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I'm a 5th year medical student and I fucking hate my OBGYN teachers for their blatant sexism and blatant disinterest in doing any more than the minimum for women. Today I am going to focus on the latter.

Yesterday was my first day rotation on high risk pregnancies and it was more of the same shit. The patient was a 30 year old in the first trimester of pregnancy with diabetes type 1 that she never actually treated. She found out she was diabetic at 10 years-old, but her family refused to give her the treatment. Then she married at 12 (yes, child marriages are rampage in my country). Her family told her that now her husband should be the one to take care of her. To none's surprise he also did not. She did not use insulin, and did not adhere to a diet- in my country you can get insulin pretty much for free, so it was just ignorance in the way of a good medical assistance.

At 22 she had her first pregnancy and her first abortion. Probably due to the rampant diabetes. She also did not treat her condition. Just now, at 30, on her second pregnancy that she realized she must start taking her condition seriously because she's worried about the baby. She clearly do not understand the risk she is, and she never consulted with a endocrinologist so we don't know the damage of two decades of poor management. She only finally started using insulin from 20 days now, after being hospitalized. It's possible nobody actually took the time to stress the importance of adhering to the treatment, because not only she was applying her doses with a poor technique, not changing the application sites as she should, she also did the blood sugar controls wrongly - she's only taking it 3 times a day, when she should be measuring her glucose levels 7 times a day, she is not taking note of the results. She says picking her finger hurts a lot, it's possible nobody taught her different approaches to reduce the discomfort. She said she's following the diet but I wasn't convinced.

I was shocked, to say the least. Uncontrolled diabetes is linked to many malformations in the baby, and I could spend hours just talking about the negative effects it could be doing on her overall health. I was also convinced she was using a low dose of insulin according to protocols. I did the OB consultation as usual, but I was eager to tell my teachers how lost she was in the treatment of her underlying condition and I wanted to ask for more exams and possible refer her to a endocrinologist.

My teacher obviously cared more about quizzing me on random medical facts than listening to the case. He would stop ever once on a while to make a few jokes and some remarks about his dog. By then it was already 12:30 and he probably was eager to leave. When I said she never did a papa smear exam he hyper focused on that - despite the fact she had sexual relations on a previous day, which could alter the results. I had to take the exam and after that it was a frenzy, before I realized he was already talking to other student.

What makes me mad is that there were other 4 doctors in the ambulatory and none actually gave a shit, they were talking among themselves and one of them was exasperated I was asking for second opinions and hurrying me along. At least I asked if I could schedule a earlier consultation, which is also in protocols, but they had no qualms about doing the usual 30 days interval until the next session.

I went home convinced I could have done more for her and felling terrible. I called my father asking for a third opinion, a general practitioner that also does prenatal consultations. He lost his shit. He confirmed all of my suspicions, we should've at least referred her to a nutritionist and an endocrinologist and asked for basic follow up exams. I studied up until late the national protocols again, those also supported this course of action.

So today I was convinced I would do all the papers on my own, I just needed a stamp and a signature, there MUST be at least one of the OBGYN there that would help me at it, right?

Before I could talk about it with my colleague and also fellow student, he beat me to it and said he was worried about that woman and convinced we could've done more. He read the exactly the same protocols that I did. I was relieve then, together we could make a stronger case.

Of course, I should've seen it coming: the FEMALE doctor completely shot down all of our worries. She said we should not refer her to a endocrinologist, because the high-risk service should be the one to take care of her now. Then what about the exams? I asked, she said "so what if we find out her vision is affected by diabetes? We can't treat her now. We have to wait 9 months." She said we should not feel such "pity" for the patients because the problem is the patient herself, she was "hard-headed" and clearly did not want to treat herself.

The patient only needed someone to convince her she must take care of her diabetes. A few exams with bad results could do the trick. I hate how little those professionals seem to care. They want to do the bare minimum. Now I'm mad because I don't even know I will be able to see this woman again as for the day she returns I will be on a different sub specialty. I wish I could steal a fucking stamp so I could follow the protocols but that will surely enrage my teachers.

So, another shitty day of OBGYN, another day unable to help women at my best ability.

observations: It's not all professionals that absolutely suck at caring for females, it's just seem all OBGYN that work/teach at my university are like that.

