December 3, 2018

The doctor dismissed an anxious patient’s ear problem. Then, an inch-long silverfish came out.

Daily Briefing
    Editor's note: This popular story from the Daily Briefing's archives was republished on Nov. 1, 2021.

    Gila Lyons felt something crawling in her ear: "[A] prickling tickle coupled with the sound of scraping—a maddening ringing and itching, mostly in my right ear," Lyons writes in Oprah Magazine.

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    But for months she kept her concerns hidden from her doctor and husband, attributing the discomfort to her anxiety disorder. "I feel weird things in my body almost constantly," Lyons writes. "So, although the ringing in my ears was nonstop, at first, I tried to ignore it, saving any need for reassurances from those close to me for more serious problems."

    But when Lyons presented at her doctor for an unrelated problem she took a chance: "I feel like there's something in my ear. Can you take a look?" She looked and found nothing, just "[s]ome dry ear wax," Lyons recalls.

    'A prickling tickle'

    But the symptoms continued, and a few days later, a squirming inch-long silverfish fell out of Lyons' ear.

    "I knew it! I knew it!" Lyons yelled when the creature came out. "The months of scratching, high pitches, and prickling inside my ear hadn't been anxiety," she writes. Lyons and captured the bug in a jar and snapped a photo, which she posted on Facebook.

    The next day was met with comments "express[ing] outrage that a doctor could have missed a bug in [her] ear," Lyons writes.

    Back to the doctor

    Lyons returned to the doctor first thing Monday. She recalled the doctor "did not apologize for missing" the bug and "did not admit to dismissing" Lyons' concerns. "On my chart, in fact, there was no mention that she'd ever looked in my ear or any note of the ear ringing I had complained about," Lyons writes, adding, "I didn't have the energy to point out that I'd been right."

    The doctor prescribed antibiotics to Lyons for an infection but refused Lyons' request for a referral to an ENT, saying it was unnecessary.

    But a few days later, Lyons said she was still experiencing "ringing, itching, and … spasming in the ear canal." She called her doctor back, and again was denied a referral. The receptionist encouraged her to make another appointment so any referral would be covered by insurance.  "So I went in again, and again she said I didn't need an ENT," Lyons writes.

    At that point, Lyons filed a formal complaint against her doctor with the practice manager and refused to leave the office without a referral. Her doctor again denied the request, and the practice manager eventually handed Lyons her referral.

    A long-waited visit to the ENT

    When Lyons went to the ENT, the specialist told her he didn't detect infection at that point, but that it would take a while for things to feel normal. "I wanted to be comforted by the good news," Lyons writes "But I had already been told there was nothing wrong with my ear—and then, a bug fell out of it."

    A bigger problem—and what female patients can do

    Lyons acknowledges that her anxiety can have physical symptoms but writes that, too often, "[w]omen, disorder or no disorder, are routinely told their symptoms are due to anxiety when they're not."

    "This dynamic is like a modern incarnation of the hysteria diagnosis," Lyons writes, adding, "Study after study shows that men reporting their symptoms are taken at face value, while female patients are perceived as overly emotional, prone to exaggeration, and therefore untrustworthy reporters of their own experience."

    For example, she cites the World Heart Federation's finding that while heart disease is the leading cause of death for women in the United States, "doctors often fail to recognize and treat it in women." Research also shows that women are prescribed valium, rather than painkillers, after surgery. In addition, a report from 2009 finds women often receive mental health diagnoses or diagnoses related to hormonal issues when they're really suffering from an autoimmune disease, Lyons writes.

    With these issues, in mind, Lyons urged women "to be ceaseless advocates for themselves." She writes, "If doctors refuse to adequately examine something or refer them to a specialist, it's time to request that they document that refusal in your chart."

    Lyons adds that women "are entitled to seek out second opinions and demand referrals, even if it makes you an unlikeable patient—or an unlikable woman, which many of us have been warned not to be." If the doctor continues to refuse, Lyons writes the patient has "the right to file a complaint with the practice manager."

    Lyons concludes, "For those of us who are both women and patients with anxiety, going to the doctor is an even more difficult task.  … As horrifying as the bug ordeal was, it taught me one incredibly important lesson: The first person I should trust, above all, is myself" (Lyons, Oprah Magazine, 11/28).

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