BY ANA PRUNDARU
Editor's Note: this piece was originally published in Gloom Cupboard.
The lackluster entrance hall reminded of a soulless corporate office, if you could think away the ambulances, that is. I took a seat on one of the sumptuous couches and admired the well-manicured yard. From there, I was shown into my room and what I saw on the way was not pretty.
By that I don’t mean the lady wiping tears as she stared at a wall, or a young woman banging her fists under the table in the recreation room. What was baffling was that while patients were in distress, the staff was either locked in their offices or chatting right next to them.
It turned out the woman was banging her fists against the table because the medications made her feel on edge. She couldn’t reach a doctor in a week and soon she gave up, idling between synthetically enhanced dreamlands and the fluorescent lights of the corridors.
But let’s begin with the origin of a bizarre turn of events that placed me in the care of a mental hospital. Roughly a decade ago, I was bitten by a tick. I found it on my bed - a blue, swollen little monster that had just feasted on my blood. Doctors showed little concern for the facial paralysis and debilitating fatigue that arrived soon after, dismissing them as stress reactions.
I have lost my hope, re-built it and watched it shatter many times in the years that followed, as nobody attempted to piece together the ever-expanding list of symptoms, which now included elevated liver enzymes, iron anemia, hormonal imbalances, migraines, muscle stiffness, skyrocketing blood pressure, chronic fever, postural orthostatic tachycardia syndrome and excruciating joint pains. It was much easier to call them manifestations of my mind. Blood tests for Lyme disease were never ordered during several hospital visits, even after mentioning the tick. Instead, I was referred to psychologists, who, despite being unable to formulate a diagnosis, treated me with medications, cognitive-behavioral therapies and anything in-between.
Around the same time I was bitten, a friend was brought in to one of the hospitals I had been to. His fatigue and joint pain set off alarm bells in physicians and despite a negative Lyme test, his doctor put him on precautionary IV antibiotics. It turned out to be Lyme disease, but it was caught early and my friend made a full recovery within a few months.
Meanwhile, almost every doctor would send me home with condescending advice like, 'learn to handle stress', or 'watch less distressing world news', while I struggled to function with multiple parts of my body refusing to cooperate.
They emphasized my disheveled appearance, the nearly transparent skin and shaky hands, my hair falling out – in their view, clearly a sign of depression. I felt I was expected to be presentable, even during lowest lows, if I wanted a shot at being taken seriously by male physicians. Speaking to male friends, I sensed that men’s mental health was rarely scrutinized, when doctors were presented with a similar desolate appearance and symptoms I had.
Numerous medical research studies mirror my observations of gender bias. The Journal of Women’s Health in 2009 found the majority of chronic Lyme disease sufferers were women. One reason for this is the selective diagnosis criteria solely based on a bull’s eye rash – which mostly presents in men.
Thus, Aucott reports that 54% of Lyme disease patients who present without a rash are mostly women and misdiagnosed. On top of that, the laboratory tests that Baker recommends for Lyme disease diagnosis have a sensitivity of only 46% and appear to yield results that are biased against women.
What is worse, a diagnosis does not in itself guarantee adequate treatment, since many doctors are in denial about a chronic course of Lyme disease. Additionally, women often encounter hurdles, not only in receiving much needed antibiotic treatment, but even when it comes to pain management. In a study published in the Journal of Law, Medicine and Ethic, "The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain", the writers came to the conclusion that "women were less likely to receive aggressive treatment when diagnosed, and were more likely to have their pain characterized as 'emotional', 'psychogenic', and therefore 'not real.' Perhaps it does not come a surprise then that an alarming number of statistics point to the link between healthcare misogyny and suicide of female patients.
Based on multiple statistics, medical biases toward women appear most visible in mental health. In my case, doctors had convinced me all symptoms – including paralysis, rashes and other visible changes - were in my head. And that brings me back to my first day at the mental hospital, which I spent wandering around aimlessly and demanded to speak to someone, till a nurse threatened me to stay in my room. As the empty days piled on, I finally learned that due to poor scheduling, I wasn’t able to start treatment for another week and so I spent the time getting to know the others. It turned out to be a blessing in disguise, however.
I cannot give enough praise to the other female patients, who bridged cultural and social barriers, creating a safe community in what was a greedy and dysfunctional station. Based on my sightings and other patients’ opinions, about 80% of the patients were women. Out of those, a staggering 60% were foreigners. Roughly half of the female patients had allegedly been there for three months and longer. In contrast, most of the male patients – including those who were brought in by police in handcuffs and needed permanent supervision - barely stayed a few days and were scarcely, if at all medicated.
A Ukrainian woman who spent the afternoons chatting to the hospital’s hairdresser in the belly of the building, said the reason of her stay was that her husband had beaten her and she was deemed safer away from him. I resonated with her view that she was safest in hospital, but disagreed with the hospital’s predominately drug-based treatment that entailed little help to tackle her abusive relationship. The worse part was, hers was not at an isolated case. Although some women had pre-existing illnesses that were exacerbated by unhealthy living situations, for about half of them, their only problem was that being in one way or another dependent on their husbands.
A middle-aged patient rightly pointed out she had been unjustly punished twice – once by domestic abuse and then by having her freedom taken away in hospital. Another told me her husband had lured her to the hospital on false pretenses. Once there, he pressured her into signing him over all rights.
I admired these foreigners most because, despite being triply disadvantaged - due to their sex, residence status, and language barrier - they didn’t crack in the face of adversity, instead comforting others in need.
At the same time, I felt transported back to the 19th century, where women were degraded for their seemingly sensitive nature and victimized if they didn’t conform to unjust stereotypes of dutiful housewives. How was it possible that in this time and day and in one of the wealthiest nations on earth, misogynistic attitudes continued to oppress women?
As near as I could ascertain, the mental health professionals did not display the kind of unfair gender biases that could constitute clear and convincing proof to be enforced before court. Nonetheless, especially higher ranked individuals were culpable by association with oppressing husbands and guilty by omission, since they did little to improve the life of female patients.
Women worldwide live in a hyper vigilant state, as a result of lifelong objectification and stigmatization, making them more than twice as likely to suffer from depression or anxiety. And if a life of intimidation in modern-day patriarchal societies was not sufficiently distressing, sexism in healthcare can have fatal results.
A study conducted by the Yale School of Public Health suggests that young women hesitate seeking medical help when they have heart attacks, because based on past experiences; they feel doctors would not take their symptoms seriously and label them as hypochondriacs. Another study by the New England Journal of Medicine added that women under 55 are twice as likely to succumb to heart attacks than men, which could describe the nauseating link between improper diagnosis of women and early death. It goes without saying that in the 21st century, we should be past women having to conform to double standards, or fall victims of outdated attitudes of their doctors.
 J Aucott et al, Diagnostic challenges of early Lyme disease: Lessons from a community case series, BMC nfectious Diseases, 2009.