It doesn't even have to be a mystery illness. A woman can walk into the clinic with a broken rib, and doctors will tell her it's menstrual cramps (true story from my partner).
The last time I really lost my temper with someone was with a nurse who told my wife (who was dialated to several cm already) that she wasn't really in labor and she needed to go home.
There has been a few times before that where a doctor would ask her what was wrong in a normal visit, and she would answer, and the doc would ask me if that was correct. She's my wife, not my child, why are you treating her like she doesn't know what's wrong?
The last one might be because some people (I'm kind of an extreme case) don't pay enough attention to their own symptoms, and typically downplay the frequency, severity, or at the very least botch up the timelines fairly well.
Not only am I ADHD, I grew up in a household where I was constantly told to just ignore things and suck it up, so now it's second nature to ignore my body and carry on. I feel like that's also part of dealing with aging-related and chronic issues.
Yup. It's fucking ridiculous that I have to go to the doctor with my wife just for her to be taken seriously. And her female doctors are the worst about it.
Concerning your first point : being dilated alone may not be enough to warrant an immediate hospitalization. My wife waters had broken, she was dilated a bit, yet it took her another 28 hours to give birth. She wasn't in labour, as such. Only reason we had to stay was that the waters had broken and that's a condition that needs monitoring. But I was told to go home and rest for a while, after 8 hours (we had arrived at 2am).
In general, one of the most important thing to do to help the mother give birth is to feel comfortable, relaxed, etc. Being in a hospital isn't generally conducive to those things so if at all doable, it's better to stay home and wait until it's actually show time. But yeah, not easy to judge, when you're not an ob/gyn!
Your second point is just... there is nothing to defend, there.
Is that worth losing your temper over? The midwife sent us home because my wife was only a few cm dilated, and active labour doesn't start until about 5 or 6cm dilation, after which it generally takes another 5+ hours before the cervix is dilated enough (i.e. 10cm) to give birth. It's annoying, but it's standard procedure.
It'd be wonderful if the healthcare systems around the world had infinite resources to care for pregnant women, but unfortunately they don't.
I got extensively checked out for why I was in pain all the time after I ate, losing massive amounts of weight to the point of near-starvation and felt like I had food stuck in my esophagus all the time. Doctors tested me for a couple of weeks for physical esophagus problems, declared I was fine, and sent me to a psychologist who grilled me for 45 minutes about whether I believed the tests or I "still thought something was wrong with me". I told her I believed the tests but that they were not the right tests yet. Pretty sure I didn't anxiety myself into losing 60 pounds in 4 months and losing my house, work and relationship... she declared I had "health anxiety". Oops, turned out I was actually developing LADA, a form of type 1 diabetes. I ended up at the ER later on and they said I would have died or gone into a coma in another 1-2 days.
How was diabetes not one of the best things they checked? I had an "unexplained weight loss" diagnosis for a while and diabetes and hiv were some of the first things they asked me about/tested for
I was recovering from extended time with undiagnosed Celiac. I assumed it was related to that. My symptoms seemed a lot like what I experienced with Celiac, but I was so stringently gluten free that I couldn't figure out what was happening. The doctor i saw was a celiac specialist - and he was great at that - but I needed a more general doctor or an endocrinologist. On the last day of 2 weeks there, after all these esophagus tests, allergists, a dermatologist and the psychologist, he said "It could be Type 1 Diabetes... some people get that too". Then didn't order a blood test or do anything.
I wish I'd figured it out myself. One problem was I was recovering from Celiac, and tried a very restricted diet, and a liquid diet - which actually worked when I started doing chicken in a blender (which is much better than it sounds, especially when you've been starving for 4 months). Tell a doctor 'I was starving and I went to this weird restricted diet' and it seems they have a really hard time with the order of things. Reality was "I was starving and in pain and then I tried this restricted diet" and they hear "you were on this restricted diet, and then you were starving and in pain".
More like "we already ran this test without telling you how expensive it would be. Your insurance didn't cover it. Here's your bill. And here's a second bill for the same exact thing but this time we'll call it 'professional services' instead of lab work -- pay that too or we'll send you to collections."
Remember all of those guys with Gulf war syndrome whose doctors told them they were faking it until they killed themselves? Ends up. They were exposed to nerve gas and doctors aren't trained in that. Oopsies!
The same is happening within the VA today. Too many of my friends have killed themselves.
My former cardiologist kept grilling me to lose weight, laughing in my face when I told him I was really active at work but still gaining. Turns out I was retaining water because the heart failure he blamed on my weight was a genetic defect that a few years later required a transplant.
Due to unrelated circumstances, I moved states between my last visit with him and the discovery of how much worse my condition was or I definitely would have had words with him.
You may want to file a complaint with the medical licensing board of that state though. While nothing will probably happen because of it, it may make him think twice the next time before he is so dismissive.
That, in itself, is a significant issue. Obesity IS a health problem but it is not treated as one or taken seriously. Instead those who are sick with obesity are shamed, belittled, and dismissed. More and more research is showing that, often, it isn't just because of people "being lazy" and having poor dietary self-control. There are significant genetic, microbiome, and other biological variations that appear strongly correlated and likely causitive.
