Those of you who are familiar with my writing know that I’ve been writing with increased frequency about gender and racial biases within the medical industrial complex, and specifically within emergency rooms. This was not, and is not an intellectual or creative interest that I’ve intentionally become invested in over time. Instead, it is an issue that I’ve been morally compelled to write about because of the ongoing abuse and ill-treatment that I’ve suffered at the hands of those whom we must trust the most (medical doctors).
I’ve written about racism that I’ve personally experienced in emergency rooms/hospitals, and I’ve pointed to the many studies that note the reluctance of doctors to treat pain if you are a woman and/or a person of color. I also continue to be more vocal than I might have otherwise chosen about what it means to live as a young single black woman, who works full time, and lives in one of the most expensive cities in the world with lupus.
During the last year I’ve finally managed to put together a solid medical team who I can trust and rely on here in NYC. As a result I’ve had fewer hospitalizations and ER visits and perhaps naively, I began to think that I might be leaving that part of my life behind me. Unfortunately, with an autoimmune disease like lupus, I will probably never put the emergency room behind me 100%.
Yesterday, my rheumatologist sent me the emergency room due to concerns about the functioning of my kidneys. This was an ER that I’ve mostly had positive experiences with, so while it was not ideal, I felt safe going there alone. While there I had the typical experiences that one can expect in a NYC ER, including a three hour wait before I saw a doctor despite having atypical chest pain. But what bothered me more than anything else, the reason I am writing today, is the lengths doctors will go to, to ignore and dismiss what women know about their own bodies.
The woman in the cubical next to me was a pediatric nurse with ongoing heart issues. She knew that her heart rate was irregular and had proof, including detailed documentation of said heart rate that she provided to the ER doctor. He then began to dismiss all of her concerns, blaming a juice she was drinking (which had a minimal amount of caffeine), despite her insistence that she drank the juice all of the time. He rushed to discharge her, and thank God for the nurse tech who took her vitals right before her discharge paperwork was submitted. A nurse nearby rushed to get an EKG and thankfully was able to get the abnormality documented. What did the doctor do? Instead of thanking the women who came together to make sure this woman didn’t go home while experiencing a heart event, he proceeded to yell at the nurse for doing the EKG. At that point he had no choice but to admit her, thank God she had enough medical saavy to essentially evaluate and treat herself.
Meanwhile, the doctor failed to screen me for any signs of lupus activity or blood clots despite my medical history. When he did show up, he assured me that my blood work was “perfect” and that there was absolutely nothing wrong with me. He insisted that I must have some kind of herniated disk that all five of my medical specialists somehow missed over the last year and a half. I was incredibly confused, I knew that I was in an abnormal amount of pain, and I couldn’t understand how I could feel that way and none of my tests could tell us why. Despite all of my years in doctors offices, I went home feeling crazy and like a hypochondriac. I wondered if maybe I can’t trust my body after all.
This morning I received a call from my rheumatologist (lupus doctor). I was shocked because usually he doesn’t call unless something is wrong. Given that the ER doctors assured me that all of my tests were “immaculate,” I was confused to say the least. It turns out, that the ER doctor lied about everything. My lab work was full of abnormalities, my rheumatologist has a number of concerns, and the pain I’ve been experiencing for the last couple of days was actually a result of the abnormalities throughout my tests. The doctors absolutely were aware of this when they discharged me last night.
So why does all of this happen? A significant portion of it are the issue(s) that I point to in my writing time and time again. Doctors do not believe women and/or people of color when they say they are in pain. It doesn’t matter (much to their surprise) if you have a MD, Ph.D, JD, or other forms of privilege. Doctors will time and time again find a way to ignore women, and whatever evidence they manage to bring to bear when they come to emergency rooms with health events. Women are assumed to be hysterical, to be exaggerating, and to generally lack credibility when describing what they are experiencing within their bodies. White men are most likely to be shown compassion, empathy and narcotics when complaining about pain in emergency rooms. This is why women are more likely to be under-treated or not treated at all while experiencing a heart attack in emergency rooms. Doctors just do not believe them.
I could go on for days writing about the way I’ve seen women and people of color treated in emergency rooms. People are told to outright ignore the signals their bodies are sending them, or are accused of simply being there to get “attention” or drugs. It is incredible the way that so many doctors approach emergency room work with the most suspicious eye possible, they do their work with an assumption that a large segment of their patients arrive in their care with the worst possible of intentions. But doctors seem to lack a a critical ability for self-reflecivity. Because in the same breath that they will berate a black patient for coming to the emergency room for “no reason,” they will berate another for not coming in soon enough for an “obvious set of symptoms.” Never once asking themselves if the emotional violence they inflict on patient after patient might impact whether or not those patients will ever be willing to go to a doctor again.
In the past I never understood why so many of my black elders hate hospitals and would literally rather die than go to an emergency room. But over the last four years I have grown in my empathy and compassion for the folks who are afraid of the medical industrial complex. Going in, you have no way of knowing if doctors will believe you, let alone if they will find anything. You have no idea what they will accuse you of or how they will treat you, regardless of the doctors who call on your behalf or the notes in your medical record. The emergency room is often the site of unregulated abuse, especially for the poor and vulnerable.
By no means am I encouraging folks to avoid the doctor, in fact, it is quite the opposite, I write because I want people to seek care. But I also want my community to be able to seek care in environments that are supportive, compassionate and healing.
Are these problems simply a result of the doctors themselves? Absolutely not. Doctors are given little to no training in medical school about racial, gendered or age bias and it’s impact on their ability to treat patients. Emergency rooms are often under-staffed and ill-equipped to deal with the many social issues (like poverty and homelessness) and patients with mental illness that come through their door. And much like institutions of higher-education, hospitals are being pushed to become more like corporations and less like sites of healing. But just like neo-liberalism doesn’t give me a pass in my responsibility to be a damn good researcher, writer and teacher, it does not give doctors an out either.