What Is My Role As A Holistic Gynecologist?

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I remember as a medical student when I saw my first babies being born. At my first delivery I remember seeing a fully formed human baby come out of a pregnant woman.

I thought to myself, “How amazing, how been beautiful!” Of all God’s creations women were the most special. For they not only had to fend for themselves as we men also did, but they also became pregnant and carried a child for nine months, only then to give birth.

It was long after having actually delivered several hundred babies that I began to feel that I had a mission to make life better for women. Now, don’t get me wrong. It isn’t that I believe that women are inferior or that men are less important, rather, I believe that I had recognized the risks, problems, hazards and benefits of women being women and how important caring for them is to our society and to them. Also, I began to recognize as a practicing OB/GYN, was how poorly women and their reproduction needs were treated as standard Western medical practice.

During the first 5 to 10 years as an OB/GYN. I watched thousands of women exposed what I believed was poor, sub standard, medical care. Unnecessary surgeries topped the list, but also rude, impolite, male and/or female chauvinist doctors, who ignored their patients problems and who immediately reached for medical or surgical therapy treatments because they didn’t know better. I saw that not only were that some of these treatments, dangerous and sometimes even brutal, they were often also barbaric and often unnecessary. Too often women were treated as almost subhuman creature’s, lied to and even, at times their real needs were ignored completely. Their emotional and spiritual needs were often left entirely unattended, as they received medical treatment when in fact they needed spiritual rather than surgical solutions.

I asked questions of my patients. I asked, “What do you want from medical care? “How do you feel when your needs have been ignored? “What do you really want from your gynecologist?” I asked, many what they had felt when they recognized that they and their body had been used for financial gain. What they really wanted from medical care and how much they wanted to have a say, even control their medical care. Armed with answers I changed my approach to taking care of my patients from that of being a standard Western gynecologist, to becoming a holistic gynecologist.

Once specific situation created a need for change in how I look at myself, my practice and how I care for my patients in the future. Susan B. at the time was 26 years of age. She come to me 10 weeks pregnant and I followed her for 6.5 months before she delivered, I performed her delivery and followed here for another 10 weeks after delivery until one day she presented with pain in her left pelvis. Upon examination, I found a relatively large but soft cystic mass where her left ovary should have been. When I had delivered her only 10 weeks earlier, and then again when I him had examined her at her 6 weeks check up after her delivery, she had at each examination had two normal sized ovaries, exactly where they were supposed to be. Now ten weeks post partum, she had an 8 cm ovarian cyst involving the left ovary. Anatomically, this could only be from a recent ovulation, a post ovulatory, corpus luteum cyst. Yes, the ovary was enlarged, but it was soft, mobile and only minimally tender, I had felt hundreds just like it in the past, and there was no indication of any real or immediate threat to her or to her well being. After the exam, we talked about the cyst and I told her the medically this was not a surgical problem and that standard of our community was to give it time and wait. To do nothing for that moment, but watch and follow the size of the cyst and how she feels. An ultrasound of the pelvis was performed and it clearly agreed with my diagnosis. She agreed to wait.

We had agreed that Susan would return in one week for a brief rechecked, but when she did not come in on the day she had been scheduled to be seen, I called her home. I was told, by a family member that she was in the hospital she had just had surgery.

The family member I talked with either would not or could not tell me what if anything had happened to Susan. I gave her my number and asked for a return call from her husband, or another family member who might have answers. The next day I received a call from Susan’s mother. She told me that she had taken Susan to her gynecologist for a second opinion. “And thank God I did, for my gynecologist immediately hospitalized Susan and operated on her that night, saving her life.” When I asked if Susan had been in pain or looked as if she were in trouble, she said, “No” but she then told me that her doctor has told her that Susan had a serious problem, one that could be life-threatening. She could not or would not give me more information. I asked her to have the patient Susan call me once she was out of the hospital.

Some two weeks later, Susan came in to see me as a patient. I asked her what had happened. She told me that her mother took her to her gynecologist and that he told her that she “had to have surgery immediately, or that she could die.” This terrified both Susan and her mother. Susan then told me that her mother and the doctor insisted that she be hospitalized and have immediate surgery. Susan submitted and was hospitalized and operated on that night. I asked Susan if she had been sick, if she was having pain, dizziness, inability to function, a fever or any other sings or indications of a life threatening emergency. She denied any and all symptoms that would in any way suggest that she was having any “life-threatening problems.” She was negative for all symptoms or signs of any life-threatening problems. In fact, she admitted that she had felt no different than when she had been in my office the previous day. She also admitted that she was very surprised that he wanted to hospitalize and operate on her. She then also told me that she had been very surprised when her mother’s doctor was so insistent that she needed to be operated on immediately and that he told her that she could be in the middle of a life-threatening emergency.

She told me that she had told him that she was feeling fine and at that point, her mother’s gynecologist smiled and told her that she would feel fine until the cyst rupture when she would need emergency surgery to save her life. Susan smiled at this point and then told me that two days after her surgery her mother’s doctor, came in telling her that he had just reviewed her pathology report, he then told her, “everything worked out okay. It was nothing but a corpus luteum cyst.” He then reiterated that it “very well could have ruptured, and that she was a very lucky girl and that she should thank him for removing the ‘mass’ it before it had ruptured and killed her.”

Susan looked at me obviously feeling relieved. I then explained to her as simply as I could that corpus luteum cyst occurred normally after ovulation, that corpus luteum cysts are normal post ovulation and that they are for the most part harmless and only signify that she was starting ovulate again and nothing more. Yes, it was large, but corpus luteum cysts of this size generally reabsorb on their own and only rarely, if ever, require surgery. Since she was a symptomatic it was unlikely that it would’ve caused her any problems. Even, when a corpus luteum cyst does rupture, unless the woman is on a tropical island with no phone and no medical care, they are rarely if ever life-threatening situations. Susan had just had undergone an unnecessary surgery. I then suggested that since she now had a new doctor who had “just saved her life,” and was also at the same time able to make a large payment on his Mercedes, she should stay with him. I told her that I would not see her again as a patient.

I don’t really blame Susan for what had happened. She was had been terrified by her mother’s doctor, her mother was terrified by what her doctor told the two of them. Most women normally trust their mother and hence their mother’s doctor. But I was frustrated and angry. I had tried to take care of her in a caring and respectful way and in the end she had not trust me enough to call me and ask what I might think about all of this.

Maybe, I was wrong in discharging her and telling her that she should return to a doctor who clearly was predatory. But, I had lost confidence in her, as my patient, she could not trust me, how then could I trust her.