Minds that Matter and Hearts that Don’t:

How the Perception of Female Minds and Mental States Affects Women’s Health Care and the Perception of

Heart Disease

Part III: Coalition, Vision, Strategies

The Problem

Macrocosm: The medical field and its professionals continue to perceive women patients through a sexist lense, sometimes interpreting legitimate physical illness as symptomatic of only a mental problem.

Microcosm: This perception directly affects treatment of cardiovascular disease/heart disease in female patients. Both female patients and their doctors do not pursue as aggressive diagnosis, treatment, and research as is conducted when a male patient presents symptoms of heart disease. Similarly, research studies have yet to comprehensively include female patients or to adequately investigate drugs or therapies tailored to female bodies and manifestations of the disease. Heart disease presents differently in women than in men, but both patients and physicians continue to follow a male model of health and disease.

The Heart of the Matter

And what shoulder, & what art. Could twist the sinews of thy heart? And when thy heart began to beat,

What dread hand? & what dread feet?

Coalition

While women’s cardiovascular disease is a legitimate medical issue facing women today, it also serves to represent a greater problem. Indeed, heart disease symbolically suggests an illness of the spirit. While truly a physical disease, heart disease also involves the minds of both patients and the medical health community. Beyond the physical suffering of the patient, the treatment received by female heart disease patients signifies a greater disorder affecting the perception of those patients.

Coalition

The perception of female heart disease by both patients and medical health professionals represents a continuity of perception: the modern health community is still affected by views of women’s shaky mental health and intellectual weakness popularized in the nineteenth century.

Coalition• Cynthia Kaufman perceives a “division of labor into public and

private spheres” operant in the historical development of the United States. She suggests that this “model of the spearation of spheres set the pattern for today’s dominant conceptions of masculinity and femininity” (159).

• While Kaufman is analyzing gender formation in a greater context, her words also apply to a critical consideration of perceptions of heart disease. As we have shown, heart disease is perceived to be a man’s illness. Additionally, women as a group are not aware of their own risks or of how to effectively address their health concerns, especially in regards to treatment options and available therapies.

Coalition

Then I went to my pretty rose tree,To tend her by day and by night;

But my rose turned away with jealousy,And her thorns were my only delight.

Coalition

Quoting Bookman and Morgan, Kaufman observes that “for women in the feminist movement of the 1970s, ‘empowerment begins when they change their ideas about the causes of their powerlessness, when they recognize their ideas about the causes of their powerlessness, when they recognize the systemic forces that oppress them, and when they act to change the conditions of their lives’” (284).

This observation is equally true of women in 2007. Heart disease is a female problem, and its perception reflects a misogynist context of society still extant today.

Only unity can empower women.

Coalitioni carry your heart with mei carry your heart with me i carry your heart with me(i carry it in i carry your heart with me(i carry it inmy heart)i am never without it(anywheremy heart)i am never without it(anywherei go you go,my dear; and whatever is donei go you go,my dear; and whatever is doneby only me is your doing,my darling)by only me is your doing,my darling)i feari fearno fate(for you are my fate,my sweet)i wantno fate(for you are my fate,my sweet)i wantno world(for beautiful you are my world,my true)no world(for beautiful you are my world,my true)and it's you are whatever a moon has always meantand it's you are whatever a moon has always meantand whatever a sun will always sing is youand whatever a sun will always sing is you

here is the deepest secret nobody knowshere is the deepest secret nobody knows(here is the root of the root and the bud of the bud(here is the root of the root and the bud of the budand the sky of the sky of a tree called life;which growsand the sky of the sky of a tree called life;which growshigher than the soul can hope or mind can hide)higher than the soul can hope or mind can hide)and this is the wonder that's keeping the stars apartand this is the wonder that's keeping the stars apart

i carry your heart(i carry it in my heart) i carry your heart(i carry it in my heart)

ee cummingsee cummings

Vision

It’s not just that we would like a world without heart disease. Of course we would. But we’re not doctors or medical researchers. That’s not really our realistic goal.

We do want a world without sexist heart disease. Heart disease for women, currently, is both a physical problem and a social one: it’s not perceived to be a women’s issue.

We want to change the underlying perception of both this disease and the women who suffer from it.

