January 20, 2023 – Preslee Marshall, a 25-year-old Canadian resident, began to experience severe electric shock-like sensations all over her body. It started happening once a week, then progressed to once a day, then multiple times a day, she said. Concerned, Marshall, who co-manages a public relations agency, consulted a neurologist.
“He told me my symptoms were caused by anxiety. He said, ‘If you get your nails done, you’ll feel better,’ which shocked me,” she said. “But I followed his advice and got my nails and hair done, got massages and facials and my pain was getting worse.”
Eventually, Marshall was diagnosed with fibromyalgia by a rheumatologist — a long-term condition that often causes pain and tenderness throughout the body — and underwent a thorough exam and MRI to rule out other serious conditions, such as multiple sclerosis, that There may be similar symptoms.
Lorrie Lewis, a 56-year-old social worker, was also turned down by her doctor. Her daughter, Beth DeCapua, a house painter in Toms River, N.J., said her mother consulted a doctor because she was struggling to remove dust from her coffee table. Difficulty coordinating hands.
“The first doctor my mother went to said, ‘At your age, you have to expect this,’ and when she went to the second doctor, he suggested that she go home and relax with a glass of wine,” DeCapua recalled road. Two years later, Lewis was diagnosed with Parkinson’s disease, which eventually took her life.
Obadiah J., a pastor from New York who requested that his last name not be used in this article, began experiencing “severe heartburn” at the age of 15. He consulted a doctor who told him the young man “wouldn’t have heartburn.”
“I wasn’t diagnosed with a hiatal hernia and inflammation of the esophagus until I got married and my wife referred me to a gastroenterologist,” he says.
Having a health care professional rule out a person’s symptoms is sometimes called “medical gaslighting,” a term that comes from gas lamp, A 1938 play, later made into a film, in which a husband manipulates his wife into questioning her perceptions of reality and sanity.
Dr. Karen Lutfey Spencer, a professor of health and behavioral sciences at the University of Colorado Denver, said that while “medical gaslighting” has become a popular term for downplaying or ignoring a patient’s symptoms, it may be a label and not accurate.
“The word ‘gaslighting’ means someone deliberately trying to mess with another person’s head, like the husband does in the movie. But we have many well-meaning healthcare providers who are not deliberately trying to ‘ignite’ their patient,” she said. That said, lack of malice doesn’t justify ignoring a patient’s symptoms, she points out.
“Horse” and “Zebra”
In medical school, doctors are taught, “If you hear hoofbeats, think horses, not zebras.” This encourages providers to look for the most common rather than the most exotic diagnoses for a person’s condition. But this approach can inadvertently lead to downplaying a patient’s symptoms—especially in today’s high-pressure healthcare environment, where providers are forced to quickly identify what’s wrong with patients.
So why are common conditions like fibromyalgia, Parkinson’s and hiatal hernia considered “zebras”?
Spencer, a medical sociologist whose research focuses on medical decision-making, health care disparities and patient-provider relationships, said some providers’ biases can influence their diagnosis and treatment decisions.
“Studies have shown that women, people of color, older adults, non-heterosexual people, and people with ‘stigmatized’ conditions — such as being overweight or suffering from mental illness — are more likely to be misdiagnosed and their symptoms to Ignored,” she said.
One reason is that much of the research that informs diagnosis and treatment has historically been done on white men. “There have been far fewer studies of other populations with other biologics. People assume that what is known about white men translates to other groups, but that’s not always true,” Spencer explained.
For example, women are often misdiagnosed with heart disease, which has long been viewed as a “masculine” condition.
“A doctor in one of my studies reported that the encyclopedia he used to learn about angina in medical school had an illustration of an old gray-haired Caucasian man clutching his chest. This image has been around for decades Neither changed, reinforcing the message that heart disease is a white male problem.”
These various influences “feed into medical training”. So, when a woman has symptoms of a heart attack, “[doctors] It might be less about a heart issue and more about other causes, like stress or depression,” Spencer said.
Also, Parkinson’s disease statistically affects men more than women, so some physicians may not consider Parkinson’s disease in symptomatic women, Northwell Feinstein Institute for Medical Research and Zucker Hospital Women’s Dr. Christine Metz, OB, suggested Hofstra/Northwell College of Medicine, Long Island, NY.
common but difficult to diagnose
According to Allyson Shrikhande, MD, Chief Medical Officer and Co-Founder, Certain Types of Diseases Are More Likely to Be Missed or Ignored Pelvic Rehabilitation Medicinea national women’s healthcare company focused on pelvic pain.
Endometriosis is a condition that causes pelvic pain, and while it is common—affecting 1 in 9 women—there are no definitive lab tests or x-rays to diagnose the condition, usually It can only be diagnosed during surgery.
