The Ugly Side of Womens’ Health Care

3 Apr

 

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written by Lauren Ouellette-Bruchez

This week has been full of controversy in both politics and Paganism. I had a few different items in the works for my Pagan Activist blog contribution but it appears that the Gods had other plans in store for me. Let it not be said that they don’t have a keen sense of timing.

For those of you who may be squeamish in regard to matters of ladies reproductive health, you may wish to jump ship now because we are going to become very well acquainted over the course of this post. You have been warned.

Most women are already familiar with this subject matter. We talk to each other about it and it’s a pretty rare occasion when someone has something nice to say about visiting the gynecologist. If anyone has ever seen The Vagina Monologues you’ll recall the discussion of “mean duck lips”.  There’s the stirrups, the paper covered table and the sterile office with hideous 1990’s still life prints of flower arrangements. It doesn’t help that gynecologists have the coldest hands on Earth because nothing says “Trust me. I’m a doctor”, like frost-bitten labia.

These are pretty standard experiences in the world of women’s health. Annoying and uncomfortable as they may be, most of us get used to it over time and resign ourselves to complaining about it over coffee. What we frequently don’t discuss are the really bad experiences. Terrifyingly enough those bad experiences can range from pain, maiming, slut-shaming, rudeness, indifference and even sexual assault and harassment.

The world of gynecological treatment is in and of itself controversial. Societal ideals of what a woman “is” and what she “should” be play as much a role in reproductive health as does the science of it. If you doubt that for a minute consider that we are still debating the legality of abortion and birth control while men can buy penis pumps and Viagra with the assistance of insurance with little question as to what they’re doing or why.

Doctors are people just like everyone else. They’re (ideally) intellectually gifted people with a great deal of dedication to what they do. Why else would someone blow the kind of money on an education as they do or spend years working insane hours at hospitals and being on-call regardless of what’s happening in their personal lives? It’s not the kind of career you pursue to pick-up hotties. But, just like everyone else, doctors come to their work with their own beliefs and values and those beliefs shape who they are as a person and even who they are as a doctor.

Why is this a concern?

For something as triggering as women’s health, values weigh heavily on both sides of the equation. Certain health concerns carry with them a thick layer of stigma. When a woman sees her doctor because she has contracted a sexually transmitted disease or perhaps would like to discuss options regarding her pregnancy, there are bound to be concerns both medical and ethical. Of course, depending upon specifics, a woman may be embarrassed. Perhaps they have an out of control yeast infection or something “doesn’t look right”. Maybe, despite their best efforts they have become unexpectedly pregnant or have discovered that their supposedly monogamous partner has infected them with something. Poor health or health changes of any variety can cause anxiety, fear, grief and anger. but none so much as those related to sexual health.

But what of the doctor? How does a doctor react to these situations? In a perfect world the doctor will respond professionally but compassionately. They will discuss the diagnosis with their patient, be prepared for possible tears and concerns. A professional will know that the patient in their care is a human being and needs support, kindness and quality health care.

Too often this is not the case. Doctors can carry with them their own prejudices as well. Intelligence and acceptance are two very different things. One would think that if someone chose to pursue a career in women’s health that they would have respect for women. You could not be more wrong. Many medical professionals come from conservative backgrounds. Some are over-worked and have little patience for those in their care. Some are misogynists. Most practicing gynecologists are men.

I am particularly invested in this subject above and beyond just being gifted with two X chromosomes. I suffer from a condition called endometriosis. “Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus”.  It turns out it’s pretty common, though I wasn’t properly diagnosed until I was 29, 15 years after the worst of this began. I had never even heard of it before.

I have had intermittent, severe abdominal pain for most of my life. As an adolescent there were times that my father had to help me walk through the house and even carry me when I was in too much pain to walk myself. My mom and I were constantly in and out of doctors’ offices and hospitals for imaging and at the ripe old age of 14, I began to take birth control to regulate periods that were highly irregular and completely out of control. Over time my symptoms only became worse.

Years later, shortly after I was married I ended up in a local emergency room, once again with abdominal pain, this time, so severe I was in tears. It hurt to walk. It hurt to sit down. I was shaking, couldn’t think and was extremely nauseated. The triage nurse interviewed me and prepared my chart and my husband and I were brought to an exam room. They took blood and urine samples. Later the doctor came and told me and my husband that I had Pelvic Inflammatory Disease. The doctor was extremely rude in his explanation and I immediately knew why. He assumed I had been cheating on my husband and he made no effort to disguise his disgust with me. As the night went on I was given an ultrasound. It turned out that I had an ovarian cyst on my right ovary the size of a softball which had entirely engulfed my ovary and it had ruptured. The same doctor shared the news with me and I responded, telling him that it made sense as I had been told that I had Poly Cystic Ovary Syndrome (my original misdiagnosis).

