I think we can all agree that if there is some good be found from Dr. Drew Pinsky's horribly misinformed comments regarding Endometriosis and Interstitial Cystitis it is the raised awareness brought to these issues. In that vein, Dr. Drew's podcast last night on his website Drdrew.com included an interesting and educational conversation with Dr. Tamer Seckin who took the time to call in from Brazil and educate, not only Dr. Drew, but all of those listening.
For all of those interested in hearing the podcast. The conversation with Dr. Seckin starts at 1:00 and ends at 30:00. At this halfway point, Dr. Drew begins an interview with Dr. Jennifer Park who discusses Hormone Replacement Therapy, commonly known as HRT. This, for me, was absolutely fascinating as I am undergoing HRT for my PCOS and the effects have been fantastic, but I digress.
First, I would like to take a moment to focus on the positive aspect of this podcast. Dr. Drew discussed Endometriosis with a highly educated doctor in the field of Endometriosis treatment and Deep Laparoscopic Excision, and that is amazing for the Endometriosis community. Dr. Seckin is the co-founder of the Endometriosis Foundation of America with Padma Lakshmi, and has had a profound affect on the lives of women dealing with this life altering disease. Let's give a big thank you to Dr. Seckin for taking time to speak out. We applaud you and all the work you have done.
Dr. Seckin touches on some of the most important aspects of Endometriosis for those who suffer with it; both patients and those who support them. He states that Endometriosis often causes pain throughout the cycle, peaking during ovulation and menstruation, but not simply appearing during menstruation. He discusses how early diagnosis is imperative, and lacking in the field, as girls as young as 12 are dealing with "killer cramps" and their pain is being dismissed leading to the seven to ten year delay in diagnosis and treatment. Importantly, Dr. Seckin discusses the current treatment of Endometriosis and how ineffective and harmful it is. The use of Depo-Lupron for women, placing them in a chemically induced state of menopause, is not ideal and in fact harmful; that birth control may help delay pain for a short time, but is no way a "cure" and should not be relied on as such. Finally, he discusses the reality that almost 15%-20% of ovarian cancer can be traced back to untreated endometriosis. For those dealing with this disease, that is terrifying.
At the 13:00 min mark, Dr. Drew shifts the discussion to the "Da Vinci Robot" and whether it's use will extend to laparoscopic surgery to excise endometrial lesions. Dr. Seckin explains that this is not likely as it takes a highly skilled surgeon to "feel" out the depth of the lesions, not removing simply the "tip of the iceberg" but the lesion as a whole. At this point I couldn't help but become frustrated. Dr. Drew is only a quarter of the way through this podcast and he has already shifted the conversation away from awareness and education, but toward tools. This is akin to speaking with Michelangelo and asking him to discuss whether the he will hire a robot to create his next "David". It was a pointless sidebar and took time away from much more important discussions; discussions such as the link between Endometriosis, Interstitial Cystitis, and digestive issues, of which Dr. Drew steered clear of completely.
Toward the end of his interview with Dr. Seckin, Dr. Drew had some interesting things to add, and I would now like to discuss them. First, let's discuss the original caller and his fiancé's diagnoses:
"Dr. Seckin brought up a couple of times pathological proof, actually being able to look at your condition under the microscope. This is how I got into trouble. That guy I was talking to, I guarantee you that girl never had a pathological diagnosis, that was why she had multiple diagnoses, because no one ever took the energy to really prove exactly what was going on with her."
Interstitial Cystitis and Endometriosis are commonly calledthe "Evil Twins" in the Endo and IC communities because they are so commonly found together. The original Loveline call was regarding the fiancé who had been diagnosed with both of these conditions, as well as a a myriad of digestive issues (which also fall in line with both diagnoses). The question all along has been, did Dr. Drew have knowledge from this caller that his fiancé did not have pathology to verify her diagnoses? Had the caller been prescreened and those questions already answered? Is that why Dr. Drew questioned her past sexual abuse history, on air, leading him to suspect Somatoform Dissociation? That question has now been answered in the defensive and justifying manner that we have come to expect of Dr. Drew regarding this issue. He never did discuss pathological proof of her diagnoses with the caller; he didn't ask on air, or off, if this woman had been properly assessed. He had zero information regarding her medical history other than the nine second intro we all heard and from that, Dr. Drew assumed her diagnoses were unrelated because he lacks knowledge in the field; therefore, called them "garbage bag diagnoses" and went to his fallback, psychiatric evaluation.
