What My Kidney Stone Taught Me About Sexism In The ER

sexismER

this won't hurt a bit

June 16, 2016

by

I woke up at 9 a.m. on New Year’s Eve—unusual for me over winter break—with severe pain in my lower back.

I immediately—and unwisely—investigated WebMD, which gave me a few conclusions: 1) I had appendicitis, 2) My gallbladder exploded, or 3) I was pregnant (which, unless I was the incarnation of the Virgin Mary, was impossible).

I was taking turns between wandering around the living room and sprawling on the couch as I whimpered. The times I was on the couch, my dog Ernie hopped onto my stomach, which felt like a snow globe filled to the brim and extremely fragile. I hoisted him up by his doggy armpits and tried putting him back down on the ground, but he hopped back up on me anyways. I almost vomited. Mom picked Ernie up off of me and felt my forehead. She fetched a thermometer to take my temperature. A perfect 98.6.

“I think you just have a stomach bug,” she concluded.

I got up and paced around in circles, darting to the bathroom every 10 minutes to vomit up the water I just drank. I decided I needed to see a doctor ASAP. They had one appointment left before closing for New Year’s Day, so I got my mother to drive me up there. After waiting around 45 minutes on a paper-covered chair, the doctor walked in.

“What are your symptoms?” he asked.

I’d just mentioned the back pain and nausea when I motioned to excuse myself. I walked about two steps before yanking the trashcan up to my face and doing what Alf called “the technicolor yawn.”

“I see . . . ” he said as he typed “vomiting” into the computer. I explained the lower back pain and nausea, and he nodded his head.

“Any possibility you could be pregnant?”

A fair, standard question. At least the first time. “No.”

“Any chance of sexually transmitted diseases?”

“No.”

“And on a scale of 1 to 10, how would you rate your pain?”

“Uh, 7 or 8?” I said, feeling another wave of stabbing pain. “Actually, 9.”

The doctor looked at my urinalysis. “Does your family have a history of kidney stones by chance?” he asked.

I did, on both sides of the family, actually. I thought I was too young to have a kidney stone, but according to the urinalysis, I wasn’t. There was nothing else the doctor could do because they didn’t have a CT scan available—and they were also closing for the holiday. I walked back into the lobby, which was now black; the only light was streaming through the lobby door’s window as the staff hastily shut down for their break.

So we drove to the ER.

In triage, I showed them the papers from the urinalysis and was told that they were going to do another test anyways, because piss from an hour ago was no longer valid.

“I don’t know if I’ll be able to,” I said, finding it ridiculous that urine from an hour ago wasn’t good enough.

“You’re not leaving until you do,” the nurse told me. I sighed and went back to my seat in the waiting room.

I waited another hour. I never thought I’d be happy about going to an ER room, but I was very ready for someone to stab me with an IV full of morphine. Three people rolled supplies into the room and hooked me to pain meds, fluids, and a heart monitor. Eventually the physician’s assistant walked in the room alongside a tall, young blonde man who was her scribe. She was stout and wore a stern glare that didn’t want to be working on New Year’s Eve. To be fair, I didn’t want a kidney stone on New Year’s Eve either.

“What are your symptoms?” she asked coldly.

“Well,” I began, and then recited the same symptoms as the scribe scribbled it all down. The Food Network blared over my voice, triggering my nausea. My mother asked where the remote was to turn it off.

“It’s right there,” she snarled, pointing to a cluster of cords next to my IV. Mom and I both looked at the tangled mess. We finally found it and shut it off. I recited the same symptoms for probably the fourth or fifth time, telling her it was probably a kidney stone and I needed to confirm it with a CT scan. 

She asked if I had any burning pain when I urinated. I told her just moments before I felt a weird burning sensation for about 10 seconds, but that was the extent. After that, the severe pain seemed to have subsided significantly (I discovered later that it was more than likely the kidney stone passing, but I never saw it myself). She asked if there was any chance I had an STD or was pregnant. I told her no. She asked about the burning again. Once more I told her that it had only lasted a few seconds and wasn’t the main issue. She glared at me.

“So . . . you’re saying you want a pelvic exam?” she asked, clearly annoyed. I was on the verge of crying—again—from frustration and embarrassment. After waiting a good seven hours for someone, anyone, to stop the pain and tell me what was happening, I was getting fed up with the same questions, the same apathy, and insisting the problem had nothing to do with my reproductive system. What was more disturbing is that the relentless interrogation was from another woman.

