Two years ago, I collapsed and was taken by ambulance to the hospital, for the first time in my life. My throat had closed. I crashed to my bedroom floor, barely able to speak and unable to move.
My husband called 911. I took that surreal ride with flashing lights and hands everywhere to the ER. And they gave me gas light.
He had had two previous but milder episodes of throat closure. The first occurred the night after Thanksgiving. As we head into the holidays, a time when medical issues arise, it’s a good time to think about how to manage healthcare, especially in acute settings.
Two Excellent columns here in psychology today describe doctor gaslighting—when doctors ignore patient reports of their symptoms, dismissing them or even belittling them. Like when doctors dismiss serious symptoms as simply “psychological.”
Patients who actually have a psychiatric diagnosis, especially a “important” one like mine, bipolar—are even more likely to be fired. Such a diagnosis can be seen by all doctors, especially in acute care. Since the diagnosis “overshadows” all other health problems, the problem is called diagnostic overshadowing. It is a pernicious form of gaslighting.
That night I had a weak pulse and poor vital signs. A doctor appeared in my ER cubicle and asked me to hold up a finger to his. I couldn’t. He held his finger a few feet above my chest. In my mind, I told my finger to move, but it just fluttered and fell. The doctor was masked, but I could see his eyebrows knit together in irritation. He huffed out of the room.
I later found out that the doctor went after my husband and said, “Your wife refuses to cooperate.” Bruce told the doctor that he couldn’t move me. The doctor simply repeated that he could move me if he wanted. I’m not sure which surprises me more: that the doctor thought I was going to fake paralysis or that he felt my husband needed to hear this. As if my wife was my babysitter and the doctor felt that she needed a good scolding.
You don’t drink enough water said a nurse as she pinched my skin and diagnosed dehydration.
I answered that I drink between one and two liters a day. He insisted that I shouldn’t notice that I don’t drink water. When I got home, I was still so dehydrated that I had to put large bandages on my cheeks. The thin skin burned when my cheeks touched the pillow. I still don’t know why.
Gaslighting often refers to personal relationships. But medical answers are personal, in a way as personal as it gets. When they are prejudiced, they hurt emotionally and physically. Doctors and nurses are at least as prejudiced about psychiatric diagnoses as the general population. Some studies say more.
That doctor and that nurse filled me with shame Y guilt. Had I become a person who could think I was collapsing? If I had put my spouse through the trauma to see me sink to the ground because I’m delirious? In this case, the person closest to me was also gaslighted.
My bipolar diagnosis may not be the reason I was treated this way. It is very likely that it is. My medical records include the fact that I have never been in an ambulance before and am not a hypochondriac, more like someone who walks, as I once did, with a severely injured knee without paying. attention. These aspects of my medical history actually seemed to be overshadowed.
Medical studies find that opacity of diagnosis affects treatment for a variety of problems, from cardiac care to diabetes to pain. administration. One factor is the suspicion that patients are fabricating symptoms or are too unreliable to understand what is going on in their bodies.
Some doctors also believe in the myth that patients liked me. will not be compatible. So they write fewer prescriptions and schedule fewer follow-up tests. People who have a serious mental diagnosis die on average one to three decades earlier than those who do not. These can be deadly choices.
I’ve spoken to Patrick Corrigan, who runs national programs to help combat psychiatry. prejudice in medicine, on the problem of eclipsing. As he says, doctors are “trained to talk to the diagnosis and not the person.” Diagnostic and Statistical Manual of Mental Disorders. Peer advocates, Patrick tells me, can be very helpful in guiding patients with diagnoses through medical treatment.
I would suggest alerting family members, who might have to speak up for you, that shadowing is a very real problem. Ask the doctors to explain why they are coming to the conclusions they did; make sure these conclusions are based on facts, not assumptions. If you are the one with a diagnosis, never accept a result that does not clearly acknowledge all of your symptoms. Ask to see someone else. I was finally stabilized by a different and very kind doctor.
Stigma means being pierced, a metaphor for being marked in the eyes of others by a condition in your life. It’s harder to do when the tip isn’t as sharp. Reducing stigma in medicine is good work. But the appreciation of neurodiversity, of different mentalities, is also essential. I resist common talking points against the stigma that those diagnosed are “people just like you” or “it could be your loved one.”
I don’t need to be like anyone or their loved ones to have value. The truth is, statistically, you’re unlikely to be like most people I know or their relatives. It does not matter. I am still a human being in a body, a body that I know. A person who doesn’t understand this harbors deeper distortions than anyone I can imagine in myself.