Bodily Bias

The first time a doctor doesn’t believe me about pain, I am seven years old. My friend and I are practicing gymnastics at my house. We’re both pretty good, so we attempt something we think would be the pinnacle of cool. She’s older than me by a year and twice as big already, so I want to impress her, prove I’m not a second grade baby, that I can hang with the worldly third graders. She extends her arms straight up and I attempt a handstand on top of her hands, determined to perfect some circus magic. We don’t pull it off. I fall straight down onto the floor. My friend loses her balance and plummets like a skydiver onto my stomach.

Something snaps and I can’t draw breath, so my dad rushes me to the hospital. The doctor doesn’t believe my father when he says I’ve broken something, but my dad knows the spine like I know the theme song to Pokémon.

“Look, I’m a chiropractor, and–”

“Well then why don’t you test her,” says the doctor, smirk flying like a red flag. My father isn’t prone to outbursts, but he shouts at the doctor, who eventually opts to give me an x-ray just to avoid a scene. The results reveal my L5 is cracked, a fractured vertebrae. The doctor defends his initial stance. Impatiently, he says “There was no reason to assume anything was broken. She wasn’t crying.”

The mood on the car ride home is less cheerful than usual. The 60s bops don’t elicit off-key sing-alongs. It is only with retrospect that I realize if my dad had been less assertive, things might have gone worse for me, that these sorts of things go worse for people every day.

*

When I’m eight, I get tubes put in my ears for the third time. It’s a minor procedure common among kids who have persistent ear infections, which is My Thing. Repeated ear infections have impacted my hearing just enough to annoy classmates when I ask them to repeat themselves. I am no better off for having had tubes the first two times, but the doctor doesn’t have any other ideas.

When he orders the third round of tubes, he’s disdainful. He says, “You’re a little old to be getting this procedure.” He says it like I’m twenty and still trick-or-treating. As though I’m a school kid not doing their homework. Like hearing is just an arena where I’m not applying myself.

*

In fourth grade, I puncture my eardrum with a Q-Tip. The pain is surreal, worse perhaps than the fractured vertebrae in my back. My hearing becomes so sensitive I can hear full dialogue from the TV even if it’s on mute, even if I’m in a different room. My ear becomes infected and that infection is trapped by the tubes I’d had put in the year prior. The plastic devices don’t allow the infection to drain, so my face swells like a wave that never crests.

It becomes apparent that this isn’t treatable by over-the-counter antibiotics, so I’m checked into the Children’s Hospital. I spend a week in the hospital hooked up to an IV. Doctors keep saying that it wouldn’t be so bad if I hadn’t had tubes.

*

I get my period in the fifth grade, though I have no idea that that’s what’s happening. I expect blood to be red, and this isn’t, so I’m pretty sure I’m dying of a rare disease.  I knew it, I think. I knew I was going to die some crazy way. I don’t tell anyone for three days because I don’t want to worry anybody and because I’m convinced genitals are shameful even at the best of times.

Only later do I learn that first periods are still picking up steam, so in the early days, the uterine lining can appear rust-colored. I don’t identify the pain as cramps, only a horrid, unfamiliar ache in my belly. The puberty book my mother handed me in lieu of a conversation the year before suggested that some people experience cramps with menstruation, but it wasn’t described as this kind of dull, deep pain that tunneled from my stomach to my back. None of my other classmates have gotten their periods yet. As we change for gym, we float a range of stances about whether or not a period is a desirable thing to have. I am firmly in camp no-thank-you, but the loudest girl in our class who wore fun, rainbow glasses can’t wait for hers, wants to grow up the way I want my parents to cave and get me a Nintendo.

Earlier that week the girl with the fun, rainbow glasses cornered me in the bathroom.

“Casey thinks you’re hot.” Casey was the most popular boy in our grade.  This was the sort of sentence I expected to be uttered in tones of excited camaraderie, but it wasn’t. She spat the words in anger, like I’d done this just to sabotage her.

“So?”

“It’s because you have boobs,” she said, disgusted. “Not because you’re actually pretty.”

I curled my shoulders inward to make my chest look smaller. My classmate was glaring at me, communicating that I was in her way socially.

“You’re changing yourself for the boys,” she said. “It’s gross.” I had something she wanted, and I didn’t deserve it. At least not like she did.

I think of this recent interaction as I stand in the same bathroom later that same week trying to discern from my panties what illness was killing me from the inside out. When I realize days later it’s my period, I wonder if my friend was right, if my body is changing itself for male attention.

*

Throughout high school, monthly cramps push against my belly with such ferocity that I can’t attend class, can’t uncurl myself from a scrunched heap on a floor, a human ammonite. I get high to mellow the pain. Adults are not impressed with my life choices. Doctors tell me cramps are normal. Drugs, not as much. Nobody offers alternative solutions, so I keep smoking up by burning plastic water bottles and shoving cheap, metal bill pieces through them. This method is convenient because you can dispose of the evidence fast.

