The Story of Eve and Some Guy

So, I’m reading along…. and I see an article about ADHD in women. My daughter’s pediatrician had told me long, long (like 25 years) ago, that ADHD is “underdiagnosed” in girls in his opinion, because girls don’t break things, climb the walls, fidget and other wise act like boys with ADHD. They do, however, have all the mental earmarks, and sometimes get the diagnosis of ADD.

At the time, medication was seldom prescribed for those ADD girls, because their behaviors weren’t problematic to anybody else. They just flunked math class because they were “airheads.” The article cited above confirms that long-ago assessment by that pediatrician, and goes one better: The reason ADHD isn’t accurately diagnosed in women is because all of the initial studies of the disease were done on little white boys.

Would you ever mistake a herd of busy little white boys for any other population demographic? I think not. The disease of ADHD is different in women. Period. What a concept.

Women are more likely to die of their first heart attack than men are. Why? In part, because for years, the usual scenario of heart attack symptoms was limited to the somewhat overweight guy clutching his chest, staggering around, unable to breathe. Heart disease is the number one killer of American women, more than every kind of cancer combined, and yet, that “I felt like a horse was sitting on my chest” scenario isn’t as likely to apply to women.

We’re getting smarter about heart attacks and women, and now realize that the disease is different for women and men.  Here again, would you ever mistake your grandma for your grandpa? No, you would not. Medical science did, with fatal results for women.

Then I came across this 75-year long Harvard study, which has a heartwarming and reassuring conclusion: the key to a long, healthy life is to spend time with the people who make you happy.

So you might think, “Well, now that I have scientific proof, I know what changes to make!” Except…. Read any article about this study (there are many), and notice that not one of them points out: The findings might be different for women. Every subject of this study was male–every one–and nobody has cited that limitation as relevant.

So on this holiday that celebrates resurrection and the triumph of love over darkness, I’m feeling a sense of my gender-identity being resurrected. Women are different from men, not the lesser included model, not the vicarious beneficiaries of male medical relevance. We are not male, and when we are mistaken for male, we can end up avoidably flunking math class, and avoidably dead.

Glad I got that off my chest. To one commenter, I’ll send a print copy of Tartan Two-Step, a story of love, whisky, and big, sunny skies. When did medicine get it wrong for you or somebody you love, and did gender play a role? When did medicine get it right, because thank heavens, medicine so often does get it right.

 

 

 

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35 comments on “The Story of Eve and Some Guy

  1. 1
    Teenie Marie says:

    My hubby is a physician. And thank God for that! My family and, to a lesser extent, his family have benefited from his his buttinzky tendency.

    My late mother was in the hospital after her first bout with cancer. Every rotten possible complication seemed to happen to her. Finally, with no energy and no desire to get up from her hospital bed and do her physical therapy, her pastor pronounced her *depressed* and insisted we ask her attending for anti-depression meds–he couldn’t *help* her if she wouldn’t *help* herself. I just didn’t feel she was depressed (but really, who could blame her after all the crap she went through?)and Hubby and I conferred with our Dad and brother (the one who was mostly *on sight* for them)to backtrack what procedures she had had within the last two weeks. BINGO! She had had a central line put in by a new-ish intern and came to find out they had BLOWN HER LUNG (punctured it so it was leaking)when they did and she had no energy because she was not getting enough oxygen. So, fixed it and she lived 13 more years 🙂

    It was assumed, because she was a woman, she was *depressed* when there was a perfectly logical explanation for her lack of energy. Her own pastor was the first one to make that assumption–her life changed because of her cancer and she, being a *delicate flower* of womanhood, couldn’t handle it–when in reality, the inexperienced professionals caused it. It wasn’t *them* it was *her* and that still ticks me off a bit!

    Just finished your latest…LOVED IT! And hope you’ll go back to Montana to finish the Logans….seems to me, Lena’s dad could use a story. And so could Shamus and Martina and Luke and Will too!

