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In early June, Anne Wheaton, wife of "The Big Bang Theory" actor Wil Wheaton, began experiencing excruciating pain on her right side, pelvis and torso. In the ER doctors suggested it was a kidney stone, gave her medication and sent her home to see if it would pass. Days later, her agonizing pain was getting worse.
"I've had two kids, and it still wasn't at that level of pain," Anne Wheaton told TODAY. "The surgeon [later] told my husband that this is the worst pain a woman can go through."
Eventually, Wheaton — who, like her husband, blogged about the experience — learned she had an ovarian torsion that occurred after a cyst caused a twist that cut off the connecting artery's blood flow — and ultimately killed the ovary. But it would take days before she got a correct diagnosis and her doctor could remove the organ.
"Abdominal pain is difficult to diagnose," said Wheaton's doctor, Dr. Tina Koopersmith of the West Coast Women's Reproductive Center, Sherman Oaks, California. "As an OBGYN, it was always drilled into us that with abdominal pain to never forget ovarian torsion. But it's a diagnosis that gets missed."
'Our bodies are very different'
Getting a correct diagnosis for internal ailments can be tricky, especially for women patients. For example, women having a heart attack are more likely to be misdiagnosed than men and, as a result, are less likely to receive life-saving treatment. A 2001 study published in the Journal of Law, Medicine & Ethics showed that while female patients are more likely to express when they are in pain, they often receive lesser treatment.
Women's pain is often downplayed — precisely because women tend to be more verbal about discomfort than men, said Anita J. Tarzian, Ph.D, RN, of the University of Maryland School of Nursing.
"The attribution of an emotional component, that the pain isn't as authentic as a man's pain because women are associated with being hysterical and overly dramatic and not valid reporters of subjective or objective pain — that could have an influence," Tarzian, co-author of the 2001 pain study, told TODAY.
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It's not only women who are at risk: A 2014 study found that at least 1 in 20 adults who seek care in an emergency room walk away with the wrong diagnosis.
But Wheaton, a director at the Pasadena Humane Society and children's book author, firmly believes that if she had been seen by a female ER doctor, she might have been spared days of pain and her ovary might have been saved.
"Men tend to think that a female is just a girl version of a male," she told TODAY. "Our bodies are very different."
For her, the ER experience was a frightening comedy of errors — among other things, she was given a pregnancy test despite having her uterus removed nine years ago.
Since writing about her experience in her blog, she's heard from "hundreds of women" with similar stories. "Something needs to be done about this, so more women don't go through it unnecessarily," she said.
A 2016 study found that patients treated by female doctors have a greater survival rate. But it's not clear that any one case — like Wheaton's — was ignored or misdiagnosed because she wasn't seen by a female doctor at the outset.
ER doctors are likely to be generalists who might not be able to think of every possible differential when diagnosing. "There is gender bias in everything," said Koopersmith. "But I don't like making blanket statements that are not backed up by fact. The error is that the doctor messed up as a physician, not because he's male."
Other factors in the ER
There's also the issue of an often overwhelmed, chaotic emergency room where triage is the order of the day.
"ERs are so overwhelmed with patients who go in and don't need to be there — sometimes, it's so busy it's easy to miss things, especially if they don't think it's an urgent situation," says Dr. Linda Girgis, a veteran family doctor and clinical assistant professor at the Robert Wood Johnson Medical School in New Brunswick, New Jersey.
Tarzian thinks changes are coming, if slowly. "Now that women make up more than half the medical students and physicians, it'll be interesting to see how this all changes," she said. "Maybe the default will be in recognizing that you have better medical care if you talk to a patient."
Have an advocate
In the end, the solution for issues like this is a familiar one: when you're the patient, try to have someone advocating for you while you're hospitalized.
"We've always heard about that," says Wil Wheaton, "about advocating for yourself in the hospital. I just feel if this doctor had spent a little more time looking at her scans, he could have made a better diagnosis.'"
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