Friday, January 19, 2018

Sexism stunts medical progress

http://daily-iowan.com/2018/01/18/rosario-sexism-stunts-medical-progress/

Rosario: Sexism stunts medical progress

Unrest, a new documentary, explores the stigma surrounding chronic
fatigue syndrome.
Isabella Rosario
Jan 18, 2018

isabella-rosario@uiowa.edu

Last semester, I began experiencing unrelenting fatigue and muscle
pain like I had never felt before. For weeks, I could barely go to
class or even stand to do the dishes. I begrudgingly made an
appointment at UI Student Health & Wellness.

The day before my appointment, I went down the rabbit hole of Googling
my symptoms. One result I came across was chronic fatigue syndrome.
When I brought up the possibility of the condition at my appointment,
the doctor chuckled and told me that it was not a real illness. He
said my symptoms were most likely the physical manifestation of
depression or anxiety — i.e., it was all in my head. He gave me a
handout for University Counseling Service and sent me on my way.

Soon after, I visited my primary-care doctor back home, tested
positive for pneumonia, and was promptly given antibiotics. So much
for "all in my head."

Fast forward to last week's PBS release of Unrest, a documentary by
Jennifer Brea. She was a Harvard Ph.D. student preparing for her
upcoming wedding when she was struck with a high fever. After the
fever broke, Brea experienced dizziness, recurrent infections, and
debilitating neurological symptoms. Her neurologist diagnosed her with
conversion disorder. He said Brea's physical symptoms were in response
to some psychological trauma she may not even remember.

Brea was eventually diagnosed with myalgic encephalomyelitis, more
commonly known as chronic fatigue syndrome — a very real illness twice
as common as multiple sclerosis and recognized by the World Health
Organization since 1969. Directing from her bed, Brea interviews
people from around the world with the condition, which causes fatigue
that does not improve with rest, memory problems, widespread pain, and
more symptoms that range in severity; 25 percent of sufferers are
either housebound or bedbound for long periods. And yet, they are
continually dismissed and disbelieved by doctors who psychologize
their symptoms—especially if they are women.

I hadn't heard of conversion disorder prior to my appointment at
Student Health, or at least I thought I hadn't. It was originally
called hysteria, which Plato described as women's uteruses "blocking
passages, obstructing breathing, and causing disease." In the 19th
century, Freud dropped the uterus component and instead theorized that
people could subconsciously convert psychological pain into physical
symptoms — which is exactly how my first doctor explained my symptoms.
Today, hysteria — renamed "conversion disorder" — is diagnosed two to
10 times more in women than in men.

And so it comes as no surprise to me that ME/CFS — an illness two to
four times more common in women — is not taken seriously by the
medical community. It comes as no surprise to me when I hear stories
from female friends who have had doctors dismiss their fevers or
coughs as stress-related. Multiple sclerosis was diagnosed as
hysterical paralysis until CAT scans revealed brain abnormalities. Why
are we repeating this narrative with ME/CFS almost 50 years into its
recognition by the World Health Organization? Why is it that when
doctors do not immediately have the answers, they assume an absence of
biological cause?

I do not believe the medical community is full of raging sexists.
Rather, my experience and viewing of Unrest illustrated to me how
incredibly human doctors are — how they are susceptible to unconscious
biases and sexism in the same way all of us are. And how they, in
congruence with society, would rather offer easy explanations for the
unfamiliar.

As we embark on a new semester, I hope we can open our minds to the
diversity of others' experiences and the class material presented to
us. With persistent curiosity, our generation can be the one that
looks deeper than hysteria and other flawed explanations for what we
do not yet understand.

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