Diagnosing women
January 8, 2016 6:24 AM   Subscribe

A writer for Gray's Anatomy on confronting the doctor who missed her rare cancer. I didn't question him when he prescribed anti-depressants—rather than another MRI—after I confided I was sleep deprived from constant knifing back pain. I convinced myself that his inability to fix me was my failure, not his. I wasn't tough enough. I weighed too much, exercised too little. It was my fault I couldn't walk to the grocery store without a cane and a fistful of Vicodin. He called me "impatient" and "emotional." It never occurred to me that being "female" was perhaps the most dangerous label of all. posted by pie ninja (131 comments total) 65 users marked this as a favorite
 
As someone who had a similar experience (although with auto-immune disease, so not nearly as life threatening as what she is dealing with), I've dreamed of this confrontation. I guess I'm glad to know that it didn't make her feel better to do it. I've also been that woman in the emergency room with kidney stones who can't get people to believe her pain levels until they see the imaging.
posted by hydropsyche at 6:41 AM on January 8, 2016 [5 favorites]


I had direct experience seeing this in 2 ER visits last year. I went in with crippling abdominal pain and was given a shot of pain medication right away, while my best friend, in a second ER visit (we accompany one another, because you should have someone to talk to during the hours you're being ignored), just a week after surgery where her rib cage had been basically sawed in half, came in with pain in her chest and wasn't asked if she wanted anything until after a bunch of tests were performed. Shameful.
posted by xingcat at 6:48 AM on January 8, 2016 [6 favorites]


Whenever I read accounts like this (and have experienced this with endometriosis), I try to understand why the female patients aren't taken seriously. Why not listen to a patient? Who benefits from dismissing the patient's concerns? What is there to gain by minimizing the problem?

Especially the way our healthcare system is set up in the US--wouldn't practitioners be incentivized to provide more care, not less? I genuinely don't understand how this happens.
posted by witchen at 6:48 AM on January 8, 2016 [4 favorites]


The Patriarchy
posted by hydropsyche at 6:51 AM on January 8, 2016 [72 favorites]


I don't mean that to be flippant. I just mean that there is an entire system of beliefs and attitudes towards women designed to dismiss our concerns and our experience that operates completely independently of financial or medical considerations.
posted by hydropsyche at 6:52 AM on January 8, 2016 [78 favorites]


I have also had a similar experience with an auto-immune disease that took 15 years to get diagnosed after visiting dozens of doctors.

My hospital visit for what turned out as a kidney stone was reminiscent of the author's experience - in my case, I was yelled at (and not otherwise treated) for my whimpers of pain, warehoused in a room for 4 hours until they could find someone to do an STD check, and then finally they brought in a doctor that diagnosed the stone.

I'm not a woman, but maybe doctors assume my long hair makes me an honorary woman and interact with me accordingly.
posted by Radiophonic Oddity at 6:53 AM on January 8, 2016 [3 favorites]


I don't know. The personal experience I have with stories like these is this: when I was five, my father, a doctor, missed the signs of breast cancer in a woman in her thirties. Twice. She insisted something was wrong, he sent her away with an ice pack, and by the time another doctor correctly diagnosed her, it was too late, and she died. Her family sued him for malpractice, and it went to court. He actually won the case, but his insurers settled after that decision was overturned on appeal.

I was five when this happened, and I still remember how haunted he was by it. I rode with him in the car to court one day, and I can still remember the color of the building. My mom remembers the case as the single most traumatic thing that ever happened to my father in their twenty years of marriage - worse than the deaths of either of his parents. He refused to talk about it, ever, and yet the way he responds to certain subjects even now, thirty years later, makes me think he has a kind of ongoing, low-level PTSD.

Missing the signs of a serious illness in a young, healthy patient is every doctor's worst nightmare. Is there gender bias in medicine? I wouldn't doubt it. Is what happened to this woman sad and scary? Absolutely. But when people write stories about their doctors that dismiss them as smug and careless, calling them names like "Dr. Perfect..." I don't know. That really, really rubs me the wrong way. Because when I think about what it would be like to have every mistake I made at work carry with it the risk of someone's death...all I can think is, I couldn't do that. I don't have the strength. And I think that strength sometimes comes with an attitude that can be misread as carelessness, but which very rarely is. This doctor's personality might have rubbed her the wrong way, but all he did wrong is miss the signs of a very, very rare disease he had no legitimate reason to suspect. Her anger is understandable, but in my opinion, it is misplaced.
posted by pretentious illiterate at 7:02 AM on January 8, 2016 [74 favorites]


,,,came in with pain in her chest and wasn't asked if she wanted anything until after a bunch of tests were performed. Shameful.

I think complaining of chest pain at the ER triggers their "are you dying of a heart attack?" protocols, which is a higher priority for them than pain, perhaps? I don't know if that's really "shameful", if I am right.
posted by thelonius at 7:12 AM on January 8, 2016 [6 favorites]


There was a similar thread not too long ago, but even since then, I went to a new doctor (a female in her sixties) for my condition who was rude, condescending, and makes me uncomfortable. She made assumptions and suggested a drastic procedure that scares me. I'm so tired of looking for new doctors, frankly, and I can't believe I have to do it again.
posted by discopolo at 7:15 AM on January 8, 2016 [3 favorites]


And if you're a black woman who refuses to leave when they won't take your pain seriously, the ER might just have you arrested. So you can die in the parking lot.
posted by emjaybee at 7:15 AM on January 8, 2016 [58 favorites]


Absolutely, hydropsyche. I think a few of things might have contributed in this instance. He's an orthopedic surgeon (she said sports med but later surgeon). Surgeons aren't known for second-guessing themselves. Or for their empathy - "You seem angry", wtf is that. He had his specialist blinders on, too, and the author didn't say, but it's possible there wasn't much discussion between him and her GP. There's a new emphasis on "well-roundedness" in med school admissions and tests - I believe the MCAT has now got more in terms of social reasoning, if I'm not mistaken - but the people who could meet entry criteria until now have had to live in almost inhuman ways to get in in the first place. Then there are the pressures of training and the hierarchical structures they work within, liability and intense pressure to be right - I think there needs to be some diffusion of responsibility across a team, and room for second guesses, I think this would help the doctors, too. But a lot of them have that dangerous confidence baked in.

There's the dismissal of patients' experience in general - I think people mostly know when things are wrong with their bodies, and that's rarely bothered with in general, and especially not when an authoritative report comes back from a radiologist (who was also implicitly guided by the suggested diagnosis) - a reluctance to admit room for that kind of error, as well.

Doctors want their work to be effective, too. When a patient is still hurting after a doctor's best efforts, I think there's some irrational thing that happens where they really want to just blame the patient.

But yeah, when the patient is a women, and she's still hurting, it's in her head, every fucking time.
posted by cotton dress sock at 7:19 AM on January 8, 2016 [13 favorites]


My mother-in-law went 2 years with a lump growing in her back before she was finally diagnosed with stage III kidney cancer in 2015 and had to have the kidney removed finally. Every time she brought it up to the doctor, he said it was nothing, even though it was getting bigger. She's doing ok with treatment, but we all wish it had been diagnosed sooner. She only finally insisted on other testing when the tumor got big enough that she could feel it through her abdomen and it was hurting.

I myself spent at least two hours in an ER with suspected appendicitis, but was given nothing for pain for a long time, and then when they had decided I needed to go into emergency surgery, the ER dr insisted on a pelvic exam to make sure it wasn't anything woman-parts-related. REALLY? even when you had the CT-thingy and tests showing you it was inflamed APPENDIX!?!?!? Gah, I hated that dr.

This is it exactly: "We'll help you when you stop screaming." WTF.
posted by cass at 7:22 AM on January 8, 2016 [17 favorites]


This is how my mother died. She was getting thinner, but her doctor diagnosed her leg pain was sciatica, and her lack of appetite was depression, so he prescribed physical therapy and a course of antidepressants. Which my mother followed for a year, until she collapsed and the hospital found she had an aggressive case off bone cancer with methasthasized cells in several organs, and it was too late to do anything but palliative care for her last three months.

I often wonder how much of that is just bad luck that her symptoms were so easily explainable away (she did have a history of both sciatica and depression), how much of it was her doctor's incompetence, and how much of that was my mother's being a working mum, and therefore someone whose complaints got discounted.
posted by kandinski at 7:24 AM on January 8, 2016 [11 favorites]


all he did wrong is miss the signs of a very, very rare disease he had no legitimate reason to suspect.

All he did wrong? Diagnosing disease is the entirety of his job. Everyone screws up at their job once in awhile, but that doesn't excuse the error as just some sort of personality conflict, rather than a huge mess-up on his part.

There is a fair amount of research to back up this woman's anecdote: women, especially low-income women and women of color, are taken less seriously by medical professionals and do receive delayed diagnoses as a result of it. That's not to say that every instance of delayed diagnosis in women can be attributed to the patriarchy but, taken as a whole, it's indicative of a pervasive attitude in medicine that women are de facto hysterical people and that they really need to prove that the opposite is true before they should be taken seriously.
posted by scantee at 7:26 AM on January 8, 2016 [55 favorites]


My father had been complaining to his doctor for the past several months about back pain.

His doctor told him it was possibly anemia but might also be just in his head.

A few weeks ago he went into the ER when the pain got so severe he could not deal with it. They sent him home.

The next day he couldn't breathe and needed an ambulance. Only then did he get an MRI, and that's when they found metastasized cancer on his spine. He's just started chemo, and I'm just at a loss at how this was missed so badly for as long as it was.

My point is not "see, this doesn't just happen to women", it's that ageism and sexism and racism permeate so much deeper than just hateful people.

Also, it's so important to advocate for yourself when receiving health care. Question doctors. Get second opinions. If you need to be difficult, be difficult. You are not there to make friends, or be bullied by someone that "knows better". Your best advocate for your health is you.
posted by mcstayinskool at 7:32 AM on January 8, 2016 [19 favorites]


Whenever I read accounts like this (and have experienced this with endometriosis), I try to understand why the female patients aren't taken seriously. Why not listen to a patient? Who benefits from dismissing the patient's concerns? What is there to gain by minimizing the problem?

No one benefits and there's nothing to gain, but it's not usually intentional bias. That's why it's so insidious, and so hard to fix, and something for which health care providers (at all levels) must maintain constant vigilance.

I'm a first year medical student, and we had a whole afternoon (lecture and discussion groups) on this topic—misdiagnosis and cognitive bias—earlier this week. The lecturer, an ER doc, told us, "You're lucky. You're getting taught about this, and being given tools to help prevent it. When I was in med school, this was something that wasn't studied or talked about." But he also told us, "Every single one of you will do this." He told us about a patient he had misdiagnosed the previous day; fortunately, he caught his error before she departed the ER, but he reminded us that while catching a misdiagnosis is good, not doing it in the first place is even better.
posted by ocherdraco at 7:42 AM on January 8, 2016 [42 favorites]


Why not listen to a patient?

The doctor has other patients and they are seeing more people these days, which means less time for each one.

Who benefits from dismissing the patient's concerns?
Insurers.

What is there to gain by minimizing the problem?

Less money spent in the short term, which is what most insurers are all about.
posted by Brandon Blatcher at 7:46 AM on January 8, 2016 [9 favorites]


And I think that strength sometimes comes with an attitude that can be misread as carelessness, but which very rarely is.

I think it is often a mix of carelessness, deviating from the standard of care, and a hesitancy to order tests that can be expensive and unnecessary. A lot of malpractice falls right in that area.
posted by roomthreeseventeen at 7:46 AM on January 8, 2016 [1 favorite]


I had to go to the ER with what turned out to be my first kidney stone last October, two days after the Atlantic article about women’s pain being taken less seriously was posted on MF.

My body did me a solid: my face was a hideous corpselike grey, and my blood pressure was hilariously, “how are you not dead” low. I was admitted instantly, and put on morphine with a speed I found miraculous, even before they had formally diagnosed the stone. (Which, technically, they never conclusively did— the stone didn’t show up on the CT scan, but my symptoms were so textbook they went ahead with treatment. Correctly, as it turned out.)

But it was simultaneously galling to know that if me saying “I am in pain” had been the only symptom (as opposed to my color, or my BP), that I could have been treated differently.
posted by a fiendish thingy at 8:03 AM on January 8, 2016 [3 favorites]


Honestly I would have preferred the lunge and pummel.
posted by Segundus at 8:09 AM on January 8, 2016


And if you're a black woman who refuses to leave when they won't take your pain seriously, the ER might just have you arrested. So you can die in the parking lot.

Oh my god. Reminds me of Allen Daniel Hicks Sr., a black man who had a stroke while he was driving, crashed his car into a guardrail, and ended up getting arrested on an obstruction charge (for not getting out of the car) and spending a horrifying night alone in a cell as his condition deteriorated. He later entered a coma and died. Also in Florida.

I don't know how the people responsible in these egregious cases live with themselves.
posted by two or three cars parked under the stars at 8:13 AM on January 8, 2016 [18 favorites]


I can understand the anger, but I have a certain degree of sympathy for the doctors.

My job sometimes involves diagnosing faults with machines, scanning electron microscopes to be specific. If something is wrong, I often have very precise measurements showing me the fault, so I know that there is a fault. I can do a full scientific investigation, complete with hypothesis testing, plan-do-study-act cycles, and I can call in technical experts if I'm outside my skill area.

I can take parts out of the instrument and measure them. I can take parts out of a working instrument and stuff it into the faulty one and see if that solves the problem. I can talk to the manufacturers of the parts and get full inspection data for everything that went into the instrument. I can take hours on one machine and no-one will bat an eyelid. I can take an effectively identical twin and do some tests on that for comparison.

