I was happy to see Katherine Leon featured in TheNew York Times recently. Katherine, like me, is a graduate of the WomenHeart Science & Leadership patient advocacy training at Mayo Clinic. She told the Times of undergoing emergency coronary bypass surgery at age 38, several days after her severe cardiac symptoms had been dismissed by doctors who told her, “There’s nothing wrong with you.” She isn’t alone. Many, many studies have shown that female heart patients are significantly more likely to be under-diagnosed – and worse, often under-treated even when appropriately diagnosed – compared to our male counterparts. This is especially true for women with her condition (Spontaneous Coronary Artery Dissection, or SCAD) that was once considered to be a rare disease. Dr. Sharonne Hayes is also featured in the NYT piece; she’s a respected Mayo Clinic cardiologist, longtime SCAD researcher and founder of the Mayo Women’s Heart Clinic. (You can read their story here).
When you open a non-fiction book, you’ll likely find a section called the foreword, written by somebody who is not the book’s author. It addresses a reader’s questions about the book: Why is the author of this book particularly qualified to write it? What will I gain or learn by reading this book?
The Chicago Manual of Style writing guide describes a foreword as “written by someone eminent to lend credibility to the book”.
Our two stories are freakishly the same in so many ways:
♥ In 58-year old Nancy Bradley’s story, she went to the Emergency Department at the Royal Inland Hospital near her home in Kamloops as soon as she felt alarming symptoms she knew might be heart-related: dizziness, sweating, shortness of breath and “an elephant sitting on my chest” feeling. (In my story, I was 58 as well, and I went to Emergency at the Royal Jubilee Hospital near my home in Victoria as soon as my own alarming heart attack symptoms started).
♥ All of Nancy’s cardiac diagnostic tests seemed to be “normal”. (All of my diagnostic tests seemed to be “normal”, too).
I can vividly remember those early days and weeks at home after surviving a heart attack, especially that cold creeping anxiety around how I “should” be feeling. I had just survived what many do not: what doctors still call the “widow maker”heart attack. (By the way, note the gender semantics there, please: doctors are not, after all, calling this the “widower maker”).
I was now resting comfortably, both of my darling kidlets had flown back home to be with their Mum, our home was filled with flowers, get-well cards and casseroles delivered by the daily line-up of concerned friends, family, neighbours and co-workers.
It’s discouraging. I’ve read (and written) far too much about how the gender gap in cardiology has resulted in women heart patients being at higher risk of being both under-diagnosed compared to our male counterparts, and then under-treated even when we’re appropriately diagnosed (here, here and here, for example). Studies even suggest that when physicians review case studies in which patients present with significant cardiac symptoms as well as a recent emotionally upsetting event (identical except for the patients’ male or female names), the doctors are significantly more likely to determine that a man’s symptoms are heart-related, but a woman’s symptoms are just due to the emotional upset.(1)
As a person who lives with and writes aboutcoronary microvascular disease (MVD), I feel lucky that my family doctor, my cardiologist and my pain specialist are all believers. It’s like the trifecta of diagnostic wins for a heart patient! I say that because one of my blog readers, after asking her physician if her puzzling cardiac symptoms might be due to MVD, was told:
“I don’t believe in coronary microvascular disease.”