MEDICAL GASLIGHTING

The term “gaslighting” came into vogue after the film, “Gaslight,” premiered in 1940 with Angela Lansbury and then in 1944 with Ingrid Bergman. The premise of being “gaslit” was that someone was manipulating you and causing you to think you were losing your mind. Unfortunately, several years ago, a new type of gaslighting called “medical gaslighting,” began happening in health care, and disproportionately to women and people of color.

This new form of gaslighting involves physicians who dismiss a patient’s complaint, blaming the illness or symptoms on psychological factors, or refuting the illness entirely by telling the patient they are not sick. These doctors show disregard for the patient by interrupting them, not listening or making eye contact, and or are more focused on typing notes into a computer than paying attention.

Women have experienced a general disregard for the validity of their medical symptoms for decades. Hysteria was a term used to explain away a woman’s symptoms. Hippocrates and Plato coined the term to explain various physical and mental conditions, which they believed were caused by the womb wandering around the female body. Freud used the word “hysteria” as a diagnosis for women whom he believed had experienced trauma, often due to erotic suppression. The term hysteria remained a term accepted in The Diagnostic and Statistical Manual of Mental Disorders until 1980.

While labeling women’s feelings and symptoms “hysterical” is centuries old, it remains a contributing factor in male physicians’ unconscious bias about race and gender. There are numerous illnesses that present with vague symptoms or without obvious signs that include autoimmune diseases. These diseases are frequently experienced at higher levels for women than for me. Lyme disease and rheumatoid arthritis are examples of illnesses that cause a myriad of untestable symptoms that may include fatigue, muscle pain, and numbness in the feet and legs. Because the symptoms are not observable by medical professionals, they are often disregarded as psychological and caused by “stress,” leading doctors to prescribe an anti-anxiety drug like valium or Ativan. Both of which can lead to addiction. Autonomic diseases such as Postural orthostatic tachycardia syndrome (POTS) have many symptoms and are frequently misdiagnosed or considered due to stress. One of my patients had undiagnosed POTS for many years, and there is no blood test for this, seeing many doctors who said she should try psychotherapy!

I spoke with a friend, who is a black woman, about her experience and she shared this horrifying story.

“Five years ago I had a miscarriage at 14 weeks I had a natural miscarriage. I bled for over 12 hours having huge clots. This was my first natural miscarriage and didn’t want to overreact. I called my doctor several times and each time they told me this was perfectly normal. I felt strange the next day but got up and went about my day as usual. I thought maybe I was just being emotional and if this was normal I didn’t want to be weak. I called the doctor’s office several more times and they finally told me to come in for a test just to stop my anxiety and constant calls. They were supposed to give me my results on that Friday. Friday came and I did not hear anything and so I decided to reach out in the afternoon to be told that the doctor had left for the day. That weekend I had one cup of wine that caused me to blackout with devastating consequences. I called the doctor again on Monday and said that they had to find the results. To add insult to injury they had not only forgotten to give me results they had actually misplaced them as well. They called me back and told me to come immediately to the hospital saying my blood levels were dangerously low. When I got to the hospital they rushed me in the back and proceeded to give me four pints of blood. The doctor wanted to give me more but was afraid my body would reject it. A nurse was the only one that showed me any compassion. She told me I was lucky to be alive, I had had a stage four hemorrhage and should have been unconscious or dead. I had less blood in me than a five- year- old which answered why one glass of wine had caused me to be inebriated. That explained why doctors kept coming to observe me without saying anything. Other than the nurse no one comforted me, or told me they were sorry for my loss, or told me how close to death I had come. My doctor never called me or checked on me or apologized for forgetting to give me my results. I was in shock and because of the trauma I experienced, it never addressed it. Speaking up may not have changed things but maybe.”

My friend’s experience is a cautionary tale as frightening as the film “Gaslight.” Remember you know your body best, and if you do not feel you are heard by your medical professional, seek a second opinion.