Paedophilia is an unusual subject for opera. Librettists normally stick to a more wholesome diet of murder, consumption, and suicide. Composer Benjamin Britten's adaptation of Henry James's The Turn of the Screw had its premiere in 1954, when child molestation was thought to be rare. Even today, scholars try to reject the obvious interpretation of James's enigmatic story about two haunted children.
In Sydney Opera House a few weeks ago, evil seemed far away. Outside, ferries hurried back and forth across the harbour, and even inside the auditorium we were conscious of the beauty of the famous sails above our heads. Somewhere in the city, however, an archbishop was facing accusations of interfering with (as people used to say) an altar boy 40 years ago. And I was thinking of the gynaecology clinic back home.
The children in the opera are a boy and a girl. The boy is the centre of attention, perhaps because of Britten's own sexuality, or perhaps because a treble among grown-up singers makes the audience nervous. He dies dramatically in the last act. The girl lives on, and I bet she presents to her doctor 20 years later with chronic pelvic pain.
After three decades in gynaecology I'm starting—I think—to develop an instinct for taking an adequate history from patients with thick case notes. Those whose sex lives began after puberty never take offence at matter of fact questioning. With the others, responses vary.
Some simply tell you, just as matter of factly, about their experience of abuse. If you are the first person to have asked, you cannot suppress a feeling of diagnostic satisfaction, like solving a cryptic crossword. It doesn't last long. Unlike in the movies, catharsis cures nothing—at least, not straight away. But at least you understand.
The difficult cases are those who deny it while instinct tells you differently. I don't believe in suppressed memories but I do know that patients choose when to talk. Sometimes they phone up out of the blue. You wish they had done so years earlier, before losing so many organs to well intentioned surgery.
Their stories can be chilling, even 40 years after the events. The worst aspect, though, is that for some the aftermath of abuse has been not so much chronic disease as a life sentence.