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Dr Rhona Mahony on Ulysses and Holles Street: so much has changed, even if the building is the same

Joyce would be amazed at the advances in women’s health since he set his ‘Oxen of the Sun’ episode in the National Maternity Hospital — although the cramped and outdated site would still be familiar

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James Joyce and the National Maternity Hospital at Holles Street, the setting for the ‘Oxen in the Sun’ episode. Illustration by Shane Mc Intyre

James Joyce and the National Maternity Hospital at Holles Street, the setting for the ‘Oxen in the Sun’ episode. Illustration by Shane Mc Intyre

Dr Rhona Mahony says Joyce’s struggle with the gestation of Ulysses reflects one of the central themes of the Oxen of the Sun episode. Photo by David Conachy

Dr Rhona Mahony says Joyce’s struggle with the gestation of Ulysses reflects one of the central themes of the Oxen of the Sun episode. Photo by David Conachy

The Book About Everything: Eighteen Artists, Writers and Thinkers on James Joyce’s Ulysses, edited by Declan Kiberd

The Book About Everything: Eighteen Artists, Writers and Thinkers on James Joyce’s Ulysses, edited by Declan Kiberd

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James Joyce and the National Maternity Hospital at Holles Street, the setting for the ‘Oxen in the Sun’ episode. Illustration by Shane Mc Intyre

One hundred years after the publication of Ulysses, there is still a maternity hospital on Holles Street. Parts of the building have changed little since June 16, 1904, the date on which the ‘Oxen of the Sun’ episode describes Mina Purefoy’s three-day labour. In the 21st century, the hospital heaves under the responsibility of 8,000 births per year. Joyce could not have known that the management of prolonged labour would become one of the major endeavours of the National Maternity Hospital, nor could he have fully imagined the ways — existential, social and medical — that the questions raised in ‘Oxen of the Sun’ would remain relevant to future generations.

Curiously, just as Mina Purefoy gave birth to a son while the men delivered a drunken exposition of literary styles, it was a female publisher, Sylvia Beach of Shakespeare and Company, who gave ‘birth’ to Joyce’s book and indeed continued to provide him for some years with the means that he consistently lived beyond. Joyce’s struggle with the gestation of the novel reflects one of the central themes of this chapter — the tension between artistic creation and procreation. Joyce eventually produces a book and Mina a son.

On the third day of Mina’s painful and protracted labour, Leopold Bloom wanders aimlessly around Dublin, knowing that his wife Molly will make love to another man in their home that day. Late in the evening, Bloom is drawn to the maternity hospital to check on Mina. Here he meets Stephen Dedalus, some medical students and a group of men getting drunk in the waiting room. As they sit drinking, the midwives quietly care for the women who labour.

The language of this chapter is an extravagant ensemble of developmental literary genres reflecting the embryology of language, while the central action focuses on the conversation of men as they drink and discuss birth, contraception and sex. From the empathy of Bloom to the overt misogyny of the men’s discussions, it is the largely unseen women who quietly achieve while the men do little. Their drunk and bawdy conversation is both ridiculous and an affront to the work of the hospital and the risk endured by women giving birth. The nurses are professional and hard-working and Mina endures the traumatic birth of her ninth child while crediting her husband for this feat.

Though a cast of ludicrous male characters dominate this episode, it is an absent son who haunts the pages — Rudy, the baby boy delivered by Molly Bloom 11 years before. Since their son died 11 days after his birth, Molly and Bloom have struggled and grown apart as they try to grieve him. Unable to go home and face Molly, Bloom waits for the arrival of another woman’s son, surrounded by his memories of Rudy.

Physical impotence

The structure of ‘Oxen of the Sun’ is drawn from the embryological stages of pregnancy and Joyce wrote it with the aid of a text of embryology. A series of parodies reflect the development of language and literary growth analogous to the embryonic development of a foetus. The chapter has 40 paragraphs, consistent with 40 weeks of pregnancy, and is divided into three sections reflecting the classical division of pregnancy into three trimesters.

