When Denise Howard was 12 years-old, she was terrified to find a blood stain in the lining of her panties. Fearful that she was dying, she finally worked up the courage to ask her mother what was happening to her. “She didn’t say anything, but instead turned and rummaged through a dresser drawer to retrieve a small booklet,” Denise writes in the introduction to her book, The Essence of You: Your Guide to Gynecologic Health. “She handed the booklet to me and told me to read it. That was how I learned about the miracle of life. I was having my first period!”
Denise is now a Senior Attending Physician at Sidra Medical and Research Center and an Assistant Professor of Clinical Obstetrics and Gynecology, Weill Cornell Medicine-Qatar, where she teaches and mentors medical students. She decided to write a book to reach a wider audience. “I wanted to provide women with much more information about gynecologic problems and health prevention than I could ever give an individual in the short time of an office visit,” she says. “Women need to know more. They deserve to know more. Women who understand their bodies and have some knowledge of health issues make better health choices and are also much easier to provide care to.”
The Essence of You begins with a detailed discussion of a woman’s anatomy and function, critical knowledge at any age. Denise then goes on to address women’s gynecologic health in stages, from adolescence through menopause. Denise hopes that women will first use her book as an educational text and then later as a reference to review again and again as health issues come up.
As a preteen, Denise made the decision to become an Obstetrician/Gynecologist after reading about the various specialties in the encyclopedia. “I wanted to be in a `happy specialty’ where my appearance didn’t bring on a feeling of dread,” she says. “There isn’t anything happier than welcoming a new baby to the family.”
In high school, Denise enjoyed biology courses, but also loved English literature. Her parents, who didn’t attend college, were insistent that she pursue any form of higher education. “All my teachers provided encouragement, but the person who stands out in my memory was my track coach and history teacher,” she says. “He suggested I consider the University of Mississippi (his Alma Mater) and then drove me two hours to an event there so I could learn more about the school.” Denise did decide to attend Ole Miss.
A diligent student, Denise was accepted by every medical school that she applied to in the southeast. She chose the prestigious Johns Hopkins in Baltimore. “When I visited the campus, the students, residents and faculty were so welcoming and seemed so happy,” she says. “I was sold.” Denise also earned a masters degree in public health from Johns Hopkins as well.. “I decided to pursue academics and the MPH provided me with the skills needed to become a clinical researcher,” she explains.
Denise completed her residency at Magee-Womens Hospital, University of Pittsburgh Medical Center, and a fellowship in Urogynecology and Reconstructive Pelvic Surgery at the University of Michigan where she also served on the faculty. In 2010, she moved with her family to Abu Dhabi, United Arab Emirates. “The move was a quality of life decision and a desire to provide my family with a life adventure,” she says. “It’s been a wonderful experience for all of us.” The family moved to Doha, Qatar in 2015.
Having practiced in both the U.S. and the Middle East, Denise says there were no regional differences in terms of how a woman approached her health care. “The differences are by education levels,” she says. “The higher a women’s education level, the easier it is to counsel her on complex surgical procedures or various treatment options. Women with a higher education also tend to take advantage of preventative health care and overall make better health choices in all aspects of their life.” No matter where a woman lives, Denise says the biggest challenge is access to affordable health care. If she could change one thing about how health care for women works these days, what would it be? “I would make preventative care (pap smears, Mammogram etc) and contraception free,” she says. “I would have women stop work at 36 weeks of pregnancy and allow them 6 months of paid maternity leave.”
When she practiced in the U.S., Denise took care of a diverse group of women. Now in Doha at the Sidra Medical and Research Center, the population is even more diverse includingnationality. “There is a large expatriate population so women are from all over the world: the Gulf countries (Qatar, United Arab Emirates, Saudi Arabia etc), other Middle Eastern countries, European, Africa and Asia,” she says. One thing she took for granted when in the U.S., was the availability of many resources and established procedures. “Their absences sometimes make taking care of women challenging,” she says. One perk is longer vacations. “I had never taken a four- week vacation before moving to the Middle East,” she says.
Denise believes there is an advantage to being a woman doctor in a specialty catering to women. “Women tend to feel more comfortable asking sensitive questions,” she says. “I learned this early on when I was an intern. I was rounding with a seasoned surgeon who had performed a procedure on a woman who was the same age as the surgeon. After our rounding team left the room, she called me back in (the only female on the team) to ask when she could resume sexual relations with her husband.”
Much of Denise’s book is written in a conversational style, a hallmark of her methods for getting patients to open up . “I usually start our meeting with a conversation aimed at getting to know them,” she says about her approach. “I try to make the interaction relaxed and I might share something personal about me. Common topic areas are the kids, their schools or I ask questions about their career or start a discussion about a book they are reading. Once we reach the topic of concern they are usually comfortable and I try to ask open ended, objective questions.”
Denise believes that many younger women have not yet decided to make their health a priority. Women with families concentrate on taking care of others first and put their personal concerns on a “back burner.” And many women are “sandwiched” between caring for children and aging parents. “No matter their situation, it’s imperative women make their health a priority,” she says.
The Essence of You: Your Guide to Gynecologic Health
Denise Howard, MD