I'm a 5th year medical student and I fucking hate my OBGYN teachers for their blatant sexism and blatant disinterest in doing any more than the minimum for women. Today I am going to focus on the latter. Yesterday was my first day rotation on high risk pregnancies and it was more of the same shit. The patient was a 30 year old in the first trimester of pregnancy with diabetes type 1 that she never actually treated. She found out she was diabetic at 10 years-old, but her family refused to give her the treatment. Then she married at 12 (yes, child marriages are rampage in my country). Her family told her that now her husband should be the one to take care of her. To none's surprise he also did not. She did not use insulin, and did not adhere to a diet- in my country you can get insulin pretty much for free, so it was just ignorance in the way of a good medical assistance. At 22 she had her first pregnancy and her first abortion. Probably due to the rampant diabetes. She also did not treat her condition. Just now, at 30, on her second pregnancy that she realized she must start taking her condition seriously because she's worried about the baby. She clearly do not understand the risk she is, and she never consulted with a endocrinologist so we don't know the damage of two decades of poor management. She only finally started using insulin from 20 days now, after being hospitalized. It's possible nobody actually took the time to stress the importance of adhering to the treatment, because not only she was applying her doses with a poor technique, not changing the application sites as she should, she also did the blood sugar controls wrongly - she's only taking it 3 times a day, when she should be measuring her glucose levels 7 times a day, she is not taking note of the results. She says picking her finger hurts a lot, it's possible nobody taught her different approaches to reduce the discomfort. She said she's following the diet but I wasn't convinced. I was shocked, to say the least. Uncontrolled diabetes is linked to many malformations in the baby, and I could spend hours just talking about the negative effects it could be doing on her overall health. I was also convinced she was using a low dose of insulin according to protocols. I did the OB consultation as usual, but I was eager to tell my teachers how lost she was in the treatment of her underlying condition and I wanted to ask for more exams and possible refer her to a endocrinologist. My teacher obviously cared more about quizzing me on random medical facts than listening to the case. He would stop ever once on a while to make a few jokes and some remarks about his dog. By then it was already 12:30 and he probably was eager to leave. When I said she never did a papa smear exam he hyper focused on that - despite the fact she had sexual relations on a previous day, which could alter the results. I had to take the exam and after that it was a frenzy, before I realized he was already talking to other student. What makes me mad is that there were other 4 doctors in the ambulatory and none actually gave a shit, they were talking among themselves and one of them was exasperated I was asking for second opinions and hurrying me along. At least I asked if I could schedule a earlier consultation, which is also in protocols, but they had no qualms about doing the usual 30 days interval until the next session. I went home convinced I could have done more for her and felling terrible. I called my father asking for a third opinion, a general practitioner that also does prenatal consultations. He lost his shit. He confirmed all of my suspicions, we should've at least referred her to a nutritionist and an endocrinologist and asked for basic follow up exams. I studied up until late the national protocols again, those also supported this course of action. So today I was convinced I would do all the papers on my own, I just needed a stamp and a signature, there MUST be at least one of the OBGYN there that would help me at it, right? Before I could talk about it with my colleague and also fellow student, he beat me to it and said he was worried about that woman and convinced we could've done more. He read the exactly the same protocols that I did. I was relieve then, together we could make a stronger case. Of course, I should've seen it coming: the FEMALE doctor completely shot down all of our worries. She said we should not refer her to a endocrinologist, because the high-risk service should be the one to take care of her now. Then what about the exams? I asked, she said "so what if we find out her vision is affected by diabetes? We can't treat her now. We have to wait 9 months." She said we should not feel such "pity" for the patients because the problem is the patient herself, she was "hard-headed" and clearly did not want to treat herself. The patient only needed someone to convince her she must take care of her diabetes. A few exams with bad results could do the trick. I hate how little those professionals seem to care. They want to do the bare minimum. Now I'm mad because I don't even know I will be able to see this woman again as for the day she returns I will be on a different sub specialty. I wish I could steal a fucking stamp so I could follow the protocols but that will surely enrage my teachers. So, another shitty day of OBGYN, another day unable to help women at my best ability. observations: It's not all professionals that absolutely suck at caring for females, it's just seem all OBGYN that work/teach at my university are like that.

