I Never Officially Practiced “The World’s Oldest Profession”

When you work with poor people, there will be at least one who earns his or her daily bread in the world’s oldest profession.  Some of them may even admit it.


I have done lots of work in various county mental health clinics in various states and I developed a couple of hard and fast rules for when I work with economically disadvantage people.

I always try to “connect” with them.  I have always loved the quote “I am human, so nothing that is human is foreign to me” by Publius Terentius Afer, better known as Terence. He was the Neil Simon of the ancient Roman empire, an author of comedies.

I have always imagined the modern embodiment of this quote to be the state of being stuck with a perfect stranger in an elevator. I want to believe that if I am not only a good psychiatrist but a good human being, I can generate a conversation with anybody.  And the people who enter my office in some of these placements are poor folks whose experience of life on the planet is very, very far from my own.

I also do everything to make them feel better when they exit the office than they did when they came in.  Sometimes this includes an element of cheerleading, but generally it is more complex.

To be a prostitute is to be beset with chronic low self esteem.  We are all women in a hostile world.  We just sell the highest levels of skills we got.

These are angry and unhappy women who have come through rotten childhoods, and seem to take little or no joy in their simulated affections.

Leave it to an analyst to tell the tale, for there is piteously little research on this object of fantasy.

My approach is first of all, straight social.  Curiously enough, this is something that the analyst who wrote the paper above never even thought of.

Do they know that they have chosen an illegal way to earn their livings?  The shadow of the cops must always be in their mind, or at least it should.  Few are in enough denial to have feelings of invulnerability.  A few of the more powerful ones may have bought it, but not the ones I see.

They know they could go to jail.  Although they may shift the regions where they work, or what they do exactly, they have at least thought ahead enough to know where their children go to stay if they are arrested.

Their voices are full of miseries we can only imagine.  I remember one prostitute from Los Angeles who showed me more plates and screws of metal beneath her skin than I had ever seen in one person — and I used to be an orthopedic surgeon.  She told me she had trained a generation of orthopedic surgeons in one of southern California’s most prestigious University hospitals, based on surgeries required after getting beaten by various pimps — a distinction I never heard anybody else even try to claim.

Second, straight medical.  I talk to them about pregnancy protection, which they generally already know about, and I manage somehow to get them some kind of Sexually Transmitted Disease screen — no mean trick since nobody has insurance.

Most of the time I can get them free baseline blood work, although they have to show up for it and usually do not.

I give them all the resources to get out of what they are doing and go to school or get some other kind of job.  They take it quietly.  I have seen it in a wastebasket outside my office.  I keep trying, but I know that is how it is.  When people are stuck in that groove of low self-esteem, it is very hard indeed to pop them out of it.

I keep trying.  Maybe it is because I have a special empathy for these women who must use the lowest level skills they have to survive.

Mostly it is because of what I would consider a strange twist of fate, had it not happened twice in my life.

Twice in my life I have been questioned by the police who thought I was a prostitute.  Of course, even in my first jobs I had high enough level skills I would never have to have done this to survive.

Besides, I had a nurturing family to go home to.

Once, in Sioux Falls, South Dakota, I was travelling through with a senior Neuropathologist and his wife.  We did “brain cutting;” and came with our own knives to examine brains held over from autopsy.

Sometimes we just looked at the brains. Sometimes, we reviewed microscopic slides.  It was such a subspecialty, they were happy to have a visit from my preceptor and me. I learned plenty.

Once after a day of brain cutting we went to the symphony.  In this rather rural region of the country, the city orchestra had an interesting if bizarre cooperative concert with a jug band that night.

Afterward we were at a place near the hotel that had a disco.  The neuropathologist and his wife went back to the hotel. I decided to stay on and dance a little solo disco, something I had done in many times and places.  Sometimes someone would join me, but here, nobody did.

I still remember the discomfort of seeing a uniformed cop — billy club and all — approach me on the dance floor.  He told me that I was prohibited from dancing alone by city ordinance, as that constituted “soliciting.”  I was so stupid I asked him what it meant.  “It means a prostitute is trying to attract clients for money.”

I told him the truth, that I was the resident physician on a brain cutting team.  I gave him the names and addresses of the people at the hotel and back at the University.  And of course, I stopped dancing.

I don’t know that he ever checked anything, and it did not matter to me because everything I told him was true, and if he would have contacted any of the people whose names I had given, I do not expect they would do anything more than laugh.  None of them reported having received a call.  If this was a “usual” story, it was not mine.  Who else would say “I’m just in town for two days to cut brains?”

The second incident is far more colorful and happened some years before in Paris, France.

One of my professors and I were dressed to the nines when we went to Les Halles, the spot where the old marketplace used to be.  She wanted me to have the experience that was the most exciting available to a tourist — staying up all night among art students eccentrically dressed for some sort of a dance, and having onion soup in the morning while I watched the sun rise over the Seine.

The professor friend was as brilliant as she was beautiful and a heck of a conversationalist. I hadn’t even thought of the fact that we were in the same part of Paris where the play/movie Irma la Douce (Irma was a sweet girl, a very nice prostitute) had taken place.  You can watch the movie trailer in the window up above.

But when we left the restaurant, two uniformed cops, wearing the Navy blue Kepi, that cylindrical hat that is the symbol of their profession, stopped us in our tracks.  They asked us what we were doing there.  This time I had a somewhat older and very distinguished friend, who told them she was a researcher (we are talking about the woman who discovered that DNA and not protein was the primary genetic material) and she had taken the liberty of showing some of the best of France to a young American who was still a student neurological surgeon.

The gendarmes said the French equivalent of “Yeah, that’s what they all say – I’m a research scientist and she’s a brain surgeon” and asked if we could prove these most fascinating statements.  As it happened we had finished our evening, and were on our way home to her husband, chef des travaux – which translates literally as “chief of all projects,” but would mean something like “big-shot boss guy” in our language — of the Institute Pasteur, arguably the most famous researcher in all of France.

They asked us how we planned to return to her home, and we said we had enough money in our purses for a taxi (but alas, not enough in our evening bags to prove our identity).  The gentlemen of the constabulary graciously offered to take us home — we thought, it was an honorable and even sophisticated way to prove our story.

The trip across Paris, highlighted with a stellar view through the bars of the window of the vehicle in which we were riding (known as a “panier a salade” or “salad basket” in French but what Americans call a “Paddy Wagon”) is one of the indelible images of my mind, which I have not lost, and never will.

Although my companion was cooler than I, I will not deny there was a feeling of fear when we had first been confronted by the gentlemen in the Kepis, who yes, had billy clubs.

It was 6:00 am on a Sunday morning when my colleague opened the door to her apartment, thinking this made all well, but the gendarmes went on to insist her husband being wakened.  That was the cause of a tirade the likes of which I have heard neither before nor since.

The Chef des travaux read them the riot act, yelling and screaming and threatening to report the gendarmes for something or other.  The public servants in their turn chastised him, for all beautiful women (my ego did leap at that one) required male protection, two such highly educated women even more so, and what the hell was he doing home in bed anyway with two treasures like us out there slumming?

Yes, the big difference, at least then, between France and the U,S.
was that our alleged exposure to danger was HIS fault!

I would never have been bothered if people did not have some pretty antiquated attitudes about who was or could be engaged in this too-often romanticized profession. There are many good programs that seek to value, even professionalize, “sex workers.”  Antiquated attitudes may at least be part of the way the self-esteem of these women is ever so efficiently kept at ground level.  Obviously, I had no such problems on either side of the Atlantic.

But please rest assured – I have mended my ways and am a respectable married woman now.  I haven’t been busted for prostitution since.