Excerpt from The Lady's Handbook for Her Mysterious Illness by Sarah Ramey, plus links to reviews, author biography & more

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The Lady's Handbook for Her Mysterious Illness

by Sarah Ramey

The Lady's Handbook for Her Mysterious Illness by Sarah Ramey X
The Lady's Handbook for Her Mysterious Illness by Sarah Ramey
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  • First Published:
    Mar 2020, 432 pages

    May 2021, 432 pages


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Norah Piehl
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The Lady's Handbook for Her Mysterious Illness

Dear Reader,

There may exist a graceful and elegant way to begin one's gynecologic and colorectal memoir, but it never does spring to mind.

Let us start then with a story. We can travel back to where it all began, and for a moment leave the particulars behind. That sounds much nicer—lovely even—considering it all began so many years ago with a cool, luxuriant swim in Walden Pond.


I remember it well. The heat was heavy, I was a summer student at Harvard with no air-conditioning, and Walden beckoned for the reasons it always will. Though I suppose the busloads of tourists beached on the imported sand should have sounded some instinctive alarm when I arrived, they didn't. I walked right on past and made my way to the side of the pond where the water was still and the snorkelers out of sight.

I remember walking into the water. I remember floating on my back. I remember the coolness and the peace and the poetry of the place, and I remember feeling like I couldn't ask for anything more.

The next day in the emergency room, I had quite forgotten all of that.

A urinary tract infection, known as a UTI, is a very painful but easily treatable infection of the urethra. Most people describe it as "peeing broken glass," and I would have to agree with most people.

But my ER doctors patted me on the back as they ordered up the standard antibiotics and I bounded off to the pharmacy, clutching my prescription, counting the minutes in the twenty-four hours they told me it would take to go away.

Fifty-six hours later, I was back in the emergency room. It had not gone away.

In fact, it did not go away for six months. "How strange," the college physician said as he took my history. I had never been sexually active, which made things particularly challenging, both diagnostically and emotionally. I was a senior in college, and it was my time. I even had the right person picked out.

But the UTI stayed. We joked and called it my PUTI, or permanent UTI, and I laughed along with the rest. But in private, in the bathroom, I was profoundly unamused.


This prologue is typical of women like me. A simple and innocuous medical event—often with a gyno or gastro tilt—that should have resolved simply, but didn't. She thinks it is just another one of life's ups and downs, when in fact Up is about to become a distant memory.

There is a secret society of sorts that no one—not even the members—has heard of. We don't look alike, we don't dress alike, and we're from all over. There is no secret handshake, no meeting place, no cipher.

We are the women with mysterious illnesses, and we are everywhere.


When I went home for Christmas just outside of Washington, D.C., my parents—who are both top-notch physicians—made an appointment for me to see Washington's preeminent, top-notch urologist.

Dr. Damaskus said I seemed like a nice, normal young woman who would probably like to get back to the business of being able to pee and have sex freely, and he saw no reason why he couldn't make that happen. He determined I no longer had an active infection— and then proposed a procedure, to be done right there, that day, in the office. As he described it, he would insert a small instrument into the urethra, rip it, and this would solve the problem.

I frowned.

But Dr. Damaskus assured me it was the only option, should I want a normal life again—the gentle ripping, he explained, was more of a light stretching of the tissue, and it would interrupt the muscle spasm and break the cycle of pain. He handed me a paper gown.

I'm almost nostalgic for my naïveté. I took the gown, steeled my nerves, saddled up, and put my feet in the stirrups.

From The Lady's Handbook for Her Mysterious Illness by Sarah Ramey, to be published March 17th by Doubleday, an imprint of Knopf Doubleday Publishing Group, a division of Penguin Random House, LLC. Copyright © 2020 by Sarah Ramey

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