Our August 2024 LMCC meeting took place on Wednesday, August 28 at 5:30pm in UNC’s HHIVE Lab (Greenlaw 524) and via Zoom. 
We discussed The Retrievals, a podcast from The New York Times by Susan Burton, Laura Starecheski, Julie Snyder, and Carla Pallone (2023).
Specifically, we focused on:
- Episode 1: “The Patients” (06-29-2023)
- Episode 5: “The Outcomes” (08-03-2023)
If you missed the meeting, you can still access the text on the Readings page of this site!
You can also access the recording of our meeting here.
This was our first meeting of the semester and of the academic year! All of our meetings this semester will take place at 5:30pm eastern time on the last Wednesday of each month in the HHIVE Lab (Greenlaw 524) with options for people to join via Zoom as well.
We’ll be posting information about our September meeting soon!
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- If you want to get more involved with LMCC, please send us other resources we should post to the site or suggestions for improvements, additions, future readings, etc. We’d love to hear your ideas and input! (See our email addresses on the Home page of this site.)
- Also, please feel free to spread the word about LMCC to other interested graduate or professional students at UNC.
Burton, Susan. “The Patients.” The Retrievals, season 1, episode 1, Serial Productions, 29 June 2023. The New York Times, https://www.nytimes.com/2023/06/29/podcasts/serial-the-retrievals-yale-fertility-clinic.html.
Burton, Susan. “The Outcomes.” The Retrievals, season 1, episode 5, Serial Productions, 3 Aug. 2023. The New York Times, https://www.nytimes.com/2023/08/03/podcasts/serial-the-retrievals-yale-fertility-clinic.html.
Meeting Notes (courtesy of LMCC Co-Director Mindy Buchanan-King):
- Individual women’s pain, and systemic issues
- Attendee was living in New Haven, and knew of the case
- How we as patients rationalize/normalize any kind of pain; highly recommend listening to the entire series; thinking about the nurse’s story and her sentencing; felt very conflicted about Donna inflicting harm upon others; she did get her license back, though she volunteered to give up her license
- If anyone liked this podcast, Doctor Death podcast goes into the medical system; John Oliver also has a great piece about the medical boards
- Re: medical boards, how you can take care of patients and struggle with something that may not put in the best position to take care of people
- Symptoms of withdrawal, how can they perform the job; how can they take care of people?
- Thinking about the pain scale, and the subjectivity of trying to quantify pain
- Systematic issues: DOJ investigated Yale, and they were made to pay out; systematically, there weren’t many avenues for justice, Yale couldn’t produce the needed evidence
- The machine that’s supposed to regulate, that Yale wouldn’t purchase the equipment; the question of responsibility, at all levels, how do you negotiate how responsible the nurse is
- Donna’s responsibility is deferred because of the medical board situation; what if she were a bus driver, she would be held legally responsible in a way that Donna the nurse was; how deeply disturbing it was that Donna was in the room and heard the patients screaming, inflicting harm on people knowingly
- The point that Donna has gone through IVF, which is shocking; maybe it’s the point that “I’ve gone through this, so everyone else will be fine”
- Women’s pain is so normalized; IUD insertions are just a small aspect of the equation, numbing the cervix was not standard of care
- Issue of responsibility; from a structural level, how was this able to occur? The podcast does well in pointing to Yale’s “bad apple” narrative, so Yale was able to negate responsibility, but Donna was also able to negate her responsibility
- What is the triangulation of communication between nurse, patient, and doctor? An affective and emotional event: It boils down to the culture of medicine, and what kind of pain they expect women to have; it’s power dynamics
- Opioid addiction may have caused problems with pain mitigation, in tension with “I don’t want to kill you”; how much is that informing what’s happening; Camille noted that there is a fear around criminalization of opioid prescription
- Scott Stonington (from Camille): argument about opium pendulum: It will never be right in the middle, because pain and opioid use will either lead to throwing medication at the pain, or it leads to the rhetoric that opioids will not be prescribed; right now, the tendency right now is not to prescribe
- See also, NYT: “Health Officials Urge Doctors to Address IUD Insertion Pain” (Teddy Rosenbluth, 08-07-2024)
- What does it do to the mindset of the doctors and nurses/health care when pain is banal, when it’s seen every day? Some people can become numb (from Sarah, as a med student); per Reese, there’s two kinds of banality of pain, from emergency situation, there is a difference between what people think is an emergency and what doctors think is an emergency; also a continuity of care setting, like with fibromyalgia patients where they’re in pain but there’s nothing you can do
- Interesting disjuncture of having to be empathetic and protect themselves; a disjuncture of how success is measured, which is again discounting female pain; the system relies on doctors to report
- Nationally, a distrust with our medical institutions; does it become a question of scale? Is there an argument to be made that healthcare should scale back? Yale is such a massive institution, but does it make things easier to fall through the cracks? The difference is that places like Yale think they are above it
- What about choice? The option of pursuing fertility and IUD, those are choices, but there’s pressure to stay in that choice; it’s not really a choice for the full span
- How much information do you need for a choice to be fully autonomous? IUDs are marketed as a “quick stop”; sometimes the procedures are done, but the pain continues
- It’s hard to feel empowered in your choice; you can’t really take control of your reproductive health
- Notion of informed consent, when you’re in pain: IC is based on decisional capacity; coercion is not addressed as part of decisional capacity, you have to show some kind of reasoning through something like risk-benefit analysis, and you have to be able to voice that consent; but these women are in the pain in the moment, how can that be called consent? Most medical decisions are made under duress
- The question of the mythical layer of consent in medical environments
- During the first episode, the podcaster takes a moment to talk about Yale as a renowned institution; some women have access because they are employees, and the procedure is costly, and the majority of the women were white; it felt like prepping or acknowledging that this group of patients are unsympathetic in the social imaginary. Is that element there?
- What does it take to be believed?
- A double-bind in medicine: You want the patient to be compliant, and this population—because of their privilege—they buy into the social structures as they are, so they’re more likely to deal with it. But, in that act, they are less likely to make more of an argument that they should be listened to. But those who may be more willing to question the authority of the doctor, then they are going to be labeled as non-compliant. How do you break through that? Side effects are part of the deal. Which gets to the elective element of the procedure…
- General dismissal of women’s pain, especially women of color
- Thinking about outcomes, but there are other questions: What else could be going on, as in terms of affecting pregnancies, speculating what else what going on with Donna
- How the podcast addresses cognitive dissonance, and being asked to confront all of these narratives, dealing with medical gaslighting
- Narrative construction is something to think about; illness narratives are spoken of from the patient perspective, or a narrative with themselves; having to come to the point themselves; the physician narrative draws on all these other narratives and you create a “normal curve,” and you generate an ideal in the middle
- Powerlessness in medical mistrust, women are continuing to stay hypervigilant; many providers are approaching this more guarded; how do you approach a patient who is concerned and guarded; how do you navigate the experience of being trapped?
- Systemic failings, and the bureaucracy; what is the perspective of overburdening the system?
- If anyone has ideas about September readings, please email us; maybe find something about pain in relation to marginalized communities, and consider the layers of other experiences
- Potential next reading: Catherine Belling, A Condition of Doubt: The Meanings of Hypochondria
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Note: The featured image for this post is a digital photograph from The Retrievals, Episode 5: “The Outcomes.” Photo credit: Erik Tanner, The New York Times.