    • 1.1

      Glad you enjoyed Bridget and Magnus! I do think Shamus and Patrick need HEAs…
      I was diagnosed with depression too, despite not hitting even a majority of the DSM diagnostic symptoms. “Oh, just try the medication…” Four medications later, I couldn’t sleep, couldn’t speak (that was scary), was losing all recall functions, and still had no energy. I was no more depressed than your mother was. I had Hashimoto’s thyroiditis and severe anemia, the most common nutritional deficiency in American women. Yikes!!!

      • 1.1.1
        Teenie Marie says:

        There is a saying in medicine, “when you hear hoof beats, think horse and not zebra.” In other words, try the simplest, easiest explanation first, then try the exotic. Your case is a perfect example and so was Mom’s. 🙂

      • 1.1.2
        Kathryn Schultz says:

        Grace, I am so sorry to hear about your Hashimoto’s diagnosis, but I am very happy for you that you were able to get a diagnosis. I have been trying for over five years to get some doctor to believe that I have almost every autoimmune thyroiditis symptom and that it isn’t “all in my head”! I was misdiagnosed as having lung inflammation causing me to be so tired and out of breath. I finally got one doctor to do the complete thyroid test panel, and then he used outdated reference guidelines to interpret my results, so he said they were “normal.” We even have a medical school here in our city, and I can’t find even one doctor to diagnose Hashimoto’s correctly and start prescribing the treatment I need. I wonder whether the fact that so many more women than men develop Hashimoto’s might have something to do with how interested doctors are in learning how to diagnose it correctly?

  2. 2
    Susan Gorman says:

    About 24 years ago, the doctor got it right.
    My daughter had a well check and her pediatrician thought he saw a funny reflection in her eye. He gave me the phone number of a specialist. Later that day, I received a phone call from the pediatrician asking if I had made the call. I had and he mentioned that he had a feeling about my daughter.
    So, on Good Friday– my baby was diagnosed with retinalblastoma. Cancer.
    She is fine– but I thank God each day that her doctor didn’t dismiss the reflection he saw. This type of cancer is more common in men.

    I read Tartan Two Step and loved it.
    Celeste hopes Magnus ex has a HEA too.

    Have a great week…enjoy the sunshine!

    • 2.1

      THAT is quite the tale, and good on the pede for not dismissing a hunch. Good on YOU, for following up. Pediatricians are among the least well paid, hardest working, and most often-sued docs, but they also seem to do some of the best medicine.

  3. 3
    Margaret says:

    I HAVE HAD 4 MAJOR INCIDENTS WITH DOCTORS.
    1. Middle child, GIRL, WAS BORN HORRIBLY CROSS EYED. Pediatrician said at noon (after 7:00AM BIRTH)that no Opthalmologist would touch her until she was 2. I nagged and he told at 6 months to take her to a new opthalmologist in town at one year.
    She was in his office on her first birthday. His diagnosis was that she should have had the surgery by 6 months. She would always have little to no depth perception. HE WAS CORRECT!!! He’s the only doctor I have ever completely trusted. Cosmetically he did successful surgery.

    This same child at 14 had a fever of 102.8 on a Saturday. The night before she had none . She was at competitive swim meets both days. Saturday she was in the emergency room at noon and the doctor on call was on the golf course. He was not a happy man when he arrived at the hospital from 2 miles away. He decided it was chicken pox and she would break out the next day. (Child who only had one childhood disease – roseola at 14 mos. and her 2 siblings had all but roseola.) She still had the fever on Monday but no other symptoms. I took a urine sample. She had a kidney infection which did not clear up until September of that year. Consequently she had a kidney transplant at 38. She had a son before the transplant and his kidneys were impaired. he had a transplant at 9.

    3. The youngest, girl at 6, had swollen glands on Friday (but had a fever on Monday and was sick-to some extent-all week. (I was out-of-state visiting my mother.) Friday Dr. gave her nothing. Catatonic like with headache and moaning on Sunday afternoon with slight fever and slightly worse on Monday. I called Dr. every hour as the temperature rose. He saw her at 3:00pm and she was having a spinal tap at 5:00pm. My diagnosis was bacterial meningitis and Dr. took credit for the diagnosis in front of me, bragging to another Dr. the next day. Massive doses of penicillin cured her and greatly reduced her immune system capabilities.

