Chapter summaries Sandwich Catherine Newman

Chapter 13 Summary, Themes, and Analysis

⚠️ Spoiler Warning: This guide contains detailed spoilers for the entire novel. Proceed only if you've finished reading or are comfortable knowing the plot.

Summary

At a routine appointment the previous month, the narrator visits her doctor to discuss menopause symptoms that she describes as overwhelming. While filling out a new patient form, she encounters questions about the number of pregnancies and live births she has had, which triggers a wave of distress. She mentions to her doctor that the form should come with a trigger warning. The doctor listens sympathetically and asks how she can help.

The narrator explains that her vagina feels smaller and that lubrication isn't solving the problem. The doctor diagnoses vaginal atrophy, a common post-menopausal condition where thinning tissues cause pain during intercourse. She recommends a suppository that costs about three hundred dollars a month, noting that insurance may not cover it.

After the appointment, the narrator calls her friend Jo from the parking lot. Jo is immediately furious about the cost, the profiteering from women's bodies, and the fact that Viagra is far cheaper. Jo calculates the per-use cost based on the narrator's sexual frequency—about two or three times a month—and advises against spending that much. The narrator reflects on her own feminist background, having read Our Bodies, Ourselves and advocated for reproductive rights, yet she is only now learning about vaginal atrophy. Jo jokes about retiring from sex altogether, and the narrator quips about sending vaginas to retired police-horse farms. Jo then has to leave to pick up her father from Elder Zumba.

Alone again, the narrator looks at the prescription and thinks about the form's questions. The chapter ends with her reflection that sex has nearly been the death of her.

Key Events

  • The narrator fills out a medical form asking about pregnancies and live births, which triggers grief.

  • She describes vaginal discomfort to her doctor and receives a diagnosis of vaginal atrophy.

  • The doctor recommends a $300-per-month suppository that insurance may not cover.

  • The narrator calls her friend Jo, who expresses anger about the cost and gender inequality in healthcare.

  • Jo calculates the per-use cost and advises against the treatment.

  • The narrator reflects on her feminist knowledge gap regarding menopause.

  • The two friends share dark humor about retiring from sex and sending vaginas to horse farms.

  • Jo leaves to pick up her father from Elder Zumba.

  • The narrator examines the prescription and revisits the form's questions.

Character Development

This chapter deepens the narrator's character by revealing her vulnerability around aging and her body. She is candid about her symptoms and her frustration, yet she also shows a willingness to laugh with her friend. Her feminist identity is challenged as she realizes she didn't know about vaginal atrophy despite years of advocacy. The medical form triggers a grief that suggests past losses, though the specifics are not detailed. Her friendship with Jo is central: Jo's 'barrel-aged rage' provides relief, and their banter shows a deep, supportive bond. Jo emerges as a pragmatic and fiercely loyal friend who is unafraid to call out systemic injustice. The narrator's humor—comparing her vagina to deli ham and joking about horse farms—serves as a coping mechanism for the indignities of aging.

Themes, Symbols, or Motifs

  • Menopause and Bodily Change: The chapter directly addresses the physical realities of menopause, including vaginal atrophy, and the narrator's struggle to accept these changes.

  • Healthcare Gender Inequality: Jo's anger highlights the disparity between the cost of women's treatments and men's erectile dysfunction drugs, as well as the profiteering from women's health.

  • Grief and Loss: The form's questions about pregnancies and live births trigger an emotional response, suggesting unresolved grief that the narrator carries.

  • Friendship as Support: Jo's phone call provides emotional relief and practical advice, showing how friendship helps navigate difficult moments.

  • Feminist Knowledge Gaps: The narrator's surprise at not knowing about vaginal atrophy underscores how even informed women can be left uninformed about their own bodies.

  • Medicalization of Women's Bodies: The chapter critiques how women's health issues are treated as problems to be fixed with expensive interventions.

  • Humor as Coping: The friends use dark humor to defuse the pain and absurdity of their situation, making the chapter both poignant and funny.

Why This Chapter Matters

This chapter is a compact but powerful exploration of how aging, gender, and healthcare intersect. It reveals the narrator's emotional depth and her reliance on friendship to process difficult news. The medical form serves as a reminder of past losses, adding a layer of grief to the already challenging experience of menopause. By contrasting the cost of a vaginal suppository with the price of Viagra, the chapter critiques systemic gender bias in medicine. It also humanizes the narrator by showing her vulnerability and her humor. This chapter sets up themes that likely resonate throughout the novel, making it a key moment for understanding the narrator's inner life and her relationships.

Study Questions and Answers

  1. Why does the medical form trigger such a strong emotional reaction in the narrator?

The form asks about pregnancies and live births, which forces the narrator to confront past experiences that may include loss or trauma. Her comment about needing a trigger warning suggests that these questions reopen wounds she has not fully processed.

  1. How does Jo's response to the cost of the suppository reflect a broader critique of healthcare?

Jo points out the unfairness of women paying hundreds of dollars for a necessary treatment while Viagra is much cheaper. She also criticizes the profiteering from women's bodies, framing the issue as a systemic gender inequality rather than a personal problem.

  1. What role does humor play in the narrator's and Jo's conversation?

Humor allows the two friends to address painful and embarrassing topics—aging, sex, and bodily decline—without being overwhelmed. Jokes about retiring from sex and sending vaginas to horse farms create a sense of solidarity and make the situation more bearable, while also subtly critiquing the absurdity of the medical-industrial complex.

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