*

At 22, I wake up unable to hear out of my left ear. I’m still prone to ear infections but I’m so busy working three jobs that I mostly try to wait them out instead of seeking medical attention, which would require several bankable hours. This time is different: it’s like a bubble has formed in my ear. Being unable to hear means I can’t work. All of my jobs are serving jobs. The majority of my income comes from tips, which are contingent on my ability to banter with and listen to customers. With my livelihood at stake, I drag myself I to the hospital.

I wait in ER for 8 hours. There’s only one ear, nose and throat doctor, and he’s not on shift yet. The nurses eventually escort me to the lone room with the proper equipment and get started without the doctor.

One peers into my ear and says, “Well, here’s the problem. You have the head of a Q-Tip stuck in your ear.”

I haven’t been big on sticking things into my ears since puncturing my eardrum as a kid. I’m not sure which part of the experience deterred me more, the staggering pain or being hooked up to an IV that accidentally ripped out in my sleep and waking up covered in more blood than Carrie. “That’s impossible,” I say.

The nurses look at each other without trying to hide their skepticism.

“Well, I can see it, so…”

“I don’t use Q-Tips in my ears.”

“I’m looking at it, so why don’t you tell us the truth?”

I’m reeling. If they see it, obviously I’m mistaken. How could I have gotten the head of a cotton swab in my ear? Could my cat have dragged one out of the bathroom, left it hiding in my pillowcase, and in my sleep I rolled onto it ear first? Did I have a violent altercation ending with somebody stabbing me in the ear with a Q-Tip that was so traumatic I repressed it?

While I theorize, the nurses wield a shiny, pointy utensil and try to pull out the Q-Tip head lodged deep inside the ear canal. It hurts enough that I try to scramble away, tuck my ear to my shoulder in self-protection.

“Stay still,” says the younger nurse, fledgling wrinkles triangulating from the corners of her stony eyes.

They tug and tug at it. I feel something hot trickling down my face. I press my hand to the warmth: my ear has begun bleeding. The pain sends my head spinning.

“It won’t come out,” says the second nurse. Her voice is low, quiet, like she is used to saying things she doesn’t want people to hear.

Inner ears are connected to balance, I think, reciting medical facts to keep myself calm. It is therefore normal that everything’s whirling. It’s normal to be nauseated when you’re dizzy.

“It’s really deep in there,” agrees the young nurse.

The nurses are unsuccessful at removing the swab. In the ninth hour, the ear nose and throat doctor shows up to the fluorescent-lit room.

“I’m Dr. Jones,” he says. “I hear there’s a Q-Tip in your ear?”

“There’s not.” I say, the words torn effortfully from my raw throat. This is a lesson I have learned at doctors’ offices: my throat is the first thing to know I’m angry. It knows even before my mind.

“Yes there is,” the younger nurse interjects, exasperated by my audacity.

“Well, let’s just take a look.” The doctor leans close to my face, inspects my ear through the auriscope. His breath smells like stale coffee, unwashed tongue.

He withdraws.

“Well, it’s not a Q-Tip head,” he says, voice confident and grim. Rage scalds my throat, so I know I’d better not say anything.

The obstruction is a pearly chunk of scar tissue. I have something called cholesteatoma caused by my multiple ear infections as a child. This is why my hearing suffers. Blood trails down my ear, traces my jaw line.

Unfortunately, the hospital doesn’t have the technology to remove the scar tissue, but they’ll call me and connect me with someone who can vacuum it out. I have never heard the word vacuum in relation to ears. It doesn’t sound like an ideal way to spend a day. The doctor dismantles the auriscope. This is the end of the appointment. Nobody acknowledges that any aspect of the medical performance was less than outstanding.

I leave the hospital. It’s that slice of time between the middle of the night and the wee hours, and the first bus of the day is still a ways off. I am scheduled to work an opening shift at the bar in just a few hours. We’re a skeleton staff. I repeat the phrase aloud to myself.  I pull my coat tight around me and start off in the direction of home.

*

In my mid-twenties, I join a gym because I’ve been sad for so long and because I have a tracking problem in my knee. Living in a mountain city, everything is uphill of me, keeps me loping upwards. My goal is for the gym to soothe the ennui and boost the knee by building relevant muscles.

As a perk of gym membership, I’m entitled to a free personal training session. I figure I’d be stupid not to take it. The personal trainer has arms the size of my torso and a name best suited to a hockey player. “Nice to meet you,” Brogan says. “Is there an event in your life you’re trying to lose weight for?”

I freeze part way through tying my runners, the laces two bunny ears resting against my middle finger. “What?”

“Like a graduation or a wedding? Or maybe you just want to get in shape for your own reasons.”

“I actually mostly want to work on my quads? They’re weaker than my hamstrings, and I don’t think that’s right.” I hear myself say it like a question despite knowing it for fact. I am again trying to make myself palatable, complicit in a system that likes me better timid, dismissive of my own power.

“Well, okay, great. We can get you started on some abdominal exercises–”

“That’s not really–”

“–get you ready for swimsuit season.”

I never book another personal training session. I spend most of my time at the gym on the stationary bikes. When I warm up on the mats near the mirror, I see dozens of women in athletic wear, diligently doing crunches, touching their elbows to opposite knees.

