Diagnosis “Stress”
By: Beverly Garside
Tags: Women, Military, Feminism, Medicine, Social Justice

Diagnosis “Stress”

How Male Doctors Trap Women Into “Hysteria”

Photo by Online Marketing on Unsplash

A Too-Common Experience

In the summer of 1982 I was an airman in technical training at Lackland Air Force Base in San Antonio, Texas. One morning I woke up sick. Class just wasn’t going to happen for me that day so I went to sick call.

The sick-call doctor at Lackland’s Wilford Hall Medical Center took one look at me and his face registered concern. I figured I must look as bad as I felt.

“Are you always this quiet?”

What? Quiet? I had come to get excused from duty, not to discuss my personality. Actually, I was always that quiet. I would later learn that this was called “introversion,” but at the time all I knew was that people often said something was “wrong” with me because I was not chatty. They also said I looked “sad” because I had a natural frown.

As for an answer to the question, I was immediately trapped. If I said “no” I would be lying and inviting even more irrelevant questions about my personality. If I said “yes” it would confirm that I was indeed always quiet, thus something was “wrong” with me besides being sick.

So I just said I felt like crap. My head was fuzzy. I was exhausted. I had a rash.

“You’re in that training program, aren’t you?”

And again, something totally irrelevant.

He then launched into how stressful technical training could be. He gave me a note for one day of “quarters,” which excused me from class that day, and said he believed that my problem was “stress-related.”

I was furious. I objected, repeating how bad I felt and showing him the rash on my chest. He speculated that the rash must be an allergic reaction to a necklace I had worn. I countered that I didn’t have any necklaces.

“Do you always sweat like this when you’re upset?”

The sweat had been revealed when I removed my uniform shirt and pulled down the wet t-shirt underneath to expose the rash. I had sweated because I walked half a mile from the barracks to the bus stop in a sweltering Texas sauna and rode on an even hotter bus for 20 minutes to Wilford Hall. On top of that, I was pretty sure I had a fever.

My objections and explanations again fell upon deaf ears. He said he was going to make an appointment for me with a psychologist because he really thought I needed to “talk to someone.”

At this point I was in a panic. Air Force training includes learning to live and work under pressure. People who break down from stress are discharged as medically unsuitable. So not only was this guy refusing to examine me, or even take my temperature — he was going to get me fired.

And for what? For catching a bug? For being quiet? Undoubtedly, the psychologist would also find me “defective.” I had learned that women were supposed to be bubbly and chatty, not quiet and reflective. He would conclude that I must be “stressed out” or “desperately unhappy.”

And worst of all, I wasn’t even that stressed. After basic training, technical school felt like a relief. I was doing just fine, with top classroom grades, decent physical training scores, and no brushes with trouble. My only problem was being sick.

There was only one way to salvage the situation. In a burst of adrenaline, I grabbed my quarters note and ran. The doctor called after me, but I didn’t stop until I was clear of the hospital and sure no one was following.

Though I resolved not to return to sick call, the next day I had no choice. One day off had not been enough. I was worse. Our training advisor noticed and made me go back.

Fortunately, I was seen by a different doctor. This one actually stuck a thermometer in my mouth, informed me that my fever was 103, and concluded that it was a virus that was going around. I got three days of quarters and instructions to come back if I had any black-outs or hallucinations.

Before the fever finally broke, I had both. But I didn’t tell anybody. Wild horses would not drag me back to that hospital.

A Self-Fulfilling Diagnosis

There’s nothing new about doctors telling women that our illnesses are all in our heads. Less acknowledged, however, is how the diagnosis of “stress” creates its own evidence.

I get that stress plays a role in illness. It can be its underlying cause or even its entirety. But whether stress plays a role or not, the illness itself causes stress. You can’t do what you need to do. You can’t go to class, so you’re going to fall behind. You can’t take care of your kids. You can’t go to work. You may not get paid or you may even get fired. You won’t be able to pay your bills.

It’s perfectly natural to be stressed at a doctor’s office. If, on top of that, the doctor refuses to take your symptoms seriously, it’s also natural to get angry and even more stressed. Then the angrier a woman becomes, the more her behavior is considered “hysterical” and evidence of her “stress” or “emotional imbalance.”

And therein lies the trap. Once a diagnosis of “stress” or “hysteria” is pronounced, there is no way to disprove it. It’s as if a sane person were falsely consigned to a mental hospital — the angrier they got and the more they protested their sanity, the more insane they would look and sound.

Doctors would then have all the evidence they needed for their diagnosis.

A Way Forward?

If there were a silver bullet to give women equal treatment in medical consultation, it would have been found and employed long before now. For too many male doctors, we start out in the asylum, and must prove our sanity before “stress” and “unhappiness” are taken off the table as the sole causes of our problems.

We are guilty before proven innocent, and proving our innocence only makes us look more guilty.

It’s a trap.

And we are guilty — of being female or transgender, of being stressed by our illnesses, of being angry at patronizing questions and dismissive diagnoses, and sometimes even of not smiling, chatting, and acting happy to be there.

Currently, there may be a scattershot of reviews on social media and review sites that identify some of these doctors’ practices. I think it would be more helpful to have coordinated registries in a single place to rate local physicians specifically on their willingness to take seriously the symptoms and concerns of their female and transgender patients. Patients could even choose to list their symptoms, the “stress” diagnosis, and the eventual correct diagnosis by another physician.

This way, offending doctors could actually discover the damage caused by their biases and unwillingness to listen — or maybe just learn from their honest mistakes. At the very least, we could identify the worst offenders, and if possible, avoid them.

If possible, unfortunately, is the limitation. Physicians in certain specialties don’t grow on trees, and lots of people, even if they are able to afford medical treatment at all, have little or no choices.

But exposure is the only way to force accountability. A place to share information and experiences may just be the impetus to educate and create systemic change.