Book Review – Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick by Maya Dusenbery

I wasn’t planning on doing a dedicated book review post for this book – I just fancied reading it. After the first 3 pages I was already frustrated and angry enough that I was ready to throw the book across the room; not because it’s poorly written, far from it, it’s the contents of the pages that annoyed me so much. I hope that this post encourages some of you to read this book, it covers a topic I knew nothing about to begin with, and does a brilliant job of making a complex web of scientific research projects – reasons behind them, the errors they contain, and the source of the funding that enabled them to happen – accessible and easy to digest. Get Maya Dusenbery’s Doing Harm, here.

What the publisher says

Editor of the award-winning site Feministing.com, Maya Dusenbery brings together scientific and sociological research, interviews with doctors and researchers, and personal stories from women across the country to provide the first comprehensive, accessible look at how sexism in medicine harms women today.

In Doing Harm, Dusenbery explores the deep, systemic problems that underlie women’s experiences of feeling dismissed by the medical system. Women have been discharged from the emergency room mid-heart attack with a prescription for anti-anxiety meds, while others with autoimmune diseases have been labeled “chronic complainers” for years before being properly diagnosed. Women with endometriosis have been told they are just overreacting to “normal” menstrual cramps, while still others have “contested” illnesses like chronic fatigue syndrome and fibromyalgia that, dogged by psychosomatic suspicions, have yet to be fully accepted as “real” diseases by the whole of the profession.

An eye-opening read for patients and health care providers alike, Doing Harm shows how women suffer because the medical community knows relatively less about their diseases and bodies and too often doesn’t trust their reports of their symptoms. The research community has neglected conditions that disproportionately affect women and paid little attention to biological differences between the sexes in everything from drug metabolism to the disease factors–even the symptoms of a heart attack. Meanwhile, a long history of viewing women as especially prone to “hysteria” reverberates to the present day, leaving women battling against a stereotype that they’re hypochondriacs whose ailments are likely to be “all in their heads.”

Offering a clear-eyed explanation of the root causes of this insidious and entrenched bias and laying out its sometimes catastrophic consequences, Doing Harm is a rallying wake-up call that will change the way we look at health care for women.

What the critics say

“Maya Dusenbery brings new life to one of the most urgent yet under-discussed feminist issues of our time. Anyone who cares about women’s health needs to read this book.” (Jessica Valenti, author of Sex Object: A Memoir)

“In this groundbreaking book, Dusenbery shows how the same forces that hold women back in society more broadly lead to subpar medical care and inadequate attention to health issues that impact women. Every doctor, scientist, and health care provider and researcher should read this book. And so should every woman.” (Jill Filipovic, author of The H-Spot: The Feminist Pursuit of Happiness)

“Maya Dusenbery’s exhaustively researched book is equal parts infuriating and energizing. No woman will see the medical establishment and – perhaps even more profound – her own body the same way after reading it. In a just world, it would be required reading in medical schools from this day forward.” (Courtney E. Martin, author of The New Better Off: Reinventing the American Dream.

My thoughts

I started this book on a flight to Brussels during my week off – and almost immediately starting to quote bits of it to my friend who was sat next to me, “Did you know that in American medical faculties there’s a gender pay gap of $20,000?”, “Oh my God, you know that aspirin study that led to doctors advising people over the age of 50 to take an aspirin a day to lower the risk of heart attacks? THE STUDY WAS ONLY DONE ON MEN INITIALLY! Then, when there was another study done on women, the results were not the same, yet the advice has stayed constant!”, “HOLY SHIT, WOMEN ARE 50-75% MORE LIKELY THAN MEN TO HAVE ADVERSE REACTIONS TO DRUGS BECAUSE THE MAJORITY OF DRUGS HAVE ONLY BEEN TESTED ON MEN!!”

You can imagine how bad the shouting and swearing got as I progressed through the book.

The book itself is split into three parts; ‘Part 1 – Overlooked and Dismissed: A Systemic Problem’, ‘Part 2 – Invisible Women in a ‘Male Model’ System’, and ‘Part 3 – Neglected Diseases: The Disorders Formerly Known as Hysteria’, and when I read the contents I was immediately intrigued by Part 1 over the other 2. After reading, I think I enjoyed that section the most, but Parts 2 and 3 were the areas that cemented my anger – they were the areas where Dusenbery was able to really drill down into the research; they provided the ammunition to back up the anger she’d fuelled in Part 1.

Honestly, towards the middle of Part 2 I was starting to feel pretty hopeless; how on Earth could we have built a medical system on a foundation of research that was conducted almost entirely on male participants? Even down to the fact that lab research has been found to be conducted on mainly male rats and mice, not female (or God forbid, and equal split)?! Urgggghhh. Anyway, the most I read, the more frustrated I got – until that frustration turned to wanting to do something about the issue of bias in medical research.
I hope that this book stays with me and influences the work that I do over the course of my career; I want to remain in the clinical trials methodology field after my PhD is complete, and bearing the issues described by Dusenbery in mind will mean I can contribute at least in some small part, to alleviating these problems.