Dr. Seckin gracefully deals with this topic when he admits that it is presentation of the disease, and not necessarily biopsy and laparoscopic surgery, that are what are needed for a diagnosis. He speaks to the benefit of definitive diagnosis in which lesions must be removed and then viewed under a microscope. However, Dr. Seckin is clear, diagnosis and treatment shouldn't be ignored until surgery/biopsy occur as so few OB/GYN's have the proper treatment, or time, to perform such surgeries and patients need treatment immediately upon presentation, not upon pathological proof. He stresses that "chocolate cysts" of any size that persist for more than three months, size being irrelevant, should be further investigated for Endometriosis, and that familial history shouldn't be overlooked. Dr. Seckin makes it evident that performing laparoscopic surgery for verification on a 12 year old is overkill, but her diagnosis is still relevant and treatment is necessary to protect her from pain and infertility. However, Dr. Drew's assumptions regarding the caller in question's lack of pathology came after Dr. Seckin discussed all of this. Did he learn anything from Dr. Seckin?
Dr. Drew also stated that patients should continue to push until they receive a satisfactory diagnosis and explanation:
"So I was saying about how frustrating it can be out in the community trying to get the proper care. I... I think this is a great opportunity to say an educated patient, a patient is motivated, he keeps going back, who doesn't take no for an answer, who really works with their physician, doesn't make it adversarial, but doesn't... doesn't... doesn't stay away from the system if they are not getting adequate attention , who don't feel that they have got an adequate complete explanation for what is going on... The doctors want you to do that! The system doesn't want you to do that, but the doctors want to do that. So, please be educated and go back, and go back, and go back until you feel satisfied with the explanation."
This goes against everything he stated in that original call. During "the call that started it all" Dr. Drew stated to the caller that "....it then makes me question why is she so somatically preoccupied that she's visiting doctors all the time with pain and urinary symptoms and health symptoms and all this stuff. And that makes me wonder was she sexually abused growing up". The catalyst for his diagnosis of Somatoform Dissociation came from her presumed "somatic preoccupation" and his assumption that she was repeatedly visiting doctors to get these "unrelated" diagnoses. That just doesn't jive with his assurance that patients should continue to "go back, and go back, and go back until you feel satisfied with the explanation".
As Dr. Cook, founder of the Vital Health Institute, stated, "Though a small minority of patients in my study revealed a history of sexual abuse, the vast majority, 98%, did not report a history of abuse". Dr. Drew's guess that this woman suffered with former sexual abuse was a shot in the dark, and he was aiming at a large target as the statistics for female sexual abuse in the United States are overwhelming (nearly one in four).
As I stated, the Endometriosis community can find solace in the awareness that has been raised and that Dr. Seckin was given a platform through Dr. Drew's podcast to share his knowledge and educate, not only Dr. Drew, but others on this debilitating and painful disease. Sadly, that same platform was not used to raise any awareness for the Interstitial Cystitis community, something that is desperately needed. Realistically, if he were to have broached the subject of concurrent diagnoses, his ignorance would have been laid bare for all to see, and that was really what this was all about; protecting his image.
Dr. Drew used a significant portion his podcast to garner sympathy for himself. He attempted to elicit that same sympathy from Dr. Seckin claiming that Endometriosis and Interstitial Cystitis patients become "dangerous bullies" through their use of social media, calling him names such as "vile pig" and threatening his family, however Dr. Seckin was not willing to play along stating he must "politely disagree", and that "they are very understanding when you hit the right tone with them because they need people who [do] understand". Let us not forget that it was Dr. Drew's Loveline co-host who called Endometriosis and IC patients "twats", "fucks", "snatches", and "cunts" while offering up his testicles for dinner.
The term "gaslighting" comes to mind when I think about Dr. Drew's actions following the comments the night of the 24th. Gaslighting is a form of mental abuse by which the abuser manipulates the victim with false information and denial effectively causing the victim to doubt their own experience or memory; "vigorous and unwavering denial coupled with a display of righteous indignation can accomplish the same task". This is precisely how Dr. Drew has handled this situation. Instead of giving a short and authentic apology for his ignorance, then following that up with a podcast featuring Dr. Seckin, Dr. Drew instead presented false information regarding the caller, claiming was the "new boyfriend" and that he was anxious when, in fact, he remained calm and collected. Dr. Drew denied that the term "garbage bag diagnosis" was applied to each diagnoses the fiancé had received, even though he stated that "everything you mentioned, are things that actually aren't discernibly pathological. They're, they're just sort of what we call "garbage bag" diagnoses". Finally, Dr. Drew turned the tables, placing himself in the position of "victim" with the offended parties being the "dangerous bullies" attacking him.
I just can't find it in my heart to empathize with Dr. Drew's plight, not with such blatant arrogance and misogyny flowing forth from his various outlets. As Dr. Drew said, "There's no role for a teacher because you can't teach people who know everything. And so there's no wisdom". Dr. Seckin's words did not appear to have resonated with Dr. Drew, however I am sure they have with millions of women, girls, and IC sufferer's world wide.
A comment left by Monetta on another post summed this up perfectly: "I have learned to stand up to Drs like [Dr. Drew]. After I had severe pain during an exam and the Dr just kept on going until I was sobbing I vowed never to let a Dr be in charge again. Maybe we are abused, by the healthcare system that is supposed to help us and keeps telling us nothing is wrong."