I’ve had some miserable medical experiences.
Once I went to see a neurologist at a teaching hospital for a throbbing migraine. Ten students crowded into the room as he examined me. Then, as one of the students was peering into my eyes with a light, she fell forward and fainted, pinning me to the table with her body.
Another time, at a fertility appointment, the doctor assured me my testing was covered by my insurance—and yet I received a $700 bill for it later that month.
I once told an emergency room doctor I was allergic to an anti-emetic medication and he said that was impossible. He didn’t believe me until I was covered from head to toe in burning, itching hives.
When I moved to a new city, I accidentally chose the most crowded hospital in the area and ended up waiting fifteen hours to be seen.
All of these experiences sucked. But only one of them involve medical gaslighting. Did you catch which one?
I’ll give you a burning, itching clue: I am very vocal and accurate about my medication allergies.
It can sometimes be difficult to pinpoint whether a negative experience with a doctor or hospital is a result of medical gaslighting, a medical necessity, or simply a product of the more-often-than-not shitty American healthcare system.
Let’s take a look at the situations in the table below.
Is It Gaslighting, a Medical Necessity, or Just Shitty American Healthcare?
Situation |
Reason |
|---|---|
The doctor is late. |
Shitty American Healthcare |
The doctor is late and tells you that you don’t look as sick as his last patient, so his tardiness doesn’t matter. |
Medical Gaslighting |
The doctor is rushing your appointment. |
Shitty American Healthcare System |
Your doctor refuses to answer questions you have about the treatment they’re prescribing because they know best and that’s all you need to know. |
Medical Gaslighting |
The nurse wakes you up in the hospital at 3 AM to draw blood when you desperately need rest. |
Shitty American Healthcare System, as well as Medical Necessity |
The nurse refuses to give you your pain medication as prescribed because you don’t appear to her as if you’re in pain. |
Medical Gaslighting |
The nurse is unable to insert an IV into a vein and after three times finally gives up and gets another nurse or the IV team. |
Shitty American Healthcare System (Most infusion centers and hospitals have a three strikes rule before a nurse can get someone else or another technology to assist.) |
The doctor makes you do vitals each time you come in. |
Medical Necessity |
You’re starving but the surgeon won’t let you eat several hours before surgery, even though you don’t have a confirmed slot on the surgical schedule. |
Shitty American Healthcare System, as well as Medical Necessity |
The surgeon refuses to discuss the risks of the surgery because he feels they are minor or unlikely. He says that you worry too much. |
Medical Gaslighting |
The doctor’s notes aren’t online within twenty-four hours of your most recent appointment. |
Shitty American Healthcare System (Unfortunately, many doctors are so overwhelmed with patient loads that they may not get to putting in their full notes until several days have passed.) |
Your doctor hasn’t called you back yet, even though you’ve already received your test results in your online portal. |
Shitty American Healthcare System |
Your blood panels keep coming back with out-of-range results that are consistently getting more out of range over time. You ask your doctor about it, and he says not to worry about it because it’s probably a fluke. |
Medical Gaslighting |
Did you get the answers right?
While things like spending three hours in a waiting room for an in-demand specialist or being woken up for early blood tests so your doctors can see your progress before they come for rounds are both annoying and frustrating parts of patient life, they aren’t medical gaslighting. Having your concerns belittled or your pain ignored or underestimated, however? That’s another story.
You may want to make a list of your own medical experiences to see if you can figure out if they meet the criteria for medical gaslighting. Learning to recognize medical gaslighting can help you understand whether the tools we’ll present in this book will be helpful to you in navigating difficult situations—because if you can ascertain the cause, method, and consequence of a specific scenario, you can better manage the outcome.
Sometimes medical gaslighting is obvious (though even then, it’s hard to fight). Let’s look at the story of Amanda Bruschelman, age forty-two, from Ohio.
On January 5, 2023, Amanda stood in her kitchen with her husband. They were making dinner for their three children when Amanda felt a lightning bolt of pain strike through her lower right abdomen. The pain was so sudden and intense that she yelped. But just as quickly as it came, it passed.
“Well, that was weird,” she said to her husband, laughing off her own reaction. She hoped it was one of those reflex pains that stung but would dissipate on its own—like stubbing her toe on a coffee table. But the pain in her abdomen came back in waves, and then spread through her chest. She writhed in pain all night. Should she go to the emergency room? No, that would be overkill. It’s just a little stomachache, she rationalized. Amanda had a history of acid reflux, and she was scared to even take ibuprofen since that often made the reflux worse. She hoped the pain would stop on its own eventually.
By the next morning, she was concerned enough to see her doctor, a general care practitioner that she knew and trusted. After all, she’d been under his care since she was seven years old. He took her concerns seriously, examined her, and pressed on her belly. During the exam, he made a joke and she laughed. The giggles quickly turned to gasping as she clutched at her side.
“It’s appendicitis,” he told her, helping her up from the exam table. “Either go to the emergency room right now or I’ll call an ambulance. I mean it.”
