Dear Doctors: We need to talk

Dear Doctors,

We really need to talk. Enough is enough. As much as we make jokes about doctors and their god-complex, the truth of the matter is that you are only human. You are as much a victim of internalized bias and prejudice as any other person who is a product of this biased society we live in. It’s unreasonable to expect otherwise given how those same biases influence how we teach doctors. But I am going to expect it, nay I’m going to demand it. Because for all that you are only human, you often have the power of life, death, and suffering over people and right now your biases are killing my friends and me.

I’m not being melodramatic. There are both studies and anecdotes that have shown the very real impact that biases have on the practice of medicine. Black children are given less medication to treat pain, are less likely to receive diagnoses of learning or behavioural disabilities, and more likely to have their mental health issues ignored. Women and people read as female by doctors are routinely taken less seriously on matters of pain, and are frequently told that their problem is hormonal in nature. People with mental illnesses are taken less seriously on matters of pain, or physical illness. And the long term consequences are becoming severe.

I have friends who have displayed stroke symptoms not even be given any type of screening.

I have a friend who has permanent retinal damage because her complaints of eye-related symptoms were ignored for years despite the fact she was on medication known for its eye-related side effects.

I have friends who have suffered with misdiagnoses for years because their accounting of the levels of pain or severity of symptoms was ignored by doctors in favour of their own erroneous assumptions.

If you’re a woman who is also considered fat, the situation is even direr. Everything is blamed on weight, regardless of whether it makes sense, regardless of whether your symptoms are the obvious cause of your weight, regardless of existing diagnoses.

The stories of women who had cancers caught too late because their symptoms were ignored by doctors who assumed that they were overreacting are so numerous as to have become cliché. I know more than one person who either personally or knows someone who only discovered their cancer after pitched battles with the doctor to get tested. The doctor insisting that there was nothing wrong only to be proven spectacularly wrong.

My own severe arthritic inflammation was mostly ignored and mistreated to the point where I have permanent damage to my joints. My crohn’s symptoms explained away as being the by-product of menstruation.

The level of bias against women and female presenting people is so high, that although it is not even actually “female” anatomy many doctors still don’t have a working understanding of how the uterus and related structures work. That most medications don’t factor in the effects of certain hormones and average body fat ratios in their calculation of dosages, which has recently been found to have a detrimental effect on women and non-binary people with high levels of estrogen.

The idea that women exaggerate their pain or our more sensitive to it is based on outdated and untrue stereotypes. The concept of hysteria even is based on a Victorian idea that women would become mentally unbalanced as a result of their uterus and led to attention seeking behaviour – the same school of thought that believed that masturbation resulted in blindness, insanity, and even death. That cumming too much was the same thing as losing too much blood. Despite this, doctors still subscribe to the same school of thought that women are prone to overreaction.

Women and female-read non binary people are so frequently gaslighted into believing that they are overreacting, exaggerating, or imagining things, that many will avoid complaining at all when they are experiencing any symptoms whatsoever. The number of seriously chronically people that I have seen who still sometimes question whether their own experiences are real is enough to elevate it into epidemic proportions.

So many of my friends are so scared of the idea that they might be overreacting or exaggerating the pain, that they often ignore serious symptoms as long as possible to be absolutely certain. In my own case, I have frequently spent multiple days in extreme pain before I consider going to the hospital. Even now, I have had pain in an area that usually suggests pancreatitis, and yet I ignore it knowing that until it reaches the point of being the worst pain I’ve ever felt, I will be sent home and considered a drug seeker. Even then, I run the risk of not being taken seriously unless the tests reveal exactly what they expect them too and not a thing else.

People condemn women for being more likely to turn to woo for treatment, and yet ignore the level to which they may well have no other choice. Imagine yourself in their place: having pain, or some other symptom that interferes with your life. You try to talk to your doctor only to be told that you are imagining things, or that it’s nothing. That’s the reality for many women, except that just because the doctor decides you are imagining things doesn’t mean that the pain goes away. And if the doctor won’t listen, if the person who is supposed to help you in these situations won’t, what other option are you left with?

Your biases are not just affecting you, they are putting our lives and our health in danger. They are putting our livelihoods in danger. We’re dying and becoming more and more disabled and it’s preventable. It’s preventable, but what makes it frustrating is we are not the ones who have to prevent it. We have to rely on you to make the change necessary, and we can’t even count on you to trust us our own accounting of our own symptoms!

You need to do better. You need to do better now. Because too many of us are running out of time.

Dear Doctors: We need to talk

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