The Nurses



Appetites: Why Women Want by Caroline Knapp

Laura Fitzgerald, CNM

At age twenty one, Caroline Knapp weighed less than eighty-three pounds.  An Ivy League graduate, an aspiring journalist, and the child of an intact family, she adhered to an identical daily menu for three years; a sesame bagel, a coffee-flavored yogurt, an apple, and a one-inch cube of cheese.

Although Caroline Knapp died shortly after the publication of her 2003 book Appetites, her sharp intelligence lingers in the pages of this thought-provoking work.  Appetites is not only a courageous documentation of Knapp's own life but also an important investigation of the psychological and cultural underpinnings underlying all sorts of unhealthy longings.  It will resonate with readers as individuals and nurses.

What would compel, a healthy, promising young woman to restrict her diet, her actions, her thoughts, and her sexuality to such rigid, self-abnegating parameters?  Fear, she answered in the pages of Appetites, a paralyzing fear about what would happen if she acknowledged the great extent of her hungers. 

In Knapp's own words, "Obsessive relationships with men; compulsive shopping and debt; life-defining preoccupations with appearances; "isms" of all kinds - all of these are about emptiness, about misdirected attempts to fill internal voids, and all of them tend to spring from the same dark pool of feeling: a suspicion among many women that hungers themselves are somehow invalid or wrong."

Far too many of us punish our bodies.  We stuff it or we starve it.  We push it though marathons, ignoring screaming hamstrings and popping Ibuprofen by the fistful, or we park it on the couch where we berate ourselves for escaping into reality TV.  By day, we nurses preach the importance of stress relieving activities and we rattle off the medical implications of hauling around extra pounds.  Meanwhile, painful knots along our spinal columns scream and slabs of chocolate cake are gobbled between patient visits.  How do we reconcile this seeming do-as-I-do-not-as-I-say behavior? 

I believe that the author Caroline Knapp would have urged us to peel away the layers of societal, familial, and personal baggage that belie our relationships to food, our bodies, and our ability to embrace life fully. 

In some ways, American women have been sold a bill of goods.  The post-1960s generations have been taught that the world is ours for the taking.  And, indeed, we have witnessed a substantial reshaping of gender roles.  We have heralded the happy arrival of the dinner making, laundry folding, stay-at-home dad, and there are currently more women than men enrolled in American medical schools. 

Then why, as described in one particularly apt anecdote, does a powerful corporate lawyer receive more compliments about her twenty pound weight loss than she does following any one of her considerable jaw-dropping academic or professional achievements?  As Knapp evidenced, expectations about image and physicality have only become more stringent with the blasting of gender barriers. 

We tend to channel our attention into the search for the right pair of shoes or the just-so sofa pattern, or to fixate on the unimaginable ease of life that just might accompany a perfect size 6 dress.  According to Knapp, we do this because these thoughts are manageable, straightforward and formulaic.  It is infinitely riskier to name the real source of our hunger.  However, after finishing Appetites, I posit that readers will feel inspired to take at least one small, gutsy step in that direction.



Knapp, C. (2003).  Appetites: Why Women Want.  New York: Counterpoint.


Copyright 2008- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved


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