Due to an interesting encounter with another GP, I made a second Subject Access Request in order to actually see the values of cortisol in my blood, plus whatever statements the previous GP had made about my condition. Gentle reminders usually have to follow the initial request, and this approach has worked in the past, but even with the nudges, all I was getting was silence. As the blood results were my real concern I decided to try and get that information in isolation from the rest of the records: and getting my tetanus booster provided the perfect opportunity.
I made sure that any and all reasons I could have for requesting the information were valid, but it transpired that all I need to do was ask for a printout. Wth my jab completed and the information in my hand, I headed home to pore over the details.
My results were clearly not examined within the parameters of my medical history
I’m not afraid to state that the words ‘mildly elevated’ sat directly next to the cortisol figure; I had already discerned that from the number given to me by the receptionist. The disturbing note, however, was written underneath. It wasn’t the words themselves that were causing me consternation, it was the fact that there was a strong possibility that that doctor had chosen to ignore them entirely. “Please interpret in light of the clinical context[…]” This would appear to indicate that some knowledge of the patient’s pathology should be considered when attempting to understand the numbers. As I noted in a previous post a cursory internet search would have revealed the fact that Endometriosis sufferers have a general propensity for elevated cortisol levels. My results were clearly not examined within the parameters of my medical history – the question is whether that was deliberate, or not. Did he really believe he was doing what was best for my health or was this a case of gaslighting? If that latter was true, I needed to unearth why a doctor would behave in such a manner.
“The whole intention of gaslighting is to decrease someone’s self-esteem and self-confidence so they are unable to function in an independent manner. The person being gaslighted will eventually become so insecure that they will fail to trust their own judgment, their intuition and find themselves unable to make decisions.” Alex Myles, Elephant Journal
Before I continue I really have to state that I am not making direct accusations (it could be that I merely saw a truly poor GP) however, I owe it to myself to find out why I was subjected to such a monumental delay in treatment, all due to an enormous, and perhaps wilful, misinterpretation of a blood result.
Two very important health care stories have broken over the past four years. One appears to be a phenomenon unique to the United Kingdom, the other is global; but both may be playing a part in how people, particularly women, with complex chronic conditions find themselves being diagnosed with various vague mental illnesses when the opinions of specialists should have been sought.
The first was a discovery made late last year that certain Clinical Commission Groups (the organizations that run health care services in designated areas in the United Kingdom) were receiving ‘incentives’ to cut the number of referrals to hospitals and specialist care units. The initial goal was to prevent so-called ‘malingerers’ from wasting precious resources, but Pulse Today discovered that the policy was being extended to suspected cancer patients: these are the people who are supposed to be referred within two weeks, for rather obvious reasons. The Clinical Commission Group in the county where I live was actually one of those named and shamed.
Doctors nowadays tend to shy away from using the word hysteria but are still more likely to dismiss a woman’s symptoms as being psychosomatic or related to stress
The second story, which broke in 2012, regarded a record fine laid upon the pharmaceutical giant GlaxoSmithKline once it became apparent that they were literally bribing doctors to prescribe their medicines over those of their rivals This is not the first time GSK have faced charges of bribery but what makes this one interesting is the timing, the drugs in question, and the medical climate in which all of this occurred.
The ridiculous lengths of time it can take from the onset of symptoms to an actual diagnosis are well documented: but there is a huge disparity in the amount of time waited based upon gender. Doctors nowadays tend to shy away from using the word hysteria but are still more likely to dismiss a woman’s symptoms as being psychosomatic or related to stress. A label such as that is doubly dangerous because, not only does it miss the initial diagnosis, but it also robs the patient of any future diagnoses, as such a characterization makes it extremely difficult to get believed about anything else ever again. If you are a woman and you find yourself suffering from a non-acute, non-blood borne illness, good luck!