Much of the action in ‘Oxen of the Sun’ is verbal, as the characters hold forth on topics of birth, sex and love. Parallels are created between the narrative of the characters and the literary or mythical figures drawn from the particular style of the narrator. Thus Bloom becomes Sir Leopold and the members of the cast are transformed into romance heroes, allegorical personages, Victorian moral crusaders and ancient knights, in parodies that trace the development of the English language.

Since Rudy died, Bloom has been unable to reach orgasm during their lovemaking. This physical impotence has been mirrored in a growing separateness within their marriage. Bloom knows that while he is out walking about Dublin for a day, Molly is having sex with Blazes Boylan. No matter how often Bloom thinks of the happy times he shared with Molly, particularly before the death of Rudy, the shadow of Boylan is never far away. Joyce has created Boylan but gives him little approval, apportioning him only three words of interior monologue — like “a young pullet” as he eyes up the female assistant in Thornton’s shop. In those three words, Boylan is relegated to the role of cheap womaniser and his easy opportunism seems particularly offensive in the context of the loss Molly and Bloom share and the love that brought about the birth of their son Rudy.

The women are on the margins of the text, heard but rarely seen, with the men the dominant focus. They are a motley crew who largely behave disgracefully, and their conversations are littered with misogyny and violations against sacred fertility. They make all kinds of deeply inappropriate comments, oblivious to their surroundings and the risk endured by women giving birth. The maternal death rate at the time was 350/100,000 and infant mortality was some 150/1,000. Today the maternal mortality rate at NMH is 3.6/100,000 and the perinatal mortality rate is between 3 and 4/1,000. The then Master of the hospital, Sir Andrew Horne, “the able and popular master’, summed up the perils of childbirth somewhat uniquely: “once a woman has let the cat into the bag […] she must let it out again to save her own”.

These conversations in the waiting room are ridiculous and while they can be comical in places, they are underpinned by a deep-rooted unpleasantness. In this place, the objectification and denigration of women is particularly misplaced and the underlying sexual immaturity of the men’s conversation is deftly exposed. The labour of women giving birth contrasts starkly with the men’s hopeless efforts to grapple with issues of reproduction. The men are all talk while the women give birth.

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Dr Rhona Mahony says Joyce’s struggle with the gestation of Ulysses reflects one of the central themes of the Oxen of the Sun episode. Photo by David Conachy

Dr Rhona Mahony says Joyce’s struggle with the gestation of Ulysses reflects one of the central themes of the Oxen of the Sun episode. Photo by David Conachy

Dr Rhona Mahony says Joyce’s struggle with the gestation of Ulysses reflects one of the central themes of the Oxen of the Sun episode. Photo by David Conachy

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Yet Bloom’s character is revealed as far more impressive than the other men in the waiting room, in ways that are at variance with traditional constructions of masculinity. The antithesis of a military hero, Bloom is humble and caring — his concern for others and particularly women conflicts with the machismo of the archetypal warrior. He is hugely empathetic and shows great kindness to those around him. He remains sober when the men are getting drunk and remains attuned to the suffering of women in labour. Bloom is a gentle Odysseus — the one who doesn’t commit sacrilege by demeaning women with gratuitous insults. He has no sword or white horse, he endures no glittering battle, but his basic decency and independent humanity set him apart.

Alongside the medical characters and symbolic use of pregnancy and birth, ‘Oxen of the Sun’ also discussed substantive medical issues that would be relevant in Irish life for decades. Albeit in drunken conversation, the characters engage in their own lively debates on the nature of sex, birth and obstetric care. At one point, the ‘right witty’ scholars are discussing whether doctors should save the mother or the baby in a difficult childbirth. They generally agree that it’s better to save the mother and “the world was now right evil governed” as doctors prefer to save the baby. Stephen argues that Catholics prefer this as the infant goes to limbo and the mother to purgatory. He also contends that Catholics oppose contraception because they think people are simply a means of reproduction and they oppose abortion because the foetus acquires a soul in the second month. Bloom quips that the church prefers to let the mother die because they make money from both baptism and funerals.

