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Indybay Feature
Your Pain Is Not Real: How Doctors Discriminate Against Women
Women experiencing health problems and pain are routinely neglected by medical professionals, because of sexist myths and stereotypes about women.
I'm going to share with you an article from The Atlantic Monthly. It introduces readers to a problem which is probably surprising to some people. Studies cited in The Atlantic article showed that sexist biases about female patients resulted in women having less treatment for health problems and pain than our male counterparts.
The article from the Atlantic Monthly, called, "How Doctors Take Women's Pain Less Seriously" shares the disturbing account of how a woman experiencing a medical emergency was treated like a hypochrondriac when she was having a serious medical emergency.
Link: https://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/
Our healthcare system is rife with backward ideas about female patients. We are seen as weaker than men, and prone to emotional flights of fancy. Most of all, we're presumed to be weak and unable to handle pain as well as men.
Sexist biases manifest into doctors seeing all female patients as potential hypochrondriacs. This endangers women's lives. Men's pain is taken seriously, because men are seen as brave, stoic and tough. In contrast, women are frequently sent away from doctors offices and hospitals, being told their pain is most likely about emotional and psychological issues over actual medical issues.
"Vice," also recently did an article on the same subject. Here's what Vice says about this problem, (read more here: https://www.vice.com/en_us/article/nz9wbg/your-pain-is-not-real-how-doctors-discriminate-against-women
"Unfortunately, women are taken less seriously more often than men when it comes to pain," Dr. Jennifer Wider, a nationally renowned women's health expert and the spokeswoman for the Society for Women's Health Research, told Broadly. "Studies show that doctors, regardless of gender, tend to undertreat female patients and take longer to administer medication to women." A 2001 study published in the Journal of Law, Medicine & Ethics found that doctors often incorrectly believe that women have a "natural capacity to endure pain" and possess more coping mechanisms thanks to the stresses of childbirth. A National Institute of Health study also shows that women tend to wait 16 minutes longer than men when they are receiving pain medicine in emergency rooms. According to the same study, women are 13 to 25 percent less likely to receive opioids when they are dealing with pain."
Here are links to the studies mentioned in the article:
"The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain."
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=383803
"Gender Disparity in Analgesic Treatment of Emergency Department Patients with Acute Abdominal Pain,"
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1553-2712.2008.00100.x
An article titled, "Is your doctor treating you based on your gender instead of your symptoms?" explains this general bias amongst doctors: "Many women have experienced doctors — both male and female — dismissing legitimate medical symptoms under the umbrella of our gender. Whether it’s attributing unrelated symptoms to our menstrual cycle or dismissing pain as anxiety or “complaining,” doctors often eschew even the most basic of tests and miss textbook diagnoses.
"One woman experienced dismissal and minimization for five years until she was finally given a simple thyroid test and diagnosed with Graves’ disease. She turned her experience into a comic strip at the Nib to illustrate the gender bias that women face in the doctor’s office. Her symptoms were indeed textbook symptoms of hyperthyroidism that had been explained away as psychological or menses-related by ER doctors, university doctors, and even her childhood primary care physician. In the end, it was actually a sleep therapist who finally recognized the symptoms of Graves disease and tested her thyroid function."
Link: https://aleteia.org/2017/11/01/is-your-doctor-treating-you-based-on-your-gender-instead-of-the-symptoms/
I will now quote from an article which goes into more depth about the history of this problem. It's called:
"Doctors, Stop Gaslighting Women In Pain: For almost 4,000 years, doctors have been treating women in pain less seriously than men. That needs to stop."
link: https://medium.com/thrive-global/doctors-stop-gaslighting-women-in-pain-3934a2fdc1b
by Sarah Wilson
"It’s February 2014. It’s been a year since I began experiencing all the symptoms of inflammatory arthritis, but had yet to get a diagnosis. For the greater part of the last year, I’ve been told by my doctors that it’s “all in my head.”
"On this particular morning, I wake abruptly to an intense pain in the base of my throat. I immediately began to panic — it felt like I couldn’t breathe. I texted my then-boyfriend. “Something’s wrong. I think I need to go to the hospital.” He arrived almost immediately. I never wanted to go to the emergency room — who does? — so he knew things were bad.
I don’t remember exactly how long it took for someone to see me. I just remember the agony, the fear that the pain would spread, and the worry that I’d be sent home with no answers and no relief. I was right about the last thing. When a doctor eventually saw me, he listened for mere seconds to my description of the golf ball in my throat, and told me I was having a panic attack.
“Calm down,” he said, and left. I was aghast. I’m intimately familiar with panic attacks — this wasn’t one. Even if it were, telling me to “calm down,” wouldn’t help me. Instead of treating me, the doctor gaslit me, dismissing me out of hand for being an overly emotional woman.
