They don’t care if you’re bleeding unless you’re bleeding out
I bled for 150 days straight, and my friends did more to address my pain than Canadian doctors.

In recent years, I’ve learned that some physical health issues are not the kind that doctors and hospitals take seriously. For those of us who have been systemically informed that our pain is insignificant, an overloaded and strategically defunded system is one of many barriers to accessing medical care.

At 17, an ultrasound identified that I had a cyst. It was 10 cm in diameter (about the size of a tennis ball) on my ovary (about the size of an almond). The doctor told me that they would give me another ultrasound in six weeks. 

Given that I had visited the doctor because of acute episodes of intense pelvic pain, I was surprised that I was offered no solution, pain killers, or referrals.

Last April, I went to Portugal on my first backpacking trip. I had been on testosterone as a part of my gender affirming therapy (or hormone replacement therapy) long enough that my menstrual cycles had stopped. Or at least that was true until the week prior to my flight. 

After three weeks of constant menstruation (Europe edition), I assumed something was wrong. I didn’t speak Portuguese, so I had minimal interest in trying to find a walk-in clinic, let alone one whose doctors were experienced with reproductive medicine. It was a while later, after going rock climbing in the south of Portugal, that I began to have some incredible stabbing pain in my lower abdomen. My companion at the time, a competitive arm wrestler, was walking with me in a national park when he asked if I was okay. I explained to him that I had been bleeding for three weeks and that I had a history of ovarian cysts. I was in severe pain, but had taken painkillers, and I wanted to wait before deciding whether a hospital visit was necessary. 

By “necessary,” I mean whether I could psychologically cope with the magnitude of the pain. We eventually walked back to his car, and by that time I was in so much pain that I could not sit. My companion insisted I speak to a telemedicine service he had called, which would help me determine if I should go to the ER. The man on the other line asked me if I was pregnant three times. 

After I explained that I was most certainly not pregnant, he said that any bleeding lasting more than ten days, especially if it caused such severe pain, required emergency attention. I was missing my ID at the time. I was tired, and I concluded that I would just cope. Coping was preferable to going to a place where I may not receive painkillers and timely attention, which I was uncertainly bound to pay for.

What I found interesting about this experience was that my companion was empathetic and concerned. He didn’t approach me with the kind of disgust and soft disbelief that I faced in Canada, when people would ask why I was feeling ill. In Portugal, someone who I had only known for a handful of days was willing to drive me during rush hour traffic and act as a pseudo-translator because he believed my testimony and recognized my pain. In Canada, I don’t even think my roommate would be willing to drive me a few kilometers to the hospital, not without heavy judgement or complaint.

My trip went on, as did the bleeding, until I was in Spain. I was staying at the University of Sevilla with students who had an encampment in protest of the war and genocide in Palestine. One night, while I was at their encampment, I was waiting on a call from a new friend so we could go to a music event. By the time he texted me, I was in immense pain. The world spun when I sat still, painkillers did nothing, and I was grateful that the scorching Sevilla sun had already set. 

This time, the pain was beyond something I could handle. I began researching nearby hospitals, trying to figure out if it was possible for Canadians to get medical care in Spain. Unfortunately, I had missed my opportunity. Back in Portugal it was possibly free for me to get emergency medical help; here it was not. 

My friends among the protestors were tremendously concerned for me. They stayed with me, asked me what was best, and offered to text my friend on my behalf because I was in too much pain to see clearly or type much.

Eventually my friend called. He was a man, one I respected and wanted to get to know.  So I was hesitant to divulge details about how much pain I was actually in. It’s humiliating to be reduced to a coping machine, a being with the sole and only thought of breath, tolerating the intolerable. 

Once again, a near stranger amazed me. My friend on the phone said his sister had ovarian cysts. He insisted that he wasn’t going to go to the music event like we initially planned, but that he would rather come to see that I was okay. He said he’d carry me to the hospital, if need be, and the protestors shared his sentiment. 