    4. Oldest, boy, at 3 years 4 months, kept getting 105 degree fevers and the babysitter would tell me when I got home from work. Luckily the Dr. would come by married student housing after he was done for the day. Three
    episodes of this. My mother, in a bigger city-80 miles away-took him to my childhood pediatrician. Diagnosis was get rid of the tonsils. Local Dr. did it but didn’t want to do it. This child was never sick again until he went to kindergarten just before he turned 6. My healthiest child and still my healthiest child.

    I listen to all doctors with a grain of salt and contemplate what they say long and hard. My heart goes out to all of you that have such experiences.
    Think hard and hit the internet when bad stuff happens.

    • 3.1

      WOW. Those are not small incidents, and thank heavens your mom-instincts stayed in overdrive. Good on ya, and let’s hope that you never add another story to that list.

  4. 4
    Hilary says:

    I used to work with an endocrinologist who told me that, years ago, there was a belief that thyroid issues were usually more aggressive in men and progressed more rapidly than in women. It turned out that it was actually a problem with delayed reporting in men. Women sought help in early stages when they noticed fatigue and weight gain and memory issues, while men tended to ignore early signs and only sought help when the disease was advanced and caused hair loss and sexual dysfunction. The motto in the office was that men didn’t go to the doctor until their pride was wounded in the bedroom.

    I had a medical issue that had nothing to do with gender differences, but was still left untreated and led to major problems. In my first pregnancy, I had preeclampsia but didn’t manifest with the usual symptoms. My blood pressure was elevated, but didn’t consistently have other symptoms, so I was always sent home and told to be “careful.” No intervention at all. Eventually, I went into preterm labor, had an emergency c-section, and visited my little preemie in the NICU for several weeks. My doctor actually apologized to me and admitted that, in hindsight, she wished she had made different decisions. I just wish I had been a better advocate for my own health, since I felt that something was wrong early on.

    • 4.1

      GRRRR. I’m one of those women with thyroid disease, and I’ve been telling the nice docs for years, “I see that my lab report is doing quite well. I can read those numbers myself, if I go slowly and sound them out. But here I sit, evidencing every symptom of the disease except goiter, so whatever we’re doing, it’s not working for me….” Come to find out, there’s a thyroid “type II” version, that works a lot like type II diabetes. You can take all the insulin you want, but your body won’t use it efficiently. Same with our old pal Synthroid…

      I was also pre-eclampsic, but my docs sent me home, directly home, do not stop at the bookstore (except I did), and Herself arrived safely after several weeks of bed rest (which was supposed to lower my BP exactly, how?).

  5. 5
    Make Kay says:

    I don’t have any personal stories, just a burning sense of injustice that so much of medicine is decided upon on the basis of white men. As with so much in life, everyone who is not a white cis het male gets the shaft. pfffftt!

    • 5.1

      It is enraging, but… it’s changing. We now know that women do a better job of listening to patients (on the whole), than men do, so maybe the guys will up their game or get marginalized. The African-American female is the most educated demographic in the country, and while I suspect an instinctive fear of her academic ascendance has fueled a lot of patriarchal baloney (that’s me, using an euphemism), the long-term result will be significant lasting progress. And while there are regional trends in the wrong direction where LGBTQ polices are involved, SCOTUS has come down in favor of gay marriage, and I don’t see that changing.

      But yes. I’m privileged ninety ways to Sunday, and I get so mad I’m ready to blow a gasket. This is why I read romance, so I can be constructive in my discontent with the status quo, rather just collapsing into foul-mouthed ranting.

  6. 6
    Glenda says:

    There was the time that I had severe allergies and knew my body enough to know that I needed a round of steriods for them to clear up — it had happened every year like clockwork. I had to see a different doctor who, according to the nurse, was running late, then forgot about me. He finally rushed in didn’t talk to me or examine me before telling me he was writing me a penicillin prescription and started out the door. Aside from the fact I didn’t have a sinus infection – I’m allergic to penicillin and sulfa drugs. I wasn’t his ideal patient when I told him he would stay in the room and listen to me before diagnosing my ailment. He grudgingly prescribed the prednisone I needed, didn’t apologize for potentially killing me with the penicillin, and when I read the checkout paperwork, he had diagnosed me with HYSTERIA.