"I was later diagnosed with Ankylosing Spondylitis. Needless to say, there’s no “calming down” from a chronic autoimmune disease of the skeleton.
"This story is in no way unusual. Women’s pain has been being taken less seriously than men’s for millennia. The words hysteria and hysterical come from the Greek word for uterus, showing that our reproductive organs have been used as scapegoats for pain and the response to it for millennia. In fact, the first use of the word “hysteria” to refer to women in pain dates back to Ancient Egypt. In 1900 BC, the Kahun Papyrus names “spontaneous uterus movement with the female body,” as being responsible for symptoms, and the Eber Papyrus in 1600BC discusses ways to force the wayward organ back to its natural position.
"In Lesley Jamieson’s Grand Unified Theory of Female Pain, the author argues that women’s pain has long been “perceived as constructed or exaggerated.” According to Jamieson, whose work is backed up by The Girl Who Cried Pain — a legal study identifying the gender bias in pain management — women are “more likely to be treated less aggressively in their initial encounters with the health-care system until they prove that they are as sick as male patients.”
"In other words? Doctors gaslighting women in real pain isn’t the exception. It’s the status quo.
"Case in point: with the arrival of her period at age 12, Maria-Jane Brodie began exhibiting all the symptoms of endometriosis, a chronic inflammatory illness that affects 176 million women worldwide. Maria-"Jane would be in so much agony each month, she would vomit non-stop for 36 hours. She was told “that’s what periods are like — get used to it.” Despite the debilitating symptoms, it took a decade of illness before a doctor finally agreed to give her the IUD that makes her life manageable.
"Here’s another example. In 2015, following the most terrifying hours he and his wife had ever experienced, Joe Fassler wrote the groundbreaking article How Doctors Take Women’s Pain Less Seriously for The Atlantic. Joe describes waking to Rachel screaming, and finding her doubled over in anguish. When asked where the pain was a scale of one to ten, she replied eleven. He called an ambulance.
“There is nothing like witnessing a loved one in deadly agony,” writes Joe. “Your muscles swell with the blood they need to fight or run. I felt like I could bend iron, tear nylon, through the 10-minute ambulance ride and as we entered the windowless basement hallways of the hospital.” “And there we stopped.”
“Nationwide,” says Joe, pulling from this study on gender bias in emergency department treatment, “men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain. Women wait an average of 65 minutes for the same thing. Rachel waited somewhere between 90 minutes and two hours.”
"Men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain. Women wait an average of 65 minutes for the same thing.
"That is Rachel’s story. That is my story. That is Maria-Jane’s story. This is women everywhere. In Rachel’s case, she had an ovarian torsion, an indescribably painful event where the fallopian tube twists, cutting off blood. It took until 10pm that day for a doctor to finally diagnose the issue. Fourteen and a half hours from when Rachel’s pain began, to surgery. And if the problem had been identified sooner, she may never have had to lose her ovary.
"Aubrey Hirsch’s comic, Medicine’s Women Problem, went viral after hitting the nail on the head. Hirsch illustrated her experience of being told for years that her symptoms — weight loss, strange bruises, reactions to food, pain, even trouble with her heart — were caused by anxiety and IBS. Eventually, things became so bad that doctors ran a gamut of tests and discovered she had Graves’ Disease, an autoimmune disorder affecting her thyroid.
"None of her problems had been in her head. As with me, her diagnosis took years, and before she had it, she was treated as if the issues were minor and inextricably linked being female.
“The system doesn’t have a crack in it” she writes. “For many women, it has a crater.”
"After centuries of having our pain dismissed and experiences ignored, it’s about time medicine took note. In the age of online communities and social media, women simply aren’t going to be silent anymore. It’s encouraging to Google women’s pain and see just how many people are talking about this. Article after article, study after study, proves that we’re dealing with a major problem.
"So what are we going to do about it? Medicine has had 4,000 years to evolve, yet it’s still seeped in what amounts to a deadly culture of sexism. How many women have died in those millennia because their pain — the body’s warning sign that something is wrong — have been dismissed until it was too late.
Women speaking up, and all the studies in the world, won’t affect change unless doctors do. That has to come from within the medical system. Gender bias in medical treatment is a proven fact. Addressing it should be woven into the way doctors are taught to be doctors.
"There’s a popular Maya Angelou quote that in these divisive times has become a rallying cry for many around the world: “When people show you who they are, believe them.” Just as much as the Hippocratic Oath, it’s important for doctors to remember that, when it comes to pain, this is their duty as well. When people show you they’re in pain, don’t gaslight them for being women. Believe them."
