Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick by Maya Dusenbery
Publishing Details: HarperCollins, June 2018
Back-of-the-Book Summary: Editor of the award-winning site Feministing.com, Maya Dusenbery brings together scientific and sociological research, interviews with doctors and researchers, and personal stories from women across the country to provide the first comprehensive, accessible look at how sexism in medicine harms women today.
In Doing Harm, Dusenbery explores the deep, systemic problems that underlie women’s experiences of feeling dismissed by the medical system. Women have been discharged from the emergency room mid-heart attack with a prescription for anti-anxiety meds, while others with autoimmune diseases have been labeled “chronic complainers” for years before being properly diagnosed. Women with endometriosis have been told they are just overreacting to “normal” menstrual cramps, while still others have “contested” illnesses like chronic fatigue syndrome and fibromyalgia that, dogged by psychosomatic suspicions, have yet to be fully accepted as “real” diseases by the whole of the profession.
An eye-opening read for patients and health care providers alike, Doing Harm shows how women suffer because the medical community knows relatively less about their diseases and bodies and too often doesn’t trust their reports of their symptoms. The research community has neglected conditions that disproportionately affect women and paid little attention to biological differences between the sexes in everything from drug metabolism to the disease factors—even the symptoms of a heart attack. Meanwhile, a long history of viewing women as especially prone to “hysteria” reverberates to the present day, leaving women battling against a stereotype that they’re hypochondriacs whose ailments are likely to be “all in their heads.”
Offering a clear-eyed explanation of the root causes of this insidious and entrenched bias and laying out its sometimes catastrophic consequences, Doing Harm is a rallying wake-up call that will change the way we look at health care for women.
I saw the cover of this book and nearly swooned (yes, that is a hysteria joke). I have had very little faith in medicine as an institution for a while now, and I couldn’t wait to get my hands on a book like this. I’d heard plenty of women’s “doctor stories” and had a few of my own, but I can’t describe how it felt to see a serious, well-researched book dedicated to those “stories.”
What I Liked:
I want to start by saying that I have a full six pages of quotes from this book saved to my computer, and I flagged so many more quotes than I actually typed out. Not only is this book incredibly informative, assertive, and kind, it is full of absolutely brutal one-liners, and I’m in love.
This book does several things well, but I want to highlight the top three: rhetoric, research and rage.
The rhetoric throughout the book is inclusive and intersectional, it clearly explains medical sexism as a systemic problem, and despite all this, it’s often still quite personal. Dusenbery opens with her own experience with rheumatoid arthritis and the shift in perspective she experienced after her symptoms started. On the very first page, she says “Most of the time, though, I forgot my body entirely. It was the loss of this luxury that I felt most acutely when my immune system started attacking my joints.” After that, the book quickly acknowledges the many faces and identities of womanhood, and acknowledges that both sex and gender are a spectrum and have different biases in medicine. Throughout the book, Dusenbery talks about the insidious stereotypes women of different races fall into as they seek help, from the anxious white hypochondriac, to the impoverished black drug-seeker. In the midst of all of this, Doing Harm still manages to come back to the root of the problem over and over: this is not a problem only found among a few bad doctors, this is a problem with our medical system as a whole. But Dusenbery says it best:
“This book, then, is not about a few sexist bad apples within the medical profession. It is about how bias is embedded into the system. It is about how all health care providers, like all of us, have unconscious biases by virtue of living in a culture that holds certain stereotypes about women. And it is about how even the very best doctors know relatively less about women’s health compared to men’s, not because of any individual failure on their part but because they are not taught as much about women’s health, often because, quite simply, less is known” (12).
My second favorite part of this book is the research. Dusenbery includes over 300 sources, making that nearly one source per page. She investigates everything: different types of heart disease, how much funding goes to various diseases, fibromyalgia, the history of hysteria, chronic Lyme disease, the use of male vs. female participants in drug trials, from humans to rats to cells—I could go on and on. Dusenbery takes it one step further, which is what really makes this book so special. She includes a magnificent amount of statistical research, but she also incorporates meaningful anecdotal research. If you have experience in the sciences, you may have heard the saying “Anecdotes aren’t data.” But when there is no data (or very little) on the subject, anecdotes become an important part of research. As Dusenbery points out, listening to women’s anecdotes has often kickstarted real efforts to get more hard data.
