Why Medical Professionals Need Mental Health Training
This week, I went to a new vascular surgeon. As usual, I was nervous, even though I knew the appointment was going to be minor - but this time, I had nothing to be nervous about. The doctor and nurse were both kind and understanding, and made me feel at ease both before and after they learned my history.
Learning about the medical reason that brought me in was one thing, but I’ve experienced mixed reactions when medical professionals see that I take psychiatric medication. Sometimes, it changes the tone of the whole conversation. I’ve had times where it’s clear that the people treating me believe that the only thing wrong with me is my head, even when I come in for something completely different.
I’ve even had doctors and nurses question if I’m making decisions about my health solely based on OCD, or if I’m even capable of making decisions – and then they look to others to speak for me.
Thankfully, my doctor visit this week was different, but thinking about some of these previous experiences reminded me of a scenario from an episode of Grey’s Anatomy (spoilers for season 14, episode 11): Dr. Miranda Bailey, a Chief of Surgery in her 40s, goes to a nearby hospital and claims that she is having a heart attack.
On the surface, it may seem like we have nothing in common – I’m in my 20s, not a medical professional, and I’ve never had any cardiovascular problems. But what ties us together is the experience we have both had in doctors’ offices and hospitals, something that allowed me to predict her lines before she could speak them, to believe in her from the very first moment.
Dr. Bailey and I both have OCD, and it is this shared experience that made me feel seen, heard and understood over the course of the episode.
The tests come back negative, at first, and rather than feeling relief, I, like Dr. Bailey, feel stress. It’s what I feel when I go into a doctor’s office. In my mind, I’m still the hypochondriac I was as a child, and I feel deeply ashamed if I go to the doctor and everything turns out fine. It may sound counter-intuitive, but I couldn’t remember the last time I went to a doctor for anything other than a routine visit and didn’t want there to be something small but fixable wrong with me, so that I wouldn’t be seen as just another person with OCD seeing things that aren’t there.
Dr. Bailey, like me, thinks of everything her symptoms could lead to, every possibility that won’t end with her going home in shame, with a bill and a sinking feeling of losing a battle to mental illness. She asks for more tests, her voice sounding desperate as her doctor refuses. She even asks for a second opinion, but before her doctor will agree, he asks more detailed questions about her medication list. He finds out that she has OCD.
And he summons a psychiatrist instead of the doctor she had asked for, assuming her symptoms are nothing more than the product of a delusional mind. This leads to a session of humiliation where she has to stand her ground against someone questioning everything that brought her to this point.
And then, she has a heart attack.
I didn’t want one of my favorite characters on the show to have a heart attack, but part of me knew if I was in her shoes, I would feel vindicated. I cheered when the doctor who blew her off was asked if he had
performed the test she had asked for, finally showing him that she had been right all along, and his prejudice got in the way of his patient care. I also cheered when other doctors believed in her and treated her properly, ensuring that she would have a full recovery.
There may have been some viewers who thought she was exaggerating her symptoms, or simply crazy. But I believed her from her first words, because I have lived her story more times than I’d like to think. And I can only hope that doctors treat me like the good ones on the show, rather than the one who almost cost Dr. Bailey her life.
Training and tolerance can make the difference between an experience like mine this week, and the plenty of times I have been belittled, disbelieved, and more simply for an unrelated mental health diagnosis.
When I watched that episode, I knew it shouldn’t have mattered that Dr. Bailey has OCD. What mattered was that she was in the emergency room complaining of chest pain. Not everything can be traced back to mental illness, and even if symptoms turn out to be a false alarm or an obsession gone wrong, a patient with OCD still deserves to be heard and respected, just like anyone else.
And contrary to what I’ve heard from some medical professionals, Dr. Bailey and I are not unintelligent because of our OCD. We have past medical experiences that inform us of what is dangerous and doctor-worthy, and because of our OCD, we put a lot of thought into weighing the pros and cons of going to see a doctor. Our mental illness should not provide an excuse for not looking into everything our physical symptoms could be. What seems fake may be completely real either in my head, my body, or both.
I still remember the names and faces of doctors and nurses who blew me off, didn’t believe in my symptoms and just heard shallow breathing or saw fidgety fingers flying across the screen of my phone. These reactions are why I Google my symptoms, or consult a friend, so that the decision to go to the doctor is not mine alone. It’s also why I bring a friend if I go to the hospital, in case I need someone else to speak for me once my medical history is out in the open.
Even tolerant people aren’t immune to this kind of thinking – even my mom, an incredible advocate whose quick notice of my OCD in early childhood helped me become the person who I am today, didn’t believe that I had a severe nut allergy even after I had reactions, because it looked like OCD on the surface. When I had my first life-threatening allergic reaction at 18, I wheezed into the nebulizer with relief, because then, perceptions of OCD couldn’t get in the way.
I also remember the good just as much as I remember the bad. I still have a scribbled message of hope and drawing of a butterfly from a nurse that I carried through my three procedures that still hangs on my fridge seven years later. And without the incredible support from the doctor at my college, there is a good chance I would have had to forfeit a semester in my freshman year for medical problems. Doctors and nurses have been some of my strongest allies in my fight against both physical and mental illness, and they have the power to make my fight as well as that of many other people so much easier. All it takes is compassion and belief.
But in order to get to that point, doctors need to act like the vascular surgeon I met this week and find a balance between putting an anxious patient at ease and relying too much on anxiety as a diagnosis rather than looking for physical problems.
As Dr. Bailey said, “I am not ashamed of [my OCD]. But it’s not my story. It’s just one piece. And if you check the ‘mental illness’ box and refuse to look at anything else, then I’m not going to live long enough to finish the rest of my story.” With proper training to help medical professionals find the balance, I hope that one day, people like me won’t have to worry about seeing a new doctor. They’ll simply be another ally in our quest to finish our life stories that are altered by OCD, but also composed of a great many other things.
Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.