One thing many people don't know is that women experience different symptoms with heart attacks than men. In a normal world, this wouldn't be that big of a deal, surely in a normal world, doctors would be taught this is the case- or if not, the doctor would take a woman at her word about experiencing a cardiac event, right? I mean it's a heart attack, those are serious, no one would let someone potentially die over a silly bias against women?
We don't live in a normal world though. This next article describes a critical problem faced by female heart patients:
"‘Gaslighting’ – or, why women are just too darned emotional during their heart attacks" by Carolyn Thomas ♥ @HeartSisters
link to article: https://myheartsisters.org/2011/11/25/gaslighting/
"I came across the term ‘gaslighting‘ the other day, and I immediately grasped its practical application to everyday life. (Very similar reaction, in fact, to first hearing the word ‘mansplaining‘!) But I digress. The concept of gaslighting may ring bells for any woman who has been misdiagnosed in mid-heart attack, patted on the head and sent home from the E.R. in abject embarrassment.
"I learned about gaslighting from Yashar Ali, a Los Angeles-based columnist and author of the book A Message To Women From A Man: You Are Not Crazy. Here’s an excerpt:
“This mental health term comes from the 1944 MGM film, Gaslight, starring Ingrid Bergman. Bergman’s husband in the film, played by Charles Boyer, wants to get his hands on her jewelry. He realizes he can accomplish this by having her certified as insane and committed to a mental institution. To pull off this task, he intentionally sets the gaslights in their home to flicker on and off, and every time Bergman’s character reacts to it, he tells her she’s just seeing things.”
"Charles Boyer’s dastardly attempts at gaslighting poor Ingrid were both deliberate and pre-meditated. But gaslighting is not always so, which according to Ali, just makes it worse. And all of us, especially women, have dealt with gaslighting at one time or another.
“Those who engage in gaslighting create a reaction – whether it’s anger, frustration, embarrassment – in the person they are speaking to. Then, when that person reacts, the gaslighter makes them feel uncomfortable and insecure by behaving as if their feelings are not rational or normal.”
"Gaslighting can be as simple as someone smirking at you and saying something like:
“You’re too sensitive!”
“You’re so emotional!”
“You’re defensive!”
“You’re overreacting!”
“Calm down!”
“Just relax!”
"Such responses, writes Ali, may seem innocuous enough, but in that moment, the speaker is making a judgment about how someone else should feel. And, worse, that judgment can render some women emotionally mute.
"When women receive push-back like this to our own reactions, we might just brush it off: Forget it! It’s okay. But that Forget it! isn’t just about dismissing a thought, warns Ali. It is about self-dismissal.
"You too might be doing the “Gaslight Tango“ (as described by Dr. Robin Stern, author of The Gaslight Effect: Don’t Be Afraid To Speak Your Truth) if:
1. you are constantly second-guessing yourself
2. you frequently ask yourself: “Am I too sensitive?”
3. you often feel confused and even crazy
4. you apologize – a lot
5. you can’t understand why, with so many apparently good things in your life, you aren’t happier
6. you frequently make excuses for the comments or behaviour of others
7. you find yourself withholding information so you don’t have to explain or make excuses
8. you know something is terribly wrong, but you can never quite express what it is, even to yourself
9. you have trouble making simple decisions
10. you have the sense that you used to be a very different person.
"Now consider, for example, the disturbingly common scenario of women who are misdiagnosed and sent home from the E.R. in mid-heart attack.
"This, by the way, happened to me, and it happens far more frequently than you might ever guess: when the New England Journal of Medicine reported on a study of over 10,000 heart patients, 48% of them women, findings suggested that women under age 55 are SEVEN TIMES more likely than their male counterparts to be misdiagnosed in mid-heart attack and sent home. The consequences of this were enormous: being sent away from the hospital doubled the chances of dying.(1)
"Anyway, back to the E.R. So you show up at the hospital, overwhelmed by frightening physical symptoms that may (Oh, no, please God, no!) be related to a heart attack. It’s actually taken a lot just to get you this far, after trying for much too long already to ignore or deny your increasingly debilitating symptoms.
"But the E.R. physician tells you that your cardiac tests are all fine, that you’re merely just experiencing ____ (fill in the blank here: anxiety, stress, menopause, indigestion) and that your symptoms are clearly NOT heart-related at all. Goodbye and have a nice life!
"What do you do? If you stand up to the doc’s confident dismissal, then you surely run the risk of reinforcing that anxiety misdiagnosis. Patient is anxious.
"When you politely question his diagnosis, the doctor sighs, one of those quietly exasperated oh-no-not-another-one-here-we-go-again-let’s-just-get-this-over-with sighs.
"But you know your body. You know when something is just not right. You know what anxiety or stress or menopause or indigestion feel like – and you know that this is none of those. Do you repeat your insistence that your symptoms must be taken seriously? Patient is agitated.
The E.R. doc now begins to repeat what he’s already told you, very s-l-o-w-l-y this time as if you are a difficult or dull-witted child. You realize as he’s talking, of course, that the more you try to stand your ground, the more your affect will actually reinforce what he’s already written on your chart. You do know how this looks. Patient is uncooperative.
Besides, by now you are acutely aware that the E.R. waiting room is filled with bleeding-crying-injured-vomiting sick people, and this doctor has many far more urgent cases to see tonight. He is ready to snap your chart shut right now and move on to the person in the next bed. You can sense this. Patient is attention-seeking.
Maybe this doctor is right.
Maybe you are just feeling a bit anxious after all.
Maybe you are indeed overreacting, just as the doctor has implied.
"Maybe you should just climb down off that gurney, thank the E.R. staff, and go straight home now, albeit embarrassed and humiliated that you have made such a big fuss over nothing."
In our culture, we like to think that doctors are always honest and fair and only practice medicine because they just love helping people so much. Still, medicine is just a profession like any other job.
Reality often gets buried under myths we believe and don't question. We need only look at back 150 years ago, when women were counted as our husband's property to see how bad things can get. We like to think things have changed and that the 1960's solved all of our problems. But as the #MeToo movement shows, women are still second class citizens, forced into unfair deference to male authority. #MeToo shows that men in authority get away with much. The lesson is that we, as women, must reclaim our own power and not let patriarchy take it away.
This problem with barriers for women in terms of healthcare and pain treatment has stayed hidden for a long time. When a doctor, someone we often think as intrinsically fair, tells the patient she's crazy and imagining her pain, other people around her almost always believe the doctor and not her. I mean, no one would ever say that about a patient if it wasn't true? That would be unthinkable! Those of us who have fallen victim to this, haven't just lost our health, we've lost our friends because of this. I need to stress this is why this issue has been hidden. Until now, women weren't speaking out namely because, to do so meant we'd likely not be believed.
Gaslighting and denying women health care is not a glass ceiling but a concrete one. Ever try to work while sick? It's hard enough to be sick when you are receiving treatment. Imagine trying to work and survive while being left untreated. I've lived it, it is not any way to live. Animals get treated better than this.
The problem of bigotry in our culture truly is pervasive. There's no magic profession that exclude these types of people.
I was disturbed to learn recently that African Americans get excluded from healthcare in much the same way as women, frome racial biases. A study found that black children get less pain medication that white children:
"Black Kids Get Less Pain Medication Than White Kids in ER" by NBC News. Link: https://www.nbcnews.com/health/kids-health/black-kids-get-less-pain-medication-white-kids-er-n427056
Black women and men also get denied healthcare:
"The Disturbing Reason Some African Americans May be Untreated for Pain:
https://www.washingtonpost.com/news/to-your-health/wp/2016/04/04/do-blacks-feel-less-pain-than-whites-their-doctors-may-think-so/?noredirect=on&utm_term=.b34403cab0de
"Chronic Pain, and the Denial of Care for Black Women"
https://rewire.news/article/2014/03/04/chronic-pain-denial-care-black-women/
Further reading on all these subjects:
"Women do experience severe and chronic pain"
https://us.blastingnews.com/opinion/2018/04/women-do-experience-severe-and-chronic-pain-002501645.html
"How Doctors Gaslight Women into Doubting Their Own Pain"
https://broadly.vice.com/en_us/article/gy899x/maya-dusenbery-how-doctors-gaslight-women-doubting-their-own-pain
"Prescribing Mindfulness Allows Doctors to Ignore Legitimate Female Pain" by Slate
https://slate.com/technology/2018/02/doctors-are-increasingly-pushing-min
dfulness-on-chronic-pain-patients.html
"Women's Chronic Pain Misdiagnosed, Undertreated, Dismissed"
https://abcnews.go.com/Health/PainNews/women-chronic-pain/story?id=15598143
"4 Out of 5 Doctors…Are Wrong," by MissTreated
http://www.misstreated.org/blog/2015/11/19/four-out-of-five-doctorsare-wrong
"We Cannot Continue to Let Doctors 'Gaslight' Chronic Illness Patients"
https://themighty.com/2016/10/mecfs-and-gaslighting-what-to-do-when-doctors-dont-believe-you/
"Petition: Stop Power-Hungry Doctors From Bullying, Gaslighting, and Blacklisting Their Patients!"
https://www.change.org/p/stop-power-hungry-doctors-from-bullying-gaslighting-and-blacklisting-their-patients
"Is Your Doctor Health-Gas Lighting You?"
https://www.women.com/alisegel/lists/is-your-doctor-health-gas-lighting-you
Youtube video about bias in doctors:
https://www.youtube.com/watch?v=0hZ0_a35hFU
The article from the Atlantic Monthly, called, "How Doctors Take Women's Pain Less Seriously" shares the disturbing account of how a woman experiencing a medical emergency was treated like a hypochrondriac when she was having a serious medical emergency.