Finally, I love the rage throughout this book. Don’t get me wrong, it is an incredibly professional book and far from a memoir or funny collection of essays, but Dusenbery does not shy away from the anger women everywhere have the right to feel about these injustices that have been perpetuated throughout the medical system for centuries. In the conclusion of Doing Harm, she says:
“I also asked everyone I interviewed what advice they had for individual women navigating the medical system. I often heard Listen to your body. Trust that you know when something is wrong. Don’t second-guess yourself; get a second opinion instead. This is good advice, but we should be very clear about why it is necessary advice: because all too often, when women enter the medical system, they encounter health care providers who do not listen to them, who do not trust that they know when something is wrong, who make them second-guess themselves and doubt the very reality of what they’re feeling in their own bodies…we are asking individual women to compensate for the medical system’s failures. While some patients may want to be partners in their medical care, and the Internet has certainly made it easier for some patients to educate themselves, not all women have the vast resources required to become ‘empowered patients.’ And doing so should not be mandatory” (317).
This is just one of many, many quotes that refuse to disguise the anger that women are entitled to feel toward such a sexist medical system. Dusenbery has written a book that represents women in medicine honestly, in all our camaraderie and ingenuity and, yes, rage.
What I Disliked:
Even though this is a hugely important book and I feel so lucky to have stumbled upon it at the library, it is not without its flaws. The first issue with Doing Harm is its organization. It is separated into three parts and seven chapters, but it covers dozens of illnesses and medical conditions. It compares how women and men are treated for various issues like rheumatoid arthritis and heart attacks, but on the same page it discusses issues that only occur in women, like vulvodynia (chronic vaginal pain). Some sections are organized by condition, while others explore multiple conditions in order to demonstrate a harmful phenomenon in how women are treated (or more often, not treated) in the medical system.
At best, the variety in organization keeps this 400-page book from getting too predictable and clinical, but at worst, it leaves the reader confused, flipping back and forth several pages trying to put things together. It wouldn’t fix all of the organizational issues throughout the book, but more chapters would certainly help. Each chapter overflows with information—incredibly useful, insightful information, but just too much.
My second problem with the book is a bit more serious. Despite being a book dedicated to bringing women’s struggles in health care to the light, it does an excellent job of sweeping a very particular type of struggle under the rug: mental illness. Throughout the book, Dusenbery repeatedly brings up the dangers of women being misdiagnosed with a psychological illness rather than a physical one. This is a huge problem in the health care world, especially for women, and as Dusenbery explains, it is a consistent pattern throughout history, from hysteria to conversion disorder. However, with the exception of one quote (from a patient she interviewed, not from Dusenbery herself), she never acknowledges that mental illnesses are often just as serious as physical illnesses.
Considering how often she brings up the danger of being misdiagnosed with a mental illness, it seems odd that she dedicates so little time to actually discussing mental illness in its own right. After all, there is no shortage of sexism in the world of mental health. Women are often misdiagnosed with anxiety and depression when they really have ADHD, women are discouraged from taking life-saving psychotropic medication if they get pregnant, even if there is no concrete evidence that the medication can cause birth defects, and women’s reports of their own symptoms are not taken seriously, just like in the world of physical health care. Despite how well Doing Harm investigates and advocates for women’s physical health care, it is actively harmful in the way it discusses mental health care. By acknowledging mental illness only as a misdiagnosis, Dusenbery says that mental illness is a lesser problem, one women should fight against to prove something is “really” wrong.
You Might Like This Book If…
- …you’ve had a negative experience in the health care system and want sweet validation that your struggles are part of a huge problem
- …you haven’t had a negative experience in the health care system and want to know what this is all about
- …you like informative non-fiction based in research, both statistical and anecdotal
- …you need a good book to read while running on the elliptical (from experience, I can tell you this book will make you so angry you won’t even realize how long and fast you’re running)
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