Maria sits on the brown leather couch at her oldest daughter's house. Her granddaughter is seated directly across from her on the loveseat, local news playing behind. Maria sees a jarring headline roll across the screen– “18-year-old Female Misdiagnosed by Male Physician at Local Clinic.” Maria immediately felt her stomach drop, and she remembered being in that exam room where she begged to be heard. Maria looked over to her 17-year-old granddaughter and thought of the possibility that this would happen to her. After experiencing a situation like a girl on the news and praying it never occurs to her granddaughter, Maria decides it is time to share her story with her granddaughter, Megan.

“Megan, can you sit by me for a minute?” Maria asks, patting the open spot on the couch next to her. Megan put her phone down, sat next to her grandmother, and replied, “Sure, what’s up?” Maria cleared her throat at asks, “After the things I have seen on the news lately, I would like to tell you a story about my experience with gender disparity and my hysterical diagnosis.” Megan replied, “What is gender disparity, Grandma?”

Maria folded her hands together. This was going to be more difficult than she initially thought. “Gender disparity is where men and women are not treated equally. I experienced this from a male doctor when I was in my late teens. The reason I want to tell you this story is to educate you. I want to make sure that this never happens to you.” Megan looked at Maria, concerned, and said, “Grandma, I am so sorry. Please tell me everything.” Maria sighed and gave Megan a soft smile. Finally, Maria said, “Ok, I wanna tell you my story. Fortunately, I was also given logs from the doctors who treated me, and I will share some of their thoughts as well.” Megan asked her grandmother, “How did you get those?” Maria explained that after she had won the court case, the judge gave her access to the logs, which is now a resource for Maria to use when she tells her story.

Maria took a sip of her coffee and then began.

“Your grandfather and I had been married for six months when the pain started. It began as a localized ache in my lower back, so I thought nothing of it. I talked to my husband, and he told me that it was nothing to worry about and that I should be okay in a couple of days. A few days passed, and the pain didn’t get any worse, so I began to forget about it. Two weeks had passed, and the pain had returned, but it had moved to my abdomen this time. I had no idea what may be causing it. The next pain stage continued for five days and showed little signs of subsiding. After this, I decided it was time to see a doctor and hopefully find some answers.”

“I decided I would head over to the clinic we had in town, you know, the one that is an Arby’s now. So, I got in to see Dr. Janet, who had a medical intern working with him. His name was Dr. Ranes. I liked the medical student. Dr. Janet calls me to come with him, and I follow behind as we enter the small, musty exam room. Dr. Janet sits down, lights a cigar, and pulls out my paper chart. I begin describing my symptoms, and Dr. Janet notes what is being said. I talked about how the pain is manageable now, but I was afraid it would get worse. After checking my vitals, Dr. Janet asked me when I was menstruating last. I ask him why that is relevant, leaving Dr. Janet to explain how, like most women, her symptoms may be related to her menstrual cycle. I wondered why Dr. Janet would ask this question, but after doing some research, I found out that the Egyptians and Greeks believed that the uterus could affect the rest of the body’s health. The female experience of hysteria was thought to have stemmed from their disappointment of not having a penis. Hysteria was essentially the diagnosis of anything a man did not understand. I left the appointment that day with nothing but an assumption from Dr. Janet and was told to take a few days off and rest.” 

Maria reached into her bag and pulled out a daily log written by the med student. “The medical student working with Dr. Janet wrote this log two weeks after my initial appointment.”

***

Excerpt from Dr. Ranes’ Medical Log

The following two weeks of work consisted of several cases of stomach flu, twelve yearly check-ups, and a seminar required for all interns to attend. It was not until I looked at the schedule that I saw Maria’s name again. She returned to see Dr. Janet because her pain had significantly increased. Dr. Janet told me he was not surprised by her again. He said, “Women usually over-dramatize things to get relief from their job at home or get medication. I will tell you this now; she won’t pull one over on me.” I was surprised by what he said, but I brushed off his comment and followed him into the room. 

Maria is now more adamant about her pain and explains how she has been feeling for the last two weeks. “I took a few days off to rest, but the pain is increasing. I am no longer able to hold my son due to the pain,” Maria described. As I write this down, I notice Dr. Janet's expression change. He seems annoyed that Maria has come back for a second appointment. Dr. Janet tells Maria, “I think that you are hysterical. There is no significant evidence that your pain is truly happening.” Maria did not like this response at all. She asked if Dr. Ranes could run more tests to determine what was wrong and help prove she isn’t lying. When I interjected and suggested a few, Dr. Janet looked at me with disbelief and said we did not need to run the test. 

After we exited the room, Dr. Janet pulled me aside and said, “You should not believe this woman. As I said, too many women come here complaining of pain. That pain is hysterical, and they are just looking for attention. We are not going to use our resources on this woman anymore. Are we clear?” I stood there in disbelief about the words I was hearing. How can I be the best for my patients if I cannot figure out what is wrong?  

***

“It was clear that Dr. Janet thought I was crazy, and I began to believe it. The log proved that he didn’t see me as an individual but rather as a statistic. Unfortunately, Dr. Janet had his mind set on diagnosing me with hysteria. I did not receive the tests at that visit; instead, I went home to think. I thought about rephrasing my feelings to get Dr. Janet to believe me.”