    The worst part was that it was as simple as drawing a circle around that option on their forms! What kind of medical system still allows Hysteria as a diagnosis??

    I’ve got Tartan Two Step lined up on my reader now! Looking forward to it!

    • 6.1

      Hysteria… the word itself frosts my cookie, coming as it does from the Greek word for uterus. Somebody needed to circle a complaint to the county medical board on that guy…. when your chart shows a hx of allergies, and he comes up with a mental label issue invented pre-modern ignorance? Geesh.

  7. 7
    Marianne says:

    I would like to see research for women, all women, funded more often. “Normal” is a range, and that range is sometimes different across genders, age groups, ethnicity.

    I would also like equal medical care for women who weigh more than 100 pounds, too.

  8. 8
    Tana Lewis says:

    Love the article. You mentioned “Ressurection Morn”. When love won out over darkness. The one fact that made it’s presence know this morning in services was a woman was the first to see Christ. There is no difference in God’s eyes and that makes me happy!!!

    • 8.1

      I recall a sermon, where the pastor was determined to drive home some ecclesiatical point along those lines–the ladies might not have been at the Last Supper, but they were the first who got the good news. Pastor posed the question, “Why the women? Why were the women the only ones brave enough to keep the vigil when it meant they might be arrested or worse? Why were the women the only ones with the tenacity to remain by the tomb? Why was this most profound….” Pastor was clearly driving toward your point: Because women are full-fledged, 100 percent, card-carrying, members of the Christian faith and have been since the first Easter.

      But what came from the back row of the congregation? Some guy replying, “Because if you want a piece of gossip spread, everybody knows you gotta tell the wimmen. That’s why Paul says they’re supposed to keep silent in the church.”

      The ladies, to their credit, neither booed nor hissed, but not a soul laughed at that sally either, because it was NOT funny.

  9. 9
    Suzanne Dye says:

    Yes, little white boys. As a retired 6th grade teacher, doctors finally figured out that during puberty, blood levels of ADHD drugs could not be kept consistent so the summer before 6th grade the medication was removed and little white boys started middle school in withdrawal without life skills to live unmediated. This is why perfect behavior in those boys went downhill when they started middle school. I can count on one hand the girls who had an ADHD diagnosis that required medication. IMO they needed meds more than the little white boys did. Glad to be retired.

    • 9.1

      I fight this battle regularly with my foster care clients. So often, those boys are diagnosed with ADHD when what they have is PTDS. Somebody finds a cocktail of meds that will help Little Prodigy sit through math class, but invariably–without exception–that cocktail stops working somewhere in middle school, and then the child has not resolved his trauma, has not learned coping skills, and has been slotted into behavioral expectations he cannot live up to.

      So do we double down on the talk therapy or tutoring? Do we make sure he has gym every day and as much recess as possible? Noooooo. We mess with his meds, and “let” him repeat the classes he flunks.

      Not something they warned us about in law school, but yikes, does it matter.

  10. 10
    Joye Isley says:

    I can’t think of any issue so am happy with my decisions to eat well, walk a lot and drink lots of water. No major issues at this time except a few sniffles now that certain plants are blooming.

    • 10.1

      The dusty lining around spring–those blooming plants. For me, it’s ragweed later in the year, though I know allergies are the living end for many people.
      Odd note: The word allergy didn’t come into common American usage until the 1890s. Maybe before than, everybody got more exercise and drank more water.

  11. 11
    catslady says:

    I have so much I can say on this one! It took various doctors 3 months to diagnose that I had gall stones. I wasn’t fat, fair or 40 so I didn’t fit their mold. My mother has had a mummer since she had rheumatic fever as a child but doctors ignored it. A year ago she had a pace maker put in after she was having problems (at 93 then) and was told she had previously had two silent heart attacks. My mom didn’t fit their mold apparently. She wasn’t heavy or male. Her valves needed repaired and it could have been done when she was younger but of course she’s too old now. Next week we are going to have to put her in assisted living after 3 weeks in the hospital with the doctors changing their minds daily and finally coming up with nothing newly wrong with her.

