Lone Female at Home
by ALICIA PUGLIONESI
In 2009, William Banning Vail III, from Bothell, Washington, won a United States Patent for a device called the Personal Pelvic Viewer, or PPV. It's basically a camera that you stick up your vagina to see what's going on in there – the same thing that happens at a gynecological exam. Except the operative principle of the PPV is that you shouldn't count on your gynecologist. You shouldn't trust anyone until you've seen it for yourself.
The invention is meant to provide “methods and apparatus for the lone female at home” to detect any number of gynecological aberrations: infection, cervical cancer, menstrual irregularities, foreign objects. The camera hooks up to a television, so you can watch the inside of your vagina on your high-definition flat screen, alone, at home. The phrase “lone female at home” recurs fifteen times in Vail's fifty-one page patent. Self-knowledge is important, you can't argue with that, but how did we get here, lying on the floor, legs splayed, staring at our vaginal walls on a TV screen? The lone female at home.
Vail has a pretty good explanation, which he includes in his patent documents because, why not? As a casual peruser of patents, I found his sudden vehemence unexpected.
On page five, under the heading, “Description of the Preferred Embodiments,” he points to a grisly photograph of a woman's infected cervix. “Just look at the photograph,” he implores. “It is the opinion of the inventor that if the woman had been able to inspect her own uterus, that she could have spotted infection turning a healthy-looking uterus into what is observed.” The infection in this photograph was caused by the Dalkon Shield, an ill-conceived intrauterine device from the 1970s, notorious for its deadly side-effects. The Personal Pelvic Viewer patent is from 2009, though. What beef does Vail have with the Dalkon Shield, long-ago discredited and consigned to medicine's hall of infamous failures?
Vail goes on to recite what sounds like the standard Dalkon Shield horror story. It's 1975 and a male doctor inserts a Dalkon Shield into a patient; the doctor refuses to remove it when the woman complains of severe pain. Finally the woman seeks a different, female doctor who removes the device, but by that time it's too late. The damage to the woman's uterus causes endometriosis, and the same male doctor who refused to remove the Shield performs a hysterectomy to cure her debilitating pain. The woman is named Marilyn L. Vail. William Banning Vail III offers no hints as to his relationship with Marilyn L. Vail; maybe that would be too personal for a patent application, but it's already gotten pretty personal by this point and surely the people at the patent office want to know as badly as I do whether Marilyn is William's wife, and whether his deep concern for women's gynecological empowerment came from witnessing her ordeal firsthand.
I couldn't help but prowl the patent records to see if they reveal as much about William Banning Vail III, the man as they do about William Banning Vail III the inventor. Would all his inventions be dedicated to righting the wrongs of the Dalkon Shield and empowering women in the privacy of their homes? What's the difference between Vail and Hugh Davis, the inventor of the Dalkon Shield, a man who never apologized for the harm that his creation caused? For one thing, Marilyn Vail is listed as a co-inventor on many of William's patents – they speak as “the inventors,” plural. An actual female collaborator counts for a lot when you're talking about foreign objects hanging out in the uterus.
It turns out that Vail holds twenty-eight patents, most of which are for oil and gas drilling processes. He is listed as the owner of a “cut stone and stone product manufacturing” business in Bothell. He has a bunch of outlier patents, though, things that have nothing to do with mineral extraction, and the oddness of this assortment kept me digging.
Based on his eloquent case for the PPV, I want to imagine that Vail is a sympathetic inventor: when something is wrong with a person he cares about, he invents a device to make it better. Mixed in with patents for electric well-pumping systems and self-sharpening drill bits are an inhaler to prevent infections in people with cystic fibrosis, a treatment for chemotherapy-induced nausea, and “Methods and Apparatus to Synthesize Primordial Life from Inanimate Materials.” Does Marilyn have cystic fibrosis and cancer? Has William decided to create artificial life because her hysterectomy left them childless? Getting to know someone from their patents is a dubious thing. But the picture that I was assembling was one of scrappy, well-meaning invention.
As a reality check, I imagined an extremely cynical scenario in which William Banning Vail III and his pelvic viewer are yet another scam targeting women perhaps overly concerned with their health. Is this a useful product or does it exploit the anxiety that many women feel about seeking medical care?
Today the Dalkon Shield is a distant memory, but it marked the beginning of an era of informed consumerism in medicine – a model in which maximum information leads to optimal decision-making. This is probably an improvement over the previous era, when you could wake up from what you thought was a routine breast biopsy to find that the surgeon had performed a full mastectomy on the spot. But it doesn't mean that the field has been leveled – information, signs and symptoms, and diagnostic criteria still need to be interpreted. Many products rushed into the vacuum created by widespread loss of faith in professional medicine – self-diagnosis, self-treatment, alternative healing – some useful and others not so much.
Vail's pelvic viewer plays both sides of this game: he spins it as a tool for extracting the best service from your doctor by gathering data yourself, recording that data on the objective medium of digital film, and presenting this evidence to the professionals when they try to dismiss your concerns. It's a weird defensive dance, but maybe Vail has the gift of sympathetic insight into the mind of the modern medical consumer. Even if the doctor tells me that I'm fine, part of me won't believe it; part of me won't trust the doctor; part of me will go home and search my symptoms for hours on the internet. Vail isn't saying that we should ignore the professionals and trust him; he's saying that all any of us has to go on is what we see through the lens.
Years before he invented the infamous Dalkon Shield, Hugh Davis invented a test for cervical cancer. Only fifteen percent of American women in the 1960s got their recommended annual Pap smear. Since so many were unable or unwilling to visit a gynecologist, Davis invented the first at-home test, known as the Davis pipette irrigation smear. A lone female at home could swab her cervix, drop the swab in a test tube, and mail it to the lab.
This is a very sympathetic invention: it seems to acknowledge the fear, poverty, and mistrust that kept many women away from the doctor's office. Probably, from Hugh Davis' perspective, it was just another brilliant problem-solving job by Hugh Davis. He hurried on to his next project, not even bothering to see the irrigation smear through to its clinical application, which never materialized. Soon enough his life was engulfed by the Dalkon Shield scandal, and his prior work on women's health appeared tainted by recklessness and misogyny.
So when William Banning Vail III, whoever he may be, cries out in a patent application, “this ongoing situation is simply unacceptable, and something needs to be done now,” I want to believe that he's a different kind of inventor. His salvos at the retreating shade of Hugh Davis suggest that people invent things for a lot of complicated reasons. An invention codes abstract relations of power between doctors and patients, women and men – but it also tells a very specific story about how particular, flawed people navigate those relations. There's a certain level of anxiety and mistrust encapsulated in the PPV. Vail says, not incorrectly, that women have been victimized by arrogant, dismissive, condescending doctors. “With scientific evidence and knowledge in her own hands,” he argues, “the female would have the power to demand immediate attention to her medical problems.” Which is to say, even if medicine has wronged you and lost your trust, the only way to win is by speaking its language. This apparently requires sticking a video camera up your vagina.