NONFICTION - July 5, 1992

WOMEN AND DOCTORS by John Smith, MD (Atlantic Monthly Press: $20.95; 237 pp.) As the baby boomers rush headlong into middle age, here is Dr. John Smith, a gynecologist and right kind of guy (though too many women might find that combination an oxymoron), who wants women to know before it’s too late that most of their paranoid fantasies about the medical community are, you should pardon the expression, dead right. Most women use a gynecologist, not an internist, as their primary physician, and that’s where the trouble starts. Since most gynecologists are unenlightened men, they do things they shouldn’t do: They perform too many hysterectomies and too many C-section deliveries, and too few cardiac catheterizations and lung-cancer screenings, since heart and lung problems are incorrectly considered to be men’s diseases. They take advantage of our lingering belief that “doctor” means God in some other dialect. They refuse to tell us what we need to know, or take enough time with our questions, or admit mistakes. Smith’s book is full of distressing anecdotal evidence to back up his assertion that men simply shouldn’t become gynecologists. Would that he had provided an equal amount of ammunition for the woman patient. His advisory summaries--under what conditions a woman should have a hysterectomy, or what the significance is of various lumps, bumps and cysts--are too brief to serve as anything but an introduction. This is not a generation that will settle for four pages on menopause.