Turns out that, like telling a person with cancer to "walk it off" or an adult with ADHD to "just apply themselves", the approach of not actually treating obesity, a known medical issue with all of the qualifying criteria of a disease, including increased risk of premature death and becoming sick with other diseases, as though it is a medical issue isn't very effective.
It would be funny if it wasn't so sad and true. A few years ago I had the flu. Took me three weeks to be completely fit again. Then, like two weeks later, I suddenly got dizzy, I felt like vomiting, I was cold but sweated like a pig. I thought I was going to faint. I laid down and slowly felt better. But it came back every ~30 minutes. Over the day it got better until in the evening I only felt exhausted. The next day I felt good again and went back to work. Around 9 in the morning, BAM, it hit again. I went to the physician and my systolic blood pressure went haywire going up and down between 90 and 180 within 5 minutes. He prescribed me something "for the bloodstream" without any clear diagnosis. It didn't do shit. I visited him I don't know how many times. Then I went to the next physician. And the next. I somehow kind of learned to live with it. One year later the third or fourth physician actually did some tests: You have a severe vitamin D3, B6, and B12 deficiency. Your immune system is fucked. Your stomach is fucked. Your metabolism is fucked. I finally got some treatment that actually improved something and felt significantly better but not good. Two years and ~three physicians later it turns out that my problems are somehow linked to my allergies: your immune system is fucked. There's some trial and error with different medications, at the end of which I actually feel better but still not good. Three years and another two physicians later the fuzzy diagnosis is that I had/have "long flu" (mind you, this is all before covid). It damaged my nerves and somehow mixed up my metabolism. There's a weird "cross-relationship" with my allergies. Now I take medication daily which lets me at least function and work. I still do not feel good. I haven't felt good since six years. But, there's an entry in my file from 5 years ago that I'm a hypochondriac, that won't go away, despite later tests confirming that several things were severely and factually wrong with me ...
Oh hey, fam! Welcome to the club. I have all that as well, they think also as a result of a viral illness prior to Covid. Metabolic (mitochondrial dysfunction) and neuroimmune. At first, I was told I have anxiety, oh no wait, schizoaffective disorder, oh no no wait, conversion disorder, as if any of those things are even remotely similar. Lo and behold when I finally got a physician who has some idea how to diagnose and treat my symptoms, I'm doing much better. Like you said, I'm functional even if I don't feel great. And funny enough, none of my treatments include psychiatric medications.
You can actually have the hypochondriac thing removed from your medical records if you want it gone. It's a HIPAA requirement that you have full control over what's in there. You'll have to send the request to every facility you've shared your record with that don't have connected systems.
I've seen doctors do so much stupid stuff.
My former oncologist prescribed two drugs I was obviously allergic to, including one that nearly put me on dialysis for the rest of my life.
Another dumbass refused to accept that I had a bone fragment in the back of my hand. Forty years later I have a hand that has permanent bone damage.
Super specialization in medicine is definitely an issue. I'm sorry you went through that. I don't think many neurologists would even think of screening someone for eoe.
There's a lot of problems with the American healthcare system, but one of the benefits to providers being businesses is that you can refuse to pay for services they don't actually provide.
Doctor refused to give me an x ray after I fractured a vertebrae jumping off a Cliff into water. She accused me of just wanting painkillers. I demanded to be seen by another doctor, who gave the x-ray and confirmed broken back and lucky to not be paralyzed. The piercing glare I gave the original doctor when the X-ray was shown…
I just meant it's a very common tactic doctors use to avoid taking the effort to properly diagnose women. There's so many stories women tell of having years or decades of that dismissal, and finally finding out they had a treatable condition (or combination of conditions) all along.
I paid 130$ for a doctors visit and another 130$ for lab work, only to be told, if it hurts you, don't eat it. It turned out to be a stomach ulcer. I lost so much weight before I figured out what was wrong.
Or they run every test under the sun and then ignore, misread, or plain refuse to treat the results.
The blood work shows that your blood sugar is borderline diabetic, your kidneys are failing and the xray shows a fracture... your fine, go home.
Cause well, fuck your diabetes, we won't give dialysis until your number of 16 gets to 14 even though the normal is 60 and all the rest of what's off relates to your kidneys, and we can't do anything for that fracture in your sternum anyways, nevermind, that we didn't see it until you came back complaining of chest pain...
I started having lots of pains in my back and some joints specifically the sacroiliac joint when I was young (at 11yo) and went to about 15 doctors, the first 14 told me that I was either faking it or it was just growing pains.
I went to a physical therapist literally told me within 10 minutes of looking at me and asking me questions "I know exactly what you have but since I am a physical therapist only I can't diagnose it, go to [doctor that I already went to and told me it was growing pains] and tell him to make you these tests"
Turns out I had ankylosing spondylitis (a type of arthritis) but since I was 11yo nobody wanted to actually look into it because they thought I was just growing or faking it.
I have had the opportunity to try three different countries medical care. The US is broken. Can't wait to travel again this year to get some stuff fixed that US doctors have been "wait and see" for years. No, hasn't gotten better.