Brilliant post! Thank you!

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Hi! I love this post! Can you please go into a little more detail about "altered glucose metabolism" as related to Alzheimers when you do your post on this topic next? Thank you!

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I have loved your latest letters and podcast as they hit me right in the face(in the best way). I am going to do a 90 day no health news. We have access to news like we never have before. I truly can’t balance the true risk of some health issues. My anxiety is still stuck in the loop that if I must know all the things about COVID so that I can control keeping me and my family safe. Yes, it still “feels” like the early days of the Pandemic to my brain. That’s me not living in the present and my values are in living in the present feeling all the feels while living my life. My hope is that giving all things COVID and health news a break along with the work I do with my therapist will allow my brain to reset, rest and allow me to practice grace. I am not leaving the amazing community you have created and I will be thankful to return. You have done an incredible job in bringing this topic up for discussion as many struggle with health anxiety. I am going to journal along the way! I am two days in and it is HARD. I am really having to let go of that false sense of security that I got by checking the news! Thank you and see you in 90 days.

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Argh. Trigger happy there! Sorry!

As someone with a hidden chronic illness (the kind that may not show on the surface but friends and family see), I find that my appearance may be more convincing to a doctor than my actual list of risk factors. Especially when presenting with symptoms that don’t align with my appearance -- “You’re young, you’re healthy, and you don’t smoke” take precedence over “I’m here today bcs last night my left eye blacked out for 30 seconds and that’s on top of my debilitating fatigue and brain fog.” (In my experience that’s actually a recipe for being dismissed).

The other unspoken risk factor of doctor dismissiveness is the doctor’s own emotions for his or her patient: sometimes the doctor has strong emotions of needing the patient to be ok and to not worry. I’ll never forget a conversation I had with a very good practitioner (a chiropractor who had known me and my family for years) -- “My right arm went so completely numb last night that I did a check on myself to make sure I wasn’t having a stroke,” I said. “You’re young and healthy,” he replied, “ you have no risk factors for a stroke.” In actuality, my illness itself and the sedentariness that accompanied it were both two risk factors for stroke that he either did not know or had forgotten in his need to reassure me (of something I’d already determined the previous night when I’d done the checks for stroke after rubbing my lifeless arm back into feeling).

I don’t say these things with a chip on my shoulder. I know that being a doctor is difficult! Especially as there are so many illnesses (and illness interconnections) we are discovering that haven’t made their way into regular medical usage.

I simply want to call attention to the fact that sometimes what comes across as dismissive (and sometimes what is downright dismissive) stems from unacknowledged factors on the doctor side of things -- their own overwhelm at symptom presentation, their need to make the patient feel ok (and we all tend to respond to each other’s perceived worry with reassurance), their own busyness and lack of time to dig in with a patient.

How human of doctors to be human in these ways!

The best outcomes I have had in doctor conversations have been when I was with a doctor who could handle a little pushback (like the chiro above) and was open to discussion on the actual risk factors I was noticing and the actual concerns I needed addressing.

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In my experience, one of the hardest parts about these kinds of risk-assessment conversations with doctors is what I call the “unspoken risk-factors of doctor dismissiveness.” Sometimes

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Thank you for this!

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