VisionSusan Brison observes that “First-person narratives can

expose the gender and other biases inherent in, among other things, much traditional moral, legal, and political philosophy. They can serve to bear witness, bringing professional attention to the injustices suffered by previously neglected or discounted groups. Such narratives can also provide the basis for empathy with those who are different from ourselves, which , as recently argued by feminist moral theorists such as Diana Meyers, is crucial for an adequately inclusive understanding of certain moral, legal, and political issues” (26).

VisionJill Reflects on Her Heart Attack

• Of course I wasn’t expecting a heart attack at 29 years of age-especially one caused by pneumonia.

• The heart attack was terrifying and painful but the way I was perceived in the ER and treated was much, much worse.

• I have never felt more invisible in my life. I told the medical personnel over and over I was having a heart attack. They refused to take my symptoms seriously or provide an EKG to verify my complaints.

• I gave textbook symptoms of a heart attack (severe pain in my upper-left chest, unable to breathe, sweating profusely, and numbness in my left arm) to ER registration, the triage nurse, the two male nurses and male physician. They all ignored me. It took over ten hours to for treatment to begin.

• Even worse, was the attitude of disbelief when I was correct about the diagnoses-how could a teacher know about medicine?

VisionJill Reflects on Her Heart Attack

• On day three in the hospital the cardiologist finally alluded to my delay of treatment. He concluded I was an exceptional case and nothing close to the norm.

• This is the exact attitude and perception of women and heart disease that needs to change.

• My experience was not exceptional nor related to the male norm. Just ask the 236,000 women who die of heart disease each year according to The National Coalition for Women with Heart Disease.

Vision• Jill’s vision is for women with heart disease symptoms to be

provided the same caliber of treatment as men in every medical facility.

• This can be achieved through educating both women and doctors about women’s heart disease.

• This knowledge, in turn, will quell misconceptions and create a female norm regarding heart disease.

• “Silence would have killed me. My friend who demanded my troponin levels be tested saved my life. I refused to be quiet and demanded that test instead of signing hospital release papers. I am writing this today as a result of my big mouth!”

-Jill MacLeod

Vision

Fairy tales weren’t always nice . . . Winter’s Vision is a re-told version of a fairy tale

alternatively called “The Girl Without Hands” and “The Maiden Without Hands.” An original may be found here:

http://www.surlalunefairytales.com/armlessmaiden/index.htmlPlease read the attached re-imagined story.

Strategies

How to Combat the ProblemEducation. As Kaufman observes, “education

is a critical aspect of social transformation. People need to understand the situation that they are challenging” (293). Movements have begun to disseminate awareness of women’s risks of developing cardiovascular disease and the treatments available to them.

Strategies

How to Combat the ProblemUnity. While certain groups face more

risks of developing heart disease, it is very much a women’s problem. As such, it should be subject to the same sort of “coalition politics” detailed by Kaufman (301-302).

StrategiesFilter-down Effect. Feminism still hopes to

change societal perception of women. As it achieves this aim, women will also take their place in science and medicine, changing the “one-sex” model still regrettably present in medicine.

(PS. Galen really did think that there was only one sex – women’s bodies were just imperfect versions of the ideal male sex. Sometimes we wonder if things have changed.)

Conclusion:• A large percentage of women’s lives can be saved through education, unity,

and the filter-down effect of feminism.• Narratives of women’s experiences with heart disease are an essential

component of education.• Unity can be created through support groups for women with heart

disease. • Mended Hearts, one large women’s support group, offers hope and

encouragement for women, their families and caregivers. Visit http://www.mendedhearts.org/ for more information.

• Doctors vow to obey the Hippocratic Oath. • “First do no harm…” Currently women ARE harmed by the lack of treatment

and perceptions of heart disease. But this harm can be undone. • Will you join in the crusade to advocate that the minds and hearts of

women matter? Thousands of lives are counting on you.

References

Brison, Susan J. Aftermath: Violence and the Remaking of a Self. Princeton: Princeton UP, 2002.

“Girl Without Hands.” SurLaLune Fairy Tales. 1 December 2007. <http://www.surlalunefairytales.com/armlessmaiden/index.html>

Kaufman, Cynthia. Ideas for Action: Relevant Theory for Radical Change. Cambridge: South End Press, 2003.