…there is still such an all-encompassing desire to throw anti-depressants at at women
Heart disease kills five times as many women than breast cancer; not because there is a dearth of cardiac specialists out there but because the early signs are all too often dismissed as Anxiety, leaving the disease to advance unchecked until the symptoms are finally spotted when the patient is close to death. That being the case, the ‘hysterical’ woman who doesn’t look sick and shows no abnormalities in her blood becomes an easy mark for ensuring that the target for a low referral rate is met. I always state that I was lucky enough to get the push I needed from this TED talk, but I often wonder what state I would be in if I hadn’t received the confidence boost which allowed me to pull my doctor off his pedestal.
So where does this multi-national drug company fit into all of this? Well, GSK were fined $3 billion in the United States for bribing doctors to prescribe two anti-depressants (one of which is widely used as anti-anxiety medicine) and one asthma drug, as well as paying to have their products appear in medical journals. This obviously happened on the opposite side of the Atlantic to the one I’m living on – but, imagine for a moment that the same practices being carried out over there were also being employed worldwide: they had already been given short shrift by the Chinese government for the exact same behaviour. Would it not go some way to explaining why, despite all the research and training put in place by groups such as Sex and Gender Women’s Health Collaborative, there is still such an all-encompassing desire to throw anti-depressants at women who are suffering from physical illnesses? With my case, in particular, it would also serve a secondary purpose of removing me from the referral ‘equation’. Prescription written, targets met, job done.
Again, I am not making a direct accusation here. But if a consolidation of gender bias, kick-backs, and a target-based culture were at play when I was dismissed as a ‘hysterical’ woman, it could be that many, many other women are experiencing the same dismissive attitudes without ever knowing why their problems seemed to matter so little to the ones who are charged with their care.
4 thoughts on “The Patient By Gaslight”
They’ve given me the ‘hysterical woman’ label too – and this despite knowing I had a subluxation of the hip that they failed to diagnose and treat, hence the severe chronic pain and disability.
Good post, thank you! 🙂
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I try not to give direct advice because it can sound a lot like “I cured ‘such-and-such’ by using infused rabbit droppings – you should too!” But I did want to suggest that, if it’s at all possible (and if you haven’t done so already) you should consider finding yourself a good Osteopath: not because Osteopathy will cure you (I’m testimony to that!) but because they can actually diagnose from the physical evidence presented to them. This may not necessarily make your GP listen, but it will provide documented evidence that the doctors were being wilfully ignorant. They can only refer to other private practitioners, but that should include private GPs; which would be cheaper than a private specialist, but can still get you to the right specialist, albeit in a roundabout kind of way… If this sounds like something that could help, I would suggest that you find someone who is registered with the General Osteopathic Council or the British Osteopathic Association (or both!)
I hope that didn’t sound too preachy! It’s just that the Osteopath I see has really helped me navigate the obstacle course that is the GP surgery. He was the one who told me that I needed to see a Rheumatologist and he often coaches me on the correct approach for requesting information without going through the whole Freedom Of Information Act palaver. He is also the person who has single handedly kept me out of a wheelchair for the last few years: even though I have a diagnosis, and am seeing all of the various hospital departments involved with that, I would be utterly lost without that man…
All the best 💛
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Thank you so much for your kind and helpful advice. Your osteopath sounds like a gem. My whole family used to see one years ago – I had complications with my elbow that had a piece of bone chipped out when I fell on ice as a child, and I had pain with it afterwards and found it hard writing. I’ve seen three different physiotherapists since this injury. To sum it up, if the GPs had correctly diagnosed me I wouldn’t have the long-term nerve and soft tissue damage, mobility problems. They have excluded this info from my medical records! The new doctor told me (he wants to help, but it’s hard getting to see him). I’m looking into legally fighting this inept medical practice – they’ve severely reduced my life quality and I’m suffering financially. By the way, they told my elderly neighbour with a broken foot to go walking! This is how ‘good’ they are
All the best too 🙂
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