“You didn’t tell me that,” he said gruffly.

“I told the nurse. It was in my chart and you didn’t ask,” I replied. Further examination by my own doctor revealed that I did not in fact have PID and that I had elevated white cell counts due to the rupture. My ovary and fallopian tube had to be removed because of the severity of the cyst.

Prior to this incident I had never had such an interaction with a doctor. I didn’t even think it was possible. I had been raised to believe that doctors were good people who took care of others. Not only was I hurting and ill, but I was livid and humiliated. Sadly, this was only the first such experience with a doctor treating me for female health issues who felt it appropriate to treat me with derision. As I spoke with other women about it, they too told me of their encounters with self-righteous, ignorant doctors. Never have I heard these kinds of stories from men.

I began to wonder why this was perceived as acceptable. While my situation was entirely out of my control, what if it hadn’t been? What if I had contracted an STD through an unprotected encounter? Why should a medical professional be allowed to treat me any differently than if I’d had another gynecological issue? Shouldn’t my health and well-being be the highest priority? Isn’t my dignity also important?

It is my belief that standard western medicine frequently lacks compassion for women. Medicine in general is an economically privileged male-dominated field. There was a time when women treated women and those women treated almost everyone. In the days of midwives, herbalists and apothecaries, it was women who cared for the health of their families and even their neighbors and friends. Midwives were usually mothers themselves. They knew the difficulty of childbirth firsthand and knew how to prepare a girl experiencing her first moon cycle and could remember their own. Over time these women were vilified as witches and heathens and were brought to the stake or the dungeon, making way for men to take over where they had served for so long. I wonder how different things would be if the midwives had not been displaced in favor of a self-appointed patriarchy.

This patriarchy has bred the diseased concepts that a woman is only worth her “purity”; that the only woman who is “respectable” is the submissive woman who would never share her intimacy with anyone else and will do as she’s told. It is the world of privilege which adheres to the illusion that those without monetary wealth don’t matter and that anyone without a college degree is deficient and easily dismissed. Misogyny just completes the deplorable triumvirate of depraved thought by reinforcing that women are only “good for one thing”. Now imagine how many doctors actually feel this way and treat your wives, daughters, mothers, sisters and friends when they are most vulnerable.

It’s disgusting and unacceptable.

As I mentioned, my ER visit was years ago. In the time since I have had many more gynecologist visits and emergency room trips. Most are horrific. One time I had an internal ultrasound performed on me by a student tech. No one told me they were a student, nor did they ask me if it was okay. It took this girl nearly 40 minutes and by the end I was shaking with rage and had to tell her to stop before I lost my mind. During another incident I was told that I had been misdiagnosed for over a decade and that it wasn’t a big deal even though I could have been treating the real condition the entire time. Some doctors have told me I can have children while others have told me it is totally out of the question and might kill me, most without any real empathy at all.

And then it happened differently. I had to go to the emergency room yet again for abdominal pain and despite being ill, had a great experience. The staff was kind, gentle and considerate. My x-ray tech happily joked with me in between photos and my nurse and I chatted about her kids and my cats. When I voiced concern about being given a certain medication, I was heard and accommodated. Upon leaving everyone wished me well. It appeared for a moment that my luck had changed. In retrospect it’s sad that I was surprised to be regarded with decency.

Only days after that ER trip, I was scheduled to meet with a specialist. This doctor came highly recommended from a family friend and after having had a positive experience, I was optimistic that we might make some progress. I could not have been more wrong. It was the same old song and dance. While discussing my symptoms I was repeatedly cut off and spoken down to for not understanding medical terminology or not telling the doctor what he wanted to hear. During the physical examination the doctor shut my partner out of the exam space by pulling the curtain over. He did not even ask if I wanted him there before he began. It was the roughest physical exam I have ever experienced. I felt less like a patient and more like a blue ribbon contending goat at the State Fair being inspected by a judge. The pain was intense and lingered for hours after.

So here I sit in a prescribed, hydrocodone-induced haze, intermittently crying out of frustration from what I’ve been through over the course of nearly twenty years and sadness for other women I’ve known who have been scarred for life by their gynecological experiences. I want to tell all of you that it will be okay and that it will get better. I want to reassure every one of my sisters that they will receive proper care from a person who is invested in their well-being, not just their checkbook. I so desperately want the young women growing-up in our world to be able to trust their doctors and know without question that they will provide them with the treatment they deserve, both medically and emotionally.

