Gendered Silence and Misdiagnosis in the Clinical Encounter: Celia de Fréine's Blood Debts and the Hepatitis C Scandal in Ireland

Abstract

Gendered Silence and Misdiagnosis in the Clinical Encounter:Celia de Fréine's Blood Debts and the Hepatitis C Scandal in Ireland* Luz Mar González-Arias (bio) … a blood disorder is a whole body issue.Unanchored, migrant—blood is its own diaspora. sinÉad gleeson, constellations (37) The history of women's health care is characterized by silenced or heavily edited episodes that have contributed to the neglect of women's bodies and minds and accordingly prevented them from receiving the best possible treatments. As Hannah Devlin has contended, this prevailing attitude toward women's health has triggered "a string of health-care scandals over several decades" in which the voices of the patients have been consistently ignored. Ireland is no exception in this respect, and its history, both past and present, is punctuated by the silencing of women's voices and bodies in the clinical encounter. The death of Savita Halappanavar in October 2012 at Galway University Hospital—where, in spite of her physical distress and severe complications in the midst of a miscarriage, she was refused a termination of her pregnancy because there was still a fetal heartbeat—stands out among the recent failures of the Irish medical, religious, and political systems with respect to women, and it has left an indelible impact on the campaigns for reproductive justice in the [End Page 264] country (Holland). The CervicalCheck cancer controversy, which first emerged in 2018 and involved scores of women who received incorrect smear-test results; the brutal procedure of symphysiotomy, performed as an alternative to caesarean sections; and the hepatitis C scandal that will be the focus of this essay have also become paradigmatic examples of obstetric violence and gender imbalances in the medical history of Ireland. Celia de Fréine's collection Blood Debts, originally published in Irish as Fiacha Fola in 2004,1 and rendered into English by the author herself in 2014, is to date the only poetic articulation of the so-called hepatitis C scandal (also known as the Anti-D scandal) in Ireland. In the late 1970s about 1,600 Irish citizens, most of them women, were infected with a contaminated blood product: Anti-D immunoglobulin, also known as the Anti-D agent. The product was given to women with rhesus-negative blood who had given birth to rhesuspositive babies in order to prevent damage to the fetus in any subsequent pregnancies. This blood product was revolutionary in the prevention of rhesus disease, but it proved disastrous for the patients who received a batch manufactured in 1976 by the Irish Blood Transfusion Service Board (BTSB) from a donor who had infective hepatitis. A number of women were diagnosed with lupus, jaundice, fatigue, and a rash, but no connection between their illnesses and the toxic agent was initially established. The scandal, which has been referred to as "Ireland's greatest medical disaster" (Keane), was made public only in 1994 when evidence was provided that the BTSB had been alerted to the possibility of contamination yet had ignored the warning.2 De Fréine is "an inhabitant of liminal spaces" (Palacios-González and González-Arias 103), and her "creative force is to be found in the rich terrain between languages, genres, geographies, and literary [End Page 265] traditions" (González-Arias, "Afterword" 102). Although mainly known as a poet, she has also published numerous essays, worked successfully in opera and filmmaking, and published and produced numerous plays. Originally from Northern Ireland, she now divides her time between Dublin and Connemara; she has been inspired and influenced by English, Irish, French, and Eastern European literary traditions; she translates her own work from Irish into English, and most of her collections have appeared in dual-language format. De Fréine is a poet who upsets traditional boundaries, a characteristic that not only flavors the formal aspects of her work but also leaves its mark on the varied themes she has worked on, the volatile relationship between health and gender featuring prominently among them. In several of her collections, for instance, de Fréine has explored posttraumatic stress disorder and the demonstrations of extreme violence against women on the part of soldiers that...