SEMs are much simpler than human beings. I still get the diagnosis wrong (at least at first) more often than I would care to admit.

A doctor would struggle with many of those options. I can easily understand making mistakes.

That said, all that really means is that I have very low expectations of medical doctors, and to be honest it's rare that they exceed them.
posted by YAMWAK at 8:15 AM on January 8, 2016 [7 favorites]


I have had some weird health issues I've been putting off getting checked out because I am afraid my doctor (late 50s and female) won't take me seriously so this just adds to my anxiety.
posted by Kitteh at 8:19 AM on January 8, 2016 [2 favorites]


Yes doctors fuck up royally, but mostly because the rarer the underlying disease is the harder it is to know to run that test. When a doctor looks at you they'll start with the most likely issue and work to the rarest. At some point the odds of it being something rare are so low that with a vague suggestion of soft tissue pain the most likely issue is something that cures itself with ice and rest.

The reality is that for probably 99.9% of these cases that ends being all that is needed. Yes tragically for a small minority there is some awful underlying condition - but the way the math works, if it is something sufficiently rate enough even the most dedicated doctor might not identify it
posted by JPD at 8:21 AM on January 8, 2016 [6 favorites]


A pregnant friend, the 27 year old mother of two young children, complained that one of her breasts didn't feel right. Doctor dismissed it as pregnancy-related breast changes. When the baby was born he, the baby, consistently refused to nurse from that breast. She died a few months later from breast cancer that wasn't diagnosed soon enough.

Another friend went to the ER with acute abdominal pain, was told it was "period cramps" and to go home and take Advil. Died the next day of a ruptured appendix.

Another friend with similar symptoms was told the same thing and almost died from a burst ectopic pregnancy.
posted by mareli at 8:31 AM on January 8, 2016 [10 favorites]


,,,came in with pain in her chest and wasn't asked if she wanted anything until after a bunch of tests were performed. Shameful.

I think complaining of chest pain at the ER triggers their "are you dying of a heart attack?" protocols, which is a higher priority for them than pain, perhaps? I don't know if that's really "shameful", if I am right.


If they performed any sort of heart protocol, that would be one thing, but they waited around for other tests (remember, I was sitting right next to her the whole time).
posted by xingcat at 8:31 AM on January 8, 2016 [2 favorites]


I would recommend to people who don't really have a lot of knowledge or experience or understanding of how women get treated differently from men with regards to getting a proper and timely medical diagnosis to step back and temper your urge to abstract it out into some kind of universal experience that everyone faces. There are specific markers that are bright alarms for those who are aware of this thing existing and it would behoove us all to listen more to those among us who are sounding this alarm and attempt to explain it away less.

Hugs.
posted by Annika Cicada at 9:03 AM on January 8, 2016 [72 favorites]


Yes tragically for a small minority there is some awful underlying condition - but the way the math works, if it is something sufficiently rate enough even the most dedicated doctor might not identify it

We aren't exactly talking about extremely rare conditions here. Kidney stones and appendicitis are quite common ailments.
posted by chainsofreedom at 9:13 AM on January 8, 2016 [23 favorites]


The focus here on rare diseases is a red herring because this phenomenon shows up for women in totally everyday interactions with medical professionals. For example, both my spouse and I have had the same cough and chest congestion for the past month. He went to the doctor and requested antibiotics and was given them without question. I went to the doctor the next day and was given a lecture about the difference between bacterial and viral infections and that I have a viral infection and that antibiotics don't work on those (because of course all women are ignorant of that fact). I'll just have to tough it out, I'm told. Now it's two weeks later and he's all better and I'm still coughing.

It's like that, every single damn time I go to the doctor. And every time I go, which I dread doing, I know I'll have to rehearse how to present my symptoms and what sort of demeanor to take on, so that I can convince the doctor that, no really, I am truly sick and/or in pain. Even with all of that forethought, I know that there is very little chance of being taken seriously, so why do I even bother with it all?
posted by scantee at 9:15 AM on January 8, 2016 [48 favorites]


Annika Cicada, if I don't find a way to explain it, I will be too angry to talk to the doctors I need to talk to and actually get the care I need. I have been plenty pissed and it hasn't really helped, ime.
posted by cotton dress sock at 9:20 AM on January 8, 2016


There are specific markers that are bright alarms for those who are aware of this thing existing and it would behoove us all to listen more to those among us who are sounding this alarm and attempt to explain it away less.

Thank you for saying this, Annika Cicada. I was trying to figure out a way to phrase it and wasn't coming up with one.

There is a huge, HUGE difference between "doctors are human and sometimes they don't catch everything" and prescribing someone antidepressants instead of further assessment for persistent back pain that is preventing them from sleeping (one of the things that happened in the OP). I have a really hard time seeing how in hell an orthopedic surgeon prescribing antidepressants for back pain is consistent with any reasonable standard of care.
posted by pie ninja at 9:23 AM on January 8, 2016 [22 favorites]


I have a friend or two who have become doctors. I see their Facebooks, the locked ones, and the amount of things they routinely dismiss as "drug seeking behavior" is unreal. Like even if they were, who cares? Give them the drugs taking them seriously would demand and move on.
posted by corb at 9:29 AM on January 8, 2016 [17 favorites]


I think complaining of chest pain at the ER triggers their "are you dying of a heart attack?" protocols, which is a higher priority for them than pain, perhaps?

You would think. But if you're sporting a pair of X chromosomes...not so much.

A couple years ago, I found myself short of breath, with excruciating chest pains radiating outwards. Felt like an elephant dancing on my chest, and I could not get my breath. I hollered for my son, and he accompanied me to the ER.

The desk asked me what the problem was. "I'm having horrible chest pains and difficulty breathing." I was not spoken to for another hour, when someone took my vitals and asked again what the problem was. I reiterated that I was having excruciating chest pains, and was having trouble breathing. Two hours later, someone came out to take my insurance information. An hour after that, someone took me back to draw blood. An hour after that, they took a chest X-ray. I reiterated AGAIN that I was in excruciating pain, breathing was difficult. They were going to put me back out in the waiting room! My son lost his shit at that point, SCREAMING at them "Look, we think she's having a heart attack! Shouldn't a doctor be talking to her RIGHT NOW??"

They finally put me in a room, and put a monitor on me. Two hours later, a doctor showed up. By this time, the pain had dissipated somewhat, I could breathe again. My pulse and BP were a bit elevated (well, duh, I had been in pain AND pissed!), but my OSATS were fine, and it was pretty clear that I wasn't in danger of dying, given how long it took the doctor to even show his face. He told me my chest x-ray was clear, the blood test was clear...but they wanted to admit me "just in case". I said that if I was gonna die, I was going to do it at home, in my own bed, with my dogs, I couldn't see any reason to stay if it hadn't been important when I arrived SEVEN HOURS AGO, it couldn't possibly be important after a clear chest film and clear bloodwork.

He threatened me with my own physician. I told him "You go right ahead and call Mark. I'm going home." He got my doc out of bed at 11PM, and my doc said "Tell her to call me in the morning, and let her go. She's not going to stay." They drew blood again and asked me to at least wait for that. An hour later, the bloodwork is clear, and I leave, pissed.

So I go see my GP the next morning, and he gently chides me for not staying for observation. "Well, doc, I figured that since I didn't even get put on a damned monitor until I had been there for 5 hours and didn't see a doc til hour 7, it probably wasn't a heart attack." That was the point that Mark flipped HIS shit! The ER doc told him that I had "just" presented with chest pains and shortness of breath, was being "hysterical and overwrought", and was being noncompliant. Mark had nabbed my films and bloodwork, and there were NONE of the usual markers of an MI, so he asked some questions about me weekend and what I had eaten and how had I slept and how much wine did I have? He knows my diet, and is astonished and pleased that you can drive a truck through my arteries, so let's figure out the pains.

Acute Gastroesophageal Reflux, the result of 5 straight days of a lot of wine, a lot of spicy food, and very little sleep. That chest pain was esophageal spasming, which does in fact mimic the symptoms of a heart attack. A ten minute conversation, a five day scrip for Nexium, and no spicy food and very little wine for the week, boom, done. Eight hours in the ER and a lying ER doc? That was not an accident, that was a man deciding that a woman was "hysterical and overwrought".
posted by MissySedai at 9:30 AM on January 8, 2016 [71 favorites]


> But when people write stories about their doctors that dismiss them as smug and careless, calling them names like "Dr. Perfect..." I don't know. That really, really rubs me the wrong way. Because when I think about what it would be like to have every mistake I made at work carry with it the risk of someone's death...all I can think is, I couldn't do that. I don't have the strength. And I think that strength sometimes comes with an attitude that can be misread as carelessness, but which very rarely is.

They're not mutually exclusive. A patient can acknowledge that making diagnoses is difficult work and also be capable of making valid assessments of a doctor's poor attitude.
posted by desuetude at 9:37 AM on January 8, 2016 [28 favorites]


Yeah, pie ninja - antidepressants as treatment for pain is the new thing, the idea being that pain is neurally mediated. My doc wanted me to take them for arthritis and widespread tendinopathy (which people still fucking talk about as if it were inflammation, when it's not, it's degenerated, rotting tissue, ibuprofen and cortisone shots will not help, everyone should know this once and for all). That was one of the many times I had to restrain myself.

Being angry definitely doesn't endear you to doctors, or make them want to help you. Neither does showing evidence of having read about your problem, that's a sure sign of a hysteric. As far as I can tell, playing dumb and being nice and the most patient patient, and asking the right questions (not too many) at the right time (before they've made a decision), engenders less opposition to your actual participation in management of your own health. If there is another way, I would be really happy to know about it.
posted by cotton dress sock at 9:44 AM on January 8, 2016 [12 favorites]


I suspect this is an extension of rape culture. People in authority - men and women - are conditioned to minimize women's bodily autonomy and feelings of distress in favor of their own perception of reality, whether that comes in the form of ignoring your partner's lack of consent or believing that women tend to exaggerate their pain and so it's not worth the attention or concern it might otherwise be.

My mother has a friend who is an eye surgeon, whose husband is an anesthesiologist. Her friend was out gardening, stood up to get better leverage on the weed she was pulling back, and fell backwards onto their cement patio. She was in excruciating pain, but home alone, and eventually was able to role onto her stomach and literally crawl back into their house. Her husband came home shortly thereafter and she asked if he would drive her to the hospital because she thought she might have broken a vertebrae. He told her that was ridiculous, helped her get into their armchair, and brought her some ice and ibu profen. Later the same day, she was crying because of how badly it hurt (still sitting), and asked him to PLEASE drive her to the hospital. He told her she was overreacting, but if it still hurt in the morning, they'd go to the hospital. She told him to bring her the phone, and she dialed 911 to get an ambulance.

At the hospital, she was explaining what happened, and her husband TOLD THE DOCTORS it was impossible for her to have a break. The doctor ordered an x-ray anyways, and - sure enough - she had broken three vertebrae. He was trying to explain that he just was used to people [women] overstating their pain levels for sympathy, but seriously, fuck that guy. Anyone who wouldn't believe their own wife when it comes to her assessment of pain has no business dealing with patients. They're still married, but I hope that he offers profuse, profound, and heartfelt apologies literally every single day.
posted by ChuraChura at 9:46 AM on January 8, 2016 [93 favorites]


I learned that they didn't like anger and they didn't like tears. So when I finally got in to see a rheumatologist, I practiced being calm and unemotional and as matter of fact as possible while describing my (debilitating) symptoms. He said my "flat affect" indicated depression, probably associated with the PTSD I must have from some childhood trauma I was not admitting to. We can not fucking win.
posted by hydropsyche at 9:47 AM on January 8, 2016 [76 favorites]


"We'll help you when you stop screaming."

When I was recovering from a surgery (general anaesthetic), I couldn't stop crying directly after the surgery (or indeed for a week or two afterwards, it was horrible), and the nurses wouldn't let me see my mother until I stopped crying and threatened to keep me in the hospital overnight. I managed to stop for about 30 seconds, which they decided was enough to get rid of me.

And when I went to the ER for the first time about this problem, I was 19 and had my 4 year old sister trailing after me, and they were absolutely terrible -- they couldn't treat me as if I were making up the injury, because it was visible even without tests, but they could certainly treat me as if I were exaggerating the amount of pain I felt, and talk to me like an idiot, refusing to use normal medical terms and only using baby words.

(When I was younger and broke my leg at a field trip, the teachers didn't believe me because I wasn't religious/asked the wrong questions, and made me hop to them and didn't bring me to the hospital. But I am pretty sure they would have done the same had I been a questioning boy.)
posted by jeather at 9:50 AM on January 8, 2016 [5 favorites]


"You've got to tell
the world how
to treat you.
If the world
tells you
how you are
going to be treated,
you are in trouble.
~JAMES BALDWIN

I think I'll be carrying a copy of this poem to my next doctor's appointment.
posted by pjsky at 9:50 AM on January 8, 2016 [12 favorites]


Should clarify -- I do know antidepressants get prescribed for pain once other causes have been ruled out. Regardless of whether one agrees with this practice or not, the issue with the OP is that they were prescribed instead of assessing potential physical causes.

I also have a really really hard time getting the right affect for talking with doctors... If I'm too clinical, they comment on that ("Are you a nurse?") and doubt that I'm actually having the symptoms I describe. If I'm too upset, I'm hysterical or depressed. If there is a middle ground, it shifts from doctor to doctor.