    • 11.1

      I’m sorry you’re having to deal with this… three weeks to come up with, “none of the above?” One of the articles I came across was about the intersection of ageism and gender discrimination, when the low cards you get because you’re female are reduced further when you become an old female. Something to be aware of, before I’m the 93-year-old whose hx of rheumatic fever gets ignored for decades.

      • 11.1.1
        Kathryn Schultz says:

        Grace and catslady, I had rheumatic fever as a child, too, but, thankfully, I have no murmur or heart damage. I had to have heart tests last year before my hip replacement, and they showed my heart is fine. Possibly I had no heart damage because I was kept on sulfa antibiotics and flat in bed for a very long time. However, just this year I read that antibiotics destroy the intestinal biome and can lead to autoimmunity, which may be why I now have Hashimoto’s. It seems everything has unintended consequences, and heart damage would have been worse. I will be thinking of your mother and you, catslady, as she goes into this transition into assisted living,

  12. 12
    Carly says:

    My husband and I see a doctor at The Cleveland Clinic in Cleveland, Ohio. We’ve seen him for only nine months Rated 2nd in the top ten list of hospitals in this country. The doctor is a genius, he diagnosed by husband in 15 minutes whereas doctors in our home (in a city of over one million people) in a nearby state couldn’t find anything conclusive after 12 months of gibberish. His comment was “doctors no long practice medicine”. I believe it! They want to give prescriptions and hope they work, or run test after test with no proper diagnosis. After doing what the esteemed doctor said, my husband is doing 100% better. His recommendation was eat like the Paleo Indigenous people of North America ate . . . no antibiotics in the meat, dairy etc., no processed foods, no GMO’s, if you can’t catch it or grow it, don’t consume it . . . basically no processed foods at all. I took it one step further and we eat only organic grown foods and meat products. When was the last time you heard a doctor say such a thing? No Rx’s involved. He is a genius. Of course, this isn’t the answer to most health problem; however most doctors wanted to give him narcotic opiate pain pills, diabetes, dementia and cholesterol meds. All he has needed was proper nutrition, exercise and he is feeling like at 50-year-old again not like he was 90 and dying. By the way, he is 70 and 100% disabled. His blood tests were 90% better last week from nine months ago and at his age is amazing to me. Every single one is getting better. No diabetic pills needed, no breathing machine any more, down from four opiate pain pills daily to two with hopes to lower even more and no cholesterol meds. Thank goodness we found a doctor who practices medicine and doesn’t write an Rx for everything or guesses instead of thinking. I will never hire another doctor without interviewing them. If they aren’t sincere, caring and have common sense and want to completely discuss the diagnosis with us as adults who want to have a say in their health, I don’t want to waste my time and money on them and wouldn’t let them diagnose my dead rat, which is of course . . . a no-brainer!

    • 12.1

      Well…. this is essentially the Whole-30 diet, expanded, and that’s the nutrition element of Dean Ornish’s approach to reversing heart disease. He’s been thumping that tub since 1990, to the point that even insurance and Medicare will pay for participation in his program. You’d think, nearly three decades later, that most docs would have gotten the memo.

      Glad you found one who did!
      https://en.wikipedia.org/wiki/Dean_Ornish

  13. 13
    anne egger says:

    I think my family has been pretty fortunate as far as healthcare. My grandmother didn’t get good care,but I think it had more to do with living in a small town. I think it is important to be an advocate for your health to communicate with the doctor and nurse and let them know what is going on.

