It's hard to put Alice Dreger in a box. Part historian, part columnist, part advocate, part educator and mother of one, Dreger works to improve social and medical treatment for people with norm-challenging bodies, including conjoined twins and intersexed individuals. Some know her as a writer who has commented on topics such as neonatal circumcision and dwarf entertainment; others know her as a professor of clinical medical humanities and bioethics at Northwestern University (or perhaps as the sassy teacher whose business card reads, "I'm not a doctor, but I sleep with one.")
One reason it's so hard to put Dreger in a box is because she aims to erase that box altogether. The author of Hermaphrodites and the Medical Invention of Sex as well as One of Us: Conjoined Twins and the Future of Normal, Dreger has spent her career asking people to consider an important question: Why not change minds instead of bodies? Here, Dreger discusses the difference between "normal" and healthy, the problem with cosmetic medicine, and why we should learn to appreciate ambiguity.
What do you say when people ask you, "What do you do?"
I'm always stumped. Recently at the ER (where they stitched up my cut finger) I claimed to study the history of 19th century medicine, because that always elicits great ER horror stories about pre-modern wounds and treatments. I do work half time as a historian of medicine at Northwestern University's Feinberg School of Medicine, and I started my career with work in the 19th century. But these days I mostly help out living people. I gave up tenure and much of my income six years ago so I'd have enough time to do what felt important. My doctor-husband pays most of the bills (yes, I trade sex for money), and I drive a 1995 Saturn SL. It's a good life.
What new idea or innovation is having the most significant impact on medicine?
Doctors are starting to really measure what matters to patients. Instead of just looking at whether your bone density or cholesterol number is up or down, they are asking, "Are you more likely to get a fracture?" or "Are you more likely to die?" This means that in cases of sex anomalies, they're finally paying less attention to how good a surgically constructed vagina looks to the surgeon, and paying more attention to whether the girl ends up feeling good about her body.
What's something that most people just don't understand about your field?
Doctors are human animals. They want to be loved, they are tribal, they instinctually favor stories over scientific evidence, they make mistakes, and even small gifts make them susceptible to being biased. If we took doctors seriously as human animals, we might hurt them—and they might hurt us—a lot less.
What's an emerging trend that you think will shake up the health world?
Sorting out the difference between normal and healthy. What we should care about is health—reduction of morbidity and mortality. Too often we instead pay attention to whether something is "normal." A hospital may spend several million dollars separating a pair of conjoined twins even though that separation is likely to leave them worse off. The problem is that going for normal is often more profitable for the "providers" in the short-term than going for healthy is.