I have a consult next week for an ongoing medical issue and I keep having to remind myself that my affect and how I describe the issue doesn't matter because it's for something that is objectively present and shows up on scans and biopsies. I don't have to present any sort of case; the tests have done that for me. It's a very weird feeling.
posted by pie ninja at 9:52 AM on January 8, 2016 [7 favorites]


My favorite doctor provided description of my coping with intense pain was "emotionally labile."

I was accused of being crazy because I could hold myself together and be conversant until the pain got so bad (and so suddenly) that I would cry.
posted by bilabial at 9:52 AM on January 8, 2016 [10 favorites]


I got sent home from the Emergency Department aged 18 when I took myself there on a foot that was so swollen there were no gaps between my toes and the bump things on either side of my ankle weren't visible. There was also a patch about a cm2 of BLACK FLESH on top of my toe.

They gave me antibiotics and told me to come back if it got worse.

A couple of days later, it split open and pus and blood were *gushing* out. I went back to the Emergency department that day, and the doctors were seriously talking amputation. The black patch on my toe was now a cm DEEP hole (so a cm3 hole at this stage) that went right down to the tendon. I have seen the tendon in my toe, every day for months, until this healed.

I was then admitted to hospital - where I was placed alone in a room with a homeless alcoholic man in his 50s or 60s. An 18 yo girl who couldn't walk because of a bad toe infection.

After surgery, IV antibiotics four times a day for a week, and a lot of talk of amputation, it turns out I had necrotising fasciitis.

Luckily I responded to the antibiotics, so I didn't need the amputation in the end. But my GP had dismissed it as a spider bite when I went in to see him three days before my initial ED visit.
posted by jonathanstrange at 10:11 AM on January 8, 2016 [12 favorites]


broke my leg at a field trip, the teachers didn't believe me because I wasn't religious/asked the wrong questions, and made me hop to them and didn't bring me to the hospital.

I have a similar story about teachers/school staff that simply decided to be dismissive. It's actually a more positive story about ER docs.

I sprained my ankle in middle school during recess, and the school nurse just wrote me off as teary over a rolled ankle and told my mother that, so my mother waited and picked me up after her work, took me home instead of the doc's, when I was still in pain and when I was still crying. Later that night, I was still in pain, still crying, my ankle was still horribly swollen, bruised, and she complained that I was being inconvenient by not waiting until the next morning, that I was just being whiny and my ankle didn't hurt that bad.

Turned out it was a really bad sprain. At least the ER doc took me more seriously than my mother or school nurse.
posted by discopolo at 10:19 AM on January 8, 2016 [4 favorites]


(When I was younger and broke my leg at a field trip, the teachers didn't believe me because I wasn't religious/asked the wrong questions, and made me hop to them and didn't bring me to the hospital. But I am pretty sure they would have done the same had I been a questioning boy.)

Wow, flashback-- I sprained my ankle on the playground in first grade, and, having had a sprained ankle before, I immediately knew what was wrong. I told the playground monitor that I had sprained it, and I needed help.

She told me I was wrong, and made me walk down a steep hill, and walk all the way to the nurse's office, confident that I was lying. When I got there, the nurse was incredulous at how I had been treated, and called my parents so they could take me to the doctor. I remember thinking it was fun, because the nurse pushed me around in a rolling desk chair in the absence of a wheelchair.
posted by a fiendish thingy at 10:20 AM on January 8, 2016 [3 favorites]


discopolo, depressing being accused of lying about a sprained ankle by school authorities jinx!
posted by a fiendish thingy at 10:21 AM on January 8, 2016 [6 favorites]


I have a friend or two who have become doctors. I see their Facebooks, the locked ones, and the amount of things they routinely dismiss as "drug seeking behavior" is unreal. Like even if they were, who cares? Give them the drugs taking them seriously would demand and move on.

In the early days of blogs, before people were as careful as they are now, there were a lot of nursing blogs out there that were written by ER nurses. They HATED their patients, and thought that every single patient who came in without looking or acting the way they themselves thought was appropriate was some sort of malingerer. I have many nurses in my family, and when I listen to their stories they tell each other at family events, the same exact attitude towards people in pain is the same. Everybody wants drugs, everybody is siphoning off the government, everybody is exaggerating their pain, fibormyalgia isn't a real disease, women are hysterical and pretend pain for attention, etc., etc., etc.
posted by xingcat at 10:22 AM on January 8, 2016 [28 favorites]


Here's another thing: even if women exaggerated their pain, why do you think that is? Could it be because we can't catch a break any other way? Women are obligated to take care of others (emotionally and practically) on a continual basis. The only way we can rest, in some cases, is by having a sick day. And in some cases, a normal sick day isn't enough. It needs to be *extreme* for some people to willingly give you a pass on the day's emotional responsibilities.

A close friend is allergic to almost everything, and she often has extreme reactions to everyday items like wood, tomatoes, grass, etc. She also basically raised her 4 brothers after her mom went on the lam, and had to live financially independently from a very young age. Her medical conditions are very real (it's not exactly fun to fake a vomiting attack) but if they are at all psychosomatic, as has been suggested, it might have something to do with the fact that sometimes she needs a break, and she needs for other people to take care of her sometimes. You know, like all humans do.

So if you've known one or two women who you suspect are overreacting to a physical ailment, and you can't bring yourself to believe their words, cut them some slack and maybe lighten their load.
posted by witchen at 10:24 AM on January 8, 2016 [17 favorites]


My mother was rejected from the ER when she was in labor with me because I ended up being born on the same day as my sister, and the nurse, seeing a lower-class Chinese woman, told her that she was just faking labor so she wouldn't have to pay for two birthday cakes.
posted by Conspire at 10:30 AM on January 8, 2016 [15 favorites]


Oh my mother brought me to the hospital as soon as I got home, and I have no memory whatsoever of the hospital, but my leg was apparently about to burst through my pants so I was visibly hurt; I'm sure they treated me fine there. (Though I got a fiberglass cast -- it wasn't standard; we had to purchase the fiberglass -- and they put it on with insufficient padding, and it was really painful to take off, which everyone 30 years later still makes fun of me for as apparently my screaming made it to the waiting room.)

When I landed, I hurt myself; my friend (another student the teachers didn't like) said I was hurt and they didn't believe her. So more compliant friends said no, I really was hurt, and then they deigned to come to the edge of the playground and have me crawl to them. After that they gave me some support so I hopped to the car. I wasn't even big! I don't know why they didn't carry me or call an ambulance or why they drove to the school, then to my house.

Anyways I left that school.
posted by jeather at 10:30 AM on January 8, 2016 [3 favorites]


This is not only the end result of sexism, but also of a system that believes "overtreatment" is a bigger evil than missing someone's critical illness. The idea that people seek out "too much" healthcare, and so should be rebuffed/pushed back on is so taken for granted, and yet so ludicrous if you think about it for even a second, that it illuminates the basic failure at the heart of a healthcare system run on a for-profit basis.
posted by emjaybee at 10:31 AM on January 8, 2016 [38 favorites]


We can not fucking win.

After that last thread, there's an accident at a job site I'm at. 5 of us are hurt, 3 ER badly, but it's a work accident and I'm a boss onsite, so I make everyone go. Because we are so far from town (~45 minutes) we load up in a few trucks and take off - the guy standing next to me sustained pretty much the same injuries I did (broken leg and ribs) and we're in the same truck. On the job site, everyone had sustained a "stiff upper lip" about their injuries but as soon as we pull away "Gary" starts hollering. I ask him in more detail about his injuries to make sure we didn't need an ambulance to meet us halfway (he said no) so okay.

I start thinking. It sounds like we have almost identical injuries, I had just read that MeFi thread - what an excellent opportunity to compare our level of care! I'm a little bit excited. (I have a very high level of pain tolerance & ridden in the broken bone rodeo lots.) As we get closer to town I start noticing my knee's really swelling - it's straining my pants to the point where I slice open my pant leg with my pocketknife. It's really starting to hurt, too: I'm even feeling pretty nauseous.

The ER is a small town, regional medical center but well set up to take all of us and there's no other patients. Excellent for my little experiment. I'm the only woman in our group; I'm put next to Gary. So the whole time I take mental notes.

Gary's still hollering and gets attention first - a LOT of attention. I'm a little startled by the traffic in his curtain area compared to mine. He's off to x-rays by the time someone even comes by to take my info. I tell the doc about my knee, and get told that it'll be part of the x-ray. The guy next to me (who has a sprained ankle) has had blood pressure read and other things, but all people have done is TALK to me.

Okay, well, I've been pretty calm, so as an experiment I start groaning and talking about how much my leg hurts: I'm told to buck up, they'll get to me. Then I start throwing up (not experimentally). Which is pretty painful with broken ribs and causes tears in my eyes, but even though I'm not actually crying the doc tells me, "honey" there are people hurt worse than me and to stop crying. I know my BP's actually pretty high because I have really low BP normally (around 87/55ish ) but oh "the doctor know's what he's doing."

Without making this TLDR, it turns out I'm the worst hurt of everybody - a shattered kneecap, 2 broken bones in 1 leg and 3 broken ribs (Gary: 1 broken rib & 1 broken leg bone). But I'm last to receive care. I'm told that I need to buck up. My concerns: dismissed. The entire time treated like I have no idea what's going on with my own body and I'm not as important the men around me. (And let's not forget the whole time I'm also really concerned about my crew and trying to arrange hotel, transportation, and workers comp stuff.)

Of course, when I raised this issue to the staff as I'm about to be dismissed - the doctor told me he thought I was being a little emotional about it and it was hard to take my complaint seriously. But I'm ALSO told that since I was so calm and not in "obvious pain" they had no idea I had the injuries I had! Nope, can't win.

Ugh, I'm still angry.
posted by barchan at 10:33 AM on January 8, 2016 [174 favorites]


When I was about 17 and headed to college, my doctor (a young woman) told me that I shouldn't bother getting the new HPV vaccine. Unless, she said in a wink-wink-between-us-girls tone, I planned on sleeping with a ton of guys right away! And I was young and shy and not really into dating so I laughed like, oh haha of course not, I guess you're right and I don't need it!

Wish I could go back in time and bold-faced tell her, "Oh actually, I plan on sleeping with a lot of dudes. Like, a lot of dudes. So give me the cancer-preventing vaccine, please."

Fuck the system that prioritizes policing women's bodies over saving their lives.
posted by Solon and Thanks at 10:36 AM on January 8, 2016 [65 favorites]


When I was 4 or 5 months pregnant, I received the flu shot for the first time. I am an infectious disease epidemiologist and pro-vaccine, but had always put it off or didn't have time for the appointment or some excuse before. My OB gave it to me right in one of our regular appointments, which I thought was super cool and I gladly received it around 4:00 PM on a Friday.

My partner and I had a wedding to attend that night, so by 6:00 I was eating fancy appetizers at a yacht club in downtown Detroit. By 6:30 I was having a hard time breathing, so we went outside. Sitting, walking, standing, moving further away from smokers - none of these things helped. By 7:00 we had to leave to go to the ER, because I was basically having an asthma attack. I do not have asthma.

The triage nurse was very helpful and got us back to a room quickly. The doctor we got though? Hoo boy. When I suggested that I might be having an allergic reaction to the flu shot - it was literally the only novel exposure I had the previous 24 hours - he dismissed it immediately, said I probably just had the flu already, and to not blame my flu symptoms on the vaccine. Because, as we all know, the first symptom of the flu is an asthma attack. I did not have the flu.

He then wanted to do chest x-rays for pneumonia. I said no, I do not have pneumonia, and also I am pregnant, which he was apparently completely unaware of, despite it being in my charts and also me telling him with my own mouth mere moments before. He still tried to talk me into getting chest x-rays. After all this, he finally busted out his stethoscope and listened to my breathing, decided I was in some respiratory distress (you don't say!), and ordered nebulizer treatments. Within a couple of minutes of starting the breathing treatment, I felt much better, could breathe again, etc.

He came back after the treatment was over, checked my breathing, decided it sounded good, and then said, 'Well, it probably was an allergic reaction, but it definitely was not related to the flu shot." My eyes, they rolled, and my inner Kanye was like I'ma let you finish, but...

So, I, a well-dressed (because of the wedding), well-educated in a relevant discipline, 30 year-old white cis-woman with a white male partner at a suburban hospital ER had my diagnosis delayed, inappropriate tests suggested, any thoughts I had on the matter dismissed, and had to entertain at least two obviously wrong diagnoses. And of course, at the end, he had to condescend to let me know that whatever it was, it definitely was not what I thought it was.

Take away any of those privilege signifiers I brought with me, and the bullshit increases dramatically. I have at least a dozen stories like this from when I was younger, or poorer, or scruffier-looking (because I wasn't going to a wedding at a damn yacht club), or with friends who were of color or obviously queer, etc.
posted by palindromic at 10:41 AM on January 8, 2016 [50 favorites]


@Cotton Dress Sock, I think we're on the same page? I'm directing that more to the comments where people are trying to excuse it as "it's not because you're a woman, it's because something else"
posted by Annika Cicada at 10:58 AM on January 8, 2016 [1 favorite]


Geez, hydropsyche, I was just considering trying out "flat affect" next time I need to see a doctor. Maybe bringing brownies?

One thing that did seem to help, once, was letting myself speak quickly, completely, and precisely (as I sometimes do when I'm angry or excited). It sometimes alienates people, but I've noticed that sometimes highly-trained people working in their professional sphere can speak this way (e.g. doctors) -- it's too fast for people to follow unless they're paying very close attention or are used to the kinds of information being communicated, so it's generally a terrible communication style, but it seemed to really break through the detached haze of my friend's ER doctor that one time.