  14. 14
    Mary Peed says:

    My daughter was diagnoses with anemia as a baby. I was also so thought it might be a genetic thing. Spent years taking iron suppliments and having the usual bad reactions to that. When she was 12 she needed a sports physical. We had moved to Chicago from a small town and this would be her first visit with the new doctor.
    He did a blood workup as part of the physical. The next day he called and said they needed another blood workup. Then another. Finally he said “your daughter has thalessemia. We don’t know if it’s major or minor” 7 or 8 blood tests later and they still can’t tell. So they did the test on me. Low and behold my life long anemia is not anemia, it’s thalessemia. Because I had 2 healthy children at that point, they decided my daughter had the minor variety. She’s had 2 healthy children now and lives back in the small town we moved to Chicago from… Her girls go to her old pediatrician… Who insists they have anemia and so does my daughter. … I get kind of cranky about it, having had the life scared out of me when my daughter was diagnosed “out of the blue”.

    I have occasionally forgotten to tell a new doctor about the thalessemia… I’ve gotten panicked calls about my sever anemia a couple of times now…. And have to go back for different tests because you can’t tell the health of my red blood cells by the regular tests.

  15. 15
    Larisa says:

    It took decades of being sick and the advent of the Internet for me to get my diagnosis of a genetic immune deficiency. Before then I was blown off, told I was just depressed, needed to slow down, take a pain pill, be more positive, given more than an dozen HIV and countless pregnancy tests – because I might be lying about sexual activities due to shame (yep that’s a quote)..by male medical professionals. Ovarian cysts were ignored because male doctor scoffed that I could tell which ovary was ovulating/exploding for the knife jabbing pain. A few of the doctors who blew me off, rather than say “I don’t know, let’s explore,” were women, but very few.

    The male doctor who got it right, right off the bat from me aggressively smacking four years of my work absenteeism history, prescription history, and bloodwork on his desk growling “don’t tell me it’s in my head,” is still my main doctor. He vets all specialists I need to see, to assess if they’re a good fit to My Team…aka I won’t bite their hand off mid-patronizing-pat.

    One female doctor finally gave me a desperately needed hysterectomy, but only after 6’4″ 220lb fiance threw a raging fit in the office…and assured three doctors he’d still marry me if I couldn’t birth a child. My broodmare potential was more important than my overall health, ability to hold a job, to pursue my own goals.

    And having the audacity to disagree with male nurses, doctors, to demand professionalism from home health care workers In My Home, got me labeled a difficult patient; but I haven’t had an unlicensed nurse or negative medication reaction since. Go figure.

    Yeah, the western medical complex can be an absolute morass of patriarchal demagogue BS. When it isn’t, it’s a wonderful, sometimes lifesaving, resource. It takes slaying some trolls.

    • 15.1

      Yikes. I’m glad you didn’t stop advocating for yourself, and may I commend your choice of fiance?
      When I’m cranking off at my docs, I’m always thinking, “You know, my vocabulary in a great health, my law degree can still do handsprings, and my analytical thinking can bench press 400 pounds… and you’re trying to tell me, ‘We slow down as we age?!’ What do you tell the people who are so sick they can barely communicate symptoms? ‘Time for your nap, dear?'”

      But I would have lost my gourd about having to mother-may-I to a fiance over the medical fate of a dysfunctional uterus. Ye goddesses.

  16. 16
    Aretha Zhen says:

    Let’s just say me and doctor did not get along very well ! As a matter of fact I hate doctor ! It started from when I was 8 years old. I was born as a very thin baby and my condition did not develop very well . For the first part of my life I was so thin ; then the doctor said to my mom that I’ll get better if only I can be a little bit plump aka not too thin anymore . So , the Docto prescribed lots and lots of vitamins to fatten me up and yes it was succeeded . It is such a success that successfully ruined my teenage years because I became a fat girl and everybody bullied me of my fat body. I tried so many dieting progress and plans to shed some weight but I could not counter-attract my fat body ; and the damn Doctor ( excuse my cursing ), did not even own up to his mistake of fatten me up instead he blamed my metabolism:(. It was sad and I could not do anything about it !

    • 16.1

      Weight gain in adolescence is a problem, because that weight is especially tough to lose. I come across some tiny babies and toddlers in foster care, but thank goodness, now the pediatricians know to look at more than just the height/weight chart before they start over-reacting. Sorry your doc wasn’t one of the more enlightened, because he did you no favors.