I’ve practiced abstinence my entire life, and to this day that is a choice that I’m very comfortable and confident with.
I’ve never felt it was a significant enough detail about me to offer up in casual conversation, but I’m very aware that it may not be the common choice. And that never bothered me until being an outlier started to interfere with my ability to be perceived as a reliable historian at the doctor’s office.
So for years I dealt with a chronic condition that left me with so much pain that I would frequently have to miss days of class in undergrad, and I occasionally had episodes where the pain was so bad I would lose consciousness. (I worked on campus part time and once left a staff meeting early due to pain only to be found passed out in the elevator moments later by my co-workers and supervisor). I was still able to succeed academically so I powered through it. Then two semesters into DPT school, I realized I didn’t have the luxury of missing classes at that frequency, so at the suggestion of a friend I went to see a gynecologist.
they went through routine questions including asking about my sexual history, and when I answered that I didn’t have one, they responded with doubt
I remember that first visit, they went through routine questions including asking about my sexual history, and when I answered that I didn’t have one, they responded with doubt, skepticism, and comments related to how unlikely that seemed since we lived in Miami.
I get it… to it a point: when something does not seem statistically likely, it’s easy to assume that that person falls into the majority. But as a patient who was seeking care for the pain, anxiety, and inability to be present for every moment my life had to offer, I was disheartened.
I acknowledge that this is a detail that adolescents may lie about, especially if asked in front of their parents. But as a young woman in her 20s who independently went to the doctor and was asked her medical history in a confidential setting, I really had no motive to lie. So I questioned what other factors about me would make it so difficult for my response to be taken as truth.
I didn’t care about the assumptions that people had about me in every day life and the factors that shaped those perceptions: the stereotypes and hyper-sexualization of black women, myths related to promiscuity, and the dating trends of my generation. I couldn’t let my life be defined by other people’s perceptions – that wasn’t my burden to bear. But when it came to my health care, I simply did not have time to tiptoe around what my doctors thought of me.
So after that initial visit (that didn’t even conclude in any recommendation to fully address my chief complaint, but did include scheduling for a follow up visit for an invasive procedure that they told me was required legally for everyone after age 21), I went home feeling really hopeless. After talking to my mom, I decided this situation merited a second opinion and looked in our network for a different gynecologist.
I prepared for that appointment by writing my medical history and related complications in a composition notebook, and filled two and a half pages with details that I wanted to highlight to this physician. This was all because I was so scared that I would leave that visit not feeling heard and fall through the cracks before I got the help that I needed.
As I sat in the examination room, waiting to be seen by the gynecologist, I quickly skimmed through my preparatory notes in an attempt to consolidate them into a smaller blurb so that I wouldn’t lose my doctor’s attention as I was speaking. When she walked in and asked me “what brings you in today?”, I was so nervous that I said even less than the little summary I came up with just minutes prior. But I did make sure to emphasize that there were certain procedures that I was probably not going to be comfortable with. She took note of my composition notebook and asked a little about my personal life: what I’m studying, what I did for fun… And I replied absently, overwhelmed by nerves for what the examination would look like. But the entire visit was modified in such a way that I really felt like we were a team. I even asked about the screening procedure that the previous gynecologist told me was legally mandatory, and she actually informed me that my risk factors were so low that I technically didn’t have to do it. So I was good. And in that moment I felt both frustration for how adamant the previous doctor had been in doubting me, and gratitude for this doctor who listened. That very visit she provided me with a prescription for an external pelvic ultrasound and a drug that would help regulate the pain. Almost 3 years later and I feel confident in the management of my symptoms and have had far fewer episodes of pain after enduring this problem for 7 years.
In its present model, healthcare has become a type of commodity where people can sort of “shop around” for the right health care provider depending on their insurance coverage or lack thereof. But it worked to my benefit because it allowed me to find a health care provider who really heard me and saw me as an individual so that she could ensure I had the personalized management I needed to be well. So much so, that even the choice of the ultrasound device and the strength of the drug was taken into account in her clinical decision making.
Healthcare is not one size fits all. As a current health care professional for a system that values family-centered care, my story is a reminder that listening to your patients goes a long way. Viewing them as individuals and truly hearing what they have to say is the starting point of empathy.
(Read here to see the difference between empathy and sympathy.)
Since emerging into adulthood and transitioning out of the care of pediatric doctors, I’ve made it a point to truly build rapport with my health care providers. From my cardiologist to my neurologist, from my dentist to my mental health counselor, to my optometrist and primary care physician (yeah, I’ve had a lot going on and I’m very grateful to be living as well as I am), I want to assume a collaborative role with them when it comes to my healthcare. I want to be able to participate as much as I can, and they have each allowed me that opportunity. I’m very grateful that as a patient I’ve been heard by them.
I know not everyone has that opportunity and there are notable reasons why people might not have access to healthcare providers who are sensitive and understanding to their needs and contextual factors. However, if you are a patient I’d like to offer the advice of finding and connecting with doctors who view you as an individual and make an effort to listen. And if you are a health care provider, I really encourage you to take initiative in learning about diverse populations and practices. Statistics are a helpful tool, but you never know which patient might be the outlier. I know time is limited (you don’t have to tell me twice about documentation standards), but it might be more efficient to collaborate with your patients in order to properly serve a community.