The doctor is out: A snapshot of women’s health in the 21st century

Each week the Reckon Women newsletter includes a column from an Alabama woman, in collaboration with See Jane Write. Click here to sign up for the newsletter. Click here to sign up for the Reckon Women Facebook page.

By Mikkaka Overstreet

I never thought I’d get a hysterectomy at 35. Aside from jokingly considering it during the occasional rough menstrual cycle, I never thought about hysterectomies at all. But, in November of 2019, I went to the Minimally Invasive Gynecologic Surgery (MIGS) Department at UNC Hillsborough and said goodbye to my uterus forever.

I was lucky to even have the option.

Let me explain. Women’s health is a disaster in the United States. According to the Chronic Pain Research Alliance, six disorders that cause chronic pain in women “affect over 50 million people and consume upwards of $80 billion annually in direct and indirect health care expenses.” Those medical costs don’t buy relief—women have to keep going back, completely misunderstood, and rarely believed regarding their pain.

Women, particularly Black women, are overlooked in healthcare. Black women experience higher maternal death and infant mortality rates than their White counterparts—even when comparing highly educated Black women to lesser educated White women. Historically, physicians have been taught that African Americans are less susceptible to pain. This misconception is compounded by gender, as women’s health lags behind other areas of medical knowledge.

Enter me: a queer Black woman in the South. In October 2018 I had what felt like menstrual cramps—pain across my pelvis and low back—that lasted a few hours, every few days. By December, the pain had become a daily occurrence.

When I saw my doctor in January 2019, I began months of tests, specialists, and gaslighting. A preliminary exam and ultrasound led to a referral for a transvaginal ultrasound at a radiologist and a gynecologist visit. In February, another transvaginal ultrasound yielded the same results—nothing.

By then, I’d learned about endometriosis, a condition that affects 1 in 10 women and that can cause chronic pain, pain with sex, and infertility. This OBGYN didn’t think I had endometriosis, but suggested we try the same plan of treatment she would for endometriosis: changing my birth control, trying Lupron, and then a diagnostic laparoscopy. She told me “women have pain” and that there wasn’t much to be done about it medically. She dismissed my questions. I have a PhD and am middle class; I couldn’t imagine how many women without my privileges were routinely dismissed by doctors like this.

I got in at a highly recommended OBGYN. All of the (white) women I knew gushed about her and my (white) queer friends loved her because she was one of us. Let’s call her Dr. Awesome. Her office administered a pelvic exam, an additional ultrasound, then referred me to gastroenterology.

I started canceling classes and engagements because the pain was often unbearable. By summer, it had increased so dramatically that I had Dr. Awesome schedule a diagnostic laparoscopy. Meanwhile, I was prescribed Ibuprofen so much that it was causing terrible stomachaches. Still, Awesome wouldn’t prescribe anything stronger because I had “no diagnosis and, therefore, nothing to treat.”

My life had changed drastically by this point. I spent most of my time wrapped in heating pads on my couch. I was exhausted, but the pain made it hard to sleep.

During the laparoscopy, Dr. Awesome said she found some endometriosis, but didn’t attempt to remove it. She told my husband that she would explain more after I was awake, but when I came around, she was in another surgery. We wouldn’t be able to speak to her until my follow-up appointment in a few weeks.

I tried to find out more, but my requests were rebuffed. Dr. Awful (see what I did there?) wanted to put me on a new drug for endometriosis, but with my history of anxiety I was uncomfortable with the mental health side effects. I grew increasingly frustrated with her dismissals and non-answers. She left a packet of papers for me at her office: a page of hastily scribbled jargon and several articles on endometriosis printed from the Internet—most of which I’d already read.

By my post-op, I wanted a hysterectomy if it meant the pain would stop, but Awful wanted to try more conservative methods. We tried a one-month dose of the Lupron shot which put me into medical menopause. If my pain responded, that would prove that removing my uterus was the right choice. Awful flatly stated that she wouldn’t prescribe anything for the pain because of the possibility of addiction. She was resistant to referring me to a specialist at MIGS, intimating that she didn’t think my case was serious enough.

Additionally, I’d had a colonoscopy, urodynamics, and a cystoscopy. I’d spent so much money out of pocket that I hit my health insurance’s limit. Again, I could not imagine how someone with a less flexible job, less income, and fewer resources would be able to handle this.

Though it worked, the side effects of Lupron were terrible. I had a constant headache, fatigue, and horrible hot flashes and night sweats.

Finally, I found out I could refer myself to MIGS by sending a detailed letter of my situation. Miraculously I got in. Everything changed.

I cried at my first appointment. The doctors were so compassionate, and they believed me. They determined that my pain was caused by a combination of tight muscles and uncontrolled uterine contractions. The plan was to remove my uterus and to start physical therapy to retrain the affected muscles. I could hope again.

They found no evidence of endometriosis in the pictures from my laparoscopy or during the surgery.

I am 10 months post-op and pain free. The post-surgical pain was nothing compared to my chronic pain. I spent a year of my life suffering, but as I’ve shared my story, I’ve heard from women who have suffered for much longer, who still haven’t been believed or diagnosed.

If this is you, I believe you. I’m so sorry that you’re going through this.

It is criminal that our patriarchal society expects women to live with debilitating pain. It’s not okay that doctors are trained to believe they know more about our bodies than we do, even though the research on women’s bodies is woefully behind that of our male counterparts. Many doctors are too overworked to have time to listen. None of this is okay.

I am speaking up for women without my privilege. I am speaking out for the women I talked to in Facebook groups and those who messaged me when I shared my story on my blog.

Your pain is real. Your pain matters. You deserve care. Don’t give up.

Dr. Mikkaka Overstreet has been an educator since 2006 and a writer since she could pick up a pencil. She is currently a professor of literacy education in North Carolina, where she lives with her husband, cats, and snake. Visit her website at DrMikkaka.com