Link: https://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/
Our healthcare system is rife with backward ideas about female patients. We are seen as weaker than men, and prone to emotional flights of fancy. Most of all, we're presumed to be weak and unable to handle pain as well as men.
Sexist biases manifest into doctors seeing all female patients as potential hypochrondriacs. This endangers women's lives. Men's pain is taken seriously, because men are seen as brave, stoic and tough. In contrast, women are frequently sent away from doctors offices and hospitals, being told their pain is most likely about emotional and psychological issues over actual medical issues.
"Vice," also recently did an article on the same subject. Here's what Vice says about this problem, (read more here: https://www.vice.com/en_us/article/nz9wbg/your-pain-is-not-real-how-doctors-discriminate-against-women
"Unfortunately, women are taken less seriously more often than men when it comes to pain," Dr. Jennifer Wider, a nationally renowned women's health expert and the spokeswoman for the Society for Women's Health Research, told Broadly. "Studies show that doctors, regardless of gender, tend to undertreat female patients and take longer to administer medication to women." A 2001 study published in the Journal of Law, Medicine & Ethics found that doctors often incorrectly believe that women have a "natural capacity to endure pain" and possess more coping mechanisms thanks to the stresses of childbirth. A National Institute of Health study also shows that women tend to wait 16 minutes longer than men when they are receiving pain medicine in emergency rooms. According to the same study, women are 13 to 25 percent less likely to receive opioids when they are dealing with pain."
Here are links to the studies mentioned in the article:
"The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain."
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=383803
"Gender Disparity in Analgesic Treatment of Emergency Department Patients with Acute Abdominal Pain,"
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1553-2712.2008.00100.x
An article titled, "Is your doctor treating you based on your gender instead of your symptoms?" explains this general bias amongst doctors: "Many women have experienced doctors — both male and female — dismissing legitimate medical symptoms under the umbrella of our gender. Whether it’s attributing unrelated symptoms to our menstrual cycle or dismissing pain as anxiety or “complaining,” doctors often eschew even the most basic of tests and miss textbook diagnoses.
"One woman experienced dismissal and minimization for five years until she was finally given a simple thyroid test and diagnosed with Graves’ disease. She turned her experience into a comic strip at the Nib to illustrate the gender bias that women face in the doctor’s office. Her symptoms were indeed textbook symptoms of hyperthyroidism that had been explained away as psychological or menses-related by ER doctors, university doctors, and even her childhood primary care physician. In the end, it was actually a sleep therapist who finally recognized the symptoms of Graves disease and tested her thyroid function."
Link: https://aleteia.org/2017/11/01/is-your-doctor-treating-you-based-on-your-gender-instead-of-the-symptoms/
I will now quote from an article which goes into more depth about the history of this problem. It's called:
"Doctors, Stop Gaslighting Women In Pain: For almost 4,000 years, doctors have been treating women in pain less seriously than men. That needs to stop."
link: https://medium.com/thrive-global/doctors-stop-gaslighting-women-in-pain-3934a2fdc1b
by Sarah Wilson
"It’s February 2014. It’s been a year since I began experiencing all the symptoms of inflammatory arthritis, but had yet to get a diagnosis. For the greater part of the last year, I’ve been told by my doctors that it’s “all in my head.”
"On this particular morning, I wake abruptly to an intense pain in the base of my throat. I immediately began to panic — it felt like I couldn’t breathe. I texted my then-boyfriend. “Something’s wrong. I think I need to go to the hospital.” He arrived almost immediately. I never wanted to go to the emergency room — who does? — so he knew things were bad.
I don’t remember exactly how long it took for someone to see me. I just remember the agony, the fear that the pain would spread, and the worry that I’d be sent home with no answers and no relief. I was right about the last thing. When a doctor eventually saw me, he listened for mere seconds to my description of the golf ball in my throat, and told me I was having a panic attack.
“Calm down,” he said, and left. I was aghast. I’m intimately familiar with panic attacks — this wasn’t one. Even if it were, telling me to “calm down,” wouldn’t help me. Instead of treating me, the doctor gaslit me, dismissing me out of hand for being an overly emotional woman.
"I was later diagnosed with Ankylosing Spondylitis. Needless to say, there’s no “calming down” from a chronic autoimmune disease of the skeleton.
