The clip above is from the well-known TV show Golden Girls, taken from a two-part episode titled “Sick and Tired” which aired in 1989. It depicts the character of Dorothy, played by Bea Arthur, approaching a doctor while out at a restaurant. This doctor had earlier dismissed her symptoms as being all in her head and sent her on her way without any help or words of encouragement. She later finds another doctor who diagnoses her with Chronic Fatigue Syndrome, showing that her symptoms really did exist and were not, in fact, all in her head.
While this particular scene may not be a common reality, the story she tells is all too common. This episode was aired in 1989, and yet, not much has changed in terms of being diagnosed with a chronic illness. All too often, patients, particularly women, are having their symptoms overlooked and dismissed. We are told that “it’s all in our head” and sent home still in pain and still confused about what is happening to us.
That is not okay. Doctors, we need you to do better.
There aren’t many places in our society where a person feels as incredibly vulnerable as we do at a doctor’s office. We trust doctors with our lives, in every sense of the phrase, which puts doctors in a very unique position. We have no choice but to trust you as we don’t have the extensive knowledge of the human body, understanding of medications, or ability to perform complex medical procedures the way doctors can. There are many doctors who understand the true depth of that trust and respect it. However, there are many doctors who seem to have forgotten what their responsibility to the patient is, or, even, that they have a responsibility at all.
About a month ago, I ended up in the ER with a heart rate of 40bpm. I try to stay out of the ER as best I can because they rarely are able to help me and I rarely find a doctor there who understands my conditions. When explaining to the doctor about how all this started within an hour of trying a new medicine, he laughed at me and said, “well, just stop taking the medicine,” and shook his head as if I had just asked if buffalo have wings. There I lay in front of him: the heart monitor blaring because my heart rate was scarily low, barely able to keep my eyes open because of the overwhelming fatigue, and shaking from the chills. And, yet, he felt that it was appropriate to make me feel as if I had wasted his time by coming into the ER to receive care.
That evening something in me clicked and I decided that I would not sit through another horrible visit where nothing is accomplished and I end up with a bill for $2000. I tried to be patient and calm, but I didn’t have enough spoons to do so. I turned to the doctor and asserted, “could you please just go ahead and let me know if you’re actually going to take me seriously and treat me or not today? Because I don’t want to waste my time or money if you’re just going to laugh at me and pretend that nothing is going on.” He began to retort with the familiar, “you seem a bit hysterical,” but I cut him off declaring, “don’t even start the whole you’re upset so it must just be anxiety crap. Yes, I am upset, I’m upset because you don’t seem to be taking me seriously, not because I have anxiety.”
I’m not quite sure where that bravado came from, but I’m glad that I said it. After that, the doctor apologized to me multiple times. He even spoke to me as if I was a peer instead of treating me like a six-year-old child (as many doctors tend to do). He treated me like a human being with a right to understand my illnesses, which, unfortunately, is not a common way to be treated by doctors. I am often greeted with disdain when I ask multiple questions in attempts to understand what is going on in my body, as if I should accept it as enough that they have come up with a description for my symptoms and any further information is unnecessary.
Now, not all doctors are like this. I have had a few wonderful doctors who are willing to sit and talk to me for however long is needed so that I can better understand what’s happening in my body. I have doctors who are willing to admit when they don’t have the answers and either promise to research to learn more or help me find a doctor that does understand. There isn’t any shame in admitting that you don’t have the answer, there is shame, however, in trying to convince a patient that they are making up their symptoms in order to cover up the fact that you don’t understand their illness.
In the many online support groups that I participate in, one of the most common complaints is having doctors that don’t believe us when we say what we are feeling. It’s hard for someone without a chronic illness to understand how disheartening a “normal” test result can be when you are desperate for an answer as to why you are feeling the symptoms you feel. The crushing disappointment isn’t because we want to be sick, rather, it’s because we already know that we are sick. We need a test to confirm it not only to be able to start a treatment plan, but to also show our doctors that our symptoms are real. We desperately want to be believed.
I get it, there are people out there who have a mental illness that causes them to make themselves sick or make themselves look sick. I know that this is a real thing. Anxiety is also a real issue that can manifest itself in multiple different ways. If a doctor truly believes that their patient has either of these illnesses, then they should try to help them receive treatment for these illnesses rather than dismiss them with the advice to “not worry so much.” Kicking a patient to the curb because you are unwilling to dig as deep as you can to find the issue goes against everything a healthcare provider is meant to be.
Doctors, please believe us when we say something is wrong. We know our own bodies better than anyone else does, so we know when something is off. We are coming to you for help, not to waste your time. We are scared, frustrated, and confused. We are seeking understanding and comfort, not judgement and dismissal. Most importantly, remember that your patients are people, not just medical charts.
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