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(Continue Reading)

TheNib.com

@thenib

THIS!!!

The Continue Reading link is somewhat small so I just wanted to point it out i the OP so people don’t just stop at this point of the comic.

SUPER relatable, but the rest is so important.

This is one of the many many reasons why I don’t fuck with anti self diagnosis people. Half the time, if you don’t go in with a thorough understanding of what’s happening to you and what you should be tested for, doctors will just write it (and you) off.

Ok. First of all you have to understand there’s a rule every doctor will use, and what they teach us first year of college: the most common diagnosis it’s probably the correct diagnosis. There’s lots and lots of illnesses that have common symptoms, and if you stop to consider every possibility, you will end up in an infinite loop in which chances are you will never get a conclusion. If you experience weight lose, tiredness and are a young woman, probably it’s an eating disorder. If this is note the case and you insist, then, yes, the doctor must reconsider. But please, don’t rely on self-diagnosis or profesionals that are not doctors (“sleep therapist”??). It may have worked for you, but let me tell you it was totally a coincidence, and spreading this type of ideas it’s harmful for a lot of people. Doctors are human, they usually overwork and are pressed by unnecessary bureaucracy. It’s not that they don’t care, as everybody insists on saying, it’s that they can’t stop to consider every possibility and care about every patient like it was their son, as bad as it sounds.

• Self-diagnosis =/= getting to know your body and what feels wrong with it.
• Other “professionals” that aren’t common doctors and that seem to care more about you bc a)you probably are paying them a huge amount and b)they don’t have as many patientes as a common doctor =/= the fucking solution to your illness. Don’t spread harmful ideas.

It is literally a Doctor’s job to figure out what is wrong with you and ensure you get treatment. That is literally their job. It is just downright lazy to spend five minutes looking at somebody’s symptoms and then anounce you know what it is, even after they repeatedly tell you it’s not. It’s also incredibly dehumanizing and disrepsectful to the patient, who knows their body, who knows something is very wrong, to tell them

The problem isn’t that the perso who made this comic went to the Doctor once and that GP at first glance assumed the obvious. The comic clearly shows a very real problem with GPs and other medical practitioners following 

Honestly the gall it takes to say that weight loss + young woman = eating disorder is a reasonable diagnosis to make is astonishing, and is precisely the problem with medicine practice at present. Jumping to the conclusion that somebody has an eating disorder based only on the fact they are a young woman, and they have experienced weight loss, requires a stagering amount of stereotyping and dismissiveness, not to mention, not doing your job as a Doctor at all. The prescence of weight loss and the fact the patient is a young woman is not nearly enough to reach a diagnosis of an eating disorder. That diagnosis requires that the patient has low self-esteem, is obsessive about their weight and views themself as fat, ugly, or undersirable, and it requires disordered eating, and it requires – NONE OF WHICH ARE SYMPTOMS THE PATIENT IS DISPLAYING. It is a completely inaccurate diagnosis based solely on the misogynistic assumption that most young women have low self esteem and therefore any young woman experiencing weight loss probably has an eating disorder.

If she had an eating disorder, why would she would go to the Doctor to say “I’ve experienced rapid weight loss and I don’t know why it’s happening!” ??? That makes absolutely no sense, and is a testament to the mental gymnastics required to be this lazy about your job.

Diagnosing people with mental illnesses, or dismissing their symptoms by saying “you’re just stressed out” or “it’s probably nothing to worry about” without first investigating physical causes, is completely irresponsible practice. If you first rule out physical causes, and it turns out they have a mental illness, then at least you have ruled out other possibilities and the patient feels listened to and taken seriously. If you diagnose someone with a mental illness without first ruling out potential physical causes, you could be letting a physical problem get worse and go untreated while they are getting useless therapy for a mental problem they don’t have. More to the point, most of these dimissive “diagnoses” never lead to anything. It’s not as if Doctors are diagnosing people with mental illnesses then referring them to mental heath professionals who can draw up plans for effective treatments and therapies. It’s literally “you’re probably just depressed” or “i think you’ve got anxiety” and then sending them on their way. Again – highly irresponsible practice to say the least.