"This story is in no way unusual. Women’s pain has been being taken less seriously than men’s for millennia. The words hysteria and hysterical come from the Greek word for uterus, showing that our reproductive organs have been used as scapegoats for pain and the response to it for millennia. In fact, the first use of the word “hysteria” to refer to women in pain dates back to Ancient Egypt. In 1900 BC, the Kahun Papyrus names “spontaneous uterus movement with the female body,” as being responsible for symptoms, and the Eber Papyrus in 1600BC discusses ways to force the wayward organ back to its natural position.
"In Lesley Jamieson’s Grand Unified Theory of Female Pain, the author argues that women’s pain has long been “perceived as constructed or exaggerated.” According to Jamieson, whose work is backed up by The Girl Who Cried Pain — a legal study identifying the gender bias in pain management — women are “more likely to be treated less aggressively in their initial encounters with the health-care system until they prove that they are as sick as male patients.”
"In other words? Doctors gaslighting women in real pain isn’t the exception. It’s the status quo.
"Case in point: with the arrival of her period at age 12, Maria-Jane Brodie began exhibiting all the symptoms of endometriosis, a chronic inflammatory illness that affects 176 million women worldwide. Maria-"Jane would be in so much agony each month, she would vomit non-stop for 36 hours. She was told “that’s what periods are like — get used to it.” Despite the debilitating symptoms, it took a decade of illness before a doctor finally agreed to give her the IUD that makes her life manageable.
"Here’s another example. In 2015, following the most terrifying hours he and his wife had ever experienced, Joe Fassler wrote the groundbreaking article How Doctors Take Women’s Pain Less Seriously for The Atlantic. Joe describes waking to Rachel screaming, and finding her doubled over in anguish. When asked where the pain was a scale of one to ten, she replied eleven. He called an ambulance.
“There is nothing like witnessing a loved one in deadly agony,” writes Joe. “Your muscles swell with the blood they need to fight or run. I felt like I could bend iron, tear nylon, through the 10-minute ambulance ride and as we entered the windowless basement hallways of the hospital.” “And there we stopped.”
“Nationwide,” says Joe, pulling from this study on gender bias in emergency department treatment, “men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain. Women wait an average of 65 minutes for the same thing. Rachel waited somewhere between 90 minutes and two hours.”
"Men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain. Women wait an average of 65 minutes for the same thing.
"That is Rachel’s story. That is my story. That is Maria-Jane’s story. This is women everywhere. In Rachel’s case, she had an ovarian torsion, an indescribably painful event where the fallopian tube twists, cutting off blood. It took until 10pm that day for a doctor to finally diagnose the issue. Fourteen and a half hours from when Rachel’s pain began, to surgery. And if the problem had been identified sooner, she may never have had to lose her ovary.
"Aubrey Hirsch’s comic, Medicine’s Women Problem, went viral after hitting the nail on the head. Hirsch illustrated her experience of being told for years that her symptoms — weight loss, strange bruises, reactions to food, pain, even trouble with her heart — were caused by anxiety and IBS. Eventually, things became so bad that doctors ran a gamut of tests and discovered she had Graves’ Disease, an autoimmune disorder affecting her thyroid.
"None of her problems had been in her head. As with me, her diagnosis took years, and before she had it, she was treated as if the issues were minor and inextricably linked being female.
“The system doesn’t have a crack in it” she writes. “For many women, it has a crater.”
"After centuries of having our pain dismissed and experiences ignored, it’s about time medicine took note. In the age of online communities and social media, women simply aren’t going to be silent anymore. It’s encouraging to Google women’s pain and see just how many people are talking about this. Article after article, study after study, proves that we’re dealing with a major problem.
"So what are we going to do about it? Medicine has had 4,000 years to evolve, yet it’s still seeped in what amounts to a deadly culture of sexism. How many women have died in those millennia because their pain — the body’s warning sign that something is wrong — have been dismissed until it was too late.
Women speaking up, and all the studies in the world, won’t affect change unless doctors do. That has to come from within the medical system. Gender bias in medical treatment is a proven fact. Addressing it should be woven into the way doctors are taught to be doctors.
"There’s a popular Maya Angelou quote that in these divisive times has become a rallying cry for many around the world: “When people show you who they are, believe them.” Just as much as the Hippocratic Oath, it’s important for doctors to remember that, when it comes to pain, this is their duty as well. When people show you they’re in pain, don’t gaslight them for being women. Believe them."
One thing many people don't know is that women experience different symptoms with heart attacks than men. In a normal world, this wouldn't be that big of a deal, surely in a normal world, doctors would be taught this is the case- or if not, the doctor would take a woman at her word about experiencing a cardiac event, right? I mean it's a heart attack, those are serious, no one would let someone potentially die over a silly bias against women?