Unfortunately, if I were having a personal emergency/health issue, I'm not sure I could muster the energy, but maybe for some occasions it would work.
posted by amtho at 10:59 AM on January 8, 2016 [3 favorites]


Ah, ok - sorry, Annika Cicada! Thanks for letting me know :)
posted by cotton dress sock at 11:07 AM on January 8, 2016 [1 favorite]


I don't want to defend anything this particular physician did - especially his demeanor when she confronted him.

I do want to point out that people often don't realize is that diagnosis is entirely a game of probability. If a previously healthy 30M walks into the ER with a twinge of chest pain, the ER doc - before walking into the room - already knows that the odds are low that it is going to be nothing serious. That's not dismissing or having a preconceived notion, its literally how doctors are taught to approach diagnosis.

Everything about the encounter, from talking to the patient, examining the patient, to looking at the labs and tests, is about multiplying that probability either downwards to the point where he can be sent home, or upwards to the point where further testing is needed.

That "multiplication factor" is made up of so many real and untangible things - the doctors clinical experience, her knowledge and any inherent biases

Every patient sent home from the ER has a certain probability of having a serious missed diagnosis. It's just the nature of their craft. I think it was a pediatrician, in "How Doctors Think," who described her job as trying to look for a familiar face in a train going by full speed. For the thousands of babies with colds that fly by, there is one with bacterial meningitis that she has to catch, and its not always possible.
posted by cacofonie at 11:23 AM on January 8, 2016 [2 favorites]


When I was younger and broke my leg at a field trip, the teachers didn't believe me because I wasn't religious/asked the wrong questions, and made me hop to them and didn't bring me to the hospital.

ugh, same. i broke my collarbone in summer camp and they didn't take me to the hospital for 3 days because "if it was broken you'd be crying a lot".

me: i can feel the bone grinding when i move my arm
counselors, nurses: no you can't

then 3 days later when the bone was tenting the mottled purple and green skin in a way that i frankly thought was super cool and awesome but which made everyone else in my bunk cry, i was yelled at for not telling someone how much pain i was in.
posted by poffin boffin at 11:26 AM on January 8, 2016 [24 favorites]


I do want to point out that people often don't realize is that diagnosis is entirely a game of probability.

The doctor in the OP operated four times on the author.
posted by roomthreeseventeen at 11:27 AM on January 8, 2016 [15 favorites]


I do want to point out that people often don't realize is that diagnosis is entirely a game of probability.

Then the ERs need to go back to fucking triage school and learn better. Thinking someone is low risk because of their age and sex ignores a ton of factors that the doctor may not know about. You need to triage by life threatening possibilities, without playing stupid demographic games.

This is like the person who said - I don't remember if it was on Metafilter or not - that Hispanic women had a code at their hospital, because people assumed Hispanic women were exaggerating their symptoms and would treat them behind other people.
posted by corb at 11:31 AM on January 8, 2016 [12 favorites]


I do want to point out that people often don't realize is that diagnosis is entirely a game of probability.

A game of probability that fails from the moment the doctor ignores what a woman is saying or dismisses her symptoms, thereby missing critical information and veering hopelessly from the diagnostic checklist.
posted by Dip Flash at 11:32 AM on January 8, 2016 [22 favorites]


These threads are always depressing as hell and then someone always comes in and says "Actually this is how it's supposed to work." Then we'll be treated to some other thread where all the doctors come in to complain that ACTUALLY coddled helicopter Millenials want TOO MANY TESTS. They demand TOO MUCH CARE. I honesty don't understand why or how anyone becomes a doctor.
posted by bleep at 11:44 AM on January 8, 2016 [14 favorites]


"Yes the baby had meningitis and her mother was a nurse and told me she was at risk but she was EMOTIONAL and also NOT ME, THE DOCTOR IN CHARGE OF SITUATION. Plus she was EMOTIONAL. How was I supposed to knowwwww I'm only huuumaaan"
posted by bleep at 11:52 AM on January 8, 2016 [23 favorites]


And of course, at the end, he had to condescend to let me know that whatever it was, it definitely was not what I thought it was.

honestly? for me? this is the part that pisses me off the most. if my docs ever gave any acknowledgment that my input was valid, useful, and/or correct or offered any kind of apology? I wouldn't be as mad as I am, in some cases years later
posted by suddenly, and without warning, at 11:52 AM on January 8, 2016 [14 favorites]


My grandmother was diagnosed with grief over losing a spouse. The actual problem was an aggressive brain tumor. Though she was in grief, I don't think that gave her terminal cancer, since we're not living in a magical realist novel.
posted by threeants at 11:57 AM on January 8, 2016 [38 favorites]


i feel so thankful that i haven't had such terrible experiences with doctors as many of the other women in this thread have had - possibly because my mother is a nurse and very strongly advocated for me e.g. when i was younger and having horrible headaches, which led to me actually getting an MRI and discovering a venous malformation in my brain (completely unrelated to the headaches, which turned out to be a result of an undetected sinus infection), which was monitored via regular MRIs for about a decade after the initial discovery - and also so thankful that one of my best friends is applying to medical school. she wants to be a primary care physician in under-served urban or rural areas, has worked for a local (i.e. west oakland) hep C clinic as well as a pricey mill valley based pain management clinic for years, so she has a wide array of experience dealing with all types of patients. she just had a great interview with UNC chapel hill, where she told the dean about getting rejected from vanderbilt, and i have to agree with the dean's assessment that vanderbilt made a huge mistake - we need more future doctors like her.
posted by burgerrr at 12:00 PM on January 8, 2016 [1 favorite]


Not to pile on here but:

I do want to point out that people often don't realize is that diagnosis is entirely a game of probability.

I am an epidemiologist. I guarantee I have taken more statistics courses than your average physician. I think about statistics and probability on a daily basis, but that's because I work with population-level data, rather than individual. I understand that physicians think horses, not zebras and all that good stuff, but that doesn't mean they are actually thinking about probability in a rigorous way.

What it seems to me that physicians do, instead, is apply probabilistically-derived heuristics, and it is really easy for unconscious bias to influence which heuristic is applied to which patients. Take, for example, this 2005 NEJM article on sex and racial differences in treatment of myocardial infarction. After controlling for a whole bunch of stuff, race and sex are still predictive of whether patients get appropriate treatment. This isn't exactly diagnosis at this point, but it gets to the same point - physicians make decisions about patient care based on clinically irrelevant factors, even for common diseases, even when there are explicit best practices.

So what does this mean? It means that physicians are not abiding by best practices laid down in their own field, but not in some random 'oh well, we all make mistakes!' sort of way. If that were the case, we could expect to see roughly similar proportions of black women and white men getting appopriate care. Instead, in a strikingly predictable fashion, white men are significantly more likely to get appropriate care than black women. Statistics definitely have something to say about how physicians act, and the results do not suggest strong probabilistic theory is underpinning their care.
posted by palindromic at 12:11 PM on January 8, 2016 [100 favorites]


Ugh. This thread could not have been timelier for me. I have a fatal and non-treatable disease that makes my blood hyper-coagulative. It took nearly six years to get a proper diagnosis of my condition and for four of those years, I was treated for arterial narrowing, despite not having any of the signs of that condition. Eventually, I was hospitalized with clotting on my brain and through that experience they finally found what was wrong with me. For the four years previous to that, when I should have been taking blood thinners, I was not. Yet, still I accept that misdiagnosis is a thing and now I take massive doses of warfarin to prevent a further clotting incident. I also deal with fatigue and other associated symptoms of severe anemia. But that's just background...

Two days ago, I visited my local ER because I'd broken a wisdom tooth about two months ago and I've been experiencing increasing pain for ages. Because of the massive amounts of blood thinners I take, just going to a dentist and asking them to pull it is out of the question, because there's a likelihood that I may experience severe bleeding. Oh, and I'm also poor, without a dental plan, and I had a bleeding episode last month that had left me even more anemic than I already was, so I coped the best I could for as long as I could. What I wanted from the ER was a referral to the hospital's emergency dental surgery department because any dental surgery has to be performed in a hospital. I was definitely not seeking pain medications (apart from my blood thinners, I take no drugs at all) or free dental work, I just wanted the referral. My mother had told me that she would pay for the work to be done.

I was kept waiting in a treatment room for over 5 hours. I understand triage, but I was tired, in extreme pain, and had seen other minor complaints already dealt with. Finally, a resident arrived, to tell me that he couldn't refer me to the dental emergency department. He then suggested I take an analgesic that I know I cannot take while on blood thinners, even after I said I could not take that. Then he told me he'd give me another painkiller, which all of my charts clearly indicate that I am allergic to, and when I pointed this out, he went to get another doctor.

The second doctor told me that I was 'overreacting' and that 'lots' of people have dental surgery on blood thinners (not on doses this high, I said). She told me that perhaps if I cultivated a 'more positive attitude' that would help. By this time, I was hungry, tired, and in horrible pain and I started to yell/cry....I'm going to die, I shouldn't have to spend the rest of my time in pain like this.....to which she, with her healthy 25 year old mouth replied that everyone is going to die eventually and that I should 'just go to a dentist'. I swear she saw my eyes change colour in response, because she scrammed out of there in record time. Fortunately, my daughter showed up, brought me a tea, and took me to buy Tylenol. The nurse tossed a package of hydromorphine pills tp me on the way out. It was only then that I realized that I'd been fingered as 'drug-seeking' because of my insistence on my pain and because I was poor. I was even more furious then.

So, I 'just went to see a dentist' and he looked at my wretched teeth (one wonderful gift of this disease is that it wrecks your teeth and contributes to bone loss) and told me that three of them needed to be pulled, but he could not do it because of my blood thinners and he referred me to the emergency dental surgery department that I was looking for a referral to in the first place. He was kind, and said I must be in extreme pain given the extent of the damage, but it cost me 70 of my last 100 dollars to get that referral. He also told me that no dentist would work on me outside of hospital setting and that it was ridiculous to think for a moment anyone would. So, one visit, two attempts to give me drugs that could have killed me, and a note on my permanent file that probably identifies me as a drug-seeker just to ensure I'll be treated poorly if I ever have to go back there....
posted by alltomorrowsparties at 12:19 PM on January 8, 2016 [39 favorites]


I JUST had this happen and I am so pissed off about it. I get hyperemesis gravardium and it escalated to the "okay lost ten pounds in about six weeks, have to pull over to vomit when I try to drive, can't keep prenatals down, need medication" point. So I called and they had me come in to see the on-call person that day, a nurse midwife I'd never seen before, who breezed into my room, barely glanced at me, CHECKED NO VITALS (or she would have discovered a catastrophically low blood pressure), and started talking to me like I was a primagravida with a complaint about nausea rather than a multigravida with a history of hyperemesis hospitalizations across two prior pregnancies. Several times I interrupted her and said, "I understand that nausea is common in the first trimester, but you know I've been vomiting 30 times a day, right? Not just nausea, but not able to keep a single meal down the last three days." "You see the weight loss on the chart?" But she diagnosed it as normal first trimester nausea and told me I'd have to "stick it out" until 12 weeks and "then it would go away." And I said, "Well if you check my chart, you'll see that in my two prior pregnancies the vomiting continued well into the third trimester and did not taper off after 12 weeks because it wasn't morning sickness, it was hyperemesis. You'll also see that I was hospitalized five times for IV rehydration." And she's all, "oh, no it'll be fine after 12 weeks, you can come back and see us if it's not."

So then there's this complicated interlude where she takes me OFF the med the doctor had prescribed that was sort-of helping, and gives me some bullshit OTC vitamin super-dose and I clarified this with her three times and she ASSURED me it would work great, it was part of "holistic management" of "nausea" and that "We don't prescribe that drug you've had before anymore because it causes birth defects, haven't you seen the commercials?" I was like, "A, No, because I do not get my medical information from plaintiff's attorney commercials, and B, that's funny because one of the name partners in this practice prescribed this for me two weeks ago." "Oh, no, well, we just don't do that anymore. It isn't safe for baby."

Sends me home. I follow the directions and take her damn vitamin, spend the entire night vomiting, and call back this morning and to the triage nurse I'm like, "Yo, I followed instructions and I just want to inform you I will now be non-compliant because those instructions were some serious bullshit." (There are zero indications for this drug in women with hyperemesis, I checked the literature during my long hours of non-stop vomiting, and indeed, it is known to make vomiting worse unless matched with an anti-emetic for women with hyperemesis.)

So today I go in and see my regular dude who promptly puts me on an appropriate dose of the "birth defect" medication (also apparently it causes heart problems in mom, not birth defects in baby, so she's not even paying attention to her plaintiff's attorney commercials properly). I took a moment to discuss with him the wholly inappropriate care I received earlier this week, but the upshot is, I had to go to the doctor's office three times in three days and narrowly missed being hospitalized because this woman was apparently totally incompetent, and could not be arsed to listen to me or read my chart.

(And when the nurse took my blood pressure today she had to take it three times because she was like, "You're so dehydrated I can hardly even hear it." Maybe if Little Susie Incompetence had bothered with my vitals, she would have noticed that!)

Anyway I have feelings, y'all. This woman was just totally ready to write me off as having "hormones" and being hysterical about my symptoms. She'd already decided that before she came in, without talking to me or looking at my chart, and no amount of PROVIDING HER INFORMATION could change her mind on that.
posted by Eyebrows McGee at 12:24 PM on January 8, 2016 [73 favorites]


"Drug seeking" as a diagnosis seriously needs to die.
posted by yesster at 12:27 PM on January 8, 2016 [38 favorites]


scantee: The focus here on rare diseases is a red herring because this phenomenon shows up for women in totally everyday interactions with medical professionals.

Yep!