*

The city I live in has a major shortage of family doctors. The waitlist for one sometimes spans years. Most of my medical interactions take place in walk-in clinics with doctors I see once, then never again. When in my late twenties, I suffer through undiagnosed stomachaches and pelvic pain, I spend five months popping in and out of walk-in clinics around the city, hoping someone will have answers for me.

One particularly shitty day, an older doctor in a button-down shirt and a tie comes in. He doesn’t introduce himself, just looks at me until I say, “I’ve been having some pretty intense stomach stuff for weeks now, I’d love to get a food allergy test, figure out what’s going on.”

“You don’t need a food allergy test,” he says with just a hint of an ironic smile.

Most of the people I know with allergies experience itchy eyes, stuffy noses, hives, and anaphylaxis, not stomach pain. I decide to explain my reasoning. “I thought maybe because the symptoms I’m experiencing mirror some of my other sensitivities, it might be one I just haven’t caught yet.”

“I’m not going to order you one.”

My patience is a one-hitter. As in, it can take one hit before it’s bowled over. This is hit two and I’m down to the final reserves of my politeness. I wonder what it could possibly cost him to get me those tests and why he seems to delight in saying no to me, why he decided to act from the beginning of the interaction like I was foolish, a damsel fainting in the face of mild pain.

Not bothering to hide my displeasure behind docility, I reiterate, “Wouldn’t it be good just to check?”

He looks at me over his glasses, clears his throat and says, “I am the guardian of the resources. I can’t just give out tests to every woman who asks for one.” I practically hear the record scratch noise. “I will, however, issue you a celiac test.”

“I’m not a celiac. I’ve never had a problem with grains. Can I please just get a referral for the tests I requested?” I know as soon as I speak that I have weaponized the word please. I know it will not yield me the results I want.

He refuses. Because it’s all he offered, I take the celiac test. As it turns out, I am not a celiac.

*

Two months after the experience with the Guardian of the Resources, I’m at a different walk-in. In the past weeks I’ve had two ultrasounds and been at walk-in clinics as often as I’ve been at my job. My bosses are both supportive and irritated that I can’t get well fast. The doctors at the walk-in clinics tell me to keep an eye on my symptoms (nausea, vomiting, cramping in my core), and come back if it’s still not better in a few days. They tell me this every few days. It’s like an Abbott and Costello bit except that I hate it.

Finally, I go to a clinic I’ve never been to. It’s further away from my apartment, but at least this place won’t have the word “difficult” on my file like that one clinic where the Resource Guardian works.

The moment the doctor steps through the door, I launch into the speech I’ve been rehearsing. “Listen man, I don’t know if it’s lack of resources or diagnostic bias, but you’re going to advocate for me because no one else has.”

He looks up from his clipboard, nonplussed. “Yeah, okay.”

The doctor puts my name on a waitlist for the pelvic pain clinic. I wonder how the doctor would have reacted had I come in with a practiced gentleness, if I had just asked politely. the idea that I have to become a bear to be taken seriously upsets me. I leave hoping the day will offer me evidence to the contrary. It doesn’t. When I get home, I disappear into my Netflix account for hours.

*

When my appointment at the pelvic pain clinic comes up, it is with Dr. Wong, the first female doctor I’ve ever had. I am cautiously optimistic that our common gender (both of us cis-women), will align us, guarantee a higher caliber of care. I think back to the nurses trying to draw a Q-Tip that never existed from my ear, how a shared sex spared me nothing. The night before my appointment, I am e-mailed a forty-five-minute survey. When I meet Dr. Wong, she apologizes for the laborious questionnaire. I tell her I loved it. It’s the most time a medical professional has ever spent getting to know my situation.

Dr. Wong spends an hour with me. She answers every question I bat her way—and I’ve come with a list. She conducts an examination, checks in on how I’m doing multiple times. I tell her I’m good even as I’m uncomfortable, because I am. She confirms that I have endometriosis. She outlines several options we could try, talks me through best and worst case scenarios. Almost as an afterthought, Dr. Wong adds that the questionnaire showed I score very low in catastrophizing. I don’t know I’m crying until Dr. Wong offers me a tissue.

I apologize, but Dr. Wong is unfazed.  “Don’t feel bad,” she says. “This happens all the time.”

I traipse through the clinic’s labyrinthine parking lot toward the main thoroughfare. I have an appointment to return and be outfitted for a hormonal IUD. Such a simple solution, if it helps. A mere trip to the drug store. I think about how many people over the years could have intervened, saved me from powerful and unnecessary pain if they’d trusted that I knew something about my body.

When the bus pulls up to the stop, I get on and pay my fare. The woman behind me taps her card against the bus’ sensor, and it honks a tri-tone of disapproval: inadequate funds. As I find a seat, she tells the driver that she’d loaded her pass a few minutes ago before she left her house, that the money probably just hasn’t show up yet.

“No problem,” says the driver. He pulls away from the stop. As the passenger hustles by me to the rear of the bus, the tension smooths from her forehead, concern cedes to relief. When I lean against the fog-kissed window, my face too is relaxed.

Header photograph © Mane Hovhannisyan