The it happens literally all the time. It happened to the person who made this comic. It is not an uncommon occurance. People – most often women – who have chronic illnesses, especially autoimmune disorders, are repeatedly dismissed, ignored, stereotyped, and sent on their way and left to suffer for years as their conditions worsen and potentially become life-threatening. Irreversible damage can be done. All because Doctors are too fucking lazy to actual investigate what is actually going on and find solutions, which is literally their job.

I appreciate that chronic underfunding is a problem. Being a doctor is an incredibly stressful job. I appreciate that. But none of that excuses this repeated issue of dismissing and ignoring patients, stereotyping them, and releasing them with little to no attempts at actually diagnosing and treating their problems.

Nobody is expecting that Doctors care about patients as though we are your children. What we are expecting is to be treated with dignity; not to be dismissed and ignored, not to have to fight tooth and claw just to be taken seriously. That to be treated like a human being with a problem that needs solving, is not the norm, demonstrates that there is a pretty serious fundamental flaw in the way medicine is operating currently.

Literally every person with a chronic illness I have ever encountered experienced years of being doubted by Doctors, being ignored, brushed off, or told they are exaggerating, they’re attention-seeking, or “depressed” or “anxious”. We have to become our own advocates. We have to figure things out for ourselves, then go back to our Doctors and convince them to take us seriously, convince them with a pile of evidence that we aren’t faking, that we are suffering, that there are diagnoses out there that explain our dizzying array of symptoms.

(And as an aside – what, exactly, is it that you find so ridiculous about a Therapist who specializes in sleep disorders? Are sleep disorders not worthy of attention by the psychiatric community? What makes them less qualified to assess somebody with sleep-walking problems than a GP??)

Another problem with saying that it’s “just depression” or “just anxiety” is that more and more doctors are discovering that depression or other mental health issues can be a symptom of a physical problem. If there is something wrong with your heart for example, it can cause depression and/or anxiety. Calling it “just depression” and sending someone on their way does nothing to address the underlying physical cause of the depression.

There’s also nothing stopping someone with actual anxiety, depression, an eating disorder, etc from also having a very real and potentially dangerous medical condition unrelated to it at the same time.

The practice of considering physical symptoms to be psychosomatic the moment certain psychological diagnoses show up in a medical file can kill. ‘A feeling of impending doom’ or ‘a feeling something is dangerously Not Right’ is a common heart attack symptom.

Lucky for a member of my family her doctor listened when she presented with worries beyond the background anxiety he was already treating her for and a highly controlled heart condition that hadn’t caused issues in years – he had her admitted for cardiac observation fast enough that when the heart attack proper hit she was already in the ICU.

I’m not even in the medical field anymore but this is such bullshit. 

What the fuck is wrong with you people that you don’t want doctors to look at the symptoms os something and first thinking of the obvious? 
IT IS OBVIOUS FOR A REASON, SHARON!

“weight loss + young woman = eating disorder” is statisticly more probable than “young woman with cancer” or “woman with unexplicable anemia” for example. 
Therefore, it is perfectly fine to assume that with only those two symptoms described as a first diagnostic. With a deeper investigation (and more data from the patient story and history), that might change. 

If a patient presents to a doctor in a first appointment and only say that she’s losing weight, it’s not absurd to assume that. If she says she’s losing weight, feeling bad and losing sleep, it’s not absurd to assume depression. 

People on this website sometimes sound so dumb because in the same breath they advocate to more awareness to mental health illesses, they bash doctors when they make those diagnostics. 

Stop advocating for self-diagnostic. You didn’t go to a Med School, and “””doctor google””” is terrible. 

Now that had been said, what would be “bad medicine” for real, not the Bullshit this site tries to pass as “bad medicine”:

1) Refuses to listen and/or examine the patient, or not to ask for exams
If a doctor just glances at a young woman that is losing weight and their mind goes “say no more, I already know what you have: anorexia” without listening to her full story and without asking for some blood exams to make sure it’s not something else, that is a bad doctor. A good one will listen to all  symptoms and only then they will make a diagnosis or make an hypotesis (that they will test with the appropriate exams). 

