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bookph1le's review against another edition
4.0
4.5 stars
This is such a sobering, eye-opening look at the many failures of medicine as both an establishment and a science when it comes to treating patients who identify as female. Sadly, a lot of it didn't come as a surprise to me due to my own experiences with doctors and a medical system that at times seems very willful and deliberate when it comes to ignoring what patients are telling them.
Aside from the fact that sexism is bad and wrong and that women should be afforded the same rights, respect, and benefit of the doubt as men, ignoring diseases that are more prevalent in women is just plain bad science. It concerns me that medicine doesn't seem to see this, that this is another area in which they're willfully oblivious to their own biases, to the detriment of all. As Dusenberry points out, more and better research on autoimmune disorders would more than likely have tangential benefits for diseases like cancer. It's just plain unfathomable to me that medical researchers and doctors aren't doing more to understand how our immune system works because this should be a central issue to the entire science of medicine.
One thing this book doesn't examine, unfortunately, is the ways in which the biomedical industry affect research. There's no doubt in my mind that doctors who think they know everything, which means they don't need to listen to their patients, are causing a lot of harm, but I wonder how the business side of things influences what's researched and what isn't. I'm inclined to believe the pharmaceutical industry plays a big role, and I even suspect that sometimes research is held back by the industry because the development of better treatments may also mean a lowering of costs, which is of course bad for an industry that profits off the hideously expensive drugs used to treat autoimmune disorders, cancers, diabetes, etc. I appreciate that this might have broadened the scope of the book to the extent that things would have gotten lost in translation, but I think this is an issue well worth investigating as well.
I'm no stranger to googling symptoms, and this book did change how I feel about that. I've told myself it's probably not a good idea, but I'm not questioning that assumption. Yes, there is the temptation to leap to conclusions at times, but educating yourself in order to advocate for yourself when you meet resistance from doctors isn't a bad idea.
Even so, Dusenberry is right that patients shouldn't have to be experts. This dovetails quite a bit with the argument that patients ought to be "educated consumers" who shop around for the cheapest deals on heart surgery, or who tell ambulance drivers to take them to one hospital rather than another because it's a more economical option. It shouldn't be up to patients to have to diagnose themselves or to know what's a reasonable fee for a variety of tests. Until medicine takes responsibility for treating patients equitably and charging us fairly for that treatment, it will continue to fail us.
This is such a sobering, eye-opening look at the many failures of medicine as both an establishment and a science when it comes to treating patients who identify as female. Sadly, a lot of it didn't come as a surprise to me due to my own experiences with doctors and a medical system that at times seems very willful and deliberate when it comes to ignoring what patients are telling them.
Aside from the fact that sexism is bad and wrong and that women should be afforded the same rights, respect, and benefit of the doubt as men, ignoring diseases that are more prevalent in women is just plain bad science. It concerns me that medicine doesn't seem to see this, that this is another area in which they're willfully oblivious to their own biases, to the detriment of all. As Dusenberry points out, more and better research on autoimmune disorders would more than likely have tangential benefits for diseases like cancer. It's just plain unfathomable to me that medical researchers and doctors aren't doing more to understand how our immune system works because this should be a central issue to the entire science of medicine.
One thing this book doesn't examine, unfortunately, is the ways in which the biomedical industry affect research. There's no doubt in my mind that doctors who think they know everything, which means they don't need to listen to their patients, are causing a lot of harm, but I wonder how the business side of things influences what's researched and what isn't. I'm inclined to believe the pharmaceutical industry plays a big role, and I even suspect that sometimes research is held back by the industry because the development of better treatments may also mean a lowering of costs, which is of course bad for an industry that profits off the hideously expensive drugs used to treat autoimmune disorders, cancers, diabetes, etc. I appreciate that this might have broadened the scope of the book to the extent that things would have gotten lost in translation, but I think this is an issue well worth investigating as well.
I'm no stranger to googling symptoms, and this book did change how I feel about that. I've told myself it's probably not a good idea, but I'm not questioning that assumption. Yes, there is the temptation to leap to conclusions at times, but educating yourself in order to advocate for yourself when you meet resistance from doctors isn't a bad idea.
Even so, Dusenberry is right that patients shouldn't have to be experts. This dovetails quite a bit with the argument that patients ought to be "educated consumers" who shop around for the cheapest deals on heart surgery, or who tell ambulance drivers to take them to one hospital rather than another because it's a more economical option. It shouldn't be up to patients to have to diagnose themselves or to know what's a reasonable fee for a variety of tests. Until medicine takes responsibility for treating patients equitably and charging us fairly for that treatment, it will continue to fail us.
sellnow_hannah's review against another edition
slow-paced
2.0
I am both a healthcare professional (family practice PA) and a woman who's had negative experiences as a patient.
Sex and gender bias is a significant problem in medicine and an important one to explore. But I found this book needlessly repetitive and while well researched, its clear the author has limited experience in the field so some of her points are off-base:
- She seems to assert that mental health problems can't cause physical symptoms and wants providers to keep ordering tests indefinitely to find a physical cause, which in practice often doesn't make sense and is wildly expensive.
- she seems to not realize that the vast majority of clinicians are not researchers so we follow established guidelines instead of going rogue and ordering tests insurance won’t pay for.
- her discussion about opioids lacked nuance. We are in the midst of an opioid crisis and she barely skimmed the challenges providers have in treating pain in the context of the opioid epidemic.
