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As a woman born in the 1960s, the child of an alcoholic home, and a 22-year veteran of the Army and Army Reserve, I know a few things about being invisible. It isn’t that I want to go unnoticed, it is simply what has been expected of me most of my life. As a kid, my job was basically to stay out of the way as my parents argued. As an adult woman, I have struggled to be seen, to be heard, to have my opinions considered, and to have the same opportunities as the men around me. In the military, the misogyny ran deep, as did every form of bigotry and racism. I fought for and earned everything I accomplished in the military, which was at once a lot and not everything that I had hoped. In the end, some guy told me I would not be allowed to do my job because none of the men were going to listen to a woman. I knew on that day that I was done. I couldn’t do it anymore. It was a sad end to a difficult career.
All I ever wanted was to matter as much as men in every aspect of my life; at home, at work, and especially in the doctor’s office. Female soldiers were always assumed to have emotional problems at the root of their physical symptoms. Don’t get me wrong, I had some great care from military doctors, but the approach to my care was always filtered by my presumed emotional fragility as a woman. When my back hurt and my legs were in pain, it was assumed I was upset about something; surely, it had nothing to do with the demands of the job. Gratuitous x-rays were ultimately followed by an MRI that revealed herniated discs, but for a while I was just another whiny female with a back ache. When I was about 15 years into my service and became so fatigued that I could hardly get off the sofa to crawl into sick call, the young Navy doctor asked how things were at home and whether I might need to talk to someone about any difficulties. The insult of this was like a punch to the gut. He would never have asked a male soldier this question. I literally struck a deal with him that if he would test for diabetes and thyroid problems, and if the tests came back negative, I would consent to seeing his shrink. Needless to say, he had an entirely different approach toward me when I came back to begin treatment of my thyroid deficiency.
These are but two examples of how I was treated differently by doctors in the military because I am a woman. If you have a uterus or, as in my case, if you used to, it is assumed that your illness may be a mere manifestation of the amplified emotional state known as “being a woman.” Decades after leaving the military, I am still battling to obtain objective healthcare, this time from the Veteran’s Administration (VA). Even though the VA is not part of the Department of Defense, many of the military mindsets can be found in the approach of the staff, some of whom are veterans themselves. Misogyny is, of course, not limited to the military, so some of this is simply a mirror of our society at large. With the VA, it is hard to know whether the issue is my gender or just the fact that I am a veteran.
The VA staff often treats us veterans as though we are undeserving of this “free” healthcare. They may be trained to say that grating line, “thank you for your service,” but most of them don’t mean it. We are often treated as an inconvenience, especially by the administrative staff, but also by many of the medical and nursing staff. Instead of viewing us as the very reason for them having a job, the institutional culture of the VA is one that views vets as somehow ‘less than.’ The truth is that we are people who have paid for our healthcare many times over in the form of lost limbs, lost sight, permanent injuries, and chronic illnesses, all acquired during our service. VA staff, like all Federal employees, enjoy the best health insurance money can buy, while we suffer through them looking down their noses as us. The sentiment that I always leave the VA clinic with is that I should be grateful for whatever care I receive because, after all, I’m not paying for it, I’m just a freeloading veteran.
Just yesterday at the VA pharmacy, I was told to wait by a young woman and her co-worker while they looked at pictures on a cell phone, laughing and carrying on. After waiting several minutes through that indignity, I took my prescription and went home, only to realize later that the pharmacy had yet again put a child safety cap on the bottle. Just a few weeks ago, I had asked them to mark my record to put only free-turning lids on my prescriptions, as my grip has deteriorated from arthritis. I saw the young man make an effort to note my record which took him a few minutes, so I don’t know if he failed to properly mark my record, or if the folks yesterday just ignored it. Either way, it is yet another example of how caring for us is simply not a priority for the VA staff; details do not matter to them. Sharing pictures and stories with co-workers is much more important.
I suppose that you, too, might want to recommend therapy for me at this point, because it is obvious that I am angry. It may also seem impossible to you that such an environment exists as more than a microcosm. You may be thinking that I am unfairly judging the VA staff, letting a few isolated incidents color my entire view of the organization. Well, I am pretty pissed off right this minute, but I promise you I am not making this shit up and I am not unfairly judging. The issues I have faced in the last year alone may be cause for a malpractice lawsuit on the outside: being told by a physician’s assistant that I probably had early Alzheimer’s, then being sent home with an article on living well with Alzheimer’s and no support of any kind, to await an appointment with a specialist six weeks later; being heavily medicated for a seizure disorder I have never had and being told I could no longer work, all on the ‘hunch’ of a recently-hired, 60+ year old neurologist who has some seriously bad reviews from his former private practice which he seems to have abruptly left; and my current dilemma, having my symptoms and corresponding alarming laboratory results ignored in favor of fixating on other minor issues. Oh, and gratuitous x-rays once again, but that’s just too much to get into in one blog post. This is all just within the last year.
I wonder how many older, far sicker veterans unknowingly fall victim to these same types of scenarios but just go home and slowly die because the VA providers can’t be bothered to pursue a proper diagnosis and treatment. I wonder how many veterans with mental health disorders go undiagnosed or not properly treated because primary care providers never refer them to the mental health practitioners. Vets are a proud lot and do not like to admit when we are having emotional or mental difficulties because we have been trained that such things are a sign of weakness. Likewise, we tend not to disclose the true severity of our pain or the more intimate details of our symptoms because of this old programming. Dignity is often all we have left, and we are reluctant to compromise it even for relief from our suffering. Medical professionals should be utilizing all of their diagnostic skills and thoroughly exploring the extent of veteran’s symptoms with this in mind.
Right now, I am overwhelmed with how to handle my current medical situation. My primary care provider – a nurse practitioner – has some very set ideas about what symptoms match with what illnesses. Since my descriptions of my pain and difficulties did not measure up to her ideas, she has dismissed them. I am worried that readdressing them in light of the laboratory results will serve to anger her and be counter-productive. Yet, these test results and my ongoing pain are concerning enough that I must reach out to someone. I am ready to complain to the administration and demand a new provider, but that may not work in my favor. It is unfortunate that I must worry about rumors among staff and grudges toward patients when trying to address my medical problems, but that is how it is. I do have a wonderful specialist who is a real MD and has been meticulous in her approach to the issues she is treating. I will be seeing her next week and I am going to ask for her help with these other issues, though the rules may prohibit her from addressing them because they are not strictly in her area of specialty. At the very least, I am hopeful that she will tell me with whom I should speak about getting a new primary care provider, since the patient representative who used to work at this clinic is gone. It’s a wonder he lasted as long as he did, poor guy.
If a vet can figure out how to navigate the personalities and bureaucracy to get their health care issues addressed, it can be lifesaving when the alternative is no health insurance, as it is for me. But how do you figure out which ass to kiss? And what do you do when your problems are ignored? To whom do you turn? Technically, there is no second opinion in the VA system. I managed to obtain one earlier this year regarding the whole seizure debacle, but I literally had to threaten to call my senator. I have involved my senator before and, sadly, it worked, but it took two years. No one should have to call their senator to get their medical needs addressed.
You are damned right I am pissed. I am still in pain and chronically fatigued and unable to open a pill bottle. Some days, climbing the stairs to my bedroom brings tears to my eyes as I take one painful step at a time. I am 53 years old, not 73. I just want some answers. I deserve decent healthcare. I earned it. I just want to be seen.