I go with my wife to every appointment that I can manage. She is a smart, capable adult…and yet I still bring my little notebook and pen, and write down whatever the doctor says, and try to keep my mouth shut.

Sometimes I can refresh their memory with a fact from my notebook, and sometimes I am just there as White Guy who is called upon once in a while to nudge things forward. (Stupid spine surgeon from New York, I was looking -- and nearly shouting -- at you. And you were wrong wrong WRONG.)

Some of the doctors & nurses we have worked with have been amazing: caring, attentive, sensitive, thorough; God bless them. But for others, it sucks when she's not cared for properly -- and it's then that I figure that using my White Male Privilege to balance the scales is fully called for. :7)
posted by wenestvedt at 12:30 PM on January 8, 2016 [7 favorites]


Oh, man! I forgot about the time I called the Infectious Disease Center in the local hospital and explained that I had a very high fever, serious headache, body aches, and chills which were occurring in 12 hour cycles, and had just returned from West Africa, and asked if I could get tested for malaria. The triage nurse told me "We don't just give out malaria tests."

I'm glad somebody is doing something about all those recreational malaria testers.
posted by ChuraChura at 12:49 PM on January 8, 2016 [81 favorites]


(And they ultimately wouldn't schedule me for a malaria test until I went to the ER a week and a half later with a fever of 106).
posted by ChuraChura at 12:51 PM on January 8, 2016


started talking to me like I was a primagravida with a complaint about nausea

Which you were, at one point, and even then that treatment would have been inappropriate (and it would have been inappropriate even if you didn't have hyperemesis gravardium).

It isn't like all these stories of crappy medical treatment would have been ok if it turns out some of us weren't actually THAT sick (though probably other people telling are like me, and unwilling to see a doctor unless they really are super extremely sick).
posted by jeather at 12:53 PM on January 8, 2016 [5 favorites]


There was a 2001 Study called "The Girl who Cried Pain" that explores how men are more likely to be given pain medication when they report to their doctors, as opposed to women. Women are given sedatives instead. Nice, huh?
posted by Dressed to Kill at 12:55 PM on January 8, 2016 [3 favorites]


I have a story similar to Barchan's for illustrating the difference in treating men and women... My brother went to visit my mum and dad (in their seventies) a few days after Christmas and both of them look so dreadful he takes them to A&E. My dad (completely healthy for his age) gets rushed straight through and an array of tests done. My mum (prior heart attack, frequent chest infections) is still in the waiting room 4 hours later after being briefly triaged. Turns out both of them had the same severe poisoning and both ended up admitted to hospital, but it took them an hour to admit my dad and the best part of a day to admit my mum.
posted by threetwentytwo at 12:55 PM on January 8, 2016 [8 favorites]


So...curious here, do doctors tell women "you feel fine, now move along!" Because I've been having this issue with a PCP here in town while trying to get better care for my translady stuff. Just curious if there's any crossover there, and how I should be viewing the care (or lack of it TBH) I am receiving.
posted by Annika Cicada at 1:06 PM on January 8, 2016 [1 favorite]


"Which you were, at one point, and even then that treatment would have been inappropriate (and it would have been inappropriate even if you didn't have hyperemesis gravardium). "

True, although they are slower to diagnose it in first pregnancies because sometimes it DOES go away after 12 weeks. If you've had it once, though, you have an 85% chance of having it again. She should have been listening to me regardless, but if it had been a first pregnancy and she'd listened and said, "Okay, as long as we can keep you adequately hydrated I want to see if we can get you to next week before we intervene because we're right at the point where we'll see it diminishing if it's 'just' morning sickness," that wouldn't have been totally insupportable. (Which is more or less what actually happened in my first pregnancy, and we got past the 12-week mark and went, "Yep, nope, okay, have some drugs.")
posted by Eyebrows McGee at 1:12 PM on January 8, 2016 [5 favorites]


curious here, do doctors tell women "you feel fine, now move along!"

Yup, pretty much. I've gotten this a fair number of times through the years.

However, it's not all doctors (#NotAllDoctors) and it's well-worth seeking out a different doctor if you have that option. I'm pretty happy with all of my doctors now, because if I run into one who's dismissive, I seek out someone else. (Although I am aware that this is highly privileged; I live in an area with lots of medical specialists, and my insurance does not require referrals and covers second opinions.)
posted by pie ninja at 1:21 PM on January 8, 2016 [3 favorites]


Annika Cicada: So...curious here, do doctors tell women "you feel fine, now move along!"

From what I have seen, it's less blunt, but still… We have heard (paraphrasing here):
  • "this typically works, but if it's ineffective we can try it again"

  • "have you considered acupuncture? Some people find that it brings relief."

  • [this technique] is worth trying because it works for a lot of people (e.g., a cortisone shot, or maybe a couple because let's be honest you can't know exactly where the pain is coming from in order to get the tip of the needle RIIIIGHT there the first time)

  • "Many women have some pain after this procedure for a week or maybe sometimes more but I don't see anything wrong on a physical exam so try two weeks of high ibuprofen doses and rest and then…"

  • "...maybe you can call one of my colleagues who I think saw something like this once."

    At least the doctor running the pain clinic was kind, as well as skilled and thoughtful. And the (lady) doctor with four specialities related to women's health and sports/dance was genuinely trying. But still… *shaking my head*

  • posted by wenestvedt at 1:22 PM on January 8, 2016 [5 favorites]


    OK, I will tell a story.

    First off, I'm a guy, but this is about my sister.

    She was in for surgery, for full hysterectomy, along with removal of massive cysts in her uterus. I was unable to be there for her surgery, but arrived the next day, and stayed by her side for several days of recovery.

    We are not medical professionals, but as a family, we have a lot of experience with direct care and are sufficiently medically cognizant.

    There were multiple problems.

    1. She specifically told her doctor and the surgical staff that she is allergic to most medical adhesive tapes When she awoke in recovery, her incision was wrapped completely in adhesive tape. Her skin reacted to the adhesive tape, it looked like chemical burns. I took pictures.

    2. She specifically requested to have trapeze available in her hospital room, post surgery. (trapeze are the weights, pulleys, cables, etc, that you sometimes see in hospital dramas) There were none available at all. Had there been trapeze, she could have used her significant upper body strength to reposition herself in her bed in a reasonable manner. Instead, she had to grab at mattress corners and other unstable points to move around. What I had to do for her was more stressful on her sutures than what she could have done for herself, had the trapeze been available.

    3. She specifically requested suppositories during her recovery. The doctor didn't write the orders for them. Her primary nurse, who was a personal friend of mine, talked to me and said that her hands were tied, "But this is what I would do." So I made a run to the local drug store, and stocked up on suppositories, adult diapers, Ensure, Vaseline, and several other things I don't remember. I administered the suppositories. The nurses couldn't, because it wasn't approved by the doctor.

    4. I charted all of her bodily functions. I kept my own log, separate from the hospital one.

    5. We know, what it takes to be released from a hospital: (a) poop and pee (b) eat and drink (c) be ambulatory/ move as much as possible. I walked her up and down the hospital corridors. No staff was going to do that. I did.

    6. She had infection, which the hospital attributed to the "unexpected" reaction to the surgical tape. Nurse friend later confided to me that the nursing staff had repeatedly reported the surgeon for his handwashing practices.

    7. I was at my sister's side for 3 days uninterrupted. The surgeon never showed up once during that time, but issued orders to the nursing staff via phone.

    8. Don't even get me started on pain management. She had a 14" wide incision just below her belly button, aggravated by blistering skin due to the adhesive allergy, and refusing to close due to infection.

    I don't know how to finish this. It's been 7 years. I'm still frustrated.

    Why did nothing she say get through?
    posted by yesster at 2:28 PM on January 8, 2016 [22 favorites]


    Why did nothing she say get through?

    Pardon my error. What I meant to write was:

    "Why didn't everything she said get through?"
    posted by yesster at 3:20 PM on January 8, 2016 [5 favorites]


    The tremendously annoying thing is that pain is a medical issue in itself. I've had to have various combinations of colposcopy, biopsy and d&c three times over the last few years. The first time around, for whatever reason I got zero painkillers coming out of surgery. So I'm lying there in the recovery area in enormous pain, being told I can go home when I'm stable... except I keep setting off the monitors because my blood pressure keeps crashing because I'm basically shocky from pain. So I ask if I can get some pain relief and they are all, 'well your doctor didn't prescribe anything', and I ask them to find my doctor and ask her, and it takes damn near forever before I am finally given a couple of pills... and within a few minutes I'm fine. But they don't send me home with anything, and that evening I damn near had a panic attack because the pain was creeping back and I was afraid it was going to get as bad as it had been, and I was having trouble getting through to the on-call and getting them to prescribe something.

    To my doctor's credit, when I brought up the issue with her she was very apologetic, and the next time around gave me toradol before the surgery and a vicodin prescription after it. But next time around (different doctor, same practice), I had to remind them I had asked for toradol *on the table*. And I bet my concern for pain relief would easily be written off as 'drug-seeking' in the hands of more hostile doctors.

    The ironic thing is I've never had to use more than 1 pill from the various prescriptions... but it's a great stress reducer to have the option available when dealing with pain. And fear makes pain worse.
    posted by tavella at 3:26 PM on January 8, 2016 [8 favorites]


    So...curious here, do doctors tell women "you feel fine, now move along!" Because I've been having this issue with a PCP here in town while trying to get better care for my translady stuff. Just curious if there's any crossover there, and how I should be viewing the care (or lack of it TBH) I am receiving.

    Yes, definitely. I think there have been previous threads more focused on the GP/PCP interactions, but it's no different than the ER and surgery horror stories above in terms of not listening and casual dismissals. There's no way to know from here if you are being dismissed as a woman, because of trans bias, or because the doctor is just generically shitty, but regardless you deserve better.
    posted by Dip Flash at 3:35 PM on January 8, 2016 [1 favorite]


    And I bet my concern for pain relief would easily be written off as 'drug-seeking' in the hands of more hostile doctors.

    Yeah, this is why I hoard painkillers for emergencies. Any time I get a prescription for anything pain-related I take 1/2 of what's in the bottle and just deal with the pain for the rest. Sometimes I'll call the doctor on day 2 of recovery and say that what they've given me is too strong, is there something a little less that they can prescribe? and then keep the stronger stuff for emergencies. It would be great to not have to deal with this shit all the time but I know what it would have been like otherwise to have to deal with going to the ER with nerve pain so bad that I keep vomiting on myself only to be waved off with a packet of 2 extra strength tylenol. Or even the mental gymnastics required to convince myself that nerve pain so bad that I keep vomiting on myself is even bad enough in the first place to seek medical assistance.
    posted by poffin boffin at 4:15 PM on January 8, 2016 [17 favorites]


    seriously though just like people can volunteer to be clinic escorts to help women in need of reproductive services get past the monsters who protest outside planned parenthood, likewise I wish it were possible to volunteer to be a doctor's office escort: a service where tall white men with good hair could accompany women and people of color,and other people who medical professionals frequently despise into the doctor's office, just to stand there and be tall and white and male and occasionally say (in as deep a voice as possible) "No, doctor, you need to actually look at their chart and you need to actually listen to what they're saying" until the doctor agrees to actually provide real medical services.
    posted by You Can't Tip a Buick at 4:52 PM on January 8, 2016 [36 favorites]


    Also he must wear an expensive suit. And they must not know that he's been hired. "She's gaming the system!!!!"
    posted by bleep at 4:59 PM on January 8, 2016 [3 favorites]


    everyone 30 years later still makes fun of me for

    jeather, my heart goes out to you. No one should be mocked for their pain. That sounds simplistic but it's just one of my many triggers. Do. Not. Mock. A. Person. In. Pain. No amount of time passing makes that right.
    posted by datawrangler at 5:00 PM on January 8, 2016 [3 favorites]


    Anybody can be anybody else's medical advocate.

    It's a thing.
    posted by yesster at 5:05 PM on January 8, 2016 [3 favorites]


    I thought this was known? The medical advocate?

    A couple of years ago, I had a medical advocate of my choice be there for my surgery. She wasn't family, she was a friend. I told all of the medical team she was there with and for me. I think I signed something.
    posted by yesster at 5:08 PM on January 8, 2016 [2 favorites]


    Yes, we know this. But it's honestly really insulting and humiliating that in the 21st century the only way I can even expect the possibility of responsive effective health care is if I bring a man to advocate for me.
    posted by hydropsyche at 5:34 PM on January 8, 2016 [27 favorites]


    I just don't have the words to express how grateful I am to hear these stories. Not because I want other women going through these issues, but because it confirms that I'm not crazy when I bitch about the medical establishment not taking my concerns because I'm a women seriously. The fact that we know it, and there are studies supporting it does diddly squat to help when you're one on one with the doctors.

    . . . Neither does showing evidence of having read about your problem, that's a sure sign of a hysteric. As far as I can tell, playing dumb and being nice and the most patient patient, and asking the right questions (not too many) at the right time (before they've made a decision), engenders less opposition to your actual participation in management of your own health. If there is another way, I would be really happy to know about it.

    Oh this. Heaven forbid you are an informed patient! I've even had doctors argue with what another doctor told me. Why are you arguing with me? If you want to disagree, pick up the phone and call him directly (she wishes she said).

    A few thoughts- the medical industry frowns upon "doctor shopping", and yet it's the only real recourse for doctors who have become dismissive. The same thing about advocating for yourself. You're supposed to, but doctors really do shut you down when you come in knowing too much. Which brings me to my next point, medicine needs to do a better job of accepting that the Internet has made people better informed. Not always correctly informed, but we're not all dummies watching Dr. Oz. And the reason I think I might be able to offer some insight into my condition isn't to do out the doctor's medical training, it's because I see you for 15 minutes, if I'm lucky. I can spend considerably more time researching options that even with medical school and experience, you might not think of or know.