- she did not even mention the way the medical establishment forces providers to see more and more patients in less and less time as a reason patients feel dismissed and not heard. Then she blames that dismissal on individual providers instead of the medical system that completely over works providers and expects us to somehow do complex and thorough care in a 15 minute appointment.
- the tone of the writing was pretty angry and based on outrage which for me as a healthcare provider was hard to read and not take a just little personally.
Read for League of Women Voters of Larimer County Informed Citizens Book Club
- She seems to assert that mental health problems can't cause physical symptoms and wants providers to keep ordering tests indefinitely to find a physical cause, which in practice often doesn't make sense and is wildly expensive.
- she seems to not realize that the vast majority of clinicians are not researchers so we follow established guidelines instead of going rogue and ordering tests insurance won’t pay for.
- her discussion about opioids lacked nuance. We are in the midst of an opioid crisis and she barely skimmed the challenges providers have in treating pain in the context of the opioid epidemic.
- she did not even mention the way the medical establishment forces providers to see more and more patients in less and less time as a reason patients feel dismissed and not heard. Then she blames that dismissal on individual providers instead of the medical system that completely over works providers and expects us to somehow do complex and thorough care in a 15 minute appointment.
- the tone of the writing was pretty angry and based on outrage which for me as a healthcare provider was hard to read and not take a just little personally.
Read for League of Women Voters of Larimer County Informed Citizens Book Club
11corvus11's review against another edition
3.0
DNF. I refuse to sit through "feminist" book in which the author argues that we need to torture and kill more female laboratory animals. Aside from the ridiculous association between feminism and promoting the nonconsensual exploitation, violation, and killing of female bodies, the author does not seem to grasp the problems with extrapolating data from studies on nonhuman animals to women. Even extrapolation from rats to mice won't match up much of the time.
If you want a book about this topic, check out Michele Lent Hirsch's "Invisible." It has a very small section near the end that discusses the abuse of female animals but it's not fighting for it like this author did.
It's a shame since this book has some good things to offer. It's just not the best of the best on this topic.
If you want a book about this topic, check out Michele Lent Hirsch's "Invisible." It has a very small section near the end that discusses the abuse of female animals but it's not fighting for it like this author did.
It's a shame since this book has some good things to offer. It's just not the best of the best on this topic.
alexisrt's review against another edition
4.0
This is an important book on the gender gap in medicine. Maya Dusenbery identifies two main gaps: the knowledge gap and the trust gap. Medicine still lags in including women in clinical trials and in researching conditions that occur only in, more frequently in, or differently in women. Secondly, doctors distrust women, discount their reporting of their symptoms, and ascribe women's pain as psychological--despite data showing that women are not more emotional, are not drug seekers, and do not seek medical care more readily than men. This bias is compounded for women of color and women who are overweight, and it's not just in the US (the book is US centric, but there are multiple examples of the same behavior from other countries.
Most of this book is great, if enraging, but it's not perfect. In order to keep the book manageable, it's selective. Routine gynecological and maternity care is excluded, as is anything psychiatric. Dusenbery is aggressive on the history of hysteria and its transformation into somatoform disorder--the latter is largely dismissed as a new way to disbelieve women. Her interest is solely in the physical--her focuses are on heart disease, autoimmune disease, and pain disorders. She's so intent to believe that bias is the root of all evil that she sometimes gets into dicey territory on science. I have thyroid disease and I've seen the downside of aggressive patient advocacy for treatment--I wouldn't rely on Mary Shomon. Similarly, she treats the chronic Lyme controversy as solely a question of doctors refusing to believe women, and as someone who's followed that debate for years I'm less convinced. She doesn't criticize "Lyme literate" doctors who charge $12,000 for months of antibiotics that aren't proven to work and who prey on women in their own way. The problem with medicine being lousy is that the alternatives are worse.
Overall, though, a great read.
Most of this book is great, if enraging, but it's not perfect. In order to keep the book manageable, it's selective. Routine gynecological and maternity care is excluded, as is anything psychiatric. Dusenbery is aggressive on the history of hysteria and its transformation into somatoform disorder--the latter is largely dismissed as a new way to disbelieve women. Her interest is solely in the physical--her focuses are on heart disease, autoimmune disease, and pain disorders. She's so intent to believe that bias is the root of all evil that she sometimes gets into dicey territory on science. I have thyroid disease and I've seen the downside of aggressive patient advocacy for treatment--I wouldn't rely on Mary Shomon. Similarly, she treats the chronic Lyme controversy as solely a question of doctors refusing to believe women, and as someone who's followed that debate for years I'm less convinced. She doesn't criticize "Lyme literate" doctors who charge $12,000 for months of antibiotics that aren't proven to work and who prey on women in their own way. The problem with medicine being lousy is that the alternatives are worse.
Overall, though, a great read.
mscalls's review against another edition
challenging
dark
emotional
informative
reflective
sad
tense
medium-paced
4.25
Content Warnings
Graphic: Body shaming, Cancer, Chronic illness, Emotional abuse, Fatphobia, Misogyny, Medical content, and Medical trauma
Moderate: Vomit
Minor: Suicidal thoughts and Transphobia
beetree's review against another edition
challenging
informative
sad
slow-paced
3.5
This is a really important book but I found it dry and repetitive, despite being passionate about this topic. It’s structure and formatting (very long chapters sometimes) didn’t work for me and because of the repetition, I sometimes lost the point of the chapters.
Content Warnings
Graphic: Sexism and Gaslighting
Moderate: Ableism, Cancer, Chronic illness, Fatphobia, Panic attacks/disorders, Medical content, Medical trauma, Colonisation, and Classism