Amanda got in her car, resigned to the idea that she would have to go to the emergency room—a place she desperately did not want to go, especially on her own. Her husband was a 911 dispatcher with no more time off. She told her mother but said she didn’t need to come with her; she didn’t want to be a bother.
But women don’t let other women go into these situations alone, so her mom was already waiting for her by the time she arrived in the ER.
Her local emergency room wasn’t crowded, a rarity since the Covid pandemic began. She was quickly triaged and taken to an exam room. The nurse was just putting in her IV when the physician assistant came into her room. Amanda told him where her pain was and what her primary care doctor suspected. He asked a few questions about her history and then had her recite the list of medications she took, which included estradiol, a hormone replacement therapy for women who are postmenopausal. He didn’t ask her about it.
They began drawing blood and took her down for a CAT scan. When she came back, she was offered pain medicine. Amanda turned to her mother with concern; she had a history of bad reactions to narcotic pain medication, including Percocet and Vicodin. Though she was fearful to try anything, eventually she gave in and allowed them to give her morphine. Initially it helped; for a few moments Amanda felt relief. But immediately after, she felt the worst heartburn of her life. She gripped the hospital bed with both hands as her mother went to find a nurse.
The doctor walked in not long after the nurse had given her a cocktail of acid reflux drugs. Amanda, at this point, was sobbing from the pain, but the doctor didn’t even look at her. He pulled up a screen on his laptop and began to explain that her bloodwork was fine, she shouldn’t be in so much pain, and she had a cyst on her ovary.
Amanda and her mother exchanged identical puzzled looks.
“What ovary?” Amanda asked. “I had a hysterectomy a decade ago. I don’t have ovaries anymore.”
When the doctor finally looked up from his screen, it was to give her a look that Amanda could only describe as shouting, You might be the stupidest person I’ve ever met in my life. He argued that she’d probably had her uterus removed but not her ovaries.
“I had a radical hysterectomy, including an oophorectomy,” she said, mirroring his expression. “Both ovaries, and my uterus.”
He looked back down at his screen. “Well, then, they lied to you.”
Amanda was in shock—not because she felt her original surgeon had lied to her. The night sweats from that surgery had eventually led to her being put on estradiol, confirming the hormonal changes caused by the removal of her ovaries. She was in shock because this man was either completely incompetent or lying to her face.
She was terrified, because she knew now that she was being dismissed, and was about to be sent home without a diagnosis or treatment. And she feared her life was truly in danger. So, she argued with him. She reiterated her claim that he had misdiagnosed her. He pointed toward the scan on his screen and she suggested that whatever he was seeing was not a cyst. But he didn’t believe her.
“She’s telling you the truth,” her mother said, stepping in to back her up. “I was there. She had a complete radical hysterectomy. You are wrong.”
He rolled his eyes, huffed with annoyance, and demanded to know who the operating surgeon was and where it had been performed.
“Why don’t you look it up in my chart? Isn’t that something you should have done before you walked in here?” Amanda asked. When he finally did, he agreed to go and speak with the radiologist and left. They sat in tense silence for a few minutes before he came back in.
“Diverticulitis,” he told them, delivering it just as confidently as he had his first diagnosis. “That’s the only other possibility in that area. I’ll give you an antibiotic.”
Amanda wasn’t as reassured by his prognosis as she wanted to be, but her mother had chronic diverticulitis, so she was familiar with it and the kind of symptoms it could cause. It might not be the right answer, but it was something. She went home, took the antibiotics—and continued to deteriorate.
She made it through the weekend, and on Monday morning called her primary care doctor again. When the medical assistant recognized her caller ID, she answered the phone with, “We were just about to call you.”
The office had received her report from the hospital earlier that morning. “We’ve been talking about you all morning. The doctor wants to talk to you—let me grab him.”
A moment later her doctor got on the line.
“For the love of God, Amanda—go back to the hospital!” he insisted. “I’m sure you have appendicitis.”
Emboldened by his support, she called her mother, and they headed back to the emergency room. A different doctor saw her this time, and he seemed kinder. He repeated the CAT scan, but once again it didn’t explain what could be going on in the area where she had pain. They sent her for an MRI with contrast, and with that, they had a new answer.
“It’s a tumor,” the doctor told her. “An adnexal mass. I’m going to give you a referral to a gynecologist and some pain medicine.”
When she pressed about whether the tumor was the cause of her pain, or if there was any possibility that it was appendicitis, as her general doctor was suggesting, she was brushed off.
“This is not an emergency,” the doctor told her.
So, Amanda did the only thing she could. She waited until she could get in with her gynecologist. When her gynecologist finally did see her and read her scans, she told Amanda that she highly doubted that the mass in her scan was what was causing her pain. Thankfully, this doctor, the same one who had done her radical hysterectomy all those years ago, wasn’t willing to just let her sit and wait and suffer. She immediately took Amanda in for exploratory surgery.
When Amanda woke after surgery, she was told right away that though they had found the mass in question—a fibroma, a relic of her endometriosis, negative for any malignancy—it was anatomically nowhere near where her ovaries would have been, had they remained.