We don't live in a normal world though. This next article describes a critical problem faced by female heart patients:
"‘Gaslighting’ – or, why women are just too darned emotional during their heart attacks" by Carolyn Thomas ♥ @HeartSisters
link to article: https://myheartsisters.org/2011/11/25/gaslighting/
"I came across the term ‘gaslighting‘ the other day, and I immediately grasped its practical application to everyday life. (Very similar reaction, in fact, to first hearing the word ‘mansplaining‘!) But I digress. The concept of gaslighting may ring bells for any woman who has been misdiagnosed in mid-heart attack, patted on the head and sent home from the E.R. in abject embarrassment.
"I learned about gaslighting from Yashar Ali, a Los Angeles-based columnist and author of the book A Message To Women From A Man: You Are Not Crazy. Here’s an excerpt:
“This mental health term comes from the 1944 MGM film, Gaslight, starring Ingrid Bergman. Bergman’s husband in the film, played by Charles Boyer, wants to get his hands on her jewelry. He realizes he can accomplish this by having her certified as insane and committed to a mental institution. To pull off this task, he intentionally sets the gaslights in their home to flicker on and off, and every time Bergman’s character reacts to it, he tells her she’s just seeing things.”
"Charles Boyer’s dastardly attempts at gaslighting poor Ingrid were both deliberate and pre-meditated. But gaslighting is not always so, which according to Ali, just makes it worse. And all of us, especially women, have dealt with gaslighting at one time or another.
“Those who engage in gaslighting create a reaction – whether it’s anger, frustration, embarrassment – in the person they are speaking to. Then, when that person reacts, the gaslighter makes them feel uncomfortable and insecure by behaving as if their feelings are not rational or normal.”
"Gaslighting can be as simple as someone smirking at you and saying something like:
“You’re too sensitive!”
“You’re so emotional!”
“You’re defensive!”
“You’re overreacting!”
“Calm down!”
“Just relax!”
"Such responses, writes Ali, may seem innocuous enough, but in that moment, the speaker is making a judgment about how someone else should feel. And, worse, that judgment can render some women emotionally mute.
"When women receive push-back like this to our own reactions, we might just brush it off: Forget it! It’s okay. But that Forget it! isn’t just about dismissing a thought, warns Ali. It is about self-dismissal.
"You too might be doing the “Gaslight Tango“ (as described by Dr. Robin Stern, author of The Gaslight Effect: Don’t Be Afraid To Speak Your Truth) if:
1. you are constantly second-guessing yourself
2. you frequently ask yourself: “Am I too sensitive?”
3. you often feel confused and even crazy
4. you apologize – a lot
5. you can’t understand why, with so many apparently good things in your life, you aren’t happier
6. you frequently make excuses for the comments or behaviour of others
7. you find yourself withholding information so you don’t have to explain or make excuses
8. you know something is terribly wrong, but you can never quite express what it is, even to yourself
9. you have trouble making simple decisions
10. you have the sense that you used to be a very different person.
"Now consider, for example, the disturbingly common scenario of women who are misdiagnosed and sent home from the E.R. in mid-heart attack.
"This, by the way, happened to me, and it happens far more frequently than you might ever guess: when the New England Journal of Medicine reported on a study of over 10,000 heart patients, 48% of them women, findings suggested that women under age 55 are SEVEN TIMES more likely than their male counterparts to be misdiagnosed in mid-heart attack and sent home. The consequences of this were enormous: being sent away from the hospital doubled the chances of dying.(1)
"Anyway, back to the E.R. So you show up at the hospital, overwhelmed by frightening physical symptoms that may (Oh, no, please God, no!) be related to a heart attack. It’s actually taken a lot just to get you this far, after trying for much too long already to ignore or deny your increasingly debilitating symptoms.
"But the E.R. physician tells you that your cardiac tests are all fine, that you’re merely just experiencing ____ (fill in the blank here: anxiety, stress, menopause, indigestion) and that your symptoms are clearly NOT heart-related at all. Goodbye and have a nice life!
"What do you do? If you stand up to the doc’s confident dismissal, then you surely run the risk of reinforcing that anxiety misdiagnosis. Patient is anxious.
"When you politely question his diagnosis, the doctor sighs, one of those quietly exasperated oh-no-not-another-one-here-we-go-again-let’s-just-get-this-over-with sighs.
"But you know your body. You know when something is just not right. You know what anxiety or stress or menopause or indigestion feel like – and you know that this is none of those. Do you repeat your insistence that your symptoms must be taken seriously? Patient is agitated.