Eventually, the gram of Tylenol and unknown amount of naproxen helped some, and I calmed down enough to laugh about the state I was in. I was alive, the time-defying pain had lessened, and I introduced my protestor friends to my music friend. We got to know each other more as we walked around the warm and dark city.

One incidence of exceptional kindness is just that: a singular event. My survival in Europe was reflective of some kind of greater kindness. The passing people of Spain and Portugal believed so strongly that they ought to help me that they forgot mostly about the ‘intimate’ aspects of my medical issue.

For context, when you are female and go into the hospital with intense pain in the lower abdomen, they ask you if you are pregnant. Typically, this happens multiple times, sometimes with the same individual asking repeatedly. More often, multiple individuals will ask. 

I wonder, if I had said there was a chance of pregnancy during any of my hospital visits, would they have been more concerned with the level of pain I was in? 

Part of the challenge with menstrual and general organ pain is that it is invisible. It is imperative therefore that clinicians trust their patients when they express how intense their pain is. If gendered medical history has taught us anything, it’s that the opposite is true. 

After returning home, I made an appointment with a doctor which I had been seeing since I started university. I told her about my many weeks of bleeding, the incredible pain, and how I needed help. Or a referral. Or something to stop the bleeding. She seemed mostly unconcerned as she casually ordered an ultrasound and bloodwork. My bloodwork came back fine. During our follow up appointment, she prescribed me nothing and gave no advice. I asked her what I was to do if this happened again, if I was in extreme pain that medication minimally helped. She said I could go to the ER. That was my only option. She told me the bleeding would stop. It did not.

When considering whether one should seek emergency medical attention, a person shouldn’t have to consider if they will be believed and taken seriously. So, after another month of bleeding, at 3 a.m I was awoken by abdominal pain. I lay there, crying and considering the options the doctor had told me. I could go to the hospital, but how would I get there if I could hardly walk? Could I handle the wait time, the bright lights? Would I be civil and patient when multiple professionals asked me the same questions, gave the same suggestions? Yes, I took painkillers. Yes, I used a heating pack. Yes, this has happened before.

Toward the end of this whole mess, I had another cyst rupture and had to visit the ER. I would kneel on the floor, as if I were praying, or I would pace around the room until my feet ached. I wanted the door to be open. I wanted the nurses to care. Another patient came in shortly after me, complaining of abdominal pain. The doctor visited him an hour before me, giving him medication very shortly after his arrival, while I paced and kneeled, breathing sharply, with no respite in sight. I don’t know that man’s pain. I know that I was suffering, and that I felt ignored. 

On that day, two doses of morphine were enough to calm the pain so I could go home. The ER doctor said she’d write me a prescription for painkillers. She prescribed the very medication I had told her did next to nothing for the pain: Tylenol.  

After 150 days or so the bleeding stopped. I spent one third, maybe more, of a year bleeding, and the strategy various professionals took was to run the same tests and just “wait and see”.  I wonder  if I would’ve been treated differently had I been a cis-gendered person. Or maybe if my bloodwork showed iron deficiency. 

Though, I had a friend in high school who fell and hit her hip badly, causing multiple weeks of bleeding. Doctors found her to be dangerously anemic and gave her blood clotting medications that failed to work. I wasn’t bleeding out. I wasn’t small or anemic. There was no catalyst for this bleeding, and it defied the usual effects of testosterone. But nobody seemed to care. I told friends and family as it happened, that I had been bleeding for 60, 120, 140 days. They all seemed more stupefied than any doctor. 

What or who is the culprit here? Is it how our health care systems are pillaged by increasing privatization? Is it how women’s and gender minorities’ pain is met with unjustified scrutiny, echoing deep-rooted biases and injustices in the systems responsible for ensuring our health? Is it something else entirely, or all these things combined to create a healthcare nightmare? Perhaps. All I know is that I, and countless others like me, simply deserve better.