Would I recommend it?

10000000% yes. Read it, gift it, take it to medical appointments with you, fold the corners of pages that contain topics that infuriate you, and please, please, spread awareness of the fact that medical research has, and continues to fail women.

Women in STEM: Events, Challenges – and Why?

I haven’t touched on any political or religious topics on this blog, I haven’t spoken about money or what I think of Donald Trump, and largely I think people believe that feminism belongs in that same pile of topics you-just-don’t-talk-about. I don’t agree.

Feminism is important, and the process of explaining my views, beliefs and actions to help support other women, especially in the scientific community, is necessary. So this week’s blog post is going to be a bit of a brain dump of thoughts inspired by events and conversations over the past week – the week of International Women’s Day. I hope it ends up being a cohesive piece about why supporting women in STEM subjects (Science, Technology, Engineering and Mathematics) is a positive and useful thing to do, rather than the feminist rant that’s in my head.

Let’s start with some nice news:

This week I was told I’ve been accepted to take part in Soapbox Science‘s Edinburgh event this July. In their own words: “Soapbox Science is a novel public outreach platform for promoting women scientists and the science they do. Our events transform public areas into an arena for public learning and scientific debate; they follow the format of London Hyde Park’s Speaker’s Corner, which is historically an arena for public debate. With Soapbox Science, we want to make sure that everyone has the opportunity to enjoy, learn from, heckle, question, probe, interact with and be inspired by some of our leading scientists. No middle man, no powerpoint slide, no amphitheater – just remarkable women in science who are there to amaze you with their latest discoveries, and to answer the science questions you have been burning to ask.

I’m going to be talking about clinical trials – why take part in a trial, how participation might be beneficial, and what happens if not enough people take part in clinical trials. It’s not designed to be a propaganda piece, or a talk to try and get people to take part in trials; just an opportunity for me to talk about the work I do and the reasons why I think it’s important, and a chance for members of the public to ask questions and take part in a discussion. There’ll be 11 other women scientists there talking about their own work, and I’m really looking forward to learning about what they do too.

And an online engagement activity for women in STEM:

This month, The STEM Squad are running a photo a day challenge on Instagram – take a look at their Instagram account here. In their own words, they are “An inclusive community of femme-identifying STEM professionals and enthusiasts“. The challenge involves people posting a photograph each day for the whole of March (including #WEARESTEMSQUAD), with the aim of showing the many sides of women in STEM. As I write this it’s currently day 10 and I’ve managed to keep up, I’ve really enjoyed seeing everyone’s posts and following what they get up to each day. It’s so cool to see what every does, how different each career is, and what we all like to do outside of the labs/offices/fields that we’re in day-to-day.

The themes covered in the Instagram challenge are in the picture above, so take a look at the hashtag and join in if you haven’t already!

I was talking to a friend earlier on in the week about the Soapbox Science event and The STEM Squad challenge, and she (very innocently) said, ‘Why is it just for women though? That seems a bit unfair.’

My initial response was to be a bit stroppy – why does every event that involves only women get the whole ‘why not men?’ argument thrown back at it, why can’t we just do stuff as a group of women supporting each other?! The more I thought about it, the more I calmed down. Maybe women in STEM get this weird backlash because people don’t understand the point of why we’re doing these events, these public engagement activities and challenges online. I figured this was a good place to talk about it (Twitter was out because of that time I tweeted about a BBC Three documentary called Men At War and got trolled for at least a fortnight ).

Women are not represented equally in the STEM workforce, in fact the percentage of women in science professional occupations dropped from 50% in 2015 to 41% in 2016. That gives a slightly skewed picture though; 41% isn’t so bad, right? Perhaps, but that 41% isn’t consistent across the board:

  • Only 18% of people in ICT professional occupations are women
  • Only 8% of people in Engineering professional occupations are women
  • Only 14% of people in management positions in Science, Engineering and Technology are women

Being a woman in STEM is not easy – personally I’ve people who are shocked when I say I’m doing a PhD, ‘but you’re blonde!’ like, really? I’m pretty sure that my hair colour has no relationship with my intelligence (feel free to correct me with a methodologically-outstanding randomised trial). Largely though, I haven’t experienced any sort of discrimination at all, just a whole host of supportive and brilliant colleagues with a view weird comments thrown in.

For others though, being a woman in STEM is really tough, and the comments and discrimination women receive puts them off being in STEM altogether, there’s a genuine gender wage gap, and there’s even research to show that women who work in male-dominated workplaces experience heighted levels of interpersonal, workplace stressors.

It’s important to even this gender imbalance out and create equal opportunities for both men and women. Doing events and drawing attention to the problem is one way to try and push that process forward. Creating a positive and welcoming environment for people to learn, ask questions, and actually see what women in STEM look like (see also #actuallivingscientist and #dresslikeawoman), can make a real difference for the next generation of STEM workers.