2) Refuses to change their first diagnosis, even when the first treatment didn’t work out or when the exams show something different
In face of things that contradict their diagnosis (for example, a young woman + losing weight + tireoidis with homones going crazy), if a doctor still insists on the first diagnosis (anorexia, for example) and ignores the rest, that is a bad doctor. 
I don’t know about other countries, but Med school here tries their best to teach that doctors have to look at the evidences to base their diagnosis. In a first moment, a doctor might not have all the details (for example, in a first appointment with a young woman losing weight, they might not have the blood exams reults yet to show that her tireohomorne is too high), so it’s acceptable for them to make the diagnosis of anorexia and treat that while waiting for the blood test results. The exams will show that the doctor was wrong, and a good doctor will then apply the correct treatmant and abandon the old.
And, shockingly, doctors are human and they might make mistakes, especially if one’s condition is unusual or rare. 
“Oh, but a doctor should consider everything otherwise they are bad!”
WRONG. THAT’S SO FUCKING WRONG!
That is the exactly reason why a diabetic would die because the doctor thinks they have rare liver condidtion instead of diabetes. 
A doctor first tries the more usual stuff, and only when they exhausts the most common hypotesis, they go to the rare stuff. Because, shockingly again, rare stuff is rare. 

If a doctor did one of those two things, then, and only then, they are bad doctors and you should look for other doctor. 

I know that the US apparently have this epidemic of bad doctors (for many reasons, but I digress), but if you go suspecting the diagnosis of every fucking single doctor just because it wasn’t what you wanted to hear, then you’ll end up miserable at best, and dead at worst. 

So, do your reseach, find yourself a good doctor, and trust then, for fuck’s sake. 

AND STOP TAKING THE WORD OF STRANGES IN THE INTERNET OVER THE PROFESSIONALS!

I’m making the reasonable assumption that the OP was not a “victim” of obvious first diagnoses, but of doctors who would make that diagnosis then cling to it. And a good doctor would, I would assume, know what questions to ask to diagnose an eating disorder…and to rule one out.

And I absolutely agree that physical causes of mental symptoms need to be eliminated. But then, I talk as somebody who’s mental illness was caused by a significant physical problem that, fortunately, my doctor checked for. I also talk as somebody who turned around to a physicians assistant and said…I paraphrase the conversation:

“I think I’m perimenopausal. My periods have lightened significantly over the last year, I’m a similar age to other women in my family. I have elevated anxiety and irritability, and my weight has gone up despite no changes in lifestyle.”

I got “Nah, your periods are light because of how long you’ve been on the pill.”

Like, uh…if you’re a doctor and a 44 year old woman presents with lightened/irregular periods, weight gain and minor mental health issues, in that case the obvious is “Perimenopause.” But because I wasn’t experiencing night sweats or hot flashes (and still aren’t), nope, it had to be something else. I finally talked to somebody else in the practice…

Not all doctors are bad. Many doctors are good.

But bad doctors are certainly out there.

And, of course, I’m also talking as somebody who lost her beloved grandmother at thirteen because a doctor literally diagnosed her with hiatus hernia because that’s what her husband had without doing an exam.

So, maybe I’m a bit paranoid about bad doctors, but that doesn’t mean I don’t believe in good ones. And there can be good and bad ones in the same practice, even.

The problem the OP is trying to highlight, though, is not bad doctors. It is sexist doctors. And there’s plenty of evidence that that’s a problem. One woman with Ehler-Danos was told she was making it up. It takes 7 to 8 years to get a diagnosis of endometriosis, and many women don’t get a diagnosis because we often think painful periods are normal. A diagnosis becomes more likely when the woman is trying to conceive.

A 2014 study of women in chronic pain show that doctors said things like this to women in pain: “You look good, so you must be feeling better.” “You are too pretty to have so many problems.” “You can’t be too sick because you have makeup on.”

Many medicines are never properly tested on women.

That is what this is about, not “self diagnosis.” The OP didn’t diagnose herself with anything. She just knew something was wrong and kept being told it was all in her head. And that is a common experience for young women.

Medicine’s Women Problem