The E.R. doc now begins to repeat what he’s already told you, very s-l-o-w-l-y this time as if you are a difficult or dull-witted child. You realize as he’s talking, of course, that the more you try to stand your ground, the more your affect will actually reinforce what he’s already written on your chart. You do know how this looks. Patient is uncooperative.
Besides, by now you are acutely aware that the E.R. waiting room is filled with bleeding-crying-injured-vomiting sick people, and this doctor has many far more urgent cases to see tonight. He is ready to snap your chart shut right now and move on to the person in the next bed. You can sense this. Patient is attention-seeking.
Maybe this doctor is right.
Maybe you are just feeling a bit anxious after all.
Maybe you are indeed overreacting, just as the doctor has implied.
"Maybe you should just climb down off that gurney, thank the E.R. staff, and go straight home now, albeit embarrassed and humiliated that you have made such a big fuss over nothing."
In our culture, we like to think that doctors are always honest and fair and only practice medicine because they just love helping people so much. Still, medicine is just a profession like any other job.
Reality often gets buried under myths we believe and don't question. We need only look at back 150 years ago, when women were counted as our husband's property to see how bad things can get. We like to think things have changed and that the 1960's solved all of our problems. But as the #MeToo movement shows, women are still second class citizens, forced into unfair deference to male authority. #MeToo shows that men in authority get away with much. The lesson is that we, as women, must reclaim our own power and not let patriarchy take it away.
This problem with barriers for women in terms of healthcare and pain treatment has stayed hidden for a long time. When a doctor, someone we often think as intrinsically fair, tells the patient she's crazy and imagining her pain, other people around her almost always believe the doctor and not her. I mean, no one would ever say that about a patient if it wasn't true? That would be unthinkable! Those of us who have fallen victim to this, haven't just lost our health, we've lost our friends because of this. I need to stress this is why this issue has been hidden. Until now, women weren't speaking out namely because, to do so meant we'd likely not be believed.
Gaslighting and denying women health care is not a glass ceiling but a concrete one. Ever try to work while sick? It's hard enough to be sick when you are receiving treatment. Imagine trying to work and survive while being left untreated. I've lived it, it is not any way to live. Animals get treated better than this.
The problem of bigotry in our culture truly is pervasive. There's no magic profession that exclude these types of people.
I was disturbed to learn recently that African Americans get excluded from healthcare in much the same way as women, frome racial biases. A study found that black children get less pain medication that white children:
"Black Kids Get Less Pain Medication Than White Kids in ER" by NBC News. Link: https://www.nbcnews.com/health/kids-health/black-kids-get-less-pain-medication-white-kids-er-n427056
Black women and men also get denied healthcare:
"The Disturbing Reason Some African Americans May be Untreated for Pain:
https://www.washingtonpost.com/news/to-your-health/wp/2016/04/04/do-blacks-feel-less-pain-than-whites-their-doctors-may-think-so/?noredirect=on&utm_term=.b34403cab0de
"Chronic Pain, and the Denial of Care for Black Women"
https://rewire.news/article/2014/03/04/chronic-pain-denial-care-black-women/
Further reading on all these subjects:
"Women do experience severe and chronic pain"
https://us.blastingnews.com/opinion/2018/04/women-do-experience-severe-and-chronic-pain-002501645.html
"How Doctors Gaslight Women into Doubting Their Own Pain"
https://broadly.vice.com/en_us/article/gy899x/maya-dusenbery-how-doctors-gaslight-women-doubting-their-own-pain
"Prescribing Mindfulness Allows Doctors to Ignore Legitimate Female Pain" by Slate
https://slate.com/technology/2018/02/doctors-are-increasingly-pushing-min
dfulness-on-chronic-pain-patients.html
"Women's Chronic Pain Misdiagnosed, Undertreated, Dismissed"
https://abcnews.go.com/Health/PainNews/women-chronic-pain/story?id=15598143
"4 Out of 5 Doctors…Are Wrong," by MissTreated
http://www.misstreated.org/blog/2015/11/19/four-out-of-five-doctorsare-wrong
"We Cannot Continue to Let Doctors 'Gaslight' Chronic Illness Patients"
https://themighty.com/2016/10/mecfs-and-gaslighting-what-to-do-when-doctors-dont-believe-you/
"Petition: Stop Power-Hungry Doctors From Bullying, Gaslighting, and Blacklisting Their Patients!"
https://www.change.org/p/stop-power-hungry-doctors-from-bullying-gaslighting-and-blacklisting-their-patients
"Is Your Doctor Health-Gas Lighting You?"
https://www.women.com/alisegel/lists/is-your-doctor-health-gas-lighting-you
Youtube video about bias in doctors:
https://www.youtube.com/watch?v=0hZ0_a35hFU
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