The Girl Who Cried Pain
When my mom expressed fear that her kidney stone would be too large to pass, the doctors told her not to worry. This was a reasonable fear, because the last kidney stone she had passed was 11 mm, about the size of a decent blueberry.
They told her, no, you must be misremembering, there’s no way you could have passed a stone larger than 8 mm in diameter, that’s impossible. But the next month, she passed the latest stone, this time 10 mm in diameter. And the physicians were floored.
Pain is a difficult parameter to measure because everyone experiences pain differently. However, there seems to be a recurring theme in healthcare, in which doctors do not take women’s pain as seriously as they do men’s. Consider a study conducted at The University of Pennsylvania in 2007 showing that women wait longer for treatment of acute abdominal pain, an average of 65 minutes compared with 49 minutes for a man. The same study showed that women who indicated similar levels of pain as men were less likely than men to be prescribed painkillers.
What can a woman do to convince their doctors to believe them?
Our society already instills a distrust in women. Whether victim-blaming in cases of sexual misconduct or dismissing women’s mental health as just being emotional, the effects are widespread. Because men are stereotyped to be more stoic, their experiences are taken more seriously, and so more appropriate actions are taken in their care. Consider endometriosis, which has been until more recently less researched. The severe pain women were going through was downplayed as simple period pain, which left the woman at blame yet again, for being dramatic.
These biases can have major consequences. Another study at The University of Pennsylvania found that women with chest pain were less likely than their male counterparts to receive aspirin by emergency medical service personnel on their way to the hospital. A study that followed the presentation, treatment, and outcome of patients from a hospital showed that women appeared “undertreated” early in the course of acute myocardial infarction (heart attack), and that the risk for hospital mortality was twice that for women due to the fact that AMI is not as aggressively treated in women.
Put simply: Women are not getting the care that they need, and its putting our lives in danger.
I’m working to one day become a doctor. I know that one way to address this problem is for me to learn how to be critical about any unconscious biases I may harbor. But this problem goes beyond attitudes. Treating women is particularly difficult in cases in which symptoms may differ between sexes. Women are being misdiagnosed because symptoms and treatments for major diseases have largely been based on research done on males. There needs to be more research done on females so that doctors understand what differences to look for. So that women can receive appropriate care.
Navigating life as an immigrant and as a woman, my mom is very aware of how she presents herself to others. She smiles at the bank teller when she stumbles on her English words, she doesn’t make eye contact with people on the street, she lowers her voice when speaking to children she nannies — the inconspicuous Asian woman. When it comes to convincing doctors that her pain is real, that her symptoms are there, it’s a losing battle. But why should my mom, or any woman, have to bend backwards to be heard by her physician?
We all have a right to be heard, and to be taken seriously. I’m confident that this is the type of doctor I can be. Because analyzing gender biases in healthcare and sex differences in disease might be the difference between life and death in female patients.