And her appendix?
It had a pinpoint opening, meaning it had been on the verge of rupturing.
“It was angry, all right,” her doctor told her. “That is undeniably what was causing all that pain. They should have taken it out the first time you went to the ER.”
As she recovered, Amanda thought of all the days and nights since that first swoop of pain standing in her kitchen.
“If it happened again, I’d think twice about going to the ER for help,” she told me. “I’ve lost all my faith that I’ll be heard and that my concerns will be taken seriously.”
Amanda followed up with the hospital and explained how both doctors had missed a crucial diagnosis. The hospital and physicians offered no apology for the weeks she spent in pain, waiting for care. They didn’t offer an apology for not reading her chart in the first place or for fighting with her about organs she knew didn’t exist.
“I didn’t care about the apology, really,” she said, though she did mention the mix of emotions that came when the enormous ER bills arrived. “I just wanted them to reassure me that I really was safe when they sent me home both times. That they really had done everything they could to keep me from harm—and they didn’t.”
This was a clear case of medical gaslighting. The ER doctor assumed that he knew more about her past surgical history than she did. He manipulated the power balance by holding the threat of being discharged without an answer over her. He was neglectful in fully investigating her pain, and gaslit her into believing her issue wasn’t severe or urgent.
For others, medical gaslighting isn’t as cut and dried as it was in Amanda’s case. Let’s talk about some of the less obvious ways that it takes place.
There are infinite ways to call a woman crazy. Doctors do it when they tell her she has no reason to be worried about a symptom she can’t explain. Partners do it when they tell her she’s overreacting after a doctor’s appointment that went south. Friends and family do it when they tell her, however gently, You worry too much. Because when we know something is wrong, we feel those words like a slap in the face—not the warm embrace others might have intended. And when we read our notes and see a diagnosis based on nothing but a doctor’s assumptions about us, made up of their observations and judgments about others like us, before us, it is not a comfort. It’s a sucker punch.
The point being: While there are phrases and wording that jump off the page and scream THIS IS MEDICAL GASLIGHTING! there are also examples that are harder to decipher. Some of these are also verbal, and others are in the actions medical providers take, but all of them result in a failure to give you the care you need, based on bias.
Amanda’s doctors didn’t call her crazy, but they did attempt to convince her she had organs she knew she no longer possessed and to dismiss her concerns as irrational when they weren’t.
Medical gaslighting won’t always sound exactly like the phrases below, but the following are things healthcare providers commonly say to gaslight women out of pursuing a diagnosis or treatment.
When a physician blames symptoms solely on mental health or stress instead of attempting to perform any testing.
•“I think this is all in your head.”
•“It’s probably just stress.”
•“I think you just need a vacation.”
•“What does your therapist say about these symptoms?”
•“If you just thought more positively, you wouldn’t focus so much on your symptoms.”
When your doctor believes your symptoms are in avoidance of something they believe you perceive as a chore.
•“Are you sure you’re not feeling sick because you don’t want to go to school?”
•“Is your goal today to have my sign-off for disability benefits? Because most of the patients I see just need a little pep talk to get back on their feet!”
•“Does sex really hurt, or are you just not attracted to your partner/confident in your body?”
•“You know, a lot of girls your age claim stomach pain when they’re trying to hide an eating disorder.”
When a physician has performed limited testing to diagnosis the problem and does not want to pursue more.
•“Your basic blood work/imaging looks normal, so you must be fine.”
•“I wouldn’t test for that because I have never, in all my years of practice, seen a single patient who had that condition.”
•“You’ve already seen one doctor about this issue, and they found nothing. I doubt I would find anything they missed.”
When a physician frames your symptoms as less severe or impactful as they are based on unrelated cases.
•“Everybody has pain.”
•“There are people who are much sicker than you.”
•“You’re too young to have all these problems.”
•“A pretty girl like you should be out there enjoying her life!”
•“It’s normal at your age to feel unwell.”
•“I don’t see any reason why you can’t function just like everyone else.”
Ideally, we would recognize signs of medical gaslighting in the moment, before they resulted in dangerous consequences. We would then use the tools we’ll go over in later chapters to protect ourselves from harm. We would stop the gaslighting in its tracks and Uno-reverse the shame card to make our physicians aware of their unacceptable behavior. If medical gaslighting always came with that feeling of shame, that hollowness in your stomach, you could always be sure what was happening. But not all gaslighting evokes shame. Sometimes it comforts. Sometimes it enrages. But always it asks that women put aside their own discomfort for someone else’s convenience.
Sometimes, it’s more convenient . . .
. . . to shut you down, instead of lifting you up.
. . . to shut you up, instead of listening to your needs.
. . . to make you a last priority in an overloaded system.
. . . to make you redraw your boundaries.
. . . to treat you like a cadaver and not a living thing.
. . . to make you accept your pain instead of remedying it.
And the consequences of this convenience aren’t always just one less body in the waiting room.
Sometimes they’re just one less body.