“It wasn’t until after I read the logs that I learned how Dr. Ranes felt. At least he was concerned about me and was willing to help.”

“I felt extremely lost, and at this time, I had no idea that Dr. Ranes was sticking up for me. I only knew what happened in the doctor's office when I was there. When I decided to come forward and tell my story, I worried it would be a “he said, she said” situation. Luckily, Dr. Ranes was on my side, but I did not know that until it was discussed with my lawyer. Leave it to the medical student to understand his patients better than his superior. This gives me hope for the future of medicine for young girls like you.”

“I went back to Dr. Janet’s waiting room for my fourth appointment in the last two months. The previous three visits have resulted in the same diagnosis: hysteria. Dr. Janet was convinced that I was seeking attention and believed it to be another case of the overdramatic woman. Again, I felt like a number rather than a patient.”

“During the court session, I learned that he had diagnosed nine women with hysteria in the three weeks following my appointment.”

“As I sat in his office felt like I was crumbling. I could tell Dr. Janet did not want to listen to me as he looked down at his watch and told me how busy his schedule was. Finally, Dr. Janet said, “You are hysterical, and if you continue to act this way, I will call your husband and have you locked away.” 

Maria’s granddaughter interjects, “Wait; he said that to you? Could he actually have sent you away?” Maria responds reassuringly, “No, that was more to scare me, but they had other methods. They would have the husband pleasure the women or use psychosomatic therapy.” Maria's granddaughter looked defeated when she asked Maria to continue her story. “Well, at this point, I was feeling embarrassed, alone, and hopeless. I felt so guilty about wanting help–needing help. I was still in pain and trying my best to manage it alone. I talked to my husband about it, but he kept convincing me not to worry. I am not sure that made me feel any better. I hoped to get my husband on my side and help me fight for the test, but I did not want to argue with him. Remember, this is the 1940s, so my job was to do all the work around the house and take care of the kids; he believed my pain probably stemmed from that. I wanted to tell him I might not have been in so much pain if he had helped around the house a little bit. One of the logs that were written describes the day when Dr. Ranes confronted Dr. Janet about the way he was treating me. I was so shocked that he had the confidence to stand up for himself and me.”

***

Excerpt from Dr. Ranes’ Medical Log

I decided to share how I felt about how Dr. Janet treated Maria. I was upfront and direct with him, saying Maria was not hysterical and needed our help. As expected, Dr. Janet was not a fan of what I said. Janet forcefully stated, “Dr. Ranes, I do not expect you to know this since you are a medical student, but women who come in complaining of back pain are hysterical, and they are only looking for a break from their lives. Therefore, I will not allow you to use our resources on Maria, who is seeking attention.” I could not let this go on any longer, so I said, “Dr. Janet, with all due respect, I think you are wrong.” I try to swallow, but my throat is dry. Hiding the shakiness in my voice, I continue, “I cannot sit back and watch you send this woman home without helping her. I have decided to help her because that is the oath I took when I decided to go to medical school.” Dr. Janet stood up and walked towards me with Maria’s chart. He placed his hand on my shoulder, gripping it tightly, saying, “Why do you think you can speak to me that way? I am YOUR superior. Get out of my office, now!” I took a step back and walked out of the room. That was the final straw. Under no circumstances am I going to let Maria suffer. She is my patient too. 

***

“So, after Dr. Ranes took matters into his own hands, I was given further tests that showed I had a small tumor on my spine. It was pressing against my sacrum, which caused severe pain in my lower back and abdomen. Within the year, I underwent spinal surgery to remove my tumor. Fortunately, the surgery was successful, and the recovery time was minimal. A few weeks after my surgery, I talked to Dr. Ranes and thanked him for giving me the tests I needed and helping me find the root of my pain. He recommended that I come forward and share my story. He wanted Dr. Janet to know the pain, emotional and physical, and he was causing several other women and me.”

“A few months after my surgery, I received a letter from Dr. Ranes. He told me that Dr. Pierre Janet was reported for malpractice and was awaiting further charges. Dr. Ranes told me he decided to transfer to another hospital because he no longer wanted to be a doctor but rather an advocate for gender disparity. Dr. Ranes told me he was planning on looking for a job in human resources, where he could advocate against pain bias.”

“Honey, I tell you this story not to scare you but inform you about gender disparity. You are a teenager, and it is these years of life when you will be experiencing new things. You are so vulnerable right now, and I want to ensure that you know everything you need to know because I would never want something like this to happen to you. Even though hysteria is no longer diagnosed in women, I still need to tell you about the dangers of misdiagnosis.” 

“Why don't doctors believe women when they are in pain, Grandma?” asks Maria’s granddaughter. “That was something I wanted to know too, so I did some reading. I picked up this book by Elinor Cleghorn called Unwell Women. I learned three very important things. First, women with chronic illnesses are more likely to be considered for psychotherapy because of their consistent pain. Second, many men thought this could be cured by just popping a pill and being quiet. And third, maybe misdiagnosis comes from the lack of what men know about the female body. The most important thing I want you to take away from this story is that you are the most reliable narrator of what is happening in your body. And don't you ever forget it.”