When I was 17, I went through a particularly bad bout of acne that prompted me, a doctor-fearing-hospitals-give-me-palpitations-introverted teenager, took the initiative to visit a dermatologist. The prescription was something some of you will be familiar with; a two-pronged attack on my acne through benzoyl peroxide and clindamycin. And all was well!
Until it wasn’t and as a 19-year-old, there was a resurgence. This time I was put on the holy grail of beauty medication – retinoids (Vitamin A or related to it, more commonly known as adapalene, tretinoin). Diligently following my doc’s sparse instructions, I obviously over-exfoliated in a week. There was no acne but my face was red with dry painful patches. Anyone who pays a little attention to their skin will know where I went wrong.
Moisturise. I didn’t moisturise at all! My doctor didn’t give me any specific instructions to moisturise and I didn’t know any better. After all, I had oily skin and oily skin means no moisturising. A decade later I am wiser. I know that I have sensitive skin which can’t bear retinoids on bare skin without moisturising. No doctor told me this, they should have. But this isn’t about my skincare routine. This is about the Indian health care system.
Did you know that doctors spend an average of barely two minutes with their patient on consultation? (Outlook Web Bureau, 2018). Coupled with a scarcity of doctors as “India has a little over one million modern medicine (allopathy) doctors to treat its population of 1.3 billion people. Of these, only around 10% work in the public health sector,” (Sharma, 2017). This statistic also involves quacks- people who haven’t been trained to be doctors.
The reality is that doctors just don’t have the time! They are overworked, and just not enough people have been trained to look after such a large population. When my dermatologist had to go through hundreds of patients every day, it is understandable why he could only prescribe medication without going into details about an extensive skincare regime. It is not his fault, it is our system. This is evident as our public healthcare systems right now are quavering under a pandemic.
When it comes to certain marginalised genders, their issues become are not only seen through a biomedical lens, but from a gendered lens as well. You know how a woman’s pain is taken less seriously? A woman’s pain is treated differently, if at all, by healthcare professionals; “Until about a decade ago, many clinical research studies excluded women, resulting in a lack of information about gender differences in disease prevalence, progression, and response to treatment,” (Hoffmann & Tarzian, 2001).
A woman’s pain therefore becomes inconsequential, overlooked, invisibilized because we just don’t have an understanding of it. Women bear the brunt of it as our suffering becomes mythical, imaginary or a call for attention.
In 2016, on a fine Wednesday morning, I had a crucial presentation because of which I spent two sleepless days sitting in a crooked position. When it was time for me to present, my spine decided it had enough of my abuse and just won’t become upright. Somehow, I wormed my way through it. But my body wasn’t done with me. My periods hit. Then came the pain, and without hyperbole, it was the second most painful experience of my life.
I was quivering in my bed, hardly able to get out. I had some NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) on hand. They helped but not much. Somehow, I did end up coasting through those days with aforementioned over the counter NSAIDs but how I wished my the in-house University doctor had listened to me and tried to understand the horrifying condition I was in. Hot water bags, chocolates and tea weren’t cutting it, nor was I in the mood to listen to ‘ghar-ke-nuskhe’ from a doctor. As an aside, I haven’t been to that doc since.
The back ache coupled with period pain was debilitating enough, the added stress of the doctor’s disbelief towards my story infuriated me further. This isn’t just my case.
In 2015, Amba Azaad came up with a crowdsourced list of gynaecologists who would offer their services without judgement and be somewhat sex-affirming and positive. Why was there even a need? Because sometimes, we just need someone to believe us as we tell it and validate our feelings.
Menstruation is an intensely subjective experience. There are as many narratives as there are menstruators. There is already an air of silence around menstruation, ignoring, disbelieving someone who chooses to speak out should not be an option. In that moment when I was in pain, all I wanted was for someone to understand what I was going through, I think it would have made my experience much less harrowing.