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'Grey's Anatomy' Episode Highlights the Frustration of Doctors Dismissing Your Pain

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Editor's Note

The following article contains spoilers for episode five, season 15 of “Grey’s Anatomy.”

The road to a diagnosis when tests and doctors can’t pinpoint the cause of your pain is full of frustrations you can only really understand when you’ve gone through it yourself. Thursday’s episode of “Grey’s Anatomy” featured a patient who highlighted how infuriating it is to be dismissed by doctors over and over again, and how persistent undiagnosed patients must be in order to get the care they deserve.

Dr. Miranda Bailey (Chandra Wilson) and Dr. Jo Karev (Camilla Luddington) go to consult with their new patient Nina (Bess Rous), and they find her already impatient. She explains that she’s already seen gastroenterologists, internists and surgeons for her pain and been diagnosed with acid reflux, anorexia and anxiety, none of which she believes to be the cause. She’s here specifically to see Dr. Meredith Grey, who she read about, and says Bailey and Karev will just waste her time. Nina looks frustrated and tense, her eyes are red-rimmed like she hasn’t been sleeping and she has a huge binder filled with research and medical records. Like any person who’s been let down by doctor after doctor, she looks like she’s been managing her own care with little support and is at the end of her rope.

Bailey informs Nina that she’s the one who taught Grey, with a confidence implying Nina doesn’t really know what she’s talking about and needs to take the doctor she’s given. The moment is played for laughs and to show the doctors “putting Nina in her place,” but the doctors’ egos reflect reality. It is all too common for patients (particularly women) to be reminded that in the medical system’s chain of command, they are at the bottom, and the doctors are the ones who know it all.

After running several tests, the doctors tell Nina they haven’t been able to find a cause for her pain. Nina is clearly frustrated, saying “I already told you that” when they mention a possible diagnosis that didn’t pan out after Bailey suggests testing for diverticulitis, showing them a research paper she found online that makes her think that’s not the cause.

“The internet does not provide accurate diagnoses,” Bailey admonishes.

“Well as far as I can tell, neither do you,” Nina shoots back. 

It’s a fist-pump moment for anyone who’s been chastised for researching their condition online. When doctors can’t figure out what’s wrong with you, it’s not only natural to start doing your own research, it can actually be extremely helpful. Doctors don’t know everything about every disease, and many patients are very capable of sifting through information online and even making connections doctors couldn’t.

Later, the doctors come back and explain they’ve exhausted every test they can think of. Nina responds angrily that she doesn’t accept their failure to diagnose her and she won’t accept discharge papers.

“Find new tests, invent them. Take care of me. That is your job,” she begs. Karev whispers, “Should I page psych?”

Nina goes on, eating the sandwich she brought with her and crying:

I can’t keep living like this. I can’t keep being told it’s in my head when I know it’s not. I can’t keep being told I’m crazy when I’m not crazy. If you don’t help me I’m going to kill myself and then all those doctors who said it was in my head will be right. But they’re not right. I know there is something wrong with me.

It’s a heartbreaking speech that will hit you right in the gut if you’ve had doctors suggest your pain is in your head when they can’t find the cause. Nina is right: Taking care of her is their job. Just because the tests they ran didn’t find anything, that doesn’t mean her pain isn’t real or their job is over. Sadly, she’s also right that leaving her pain untreated could, in fact, lead to suicidal thoughts and actions.

Nina’s words feel like they’ve been spoken by the thousands of other women who have been dismissed for their pain. Research has shown that women wait longer to receive pain medication in the hospital, are more likely to be misdiagnosed after having a heart attack, and are more likely to be have their health problems attributed to their mental health.

Then, while Nina is talking, there’s a breakthrough — she suddenly yells in pain, clutching her stomach. That gets the doctors’ attention and they take her to an exam room. Suddenly they’re not dismissing her anymore, now that they’ve seen a visible sign of the pain she’s experiencing. This, too, is sadly common. When pain is invisible, it just becomes that much easier for the medical community to conclude it’s “all in her head.”

After a brief investigation using an ultrasound machine, Bailey diagnoses the problem: Nina has median arcuate ligament syndrome (MALS), a rare condition in which the median arcuate ligament presses on the celiac artery, which expands when you eat. Nina always fasted before taking doctors’ tests, so that’s why no one could figure out the cause until Bailey and Karev saw what happened after Nina ate her sandwich. Nina just needs to have a simple surgery, and her pain should go away.

“I knew it was real,” Nina sighs. Yes, viewers, when a woman says she’s in pain chances are there is a scientific explanation!

Of course, this is a TV show, so not every element of the episode was realistic (would two doctors at a hospital really have spent that much time investigating a single patient? In all likelihood, probably not). However, as an overview of what it’s like being an undiagnosed patient searching for answers for an invisible condition, Nina’s story is painfully accurate. Without Nina’s persistence and research, and the luck of  having a pain flare in front of the doctors, she may have left Seattle Grace Hospital without a diagnosis, again dismissed and told her pain is all in her head. That’s a sad but common reality for so many — and hopefully a cautionary tale for any medical professionals watching this episode.

Originally published: October 26, 2018
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