This conversation was indeed prescient. The Irish Free State was a state in which Catholic teaching and state policy were deeply intertwined, particularly in the arena of women’s health and reproductive rights. Arguably one of the most egregious laws passed in the Free State was the Criminal Law Amendment Act of 1935, which decreed that the procurement or sale of contraceptives was a criminal offence. It had a long tail and few will forget the spectre of the state taking action against the Irish Family Planning Association for the illegal sale of condoms at the Virgin Megastore in Dublin in 1991. Interestingly, in 1904 and prior to 1935, contraception was available in Ireland, and the men discuss the procurement of a condom “as snug a cloak of the French fashion as ever kept a lady from wetting”.

Decades after the drunken men in ‘Oxen of the Sun’ debated whether a baby or a mother should be saved, Ireland grappled with a related question in 1983. Fearing the introduction of abortion to Ireland, powerful lobbies put pressure on two successive governments to hold a referendum for a constitutional amendment that would effectively confer equal right to life to the mother and the foetus and thus make it virtually impossible to legislate for termination of pregnancy in Ireland.

This amendment created huge difficulty for women and clinicians caring for women in the context of maternal risk, women’s physical autonomy and the compassionate management of fatal foetal anomaly. Ultimately, this amendment was removed following the 2018 referendum, paving the way for subsequent legislation permitting termination of pregnancy in restricted circumstances.

There is no longer any waiting room for men at NMH — indeed there are hardly any male bathrooms in the cramped, outdated facilities, which retain some of the long wards that would have been commonplace in hospitals in 1904. Nowadays, it is unusual for a father not to be present at a birth, although the AML (active management of labour) manual, which is still in print, suggests: “The extent to which husbands should be influenced to remain with their wives during the entire course of labour and delivery remains an open question. Experience suggests that women have far more to gain from the presence of a female companion who is not only sympathetic but also well informed…”

In my experience, most men are profoundly moved by being present at the birth of their children and it is wonderful as an obstetrician to see a couple welcome their baby into the world. The inability of some fathers to attend the birth of their children during the Covid-19 pandemic was a source of great distress.

Female cast

Thankfully, women no longer labour for three consecutive days. At the time of the publication of Ulysses, caesarean sections were rare and fraught with morbidity and mortality, especially before the introduction of antibiotics, blood transfusion and safe anaesthesia. Nonetheless, in all the celebration of new life, grief is never far away, and people continue to mourn babies who have died.

Elements of the physiology of pregnancy and birth remain elusive. Midwives continue to care for their patients with extraordinary skill and, contrary to their portrayal in ‘Oxen of the Sun’, doctors and medical students do not sit drinking with friends as they await a birth. Nowadays, doctors are increasingly female, and it is not at all unusual to find an entirely female cast in the delivery room or operating theatre.

Sadly, misogyny continues to flourish, and especially in the cowardly anonymity and scarcely literate language of social media that might warrant additional parody if Joyce were writing now. The worst excesses of the waiting room conversations are amplified daily in current social media through hateful language that persistently denigrates women. Joyce’s deft exposure of the deep-rooted misogyny that pervades the men’s conversations in this chapter is sadly as relevant today as it was on June 16, 1904.

Ulysses will continue to bring forth conversation, thought and literary endeavour for centuries to come and for many more years than an average human lifespan. In this way the tension between artistic creation and procreation is soothed. Words, whether spoken or written, will continue to help us explore the lives we live, but however brilliantly assembled, words will never tell the whole story. And among all the words, babies will continue to be born, and all kinds of different lives lived. Ultimately, with the safe arrival of Mina’s son, ‘Oxen of the Sun’ concludes on a note of hope and redemption, just as the sun and rain follow the thunder that terrified the men. “The air without is impregnated with raindew moisture, life essence celestial […] God’s air, the Allfather’s air.”

 

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The Book About Everything: Eighteen Artists, Writers and Thinkers on James Joyce’s Ulysses, edited by Declan Kiberd

The Book About Everything: Eighteen Artists, Writers and Thinkers on James Joyce’s Ulysses, edited by Declan Kiberd

The Book About Everything: Eighteen Artists, Writers and Thinkers on James Joyce’s Ulysses, edited by Declan Kiberd

This is an edited extract from ‘The Book About Everything: Eighteen Artists, Writers and Thinkers on James Joyce’s Ulysses’, edited by Declan Kiberd (Apollo)


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