    Medicine for women still lags behind that of men. We had thousands of years where our uteruses were blamed for most ailments and it's only very recently that science said wandering uteruses were a silly, silly idea. We only allowed women into pharmaceutical testing in the 70s and it wasn't until the 90s that we started requiring equal male and female test subjects. Gender parity in lab animals in 2014. With many long winded objections that including female test animals was too much work.

    Rare diseases and syndromes individually are rare, but on the whole are actually pretty common. I can't remember the statistics, but it's small but solid minority. I'm one of em! After searching hell and high water and sort of giving up, I'm the 1 in a million with a symptomatic thoracic herniation. I probably have thoracic radiculopathy, but am still being diagnosed so for now, the pain clinic is calling it thoracic radiculitis. So while the think horses, not zebras is probably good wisdom, it's not great wisdom.

    Women present with more pain. Testosterone protects against pain. There was a study not long ago that suggested that men and women might even process pain entirely differently. Yet most medication for pain has been developed for men. Take that into consideration with the study that men get pain killers more readily than women.
    posted by [insert clever name here] at 5:53 PM on January 8, 2016 [12 favorites]


    I've been on the testosterone side of pain and the estrogen side of pain. In my experience it seems like my tolerance for pain increased as my testosterone went down to cis-female levels. I would say that I'm more in tune with my body now so I definitely feel more of what's going on in my body, but I don't know how much of that is accounted for by less disociation caused by treating my sex/body dysphoria with estrogen. So I suppose there is may be some biological quality to how hormones help or hinder pain signals, but my experience has been opposite of what the research you referring to suggests. At any rate pain is personal and I don't know how reliably it can be measured by the hormone levels present in a person's body? But maybe there is some biological root of it that ties back to sex characteristics? I mean, there's been a difference for me. I just don't know how reliable a study like that would be to try to generalize out to entire populations.
    posted by Annika Cicada at 6:05 PM on January 8, 2016 [3 favorites]


    I just had to do that, poffin boffin, because a lady friend of mine presented doubling over in pain and screaming and they were like "take Tylenol". So now I guess I'm a drug dealer. Or does it count if you don't charge? It's like somehow a crime I guess?
    posted by corb at 6:15 PM on January 8, 2016


    Good luck if you have a mental illness or trauma history and have any sort of illness that requires more than one blood test. Actually good luck getting that test done in the first place. Things I have had dismissed as depression or trauma:

    Stomach infection
    Anemia
    Celiac disease
    Bursitis
    The dreaded hysterical woman illness of fibromyalgia
    The stomach infection again
    Sciatica
    Lung infection
    Being trans

    Bringing in your mental health case worker to prove that your treating your mental illness? Now your just confirming your crazy and the doctor will talk over you to her.

    God forbid your fat on top of that.
    Lost 150lbs but still overweight? Not enough. Fatty. Try to get a dietician to teach you about Celiac disease and have her just focus on portion control. That 150lbs lost counts for nothing.

    Think that maybe if your crazy they'll at least help you with the periods that cause your suicide attempts and psychosis? Nope. Can't help there because don't want to make your moods more unstable.

    Try to advocate and say you are in so much pain your passing out almost and can't walk anymore and beg that it is affecting your mobility so it's making you depressed and look your trying to help your mental illness but maybe you really don't want to take the medication that you experienced Parkinson shakes on? Well, you now are defiant because you refused a med.

    I have PTSD on top of my PTSD from the medical profession. I have a good doctor now and I still am hiding my mental health stuff from her (which actually is getting worse cause I'm so tired of the constant body pain and being in the wrong body and these stupid horrible periods) and going in to every appointment assuming I will have explain how much of a perfect person I'm being in hopes she'll treat me. I left my first appointment with her with a referral for my stomach, a shot in my hip, and a promise she'll treat my pain.

    I'm ranting but I still cry about the years I wasted in pain and thinking I deserved it because obviously I'm just a hysterical woman.
    posted by kanata at 6:29 PM on January 8, 2016 [15 favorites]


    > I've had to have various combinations of colposcopy, biopsy and d&c three times over the last few years. The first time around, for whatever reason I got zero painkillers coming out of surgery. So I'm lying there in the recovery area in enormous pain, being told I can go home when I'm stable... except I keep setting off the monitors because my blood pressure keeps crashing because I'm basically shocky from pain. So I ask if I can get some pain relief and they are all, 'well your doctor didn't prescribe anything', and I ask them to find my doctor and ask her, and it takes damn near forever before I am finally given a couple of pills... and within a few minutes I'm fine. But they don't send me home with anything, and that evening I damn near had a panic attack because the pain was creeping back and I was afraid it was going to get as bad as it had been, and I was having trouble getting through to the on-call and getting them to prescribe something.

    I had literally almost the exact same experience after a cold knife conization and D&C.

    They gave me ibuprofen after surgery and it didn't even touch the pain. They left me lying there in one of those outpatient surgery recovery recliners. Meanwhile, when I tried to shift my weight to adjust the tilt into a more comfortable position for my belly, the chair tipped into an even more uncomfortable incline.

    I went from saying "excuse me" to HEY!! and couldn't get anyone's attention; it was like when the bartender won't meet your eye because they're in the weeds. A nurse finally acknowledged me and I told her how much pain I was in, and she assured me that they'd given me ibuprofen. I pointed out that it wasn't helping and that I was in a LOT of pain and can she talk to my doc? Meanwhile, I'm trying to get her to help me with the chair and she seemed utterly confused about why I care about the position of the chair and why I'm upset. DID WE MISS THE PART WHERE I AM IN A HAZE OF POST-SURGERY PAIN?

    And ohhhhh, she said, it might take awhile to contact my doc, gee she already prescribed what she thought was best but she can TRY to contact her. YES GET ON THAT. (My surgeon was my regular gyn, I was pretty sure she would have absolutely no problem authorizing a scrip for me.)

    At some point during all of this, one of the nurses did get authorization to give me a dose of Percoset (from whoever supervises the recovery room floor, I guess?) , which dialed back the pain enough for me to stop panicking.
    posted by desuetude at 6:31 PM on January 8, 2016 [3 favorites]


    Er..I left with her doing all that and I still can't trust her. My case worker says to tell her about the PTSD and trauma and I can't cause then I'm sure she'll dismiss the trans stuff. It'll take a long time to trust another doctor again which is a shame cause she seems helpful but I just can't do it.
    posted by kanata at 6:32 PM on January 8, 2016 [1 favorite]


    Hah, when I was six I broke my leg jumping off furniture and both of my parents just didn't believe me for hours even though I was screaming and crying. My dad was left home alone with me and he just kinda gave up and left me on the couch crying. When Mom got home, they tried to stand me up (I could not do that), then tried to take me out for ice cream. When I had zero interest in eating that, that's when they figured something must be wrong. But I kinda chalk that up to my being an only child and that being my first injury and them not really having any idea or having broken a limb in their own past

    "But it's honestly really insulting and humiliating that in the 21st century the only way I can even expect the possibility of responsive effective health care is if I bring a man to advocate for me."

    Or for that matter, to believe you if you say Bill Cosby raped you. Paying a man to convince people to believe you could be a very lucrative job.

    And why is this? Because men think women are liars, period.
    posted by jenfullmoon at 6:51 PM on January 8, 2016 [13 favorites]


    When I was 10 I fell off our pony and landed on my side. It hurt a lot and I was in too much pain to put the pony up. I tied her to the corral gate and walked home and sent one of my sisters to tend her. I was hurting a lot, but thought that I should be able to take a simple fall like that and was too embarrassed to complain. I had lost my seat, hadn't even been tossed. But I was hurting too much to do anything but lie in bed.

    Mom and Dad checked me out and thought that maybe I had cracked a rib. That got me some TLC and aspirin and a warm bath, which I threw up in. The next morning, my little sister was home from school with tonsillitis, and was going to be taken to the doctor. "You might as well stay home, too, and we'll get you checked out, since we're going anyway."

    The clinic (military base) had a 2 hour wait, and after that,they promptly sent us to wait again in the Emergency Room for another couple of hours with a pillow clutched to my belly. Finally, I was seen and diagnosed with abdominal bleeding, which surgery showed to be a ruptured spleen.

    Here's the thing. Years later, Mom said that if I had not been so stoic, I would have been seen faster. She meant at the hospital, but I think she would have taken me in a lot faster if I had been crying a little instead of just trying to tough it out. It was my own sense of shame for my injury that prevented quicker care.

    Where did I even get a shame like that?
    posted by SLC Mom at 7:16 PM on January 8, 2016 [9 favorites]


    Everyone who has related stories in this thread, I'm so sorry for what you've been through. My stories do not approach the level of most of the things you're relating.

    Still, God forbid you're a woman who's overweight and doesn't shave your legs due to dermatographism (and because you choose not to) and you want to find out why you have some interesting new hair stuff going on (growth in some places, loss in other places). You will be goggled at by impeccably groomed and tanned doctors, told to lose weight, told you have anxiety and need a microdose of antidepressants, get some blood work done but then never be told the results until you demand them, get a diagnosis of metabolic syndrome but no suggestions for follow-up, just threats about needing to get your life together. Great, thanks, I'll do that once everyone I care about stops suffering from serious and debilitating illnesses.

    My father and brother were both diagnosed with cancer this year, they suspect a cancer cluster from contamination in my hometown, my aunt just told me about more family history I didn't know about, and it's been more than a year since I've seen a GP, after the runaround I got above. Clearly this time I'm going to need to start having some difficult conversations requesting more advanced preventive screening. And I am just dreading even having the conversations I have to have to get this rolling. There's no magic that's going to take off the extra pounds and keep me from being judged unfairly before I embark on this.

    This also reminds me of the most recent time a close male family member was in the hospital. The nurse drawing blood initially assumed that being overweight, this family member had made himself sick eating pizza, and they glared at me for I guess being a bad and permissive woman. Then another nurse came in, and my family member asked me to speak on his behalf, because he was in pain and could barely talk. The nurse waved me off and said "I WANT TO HEAR FROM HIM," scolding me like the overstepping harpy shrew woman I clearly am. I felt pretty vindicated when, well, unfortunately, it turned out to be something serious and new and not what the nurses thought from a minute's consultation and judgment.

    Internalized stereotypes about women, overweight people, and drug seekers are all huge barriers to effective treatment. It's really disappointing to run into this sort of thing when people you love have serious illnesses that require frequent hospitalization, or you happen to need care yourself.
    posted by limeonaire at 7:20 PM on January 8, 2016 [4 favorites]


    FWIW: I studied medicine (thus the 'nym), and one observation that I found insightful (but noone else did) was that there was a lack of Dr House-like obsession on finding an answer to an intractable chief complaint. It just doesn't typically happen. At some point in the process, the standard ideas and the slightly-zebra-esque ideas don't pan out, and I saw many people go into a kind of palliation mode. The Elle article seems to fit that, rather than anything specific on the part of Perfect Doctor -- he tried a bunch of stuff that seemed reasonable and even slightly-less-than-reasonable, and then he shut down and tried to do something for the pain. My own feeling was that it comes from direct experience on the part of practitioners on failure to get the right diagnosis, and understanding the limits of medicine and knowledge. This leads to a kind of normalisation of diagnostic failure, with some parallels to the way you get conditioned to death in the hospital setting. Just a hypothesis. At the time, I thought "how could you not devote untold hours to resolving this medical mystery?"
    posted by Vcholerae at 7:24 PM on January 8, 2016 [6 favorites]


    I think I would be much angrier about my initial mis-diagnosis if there were a treatment for my disease but seeing as there isn't and I've probably had it for over a decade I've just decided to take my blood thinners and try to otherwise act as if I don't have a disease
    until I get so tired that it reminds me. Being stoic about it means that my family and partner are able to forget about it for the most part, until I can't make it through the day without napping or I don't want to get out of bed and then I have to remind them that I'm ill. Nobody in my university life had any idea until I required hospitalization and had to miss a week of classes. Sometimes I wonder why it's so important to me not to be perceived as a sick person; then I have to interface with the medical establishment and I know why -- because being a sick person means that people treat you like you're not a whole person anymore and when you're also a woman, then you're really not valuable or considered to have valid thoughts or opinions, you're just an annoying cog in the machine.
    posted by alltomorrowsparties at 7:53 PM on January 8, 2016 [3 favorites]


    A lot of what I read in the article and this thread sounds like my experiences with doctors too, and I'm a man. I'm sure it is worse for women, but it's not like there's this great system and women are locked out of it.

    Doctors ignore all of us; they only do the minimum work required to get their insurance payout. Our system works pretty well for easy-to-diagnose things like ear infections and gunshot wounds, but completely fails for anything difficult to diagnose.
    posted by foobaz at 7:57 PM on January 8, 2016 [4 favorites]


    The tendency of doctors to consider a woman unqualified to recognize when something is wrong with her own body is real, and horrifying.

    I know not one, not two, but four women whose appendicitis was brushed off as "you just have menstrual cramps, go home and take some ibuprofen". One was sent home from the same ER twice in two days before her appendix burst. Another had a post surgical infection that was also dismissed as not real until her skin gave way and starting pouring pus.

    My mother-in-law spent almost a year seeking explanations for "stabbing, electrical" pain in her hip and groin that became so extreme it prevented her, a formerly dedicated daily walker, from walking more than a few steps at a time. Doctors told her she just needed more exercise, said x-rays showed her hip wasn't deteriorated enough to cause the pain she was reporting, told her it was menopause, gave her antidepressants, and so on and so on. Finally they said if she insisted, she could have a hip replacement, but she should lose weight first.

