1
" To be sure, depression, anxiety, and prolonged stress can cause specific physical symptoms, but these symptoms are not limitless, nor are they actually unexplained. When doctors invoke these labels for symptoms as diverse as vomiting, paralysis, and sever, unending pain, it is the concept of the somatoform disorders--hysteria dressed up in modern garb-- that allows them to do so. "
― Maya Dusenbery , Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick
8
" There is always a gap between when a symptom begins and when it is 'medically explained.' It is unreasonable to expect that doctors, who are fallible human beings doing a difficult job, can close this gap instantaneously - and, given that medical knowledge is, and probably always will be, incomplete, they may at times not be able to close it at all.
But it shouldn't unreasonable to expect that, during this period of uncertainty, the benefit of the doubt be given to the patient, the default assumption be that their symptoms are real, their description of what they are feeling in their own bodies be believed, and, if it is 'medically unexplained,' the burden be on medicine to explain it. Such basic trust has been denied to women for far too long. "
― Maya Dusenbery , Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick
14
" A 2016 study published in Proceedings of the National Academy of Sciences of the United States of America suggested that health care providers may underestimate black patients' pain in part due to a belief that they simply don't actually feel as much pain - a myth that dates all the way back to the days of slavery. For centuries, the claim that black people were biologically different from whites was 'championed by scientists, physicians, and slave owners alike to justify slavery and the inhumane treatment of black men and women in medical research,' the authors wrote. Black people were thought to have 'thicker skulls, less sensitive nervous systems,' and a super-human ability to 'tolerate surgical operations with little, if any, pain at all.'
In the first phase of the study, over two hundred white medical students and residents were asked whether a series of statements about differences between black and white patients were true or false. Some of the statements were true, while others - for example, 'blacks' skin is thicker than whites' and 'blacks' nerve endings are less sensitive than whites' - were false. They found that a full half of the respondents thought that one or more the false statements - many of which were 'fantastical in nature' - were possibly, probably, or definitely true. Also, notably, many of them didn't agree with the statements that were actually true; only half of the residents knew that white patients are less likely to have heart disease than black patients are. When asked to read case studies of two patients complaining of pain, one white and one black, the respondents who had endorsed more false beliefs were more likely to believe that the black patient felt less pain, and undertreated them accordingly. "
― Maya Dusenbery , Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick
17
" Experts in diagnostic errors provided an answer to the puzzle that had been nagging me: How was it possible for missed diagnoses to be so common and yet not perceived by doctors as a major problem? The problem is that physicians, while generally aware that mistakes happen, greatly underestimate how often they make them. In his talks to doctors on the topic, Graber often asks how many have made a diagnostic error in the past year; typically, only about 1 percent of the hands go up. 'The concept that they, personally, could err at a significant rate is inconceivable to most physicians,' he writes. In short, they think it's the other guy. This overconfidence is not necessarily their fault: doctors simply do not get the feedback needed to gain an accurate sense of their batting average. They assume their diagnoses are correct until they hear otherwise. Since there are few, if any, health care organizations that systematically measure diagnostic error rates, they typically learn of their mistakes only from the patients themselves. "
― Maya Dusenbery , Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick
