Not All In The Head

Dr. Priyanka Sarkar: If there are Grey’s Anatomy fans out there, a spoiler alert- this story might sound like that of Season 14 and Episode 11. Dr. Bailey aka Chandra Wilson steps into a hospital on her way to work with symptoms of a heart attack and requests an intern for a cardiac stress test.

However, the doctor focused on Chandra’s OCD and refers her for a psych consult. Between words of exchange, Chandra says “Sixty-three per cent of women who die suddenly from coronary heart disease had no previous symptoms, and women of colour are at a far greater risk”.

What happens next in the episode is Dr. Maggie Pierce saving Dr. Bailey’s life by performing the required procedure after the intern missed out on the initial checks. Well, this is a story from 2018 and I always wondered how physical pain gets misinterpreted as a psychological issue until I was at the receiving end of it.

I am a healthy woman with no complications except for occasional migraines. I do not remember the last time I had a fever. But yes, 18 months before like many of my fellow human beings, I too was affected by Covid-19 and was hospitalised for a week. I have been on the luckier side of the surviving lot. And I have been healthy ever since.

I continue to work out, keep an eye on my nutrition and maintain a healthy lifestyle. And rightfully so, when I was finding it uncomfortable to breathe in the early days of December, I thought it must be the harsh winter. I stopped stepping out of the house while it was snowing or in the evenings once it started getting dark.

For a few days, I noticed relief from the discomfort and I was back to my normal life. Then came Christmas and the untimely rains disturbed the entire Christmas decoration which means, it had to be redone thrice, every time, exposing me to the weather yet again. This time I realised I was not quite energetic. But who likes to decorate and redecorate, I told myself. I was coughing occasionally and was finding it difficult to breathe comfortably as Christmas approached and things got difficult with New Year inching closer.

Now, I was unable to eat or drink without feeling pain or breathless. I had to talk less and sleep more because the upper back of the body on either side was hurting. I took over-the-counter medication because I did not want to ruin the festive season.

It was my birthday a few days after the New Year and I had my friends over for dinner. I suddenly couldn’t eat because I was not able to breathe. I now realised that it was something more than the weather. The next day, while I was talking to my maid, I couldn’t breathe. I started gasping for breath. A few moments later, I was fine and my maid rushed to tell my mum. What followed was an immediate visit to the hospital precisely, a pulmonologist.

The doctor, after a series of blood tests, PFT and an X-ray asked me if I was afraid of open spaces. I answered no but I do not like closed spaces. And he did mention -Agoraphobia on my consultation sheet. I did wonder why he mentioned it but was too tired to ask. And then he comes up with a strange solution- a Psychiatric Consultation.

I was taken back or must I admit I blanked out? I told him respectfully, I am a Psychologist myself and had I known my pain was psychological, I would have consulted a psychologist rather than a pulmonologist. However, I was in severe pain. Failing the PFT and being exposed to a bunch of doctors who thought my fear of closed spaces and my breathlessness could be a psychological issue was just cherry on the cake.

The moment I told them my profession, the doctor and nurses exchanged looks. That is when they asked me for my previous medical history which I have been trying to show them from the moment I walked in for the consultation. Now with the medical reports in their hands, they again guessed it must have been side effects of Covid-19.

I was glad that we were getting somewhere. And how wrong was I? Another series of chest tests declare that my lungs are normal and so it would be ideal if I could consult a psychiatrist. Their version-I was under some stress. I was losing it. But I was no Dr. Bailey I was just a normal woman who has gone to an expert with symptoms. But I put up my stubborn front and made my point about how it is not a psychological issue but a physical issue.

I told them that despite their expertise, they were wrong in this case. And maybe just to be done with me, they suggested I get a CT chest done and meanwhile put me on medication for what might be one of the reasons – Bronchial asthma. They suggested I take the Chest CT post the completion of the medication.

A week later, I get a CT Chest done and for a moment, I did wish they were right and I was wrong. The CT chest shows fibroid bands on either side of the lungs. With the report in hand, I yet again had to visit the hospital; only this time, with an odd sense of relief that I finally knew what was happening to my body.

While the symptom management and the next steps to prolong life continues, this brings me to the important part of this narration- the subtle act of ignorance in spite of all the experience on the part of the medical system and the ones who work in it. I by no means bring all the healthcare professionals under this bracket. There are many amazing healthcare staff across the globe who diagnose and treat multitudes of patients across.

In 2020, TV reporter Victoria Price was alerted by a viewer after noticing a lump on her neck. She asked Victoria to get her thyroid checked. Victoria Price though apprehensive, got it checked only to find out that she had papillary thyroid cancer that had started to spread to her lymph nodes. Her doctor recommended that she have surgery as soon as possible.

In a similar incident from 2 years before that, in 2018, in another incident, Dr Erich Voigt spotted a small lump on Nicole McGuinness, throat while she was featured on US television station HGTV’s show Beachfront Bargain Hunt. Dr. Voigt reached out to Ms McGuinness through a social media post and alerted her. She promptly underwent a biopsy and her results revealed that she had Thyroid cancer. These are just 2 examples of attention to detail at a place that one doesn’t expect. The last thing that I want to add to this topic is gender. Unfortunately, the statistics speak something else.

A US-based research study says, “Women are more likely to wait longer for a health diagnosis and to be told it’s ‘all in their heads’. Thanks to advanced technology and access to the internet that we have, symptoms can be read and understood but how about the diagnosis? One cannot be put on medication unless “officially diagnosed.” And what can be done about it? 

Well, I do not know. I have been lucky enough to have studied Physiotherapy and majored in Psychology to know the difference between physical and psychological issues. For those who can read and write, there is the internet. But what about those who cannot read or write? Where does that leave them? No healthy lifestyle and no amount of meditation or mindfulness will come to aid. 

The only 2 things that I can think of are appropriate sensitivity from the healthcare professionals and not brushing off symptoms as psychological. Know one’s body and be aware of the minutest changes that one can notice. After all,  all the king’s horses and all the king’s men couldn’t put Humpty together again.

The writer is an Athlete Well-being Specialist from India who works with International and National athletes from various sports and she can be reached at priyaankasarkar@gmail.com