All In Her Head

A Letter To My Doctor In the Wake of the Election

Paula confronts Gregory in Gaslight, 1944

Doctor,

You can ignore my last message; I don’t need an appointment. This isn’t about my jaw.

This might not make sense to you but I’m writing to you because of the election. I’m struggling to come to terms with the reality that my country just elected a racist, misogynistic, xenophobe when the alternative was a qualified, fiercely intelligent, accomplished and powerful woman who has spent decades proving herself as a public servant. It validates what I’ve long suspected: I can work hard, be truthful, do everything right and still be buried under other people’s assumptions, bias, and baggage. As a woman, I’m taking it personally. It’s making me feel the full weight of 47 years of tolerating, surviving, fighting, and yet still internalizing sexism in all of its marginalizing, silencing, and degrading forms. Instead of buckling under, I’m finding that I’m much stronger than I knew. I’m waking up.

Disillusionment brings enlightenment. When I look at my past with freshly disillusioned eyes, I see that experiences I thought broke me actually made me wiser and stronger. I see that I often tried to stand up for myself, though I didn’t always win. I see that like all women, I’ve had to choose my battles carefully. I now see that some of the fights I walked away from were worth fighting. I regret those. I see that unless I stand up for myself I can’t expect anything to change, even though all the evidence seems to say that no matter what women do, it’s not good enough. More importantly, I now know that when I don’t pick up the fight, I lose.

So today, that means getting real with you about how shitty our interactions have made me feel. I have put a lot of trust in you over the years. I’ve come to you for help during very vulnerable, difficult times. And you have helped me! But at some point you decided I was someone you couldn’t trust and the medical treatment you once prescribed for me was no longer valid. I don’t know how or when it happened but it has weighed heavily on me for some time. I felt judged, misunderstood, and somehow responsible.

A few years back, when you told me that you decided to begin tapering me off of opiate treatment, I was about a week away from returning to work after a period of unemployment. I was (rightfully) afraid of not being able to manage my symptoms while proving myself at a demanding new job and raising two kids by myself. As a mid-forties woman in tech, the pressure is incredible to be dynamic and on-point. You did not hear me when I objected to the timing and asked for more time to come up with alternatives, of which you were offering me none. That conversation left me feeling unbearably powerless.

I found out later, by looking at my records online, that you gave me a diagnosis of Addiction. That was cowardly and unprofessional of you. The diagnosis has served no purpose other than to shame me. I did not receive any treatment for addiction, any referral for treatment, or even a conversation to tell me why you were giving me this diagnosis. To diagnose me with a condition that you had no intent of discussing with me or helping me treat is careless, disingenuous, and counter to the whole concept of a doctor’s responsibility to a patient.

I have to point out a few things:

  • In all the years that I was on opiate treatment, I never escalated my daily dose. After tapering off, I returned unused medication to your office. I was still trying to prove to you that I was a responsible patient. I was worthy of respect and should be believed.
  • I took the risks and responsibilities of opiate treatment very seriously. I followed all the rules. To me, that meant sticking with you even when we disagreed about treatment. In retrospect, this was an error. In retrospect, maybe you wanted me to leave.
  • You should have referred me to a pain management clinic or specialist when you decided to stop treating me. You should have checked in with me as I was transitioning off these powerful drugs to make sure I was functioning and maintaining my quality of life. You should have felt responsible for continuity of care.
  • Despite your swift and severe decision to take me off the pain medication that helped me function during my illness (while throwing a medical marijuana prescription my way), I have functioned, I have gotten by. It is important for me to tell you this.
  • In retrospect, you treated our professional medical relationship like a breakup. You ghosted me. You shamed me. You put a label on me and I felt discarded.

You’re not the only doctor I reached out to for help this week. I called my GP who sent me to urgent care who sent me back to my GP who sent me to the ER who sent me to an ENT who sent me back to my GP who told me to get an appointment with you. No joke. That’s seven attempts to get help over the course of eight days, all while in ridiculous pain. It took six tries before I could convince someone to order the MRI that now clearly shows the source of my pain and the threat to my health. I think he did it just to humor me.

I was honestly confused about what was happening until today. I get it now, I’ve connected the dots. No one who saw me this week actually saw the person sitting before them. They saw an addict. And I have you to thank for that. I won’t internalize your label, but I can’t escape it either. It makes me hesitant to seek help, especially for pain. I’m sure other health care providers read this as guilt or deceit. This week, I had one doctor, based on no evidence whatsoever, tell me that he was sure the source of my jaw pain wasn’t an anatomical problem. He hadn’t examined me. He was sure. That is commonly referred to as gas-lighting. Half the people who voted are sure Trump is going to do a better job than Hillary Clinton. They don’t even know what he thinks. They’re just sure.

I think the fact that you took three days to send a message to me saying that you wouldn’t see me is the perfect ending to our relationship.

My hope is that you’ll see this letter for what it is, a sign of my respect for civilized discourse and the professional relationship we once had, a voice to the emotional pain your behavior toward me has caused, and an effort toward closure after your abrupt shutdown. I was ready to walk away from this whole demoralizing experience without saying anything. But as I said, this week has opened my eyes. You have done good by me, but you have done wrong. I want to show you how you made me feel — ignored, marginalized, crazy — for all the women who seek treatment from you from this day forward. Please don’t treat them like you treated me.

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