    While waiting for that surgery, she stumbled and hit her back, leaving her in immense pain because several vertebrae, mostly consumed by the bone cancer at that point, fractured. I sometimes wonder about the alternate world where the cancer was treated before it metastasized and she is still with us because a doctor kept looking for the root cause of her symptoms instead of dismissing her as a whiny fat lady.
    posted by superna at 8:18 PM on January 8, 2016 [26 favorites]


    reading this thread just keeps bringing things back. it's amazing. I've been really lucky not to have things happen to such horrible degree as a lot of people are talking about, but I have so many of these stories (granted, I'm really physically active which has resulted in some uh pretty regular injuries). does your average man have a lot of these stories or is it more of a one-off? like what's the ratio of satisfactory to unsatisfactory doctor's visits?

    ever major injury I can remember I've had either my pain drastically minimized, my recounting of what I'm experiencing partially or wholly ignored, and ended up wasting both my time and money to ultimately get the treatment I needed.

    also seconding the difficulties with having a mental illness mentioned upthread. I didn't expect a doc to just take my word for my diagnosis, but I had been hoping my saying 'hey this medicine is making me feel completely out of control and I don't think major depression is the right diagnosis' might have actually like... warranted at least discussing some changes. but instead I didn't sleep for 5 days in a row, rolled the family car out of the driveway every night before driving off and disappearing until morning (I do not do These Things), and then was chided by the docs when I finally took myself off the meds because I constantly felt like I was going to explode. my mom didn't chide me. even without knowing about the car thing she knew something was up.

    I've gotten this treatment with allergies really, really badly (my worst doc experience of my life), which I don't think is helped by how nebulous allergies are but I can only hedge my suspicions so much before it's like 'please just do the test I am breaking out in hives again and I can't breathe'

    one of my favorites, probably because I got some validation, was after my ACL surgery. It was super terrible, when I came out of it they wanted to send me home immediately but I apparently woke up gripping the bedsheets and my mom was like, no, we are not taking her home. they put me on a codeine drip and I spent the entire night mashing that button, I think it was every six minutes. three beeps bad, two beeps good. my mom was livid that they'd wanted to send me home with ibuprofen because she was like, you could see how bad it was.

    I know physical therapists are supposed to push you but I'm 100% convinced my PT thought I just wasn't doing the exercises he sent me home to do. I was supposed to stick my heel up on a stool and let gravity weigh my leg down to stretch out the ligament (which I did), then graduate to hanging a heavy book over it (which I did as much as possible), but I wasn't getting it flexible fast enough so he was like 'we're gonna put your heel on this stool and I'm gonna push down on either side of your knee'.

    I mean I gave him the ok because what else was I gonna do, but apparently I instantly went white as a sheet and passed out, and he's sitting there with my mom right next to me and well after I came to he was like 'I think we're good for today'. he gave me a lot more consideration after that. it was very satisfying.

    sidenote I actually found out I'd been standing wrong my entire life during PT for piriformis syndrome, I explicitly learned in junior high that 'good posture' for girls was basically boobs and butt both out as far as possible and the PT guy was like 'yeah this has probably been fucking you up for a while now'

    the ACL thing reminded me of the time I was a little kid and my orthodontist accused me of not wiggling the two teeth that needed to come out enough (I had shark teeth). I mean I'd been trying but those things were solid, 'wiggling' wasn't doing the job because they weren't loose at all. so he shoved those metal clamps over them and just straight ripped 'em out, no pain killer or anything. I might've said something if I knew he was going to pull them but by the time I realized it was just a 'more painful than usual braces adjustment' (that should tell you something there also) I had a mouth full of blood and it was already over. but I was a little kid. that's pretty messed up, right? he didn't tell my mom he hadn't given me any painkillers and I didn't either because I just figured that was normal. I kind of still wonder if it is.

    I guess my main thought on this is ultimately that I should always have my mom come to the doctors office with me or I'm gonna have a bad time. time to schedule a mom-call for tomorrow!
    posted by suddenly, and without warning, at 8:23 PM on January 8, 2016 [2 favorites]


    If a patient presenting at the ER with textbook appendicitis symptoms is not something that should be easy-to-diagnose, I don't know what is. I'm sure there are some out there, but I have yet to meet a man who went to the ER with appendicitis and was sent home with ibuprofen with no tests done.

    As was mentioned up thread, it's not that doctors provide perfect treatment for men, but the odds are demonstrably worse for women.
    posted by superna at 8:28 PM on January 8, 2016 [7 favorites]


    A lot of what I read in the article and this thread sounds like my experiences with doctors too, and I'm a man. I'm sure it is worse for women, but it's not like there's this great system and women are locked out of it.

    *reads comment*
    *I'm a man...*
    *looks at post title again*
    *I sigh so loudly that I wake the dog from his blissful snore fest*
    posted by futz at 8:43 PM on January 8, 2016 [26 favorites]


    MissySedai, re your heart attack-like experience: Holy crapfuck, that is so much like my recent ER experience it's unreal. Only mine wasn't GERD-and-pain, it was post-baby stuff (having just delivered 6 days ago) and weird heart issues. Hours between visits from any medico, condescension from the attending cardiologist, and the fun of them trying to give me the wrong drug even after I'd told them multiple times exactly what I'm taking.

    I still have no idea if that goddamn heart monitor (that they didn't put on me for ~12 hours) was even doing anything.
    posted by XtinaS at 8:49 PM on January 8, 2016 [3 favorites]


    Interestingly, I am in what could be described as a very patriarchal society (Turkey) but here is the one country where doctors have listened to me, asked me my thoughts on what is going on, actually diagnosed more serious stuff than I thought was going on, and treated me as a human being (admittedly I am at a private hospital, but all my drs and specialists have been men).

    In the UK, most of my dealings with drs have been awful - especially women drs. To the point of telling me it is all in my head, more than once. I wonder if it is as much to do with 'medical cultures' as it is to do with 'general cultures'.
    posted by Megami at 10:18 PM on January 8, 2016 [2 favorites]


    These stories about not getting pain relief after surgery are mind blowing. What the actual fuck.
    posted by bleep at 10:40 PM on January 8, 2016 [3 favorites]


    These comments are a real horrorshow. I am so, so sorry.

    My aunt died of lymphoma complications before I was old enough to know her. She had been to her doctor repeatedly with a severe, persistent cough and kept getting prescribed antibiotics and such for anything from a cold to phenomena. She went time and time again and he never believed or listened to her, even when it got worse. Eventually, she got a second opinion…by that point she had a tumor that took up most of her chest.
    She really had it hard from all sides on this, dealing with the complete inadequacies of rural healthcare providers, being a woman, and coming from a very poor Native American family. She was able to sue for a substantial amount, but she still died in her late 20’s.

    My own oncologist is a younger woman, which I feel helps her be more sympathetic to my concerns when I come in for regular post-treatment check-ups. Her being a caring and attentive doctor sometimes means spending most of an appointment talking about some pretty small symptoms, but it also means my experience with remission isn't peppered with regular panic spirals about, say, an unusual amount of bruises or something. I will never apologize for taking "too much" healthcare in situations like this, because my mental health in dealing with something this scary is also part of my overall health.

    In contrast, my general practitioner (a man) barely wants to hear what I have to say as I'm trying to address some other health problems (I have depression, so of course that's the answer to everything!!). I’m pretty certain switching to a woman GP likely won't help a ton though, as women doctors can demonstrably be part of the problem as well, and because it’s my (possibly naive?) impression that this seems to be a more prevalent problem with medical providers that function in a “gate-keeper” capacity moreso than the specialists. But I’m sure it’s at least a measurable problem at every point in the system.
    posted by giizhik at 5:43 AM on January 9, 2016 [6 favorites]


    I've been very lucky in that I've had very few health problems or injuries in my life, so I don't have a lot of examples like many do.

    In high school I partially tore my ACL in a skiing accident. My parents brushed it off when I got off the ski club bus in a cardboard splint from the ski patrol and didn't take me to the doctor for a few days. The family doctor diagnosed it as a partial tear just from a physical exam and I never got an MRI or saw a specialist, just did a few weeks of physical therapy. The knee felt unstable now and then for years afterwards.

    I then got the brush-off from an urgent care doctor when I re-tore my ACL a couple months ago. From my previous experience I knew what it felt like but the doc kept saying because there was no swelling and little pain it was nothing. But honestly considering they put the knee brace they gave me on backwards I'm not so sure that was a bias issue, more just general incompetence.

    But it's funny how I do feel this weird... guilt? or something that my current orthopedist does take me seriously, I did get an MRI showing at most only 10% of my ACL is still attached, and I am having surgery in two weeks. Like somehow because it isn't the Worst Injury Ever, I don't deserve to get surgery or maybe I should be toughing it out or doing more PT. He didn't discount me, he just said let's try PT for 6 weeks and for some people that's enough and if it isn't enough, then we'll do surgery. Perfectly reasonable approach.

    So yeah I have moments where my knee feels unstable and I fell over on Christmas because I tried to crouch under the Christmas tree and my knee noped right out. But because there's not much pain and I can walk and go up and down stairs now thanks to the PT, it just seems like maybe I am making it out to be worse than it is. My orthopedist and physical therapist have been great and supportive of my decision to have the surgery, so it's just the patriarchy inside my own head making me gaslight myself I guess. I honestly have had moments where I question *myself* about whether I'm just making it up for attention. Then I have a moment where my knee feels wobbly and I remember I'd like to get back to a life where I can ride my bike and run and do yoga, and I try to assure myself that you can't fake an MRI and that surgery is a perfectly reasonable treatment for my injury.
    posted by misskaz at 8:18 AM on January 9, 2016 [6 favorites]


    I hear you, misskaz. I was willing to downplay bloody urine and horrible pain in my kidneys as not worth bothering the doctor about, until my (awesome) current GP sent me to get an MRI, and I got to see for myself that my kidneys have constellations of stones in them. You can't fake an MRI.
    posted by hydropsyche at 8:27 AM on January 9, 2016 [3 favorites]


    Ugh, this hits so close to home for me. Forgive me if this is a bit long.

    I've always had trouble with my menstrual cycle- I was on birth control at 14, diagnosed with PCOS at 15, and then any complaint I had about anything came down to PCOS. Doctors would just tell me that's what I had to deal with, given what I had, and that I should just lose weight and deal with it.

    Things got steadily worse in college- I was exhausted all the time, emotional most of the time, and missed about a quarter of my classes. I started trying to figure out what was wrong with me junior year, which led to 8 different OBGYNs and three different hospitals. I was in the emergency room a handful of times for literally passing out from pain- and every time, they put it down to my PCOS and my weight. If I just lost weight, I'd be better. Never mind I didn't have enough energy to get out of bed some days. I was prescribed anti-depressants and pushed into group therapy. I was given a diet plan, not pain medication. I was told I was overreacting.

    And you know what? I believed them. I thought it was all in my head. That I was being sensitive, and that everyone lived in this much pain, all the time, they were just better at handling it. I was overreacting. I was too thin-skinned. I should be able to do this.

    My best friend and roommate said that was bullshit, and she dragged me to doctor after doctor. One male doctor gave me a lecture about how periods work. Literally gave me, a 21 year old woman at the time, who had been getting a period for 7 years, a lecture about how periods worked. He had diagrams.

    Finally, a female doctor said the word surgery. A week later, I was in recovery after what was supposed to be a 2 hour surgery turned into 8. I had stage IV Endometriosis, and it was everywhere, gluing my insides together. The amount you have is no indication of how bad your pain will be, but it was clear I hadn't just been dramatic about cramps for the last 24 months.

    When I graduated, I moved cities, and ever since, I've been having to explain my medical history to any doctor I see. Yesterday, I saw a GP about some intense back pain.

    Their treatment plan? Lose weight.
    posted by Torosaurus at 8:54 AM on January 9, 2016 [10 favorites]


    Weight is the worst because it can't be hidden. I've gotten to the point where I don't tell my doctors about my IBS because once I do, that's always the answer. But at least I have the option of not sharing my diagnosis. :-(
    posted by chainsofreedom at 9:01 AM on January 9, 2016 [3 favorites]


    God, these stories are infuriating to read. How can anyone make excuses for stuff like this? It so clearly has nothing to do with 'rare diagnoses' or 'doctors not being perfect' and EVERYTHING to do with a broader culture that doesn't trust women with their own bodies.

    At my first appointment with my current psychiatrist, I used the words 'executive function' and 'quality of sleep' in my description of the issues I wanted to work on. He appeared to find that charmingly baffling, like I was an adorable talking cat telling my veterinarian about my symptoms. This continued throughout the entire appointment: everything I said about my own brain function was basically an amusing novelty. She thinks she's people! How cute.

    When I asked whether anyone in his office specialized in CBT, he said that particular kinds of therapy don't matter as much as the patient's willingness to change. I gave him the side-eye and described the positive results I'd seen from CBT in the past, versus the total lack of results I'd seen from other kinds of therapy. This did not dent his air of amused toleration even slightly.

    I am 30 years old. I was there to get prescriptions for the meds I have been taking for years, and would not have been there at all if my previous practice ever returned phone calls or wrote prescriptions correctly. I had hoped to get back into some form of useful therapy and investigate whether there might be some better medication options, but instead i'm just counting myself lucky he was willing to write the correct scripts at all. I'm not expecting to interact with him more than the bare minimum, going forward.