12 comments

The fact that insulin is basically free, yet nobody cared to help this woman, freezes my blood. Though it makes it no better, you can kind of imagine nobody taking an interest in this woman if they know she would never even be able to afford help, but apparently she would have. So, you're right, nobody cared. I really sometimes wish we could just pick the world up and give it a good shake until it snaps out of its collective lack of concern for one another, but especially women. I'm so sorry you're starting your medical career this way. I hope by some miracle you can help her.

[–] Willow9 [OP] 11 points (+11|-0)

So, you're right, nobody cared. I really sometimes wish we could just pick the world up and give it a good shake until it snaps out of its collective lack of concern for one another, but especially women. I'm so sorry you're starting your medical career this way. I hope by some miracle you can help her.

We have universal health care system in brazil. Her consultations are completely free, her medications are really cheap because the price is funded by the government. She could go to the nearest health care clinic in her neighborhood ever since the diagnosis and have access to a general practioner there. Of course, she clearly comes from a poor family that lacks instruction, so she wouldn't know any of that. It takes some effort to actually talk to the patients and explain everything and I can see how some doctors don't want to do that when (over)working in the public system, because they earn less there than in private care.

I think it's worse for women, honestly. They are taken less seriously, even when they have serious health problems. When pregnant it's worse because it's all about the baby, and not the mother's health. I won't specialize in OBGYN despite the fact that I like to treat women, but I hope to at least work in the public health system so I could make a small difference there. It's the best I can hope for.

I don't envy you the choices you will have to make during your career. Your empathy will both make you a fantastic doctor, but also mean that much of the hurt of others will get to you. But the world does need more people like you. I also hope you learn to use the system to your advantage, and help as many people as you can.

[–] platypus 11 points (+11|-0)

She said we should not feel such "pity" for the patients because the problem is the patient herself, she was "hard-headed" and clearly did not want to treat herself.

Oh that makes my blood boil. I hate when people use the "you can't change people who don't want to change" defense as an excuse for not even trying with someone who clearly has not even been given the chance to change. Usually a woman. "You can't change her," "not our business," "she's doing this to herself"... It's just all code for "fuck that woman, I don't care if she dies."

Thank you for saving her life. You're fighting for her, which is more than she's ever had. I hope you can get more colleagues on your side.

[–] dasehe 8 points (+8|-0)

It's awful to hear the disregard for the patient's welfare here. I've done bioethics from the other side of the fence, and we were always taught about how important it was that the patient be properly informed. I'm sorry you have to deal with being so powerless to help her in light of all this disregard, and thank you for caring and at least trying.

[–] Willow9 [OP] 8 points (+8|-0)

Yeah, the worse is that this only happens in the OBGYN service here, it's like they rounded up only the shittiest of doctors up for contraction. It's clear they care a lot more about the "learning" experience than the patients themselves. They treat us students really well. Some colleagues of mine like those professionals because of this, but I honestly cannot forget all the times I've seem they go "well, there's nothing we can do" and shake their heads at the women likes they are the ones at fault.

I'm going to keep trying. I will ask the one obgyn teacher here that I actually respect for another opinion. It's possible he could see my point, and I could pass that along my colleagues that will be in her next consultation.

[–] dasehe 6 points (+6|-0) Edited

Please do, and I hope that this works out. It sounds to me like the doctors the patient has seen so far have not been properly upholding their duty of care.

Being a good teacher is one thing. But there's the oath, too:

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

[–] Willow9 [OP] 3 points (+3|-0)

Good point, it's all about warmth and sympathy, if you don't have that you won't be able to be a good doctor.

[–] carpetplaydohx2 4 points (+4|-0)

I have a family member with poorly controlled type 1 diabetes (also since 10). She got pregnant around the same age, and her baby was fine, if delivered early due to diabetes-related complications. But my family member is not fine -- she's got kidney disease, diabetic retinopathy, autonomic neuropathy, and cardiovascular disease, all related to her diabetes and poor blood sugar control. This poor woman you saw is in for a world of hurt if she doesn't or can't get her health under control soon. It's heartbreaking to see.

[–] ArmyofMe 3 points (+3|-0)

My heart breaks for that woman and her fetus. Your country is lucky to have women like you training to be doctors.