Book review: Doing Harm

Maggie Hulbert is a medical student in the Class of 2020 at Queen's University

 

(HarperOne/HarperCollins Publishers, 2018)

I remember learning about “atypical” presentations of heart attacks during a cardiology lecture in my second year of medical school. Jaw pain, shoulder pain, and fatigue replace the archetypal central chest pain and diaphoresis, making the diagnosis much more subtle and easy to miss. Only later, as a footnote, was it mentioned that these presentations usually occurred in women. I thought it was odd that something that occurs in half the population was said to be “atypical,” but as is so often the case in medical school, I didn’t have time to dwell on it for long; the lecturer had already moved on to angina and I missed what he had said about beta-blockers.

That thought — that need to take a second, pause, and really look at where women fall in the grand scheme of medicine — is the basis for author Maya Dusenbury’s new book, Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. A quick look at Dusenbury’s professional background makes it clear she has been preparing to write this book for a long time. As the editor of , an award-winning feminist blog, Dusebury has ample experience considering the many ways in which women are oppressed in today’s American society. As an author on the site, she has tended to write about the disparities women face in the American health care system, discussing everything from to in the United States during the Trump era. And lastly, as an employee of the National Institute of Reproductive Health, she witnessed some of the huge policy changes that occurred in the States regarding the inclusion of women in clinical trials. Doing Harm is, essentially, a 400-page research essay on the dangers of being a woman in the American healthcare system. It is thoroughly researched, urgent in its writing, and a testament to Dusenbury’s incredible dedication to equality in healthcare.

While Doing Harm is written from an American perspective, it highlights global principles of women’s health. Chief among these is the very label “women’s health,” and the propensity to equate it with reproductive health. This bad habit has contributed to the current deficits in research and treatment guidelines for the many systemic diseases that primarily affect women such as fibromyalgia, Alzheimer’s disease, and many autoimmune conditions. Doing Harm is a firm reminder that — despite hashtags like #smashthepatriarchy trending on Twitter and women’s marches drawing in tens of thousands — there is still much to be done to achieve equality in healthcare. Dusenbury specifically addresses millennial women, offering cautionary words to those too young to remember Roe vs. Wade: “Our society — its institutions, policies, and norms — has not changed nearly as much as our expectations have.”  Doing Harm is an essential reference text that deserves a place on the shelf of any physician or medical student who plans to treat women.