I am returning from my Labor Day hiatus with a topic that is a little different this week: the dismissal of women’s pain in healthcare.
This weekend I listened to a podcast series called “The Retrievals” that was published in the summer of 2023. Below is a link to the 3-minute trailer. In short, it’s the story of a group of women who went through IVF at the fertility clinic at Yale in 2020 (and possibly years before that) where a nurse was stealing fentanyl and replacing it with saline. The result, of course, was that these women went through the egg retrieval process without pain medication. I can’t possibly do the story justice – so I highly recommend listening to it.
While I haven’t experienced anything close to what these women went through, there were some lines in the podcast as I listened that brought back memories of my own pain during medical procedures. And while it’s tempting to write this case off as a terrible crime committed by one individual, my connection with the story – in so many different medical contexts – makes it clear to me that this is much bigger than a single drug addict diverting fentanyl in one clinic. What follows are a sampling of quotes from the series and the memories they brought up from my own experience.
“Any patient in severe pain … should not have been discharged.” (A doctor interviewed after the story came out)
When I was in my mid 20s I had an outpatient surgery to remove a cyst from my tailbone. I had local anesthesia. The simple surgery was early in the morning and a few hours into recovery, I told the nurses I still couldn’t feel my legs. After a while, the nurse said, “You should be fine by now. Just go ahead and try to get up.” I followed instructions, and guess what? I fell to the floor because I had no feeling in my legs. (As I had clearly stated.) At the end of the day, I had some feeling back, but not all of it. Rather than admit me, they sent me home with my boyfriend (now husband, but newly my boyfriend at the time) with instructions that he should help me walk since I was still numb. (While this is not the same as being discharged in extreme pain, the fact is I was discharged before I was comfortable with it.)
“[His] response was more often a kind of impatient, ‘I can’t do this unless you stop moving,’ kind of almost scolding the patients for the discomfort they were having.” (A staff member who was present at an unmedicated retrieval)
About 10 years ago I was having a dental procedure – I think it was a crown or something like that. I had normal novocaine injections which were not new to me, so I was relatively calm about it. This time, though, one of the shots sent a shooting pain up my face between my eye and my nose. The pain receded fairly quickly, but the experience was terrifying because it was so unexpected. I was rattled and upset. The doctor sat back, silently, waiting for me to “calm down.” At some point he explained that “it happens sometimes” and “it actually is a good thing, because the nerve will be numb.” As I tried to collect myself, he asked flatly, “Are we going to be able to continue?” As if my emotions were really putting a damper on his schedule.
“I was told to calm down. … And if you cringe: ‘Okay, it will just be another second. Just be patient.’ So you’re [made to feel as if you are] constantly over emphasizing or over dramatizing what’s happening.” (A patient)
In the last decade I have had to have two endometrial biopsies. The fact that I had to have them could be a topic for a post on its own. The best summary of my gynecological history is that things that “aren’t supposed to hurt” do, and things that are “supposed” to feel like “a gentle pressure” are painful enough to make me faint. (My fault, I guess. My body doesn’t respond the way it is “supposed” to.)
I was outrageously nervous for my first biopsy. It was bordering on panic attack nerves. I called the doctor’s office the day before and asked if they would prescribe something for anxiety to make the procedure easier for me. “We don’t usually do that. You will be fine. Take two Advil before you come.”
I was so nervous I was in tears the day before. I went for the procedure and the attending nurse said “Wow, your blood pressure is really high.” (I thought, “No kidding. I tried to tell you.”) The procedure went forward. It was, as I expected, pretty painful. I was clearly very uncomfortable. As soon as it was over, the doctor said brightly, “See, that wasn’t so bad!” as if I had been overreacting the whole time. I can’t remember if I said it out loud or not, but I definitely thought “No, actually it was.”
“The syntax in the waiting room … told me that my body was to blame. My body was inadequate, deficient. My body couldn’t cooperate long enough to get through a critical procedure.” (A patient.)
Fast forward two or three years and I was having my second biopsy. Different practice, different doctor. I let them know about my prior experience. The doctor I initially met with was understanding and said she’d “take good care of me.” Yet when the day came, a different doctor came in to do the procedure, without any explanation or warning. One I had never met. I told her that pain often makes me faint, and she still attempted to do the procedure with me semi-upright. During the procedure I had to tell her to put me horizontal. As the procedure continued, she kept saying “stay calm I’m almost done” — I was obviously in pain. And then, when it was over but I was still sick from the pain she said “How did you ever give birth to two babies?” I was shocked, and asked her to repeat it to be sure that’s what she had said. I remember being fed up enough in my semi-conscious state to give a three word answer. “With pain medication.”
“After I delivered, I went in for my six week postpartum visit .. and it came up that I was a part of this lawsuit [because I had not received pain medication in my retrieval.] And she looked at me and said ‘So? What’s the big deal? I mean, you ended up pregnant.’” (A patient.)
Thankfully I don’t have a memory that was triggered by that comment. Yikes.
I want to be clear here — I don’t think my experience is different than that of many women, if not most women. I suspect I am just your average female with an average medical history. I am not looking for any sympathy. I am simply sharing my experience as, not a victim of a newsworthy crime, but a Regular Joanne, so to speak.
Ultimately, all of this brings up so many questions. Why aren’t patients believed when they report how they are feeling? Why is there so much tolerance of women’s pain? Why is it even normalized? Why is the onus on us as patients to self advocate during situations where we are at our most vulnerable?
If you listen to the series, let me know your thoughts. And if anyone is interested, I would love to put together a book-club-ish discussion of this one! Comment below to get on the list!
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