratulations: your prefrontal cortex is top-notch!), but you're also curious to know what all this has to do with Geen.  Geen is a technology that helps identify the real problem, condition, or pathology and direct people towards the appropriate professional to diagnose and treat it. The Geen experience is a bit like a chat – yes, like ChatGPT – but with a big difference: ChatGPT, which by the way shouldn't give medical advice, is not trained with necessarily reliable data; it relies on sources like articles, websites, and other data it was trained on, but whose origins we can't truly know. How many times have we self-diagnosed the impossible by reading things online! Moreover, one of the problems with artificial intelligence is that it's not neutral: in several cases, it has been shown to discriminate based on sex. And this is where Geen: a platform that can not only give you more precise and reliable information, but also guides you towards choosing a professional suitable for your characteristics and needs. It could be seen as a triage system that allows users, public administration, and businesses to optimize referrals to the appropriate service. Essentially, on Geen, we talk first, and then we send you to someone who can truly help you, saving you money and time. 

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