    I hate that I'm grateful that it wasn't any worse.
    posted by nonasuch at 9:10 AM on January 9, 2016 [18 favorites]


    This hits. I went to the ER once with a dislocated jaw - horrible pain, but pretty obvious what the problem was. I was already weak when I got there (it taking actual hours to convince my then (male) bf that I even needed to go, but I could not talk to make the 911 call. At the ER I wrote a description of the problem, what happened, past major medical events (surgery, pregnancy, ect), current medications, and known drug allergy. And my pain level. And that it was not only excruciating but that I could not talk. Though again, my jaw was stuck hanging off my face. Of course I couldn't talk.

    Presented it all to the doctor. He took one glance and said "no, I need you to tell me. I'm not going to read this."

    The despair and pain and rage and helplessness I felt. It still haunts me.
    posted by blue_and_bronze at 11:11 AM on January 9, 2016 [26 favorites]


    This is all a bit terrifying. Ok, a large terrifying. I've just recently started the process of seeing a rheumatologist, who after a multiple blood panels and xrays diagnosed some things, and put me on a sort of scary drug that I'm not sure how I feel about yet, but referred me to, and send my records over to a hemotology oncologist. But when I said "Erm, why?", I got the typical hand patting, condescending "well, it's just a to check a few things out," which I understand is supposed to be comforting, but now I've just got a week of wondering if I have cancer until I see the other doctor.

    In July, I had a kidney stone; xray and tests confirmed. When the internist (filling in for my regular doctor) saw that I had an ongoing small dosage pain prescription for my arthritis and stenosis, he decided to give me a 10 minute lecture on how I was fat and lazy, and any use of pain killers was a clear moral failing on my part, and that they weren't going to do anything about the kidney stone, because clearly I was just one 5 mg hydrocodone away from riding the white pony in a opium den.)

    Because I had tears in my eyes, both from humiliation and because kidney stones fucking hurt, when I left his office, I missed the curb, and came down wrong, and tore the tendon in one foot, and ended up seeing an orthopedic surgeon, who said "Meh, you'll be fine. Stay off your feet for a few days, and then, you just need to get more exercise." No physical therapy, no offer of pain management, no referral to another doctor who might be able to help, just 'here's this walking boot, wear it. Also, you should lose 50 pounds. Try riding 10 miles a day, that should stretch the tendon back out." It's six months later you guys, and it still hurts so much, but I don't have the 5 grand to have another specialist run MRIs and tell me to lose weight.

    So even though I'm not really sure about this rheumatologist yet, and I don't care for the way she just sort of handwaved my questions away, she's the first medical professional I've seen in six months of seeing professionals that acknowledged that the pain I'm in is real, acknowledged that my pain management regime was significantly less than most people with my underlying condition, and didn't try to body shame me for being 20% heavier than charts claim I should be.

    That said; I'm still freaked out about the referral to the blood guy.
    posted by SecretAgentSockpuppet at 7:04 PM on January 9, 2016 [5 favorites]


    I can't avoid the frighteningly negative thought about how much greater the difference in life expectancy between men and women would be if the medical profession treated them equally.
    posted by oneswellfoop at 7:18 PM on January 9, 2016 [1 favorite]


    SecretAgentSockpuppet, Google polycythemia vera. Cancer not cancer. Caused mostly by a gene mutation. Can be reversed on the right medication, though the findings are new and not every doctor is up to date. Kidney stones can be a symptom.

    And argh! being as of being a women isn't bad enough, being an overweight women is a recipe to be dismissed. I am overweight now, but it's close to normal bmi. I was a lot more over weight 3 years ago. I had one doctor tell me that if I just lost some weight, that would help with my joint pain. I don't have joint pain (didn't, now my hands do), explicitly don't have joint pain, which is why doctors seemed to have trouble diagnosing me. And the thing is, I wasn't even that heavy. It wasn't good, I was chubby, but men with a similar roundness would never get the kind of commentary on weight.

    I eventually lost about 40lbs (I have a small frame so it was drastic for me) , and the change was markedly different. I didn't recognize how much the go to answer was weight. Doctors were much more willing to try something for my problem rather than telling me I needed to lose weight first. I've gained about 20 of it back, which I'm not thrilled with, but I still seem to fall on the normal weight continuum. And yet. I had a little eating splurge after being particularly miserable from pain, and my therapist called me out. He did it in a kind, compassionate way; yet I'm torn on how to feel about it. On one hand, it encouraged me to get back on a healthy eating track, on the other side, this was the first time we ever talked about food. I had at most put on 4-5 lbs over a few months. I just can't imagine that would happen to a man.

    I have a few pain friends online, and was discussing with one the horrible truth about weight because she's having trouble getting her doctors to take her seriously even though the pain caused in activity cause weight gain. And yet- they don't take it seriously. She's got the weight double whammy. A woman and weight (and like me, she's not really that heavy, just enough to hit the bias line).

    And so I've been working to keep weight off for the same reason I can't cry in a doctors office or show too much knowledge or other reasons to be discounted.
    posted by [insert clever name here] at 8:13 PM on January 9, 2016 [3 favorites]


    In addendum . . . Or your doc made a bad call. My pain doctor wanted to send me to an oncologist over a lump in my leg. I was pretty sure based on the MRI report it was suggestive of not being cancer, and when he read the MRI report, he was running an hour late and frazzled. So I spent a week freaking out before I called my GP and explained what was going on. She did refer me to an orthopedic surgeon just in case, but felt strongly too that the report indicated there were no findings to indicate cancer. (The Orth. Surg. agreed.)
    posted by [insert clever name here] at 8:18 PM on January 9, 2016


    . . . had a mouth full of blood and it was already over. but I was a little kid. that's pretty messed up, right?

    I don't think it is. I've been going to the local dental school, and something similar happened to my sister when growing up. She had a cavity filled even though the lidocaine was not working. I told my student dentist and he was mortified. Back then though, the dentist didn't believe her or care. Because you know, little kids often ask for more injections in the mouth for kicks.

    Oh hey, what were we saying about not believing women? Apparently it extends to little girls too.
    posted by [insert clever name here] at 8:22 PM on January 9, 2016 [3 favorites]


    I put up with my GP's terrible office staff and scheduling because SHE is great and if I go to see her with knee pain she'll be like, "Of course weight loss helps with joint pain but that's a long term and complex goal, let's talk about managing your pain NOW and finding out what the root cause is."

    And unlike a shocking number of doctors she doesn't labor under the bizarre belief that if you're in too much pain to move, EXERCISE IS THE ONLY THING NEEDED! "I had to stop exercising because I did something to my knee and now I'm putting on weight and the pain is getting worse ..." "Oh, exercise more!" "Uh ... What med school did you go to again? Was it TV? Did you watch a lot of House and then just grab a stethoscope and hope for the best?"
    posted by Eyebrows McGee at 8:25 PM on January 9, 2016 [17 favorites]


    There's also the fact that women are led to believe that pain and suffering are just an inevitable part of their life (because: periods, childbirth) and therefore we should put up with it. At least that's my only explanation for how I came to be woken in the night by pain which had me on all fours howling like an animal, and didn't go back to the doctor.

    I eventually went back when the coil I'd had put in started coming out of its own accord and needed to be removed, but it was a looong time later before I finally got a scan for my insanely heavy, painful periods (and then only when I'd specifically asked my GP for it, not at her suggestion) and found one of the biggest uterine polyps the gynae had ever seen. On her first, unsuccessful, attempt at removing it, the gynae was astonished at my tolerance for pain and told me I was incredibly stoic. I was baffled, because the pain was similar to what I'd been putting up with monthly, silently, for several years. She was particularly gobsmacked when I told her that I'd somehow also had a coil in there for a while, squeezed in alongside the polyp and causing me no end of agony.
    posted by smock puppet at 10:04 AM on January 10, 2016 [2 favorites]


    Presented it all to the doctor. He took one glance and said "no, I need you to tell me. I'm not going to read this."


    this is the kind of thing that if you wrote "and then i spontaneously generated a viciously toothed sentient xenomorph murderous tongue probe that tore out his throat" i'd be like yeah that sounds about right
    posted by poffin boffin at 9:06 PM on January 10, 2016 [7 favorites]


    I'm a little late to this thread, but this happened to me as well. I had gallbladder issues for the better part of a year. It was extremely painful and I ended up in the ER four times because I became too dizzy with pain and nausea to function on any level. I was sent home three of those times with diagnoses of heartburn and constipation (!!). My family doctor also insisted it was acid reflux.

    The time I actually got in, the triage nurse asked me to rate my pain on a scale of one to ten. Instead of doing that, I puked a litre of fluorescent yellow bile into the trash can nearby.

    It was a very frustrating experience. It cost me a lot of money (even Canadian, I paid for three ambulance rides), it severely impacted my quality of life, and if left for long enough it could have poisoned me from the inside. I mentioned gallbladder suspicions to FIVE separate doctors. Only the last one believed me.

    Two of my acquaintances got the appropriate diagnostics run (ultrasound) and a cholecysectomy on their first ER visit. They were both male.
    posted by one of these days at 5:13 AM on January 11, 2016 [3 favorites]


    > Two of my acquaintances got the appropriate diagnostics run (ultrasound) and a cholecysectomy on their first ER visit. They were both male.

    Considering that the classic profile for gallbladder disease is that occurs more often in women (shorthanded as FFF -- female, fat, forty), that's particularly galling (ha!)

    I was really, really lucky that my doctor diagnosed my gallbladder after my first and only attack, because I would have been considered too young and slender for it to be an obvious conclusion for many doctors, but I have an amazing GP who truly listens to her patients. Ironically, my following the typical feminine habit of "just endure the pain and don't inconvenience anyone" probably did me a huge favor there. I was diagnosed by my GP because I got up in the morning after being in excruciating pain all night and scheduled an appointment for the first available "drop in" spot with her, a couple of days later.

    It hadn't even occurred to me to go to the ER that night. I mean, it didn't even occur to me that it was an option; I was so delirious with pain that it was as if I had forgotten that there is such a thing as emergency medicine.
    posted by desuetude at 6:03 AM on January 11, 2016 [2 favorites]


    Hah, when I was six I broke my leg jumping off furniture and both of my parents just didn't believe me for hours even though I was screaming and crying. My dad was left home alone with me and he just kinda gave up and left me on the couch crying. When Mom got home, they tried to stand me up (I could not do that), then tried to take me out for ice cream. When I had zero interest in eating that, that's when they figured something must be wrong. But I kinda chalk that up to my being an only child and that being my first injury and them not really having any idea or having broken a limb in their own past

    Oh hey, when I was six I broke my arm at my sister's band concert when a folding chair closed on me, and I went to catch myself. You can hear me cry on our home video--this long hysterical screaming sob that starts during jingle bells and continues the whole concert. My parents put some ice on it, then sent me to bed. They only took me to the doctor about it when over the next week or two, I'd shriek in pain any time I casually put my weight on my arm.

    (I had a whole bunch of weird childhood injuries like that that weren't treated. I sprayed myself in the eye with spray paint once, that was a good one. Plus a dog bite to the face that probably needed stitches and at least painkillers but never got them--I still have scars.)

    My favorite bad doctor experience was when I was 36 weeks pregnant and had to have a new GP because of insurance changes. I went for a general meet-and-greet type appointment, and the nurse immediately wanted to take my blood pressure. I told her that I have white coat hypertension, and always need a minute to sit down and chill out for my BP to normalize. It had been like this throughout my pregnancy, and my midwives were monitoring it. It was always a little high when I first got there, but if we waited until later in the appointment, after I'd relaxed a little, it would be normal. She took it anyway, then ran to get the doctor, who took it again even as I protested that if he let me wait a few minutes, it would be fine. He then started chastising me for my high blood pressure, insisting I needed to be seen by a high risk doctor, and asked me if I was going to midwives for my pregnancy because I was poor (I was on medicaid at the time).

    This had the effect of making my blood pressure skyrocket every time my midwife took it with a cuff, and I had to monitor it at home for the last two weeks of my pregnancy, which compounded my stress at an already stressful time. My midwives were great, though. For example, when I told them I was super tired at the end of the first trimester, they ran some extra bloodwork and figured out I was vitamin D deficient and anemic. They didn't dismiss those symptoms as "normal," which a lot of doctors seem to do.

    But man, I'm glad none of this was life or death stuff.
    posted by PhoBWanKenobi at 6:25 AM on January 11, 2016 [1 favorite]


    puffin boffin: Yeah, this is why I hoard painkillers for emergencies.

    I'm certainly hanging on to the rest of those prescriptions, I don't want to be caught out like that again. Long ago, I had a stash of Tylenol-3, but once I discovered freshman year that Advil would take care of really bad cramping, it literally had been 25 years since I had needed a prescription for pain. And I had forgotten what overwhelming, hours-long pain can do to your head. And for that matter, your body.
    posted by tavella at 10:08 AM on January 11, 2016


    I still have no idea if that goddamn heart monitor (that they didn't put on me for ~12 hours) was even doing anything.

    After that long without it, they were just ass covering, same as them wanting to admit me after leaving me hanging for 8 hours. They need to be able to say "Well, the monitoring didn't show anything!".

    Fuckers.
    posted by MissySedai at 10:39 AM on January 11, 2016


    They only took me to the doctor about it when over the next week or two, I'd shriek in pain any time I casually put my weight on my arm.

    OH MY JEEBUS THAT'S SO MUCH WORSE OMFG.

    Come to think of it, I wasn't a kid that was inclined to making up lies, but to this day my mom doesn't seem to believe anything I ever tell her and immediately, in front of my face, fact checks anything I say. Argh.
    posted by jenfullmoon at 8:06 PM on January 12, 2016 [2 favorites]


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