Mentioning the Unmentionable—and Treating It

Dr. Miriam BENTLEY-TAYLOR Seitz’99 is very good at talking about very hard things. 

The way women accidentally pee? Not a problem. Embarrassing leakage after childbirth? Please bring it up. Pain with sex? She’ll absolutely go there. 

These are no-go topics for many women, but not for Miriam, a urogynecologist at Hawai‘i Pacific Health in Honolulu. “Talking comes easily to me, and I find the more relaxed I am, the more comfortable patients are about discussing these difficult topics,” she says.

Miriam specializes in caring for women with conditions that affect their pelvic floor, the area of the body that contains the bladder, reproductive system and rectum. Some of her patients are young and busy caring for children and juggling careers. Others are elderly, and have never spoken openly to anyone about these medical issues before they arrive in her office. 

“Some of my patients really suffer, and they accept urinary frequency or incontinence as a normal part of aging. And so, when we can fix something for them, it’s transformative,” she says. 

Urogynecologists like Miriam are doctors trained in both gynecology and urology, and they provide medical and surgical care. A relatively new specialty, urogynecology was not even recognized by the American Board of Medical Specialties before 2011. Prior to that, women often had to see both a urologist and gynecologist to get treatment for relatively common conditions of the pelvic floor. Pelvic organ prolapse, for instance, affects nearly half of adult women. It’s caused when one or more of the organs in the pelvis—the vagina, uterus, bladder or rectum—drops from its normal position. But women were bounced around from physician to physician, or sometimes didn’t see one at all when they endured symptoms.

“Many women accept changes to their body after childbirth and suffer for years. They avoid exercise for fear of leakage, intimacy due to discomfort or social events because of their urinary frequency,” says Miriam. 

When the new subspecialty was recognized, the care available to women improved. Women could see one specialist who would address their health issues. And that’s changed lives. 

Miriam’s favourite part of her job is the relationship that she builds with her patients as she cares for them. “There are tears, there are hugs, they are really overjoyed. It’s usually something that they’ve been suffering with for a very long time,” she says. “It’s nice to know that we can help them and improve their quality of life.”

Her career path will probably come as no surprise to her Branksome classmates, several of whom are still her closest friends. In high school, Miriam—or Mims as she was known at Branksome—dreamt of becoming a doctor. She even missed her annual grad trip in Grade 13 because she joined her family on an expedition to Thailand. Her father was volunteering in a leprosarium, a hospital for people with leprosy. A cardiologist, he often worked in developing countries. Miriam caught the medical bug from him. 

After graduating from Branksome Hall, she moved to London, Ontario, where she completed a bachelor of science in psychology, picking up some of the communication skills that she now relies on in her conversations with patients. Next, she moved on to Grenada, in the Caribbean, where she did her medical degree at St. George’s University. 

As an undergraduate and again a medical student, she travelled to Angola, where she worked with a Canadian general surgeon, Dr. Steven Foster. There, she saw women suffering with obstetric fistulas—a treatable but often untreated injury that is common in places where women don’t have reliable access to obstetrical care. Many go through prolonged and difficult labours, increasing the risk of tearing between the birth canal and the bladder or rectum. Then they suffer with continual leakage of stool or urine, and associated shame and ostracization. 

“I became interested in wanting to fix fistulas. And I saw the inequalities in health care for women and knew that it could be done better,” says Miriam. “It was my inspiration to be a physician/surgeon and pursue women’s health care.”

“There are tears, there are hugs, they are really overjoyed. It’s usually something that they’ve been suffering with for a very long time,” she says. “It’s nice to know that we can help them and improve their quality of life.”

She went on to complete her residency in obstetrics and gynecology at Beaumont Hospital in Royal Oak, Michigan, just outside Detroit, and then a fellowship in female pelvic medicine and reconstructive surgery at the University of Chicago. In Chicago, she would ride her bike to the hospital in the bone-chilling hours of dawn during her training and think about her mornings rowing at Branksome. “Those early mornings made it seem totally normal years later to ride your bike in the freezing cold,” she says. 

Miriam met her husband, Dan Seitz, an emergency medicine physician, in medical school. After they finished their training, he wanted to move back to Hawaii where he had family. That’s now where they make their home, with their three kids, ages 12, 10 and 7. The kids surf and go outrigger canoeing, and the family has two golden retrievers who love to swim in the ocean. As glamorous and fun as Hawaii is, Miriam says she still misses Toronto. “All my family is there, so we go back home two to three times a year.” 

In addition to her clinical practice, she is an assistant professor and faculty in the John A. Burns School of Medicine at the University of Hawai‘i at Manoa, where she teaches residents and medical students in and out of the operating room. 

Miriam credits Branksome with instilling in her the belief that she could do anything. “Being told day in, day out that the sky’s the limit is a really important message, especially to girls, because you can easily look around and not feel that way,” she says. At one point in her career, she was the only female urogynecologist in her hospital group. 

Miriam was a “lifer” at Branksome, attending from kindergarten through Grade 13, along with her sisters Anna BENTLEY-TAYLOR Marshall’90 and Elizabeth “Zibby” BENTLEY-TAYLOR Tutsch’00 and cousins Jennifer GRIFFITHS’88, Fiona GRIFFITHS’90 and Joanna GRIFFITHS’02, founder and president of Knix, the pioneering women’s apparel brand. It’s an experience she wouldn’t trade “for anything,” she says. 

“Branksome provided me with a community where relationships matter and where women are valued. 

It taught me that you can laugh a bit while still being highly effective. Those 15 years of Branksome shaped the physician I am today and the care that I provide.”