Bias in medicine is a real bitch
I don't have a photo of medical bias, so here's a foggy Seattle photo that looks ominous.
This week's episode of Last Week Tonight couldn't have been more poignant for me. It was about bias in medicine and how women and people of color are often not believed about their symptoms or trusted with proper methods of treatment.
And before I go further I'll just acknowledge my privilege right here. For starters, I'm white. I grew up with insurance and access to healthcare, currently have insurance via my partner's company provided healthcare, and live near high end medical institutions. My experience is by no means as bad as it gets. Which should be fucking alarming because it can be, and is for many, so much worse. Serena Williams's story is a perfect and horrific example of this and how socio-economic status is only a fraction of the problem.
I'm not going to list out all of the appalling details from the episode, but please watch it. It's 20 minutes long and eye opening. John Oliver has an abundant list of outrageous statistics and real life experiences of bias in medicine that has or could've resulted in someone's death. And as he points out, these biases increase medical risk the further you are away from white and male.
(Oh and before you read further--I know not all doctors are like this and that white men can have bad experiences too. Keep the bigger problem in mind.)
Since I was a kid, I've had a slew of ridiculous doctor's experiences. Let's go down the list.*
When I was 4, I used to get 100+ degree fevers about every other week. My mom took me to doctor after doctor where I was prescribed copious amounts of antibiotics, antihistamines, steroids, and the like to try and break the cycle. Eventually, someone realized that I was calcium deficient and I stopped getting fevers. When my mom told the other doctors that I stopped getting fevers by taking calcium, they didn't believe her.
During the same time, we found out I am allergic to amoxicillin and pseudoephedrine. To this day when I see a new doctor they tell me that if they prescribe amoxicillin I need to take it and that I can't possibly be allergic.
With the pseudoephedrine and antihistamines, we learned that I have paradoxical reactions to many medications. If it says it makes you sleepy, I'm wide awake. If nausea is a side effect, I want nothing more than to eat a bucket of fried chicken. Doctors usually make a note of this but say it's not been clinically studied or tested to we'll address it on a case by case basis.
It took two years to convince doctors to do an MRI on my knee when I was in high school because there was no swelling or bruising. Just me complaining of chronic pain. But wouldn't you know it, when they did the MRI, I had a torn meniscus and had been walking on it for two years. When I was getting prepped for surgery, I told the anesthesiologist about my paradoxical reactions--he didn't believe me. So he tested my "theory" with a muscle relaxer in which my whole body stiffened up and I involuntarily kicked my feet like I was treading water. Only after this weird experiment did he prescribe the appropriate medications.
Safe to say for my second knee surgery, I scheduled the MRI myself before I saw the doctor. I had the same discussion with the anesthesiologist minus the experiment. Guess they couldn't be bothered to make a note in my chart.
After five or so years of being on the same birth control (a shot called Depo-Provera which you get every three months, give or take two weeks), I was told I had to see a doctor (not my regular physician) rather than the nurse technician because I was outside of the official window (which I wasn't). This new doctor said, "I know it can't be difficult to count out twelve weeks, so I always recommend you ladies put a note in your calendar." The asshole thought I couldn't count to twelve.
When I had an ingrown toenail, the doctor asked me if I got pedicures because sometimes nail salon tools aren't cleaned properly. I told him that I do my nails myself to which he replies "Oh, you don't make enough money." I looked at him and told him I was accepting donations. He didn't say another word the whole appointment.
All of this brings me to present day. The past couple months I've been in a lot of pain and haven't felt like myself. I thought it was likely a hormone imbalance, which is a nerve wracking thing to bring up given how often doctors attribute women's pain to their "wacky hormones." When I talked to my doctor about switching my birth control from Mirena back to Depo-Provera she mentioned that most women don't have the experience I've been having on Mirena. She also said most women don't do well on Depo-Provera but hoped that it'll work for me given my good history with it (again, this can't possibly be due to my paradoxical reactions to medications…). So long as I am on this medication, I have to go to the doctors office every three months and have someone administer the shot.
When I asked if I was able to get pre-measured doses to administer myself, at home, I received a quick and forceful no. We trust patients with blood clots to take home two weeks worth of Warfarin and diabetics to take insulin (both injected medications with potential catastrophic side effects) but don't trust women to administer their birth control. I pointed this fact out and both the doctor and the nurse did not argue with my point but said they could not send me home with the shot.
I'm hoping that I'll feel more like myself in the coming weeks and the pain will subside, but in the meantime--it's 2019. Doctors should be required to take bias training. We should believe women and people of color about their pain and symptoms. Women are perfectly fucking capable of making decisions about their bodies.
Please listen to your bodies and talk to your doctors about what you're experiencing. If they're not listening, and you have the option, find a new doctor. And if all else fails, listen to Wanda Sykes and bring a white man to your appointments.
*None of this is medical advice, just my journey of advocating for myself.