I want to see more midwives, doulas and herbalists putting themselves out there to advocate for women’s health. I want you to reclaim the legacy that was taken from our ancestors, a legacy of not just treatment but compassion for women who are equally entitled to health care and respect. After speaking with a few modern day midwives, you give me hope that health care does not have to be driven by shareholder profits.

To any doctor who feels that they are beyond reproach for disrespecting their patients…get a grip. You may fantasize about a scenario in which you get to play Dr. House but really, your judgmental, small-minded disregard for women only proves that you are becoming obsolete. As women continue to create even greater, more complex places for themselves in society they will be more willing to take action against you for your behavior. Bear in mind that you did not become magickally successful on your own, that you survive on the patronage of those who entrust you with their health. If you wish to practice long term, remember who funds your life.

Ladies, it is now up to us. We have to talk about what scares us and what causes us pain and discomfort. We have to hold doctors and medical professionals accountable. Speak with your insurance company. Write a message to the provider group the offending doctor works with. File quality of care complaints with your state department of health. Tell others and spare them the difficulty of dealing with these fools or putting more money in their pockets. If you feel that the situation warrants it, get the opinion of a lawyer. Hell, if you have the passion, prerequisites and believe you can do better, get your medical degree and show these people how things are done. Remember always, regardless of anything you’ve done, no matter what the results of your tests are, you do not deserve disrespect. If you have had multiple partners, contracted an STD, are pregnant out of wedlock, wish to terminate a pregnancy, are a sex worker or are experiencing any health problem at all, a doctor never ever has the right to demean you. You are not at fault for someone else’s inability to be kind. They can and should by all means tell you what should be done to prevent further difficulties and while that may be a harsh discussion, you should never feel as if you’re on trial with your health care provider.  You are the priority always.

4 Responses to “The Ugly Side of Womens’ Health Care”

  1. Erica April 5, 2014 at 11:03 am #

    Thanks for writing this! I especially related to the bit about not being allowed to have your partner there. At one particular visit, I asked, repeatedly, to have him in the room during the exam and discussion, and subsequent procedure. I was told “no” — ostensibly because the doctor didn’t want him to have any “influence on my decisions.” “BS!” I thought, “Why do you, who I’ve known all of two minutes, get to tell me I can’t get input from my partner of 7 YEARS?!” I should have walked out then. But I was dumb and stayed because I saw no other options at the time. Like you, I got some of the roughest treatment of my life for my trouble.

  2. Kalisara April 5, 2014 at 12:47 pm #

    I try to make time to interview any new doctors before actually seeing them. It got to the point where I would sit there and say “I’m smart enough to understand what you are saying and make the decisions; if you can’t respect that, I’ll find someone else.” The last time, he wad like “I advise; you decide.” He is awesome and actually talks to us like intelligent people. He sees my whole family and I sing his praises every chance I get.

    Don’t be afraid to leave a doctor for another. If one isn’t giving you the healthcare experience you want/need, find another. Most doctors will make time for a new patient to consult with a free visit. Call the office and ask. A free visit is a small gesture that says the doctor has confidence that they can earn your trust and patronage. Use it. Prepare questions about their practices and beliefs that can influence their care. I talked about breastfeeding, co-sleeping, anti-biotics overuse, and care of uncircumcised boys. When we see the doctor, I will often ask about what I think the issue might be. I expect a good, intelligent, professional answer as to why it is or is not likely. Also, find out how the doctor feels about spending “extra time” with patients. If they make noises about being too busy, or express frustration or annoyance, they will rush your visits every time, so you may not feel you can bring up those “little” things that can mean a lot.

  3. DanieleEraLegend April 6, 2014 at 8:17 pm #

    You know why this nonsense happening? Because the field of Gynecology is built on abusing women’s bodies. Never ever trust a doctor! The “Father” of Gynecology Dr.James Marion Sims (1813-1883) was actually a cruel, sadistic, torturer who experimented on black female slaves and poor Irish women. He did not know squat about women’s bodies (duh! because he’s a man); all women that came into his care were butchered on every level. Before you read this, be ready to be angry and terrified. http://www.nathanielturner.com/anarchas_story.htm
    http://www.mnwelldir.org/docs/history/biographies/anarcha.htm

  4. v April 18, 2014 at 9:39 am #

    This is a great book. Check it out http://www.tcoyf.com/

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