No,” I huffed. “I was just told to get a CT scan to figure out if I have a kidney stone or not.”  

The PA finally left to terrorize someone else. Throughout the visit I was asked—again and again—about potential pregnancy for the CT scan, badgered about STDS, and of course if I was on my period. The staff assured me it was just because of my age group, so they had to ask. (An estimated 10 times.)

The only one who didn’t ask me was the doctor himself after bothering to look at the CT scan and finally confirming I had, in fact, had a kidney stone (and more where that came from sitting peacefully in each kidney). It took six hours in the ER to do something my regular physician suspected in the first hour I stepped foot into the hospital. 

I finally broke down in front of a nurse in tears I held all day. I don’t like to appear weak in general, and I also knew that I wouldn’t be taken seriously if I cried, but at that point, I didn’t give a damn. The nurse was kind and told me everything would be fine, but also added “No more tears, okay?”

I nodded. I was discharged and went home with my strainer.

My mother, an RN, insisted the “female” questions were normal and to not take them personally. I don’t think she understood that I didn’t take them as personal insults as much as I did a sign of a larger problem with health care. I understand that if there is a potential chance of pregnancy, it’s vital to know. But having to repeatedly insist, I’m not pregnant—it’s not even possible that I’m pregnant (or have a STD!) isn’t thorough, it’s offensive, and wastes time that could be used to help other patients instead of harassing them.

***

I did consider—for a moment—that I was overreacting, but then I began to wonder how many women had similar experiences. I’m a member of an extensive women writer’s community with people who hail from all over the country. I spoke to several women willing to share their stories with me—the first being Wendy, a writer and nurse case manager in Missoula. She told me she is frustrated with having to vouch for women’s pain—again and again—when doctors brush it off as “female problems.”

“‘Are you sure it’s not that time of the month?’ should be outlawed as a serious question in the ER,” she said. “Women know how to handle their periods, even painful ones. Acute pain we’ve never felt before always needs to be taken seriously. As a nurse, I’ve lost count of the number of times I’ve had to stick my neck out for women [and] not nearly as frequently for men.”

Kat was recently confronted with three different male doctors asking if she was on her period during a medical emergency. “Like I can’t tell the difference,” she noted sarcastically.

Terrah, another writer, left the ER feeling abused and dehumanized. “I had a hysterectomy back in January of 2009. In 2013, I started bleeding,” she recalled. “I thought that the place where I was sewn up was opening (which could have been fatal), so I called the paramedics to take me to the same hospital where I had the operation.” The two male paramedics snickered when calling in the report, saying, “She’s bleeding from her va-gi-na.” Even the ER doctor, believing she was overreacting, argued with Terrah that her cervix was still intact.

“I told him to research my notes, that I had the surgery at that hospital, and the notes will show that I had my cervix removed. He did the print out and tried to argue [with] me [until] I pointed out where the notes said what I had done. Then he went, ‘Oh, guess you’re right.’”

After a handful of women shared their stories with me, I began researching sexism in the ER against women and found two thought-provoking sources: The Atlantic’s “How Doctors Take Women’s Pain Less Seriously,” written by Joe Fassler, and “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain” by Diane E. Hoffman, a 2001 study published by the Journal of Law, Medicine, and Ethics. Fassler’s piece is about his wife Rachel experiencing an ovarian torsion, which can have fatal consequences when left untreated. The essay further describes how the ER brushes off Rachel’s agonizing pain as they wait for hours in the waiting room and for time-sensitive surgery.

Hoffman’s study is referenced in Fassler’s essay and states that women’s pain “might be perceived as constructed or exaggerated,” and referred to as “Yentl Syndrome.” The study also confirms that “male patients undergoing a coronary artery bypass graft received narcotics more often than female patients, although the female patients received sedative agents more often, suggesting that female patients were more often perceived as anxious rather than in pain.”

The good news about my research and confirmation from other women is that it means I wasn’t overreacting. The bad news is that the more times women have to insist those issues aren’t the problem, the longer everyone is suffering—and the faster a fatal disaster could occur. 

***

Lead image: flickr/Andy De

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  • Gretchen Gales

    Gretchen Gales is managing editor and a staff writer for Quail Bell Magazine. Her work has also appeared in Bustle, Yellow Chair Review, Afflatus Issue One and more. Her biggest ambition is to be as much like Shania Twain as possible.

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