Author Maya Dusenbery interviewed me while I was neck-deep in final copy edits of my book, A Woman’s Guide to Living with Heart Disease. She wanted to talk about why women heart patients are more likely to be under-diagnosed than men, and then – worse! – more likely to be under-treated even when appropriately diagnosed. Maya was writing her own book at the time, and it’s finally out this week. Its pithy title sums up the focus pretty succinctly: Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. Here’s a 10-word summary of her book:
My own review of Dusenbery’s book starts with this warning to my heart sisters: “Do NOT start reading Doing Harm unless you have first taken your blood pressure meds!”
I offer this cautionary advice because, although I’ve been writing my Heart Sisters blog posts (here, here and here, for example) about the well-reported cardiology gender gap in women’s heart disease, everything I read in Doing Harm – across the board throughout almost every medical specialty including heart disease – made me want to go have a wee lie-down to recover.
Dusenbery cites credible research like that of Dr. Alyson McGregor, an associate professor of emergency medicine and director of the Division of Sex and Gender in Emergency Medicine at the Warren Alpert Medical School of Brown University, and co-author of the medical textbook, Sex and Gender in Acute Care Medicine, who told her:
“It’s amazing and really alarming to see that cardiac arrest, stroke, sepsis—in almost all of these conditions, women receive less intense care.”
Indeed, when you read Dusenbery’s broad coverage of modern medicine’s view of women’s health issues overall – no matter the diagnosis – it’s likely you will feel even worse than you do now when you read something like this (from the section of Doing Harm called “The Disorders Formerly Known as Hysteria):
“Chronic illness, with its invisible symptoms of fatigue and pain, is largely the burden of women. And it’s worth considering to what extent its relative neglect by the medical system is because it mostly affects women, whose complaints are so often heard not as a roar but as a whine.
“Are women’s complaints so often dismissed because doctors simply don’t know enough about their bodies, their symptoms, and the diseases that disproportionately affect them?
“Or are women’s complaints so often dismissed because doctors hold an unconscious stereotype that women are unreliable reporters of their symptoms?”‘
NOTE from CAROLYN: If you’re already intrigued, you can enter to WIN THIS BOOK from Harper-Collins! Contest winner will be notified on April 1, 2018.
Drum roll please!
The official WINNER of our “Doing Harm” BOOK CONTEST has now been drawn. Congratulations to SUNNY! – and thanks to all of my readers who entered and shared such heartwarming words along with your entries! ♥
.“The diagnostic and therapeutic strategies which had been developed in men, by men, for men for the last 50 years weren’t working so well for women.“We’ve been working on (female-pattern heart disease) for 15 years, and we’ve been working on male-pattern disease for 50 years.
“While an awareness that men or women have, on average, greater or lesser risks of certain diseases is important and useful up to a point, this awareness can lead to diseases becoming so stereotyped as a ‘man’s disease’ or a ‘woman’s disease’ that doctors are blinded to the individual in front of them – to the extent that the stereotype actually becomes self-fulfilling: knowing a condition is more common in one gender tends to result in its under-diagnosis in the other gender.”
Dusenbery asks – and answers – this question about the reasons for such blindness:
“Is it a lack of knowledge or a lack of trust?
“It seems to be both. The knowledge gap and the trust gap are so tightly interwoven at this point that they could be thought of as two sides of the same coin. Women’s symptoms are not taken seriously because medicine doesn’t know as much about their bodies and health problems. And medicine doesn’t know as much about their bodies and health problems because it doesn’t take their symptoms seriously.”
So what can we do to improve diagnostic tools, treatments and support for women’s healthcare? Dusenbery suggests:
“It is the funders, scientific journal editors, and researchers at all levels of biomedical research who need to help build a consensus within the research community that analyzing study results to detect potential sex/gender differences is just good science.
“And integrating the emerging knowledge of those differences into medical school curricula is a challenging task that requires the will of those within medicine. The same goes for reforms to give medical students more education about the implicit biases that can a ect them and to ensure that doctors receive more sorely needed feedback on their diagnostic errors.”
As Maya Dusenbery told a UC Berkeley Greater Good interviewer:
“I want to make clear that it shouldn’t be on individual women to have to become super advocates for themselves and super educated and learn everything in order to get proper medical care. We should be able to rely on the medical system. I hope patient advocacy can help birth changes, but that people within medicine will really take on this problem.
“They’re the ones who we need to fix it.”
- A Woman’s Guide to Living with Heart Disease (my blog-turned-book, published by Johns Hopkins University Press, November 2017)
- Same Heart Attack, Same Misdiagnosis – But one Big Difference
- Misdiagnosis: is it What Doctors Think, or HOW They Think?
- When Your “Significant EKG Changes” are Missed
- Yentl Syndrome: Cardiology’s Gender Gap is Alive and Well
- How Does It Really Feel to Have a Heart Attack? Women Survivors Tell Their Stories
- Diagnosis – and Misdiagnosis – of Women’s Heart Disease
- 14 Reasons To Be Glad You’re A Man When You’re Having a Heart Attack
- His and Hers Heart Attacks
- What is Causing my Chest Pain?
- When Your Doctor Mislabels You As an “Anxious Female”
- Heart Disease: Not Just A Man’s Disease Anymore
- How Doctors Discovered That Women Have Heart Disease, Too
- Gender Differences in Heart Attack Treatment Contribute To Women’s Higher Death Rates
- How a Woman’s Heart Attack is Different From A Man’s