“Women often have pain in their lower abdomen during intercourse and they’re told by their doctors to relax and have a glass of wine, they’re just overwhelmed with anxiety. They’re driven crazy,” says Shrikhande.
One of the main reasons is the lack of education about chronic pelvic pain and similar conditions during medical school and residency. According to Shrikhande, lack of education can even lead to a common condition being seen as a “zebra”. The same goes for other conditions, such as fibromyalgia.
Myths and Facts About Pain
There is also no “objective” measurement technique for pain, Metz said.
“Yes, people are asked to report their pain on a ‘pain scale’ of 1-10, but it’s still very subjective. To me, a grade 1 or 2 pain might be the same as your grade 1 or 2 The pain is different,” she said.
Despite scientific evidence to the contrary — blacks, for example, have higher pain thresholds than whites — leading to their pain complaints being underrepresented in the medical establishment, many myths persist, says Dr. Tina Sacks Professor of Social Welfare at the University of California, Berkeley.
Sachs is a social scientist who specializes in racial inequalities in health and has written a book called Invisible Access: Black Middle-Class Women in the U.S. Healthcare SystemWomen’s pain is also more often underestimated and undertreated than men’s pain, she noted.
Spencer said female athletes told her, “When they seek treatment for an injury, they’re told to go home and use ice or take ibuprofen, while male athletes who are also injured are treated more aggressively.”
Sachs agrees. “There are still versions of women who are seen as ‘hysterical’ – and providers sometimes think that pain is a product of ‘female hysteria’.”
According to Sacks, people with “intersectionality” — for example, people who are both black and female — are more vulnerable because neither group is taken seriously when it comes to complaints of medical symptoms such as pain.
People with disabilities are among the most vulnerable to medical gaslighting, she noted.
“In medicine, ageism, sexism, and abilityism are closely related, and these factors can sometimes work together to effectively reduce or even completely negate what a person is going through,” Sacks said, noting that immigration is often given less weight , because brilliantly.
Medical Gaslight Signs
“Unresolved pain — or, for that matter, downplaying or denying any symptoms you describe — is a red flag,” says Spencer. And “don’t worry if your question is not answered or is being resent.”
Experts point to phrases that could serve as gaslighting “wake-up calls”:
- “It’s all in your head.”
- “Your pain is manageable.”
- “You’re just nervous.”
- “You’re too young to feel—”
- “As you get older, you have to anticipate that.”
- “All you need to do is lose weight.”
- “It’s just your depression.”
Providers don’t always agree with a patient’s proposed plan of action, but that doesn’t necessarily equate to gaslighting, Spencer noted.
“A doctor may not want to perform a specific test that you think you need, or may think your hypothesis is incorrect, but he or she should at least take your concerns seriously and explain why the test or treatment isn’t appropriate,” she says.
You should feel respected and recognized when you leave your provider’s office. Feeling disrespected, belittled, belittled, or invalidated is another warning sign.
Protect Yourself From Medical Gas Lighting
Spencer recommends taking a trusted friend or family member to see a doctor — especially someone who will be with you when you develop symptoms.
“Firing two people is harder than firing one, and your ‘partner’ can defend you,” she says.
It’s also helpful to keep a journal of your symptoms and write down any questions ahead of time, suggests Spencer.
“You can say, ‘I’ve documented my symptoms and I understand my body. What I’m going through isn’t normal for me,'” Having a written list of questions not only helps keep your concerns in mind , but also conveys a sense of organization and thoughtful planning that makes it harder for providers to turn you down.
Metz recommends going back to the list of issues that you don’t think are getting enough attention.
For example, this might look like, “I want to go back to something I mentioned earlier. Why do you think I have pain in the middle of my period?”
Taking notes of what the provider says may also help, Marshall said. You’re less likely to be told to “get your nails done” if the provider knows everything is being recorded.
Obadiah records medical appointments. Not only does this make the doctor more responsible, but it is also easier for him to remember what the doctor said.
But keep in mind that some state laws prohibit recording someone without their knowledge or permission, Metz warns, so don’t do so unless you’ve asked your doctor about it.
And, if possible, talk to your doctor while you’re fully dressed, rather than sitting on an exam table in a skimpy gown, Sacks advises.
There is already a power differential between patient and doctor, and you feel even more vulnerable when the other person is fully clothed and you are half naked. “
Finally, “if you continue to feel uncomfortable, seek other advice,” advises Spencer. The healthcare system can be intimidating at times, and you probably don’t want to go through the hassle of finding a new provider if you’re not feeling well. But it’s important not to let a provider’s dismissive attitude stop you from gaining insight into your health.
A support group may be helpful. Marshall joins the community of fibromyalgia patients who offer validation, support, resources and practical information. Shrikhande notes that support groups can also help you find professionals who specialize in your specific situation.
