One of the most counter-productive and unhelpful entities in the hospitals is the stigmatization of certain diagnostic labels that are attached to the patients who walk through our doors. Of the most stigmatized diagnoses, borderline personality disorder, chronic fatigue syndrome and fibromyalgia seem to bring the most baggage. Physicians, nurses, and paramedics are all guilty: it is as if the label immediately paints a vivid picture in the health care provider's mind of the type of person beneath the label. A word worth a picture worth a thousand words.
We had a patient come to us during this shift who has been battling stigmatization for the past year, for a confusing array of neurological, muskuloskeletal and gastrointestinal complaints. She felt she was at the end of her rope and needed help. I could see from her online record that she'd been seen previously by a variety of specialists and by the mental health group, all with apparently little success.
She was bristling before I even said hello, and the interview was certainly an emotionally laden one. She felt as if she'd been let down by the health care system and that nobody believed that she was suffering. She felt that because she had no objective findings of disease, and had been diagnosed with anxiety disorder, health care providers had been attributing all her symptoms to the anxiety, without a proper work-up. I could tell that she thought I was about to do the same thing to her She'd felt so stigmatized by the label "anxiety disorder", and so defeated by her symptoms that she had even begun to think about hurting herself.
It is sad to think that health care providers were contributing to her suffering. Even if everyone she's seen in the past were completely legitimate in their diagnoses (and they may have been, an anxious mind can play strange tricks on one's body), there has been a failure somewhere along the way if the patient comes to us feeling discriminated against.
The patient is not a diagnosis in a johnny shirt. He or she is first and foremost a person who comes to us at their most vulnerable and exposed, asking for help. Bringing in any of the baggage of 'typical fibromyalgia' or 'typical anxiety' will do nothing for the patient and may even significantly worsen their well being. I'll have to work hard to fight against this stigma in my career. I think my patient felt heard and validated by the time she left the department, with some hope that plans were in place to get her the help she needed.
