Vulnerable, scared, and ignored

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Post by Wendy Nickel

I was pregnant and labeled high-risk due to my “advanced maternal age” (a term I hope someone revisits in the near future). My regular ob-gyn recommended that I see a high-risk specialist because I had miscarried during my first pregnancy and to make sure the pregnancy was advancing as expected. During my first trimester, my pregnancy visits were filled with anxiety, especially given my prior miscarriage. Visiting the high-risk specialist was no exception.  I recall my husband gently taking my hand in the waiting room and quietly reminding me that the visit was just precautionary.

We were led into the exam room for an ultrasound and to meet the specialist. I undressed nervously and put on a paper gown. The medical assistant asked me to lay on the exam table with my feet in the requisite stirrups; I waited for the physician to come in, my husband sitting beside me in a chair. You learn to accept that vulnerability and pregnancy go hand in hand. In this case, I was feeling particularly exposed (pun intended) with a thin piece of paper separating my naked body from anyone who walked in the room, my legs in the air. But I trusted that this was all just part of the health care experience.

The physician walked in the room, with a male medical student trailing behind. He proceeded to introduce the student to my husband, but not to me. The student shook hands with my husband. The physician, whom I had not met before, didn’t directly acknowledge me. I think the student was somewhat embarrassed that he was not introduced to me and so he awkwardly said hello – all while I was laying on the table, legs in the air, exposed to the world. The rest of the visit was somewhat unremarkable. The physician completed his exam and the pair left the room. 

I went on to have a healthy, beautiful baby boy with my regular ob-gyn. But that visit left an indelible mark. Did the physician and his student not acknowledge me because I am a woman? Was I somehow considered inferior because I am a woman and did not deserve acknowledgment? Why did he shake hands and engage in conversation with my husband and not me? It all left me feeling even more vulnerable. And sadly, the physician was setting an example for his student. How many other women would experience the feeling of being “less-than?”

I have spent much of my professional life advocating for patients in vulnerable communities. My experience was minor when I think of the number of women of color who have felt vulnerable and ignored in health care settings. Building trust in health care starts with the very basics: courtesy, respect, and dignity. A kind word, an acknowledgement of me and the vulnerability I (along with every other woman I know in that situation) felt at the time, and perhaps a better gown, would have gone a long way to eliminating fear, establishing a trusting connection, and having a satisfactory patient experience.

With a lifelong passion for ensuring that all individuals have access to high-quality healthcare, Wendy has served in senior leadership roles in patient advocacy, quality, and patient safety in a variety of healthcare settings. She is currently the President of the Health Care Improvement Foundation, an organization committed to improving the health and lives of the community through collaborative solutions.