She raised her finger to declare her shahada, her voice barely audible as she said those final words. Then she collapsed, her eyes remained opened and crossed.
Her husband and son; sturdy, strong men left in tears and utterly helpless.
9-11, I need an ambulance.
She was not dead, though to anyone in the room who had witnessed her demise would have sworn that she had just died.
The paramedics said she has all the signs of a stroke. Rushed to the ER, the medical professional quickly hastened to assess her state. ECG, MRI, blood work, you name it, they ran all sorts of tests to understand what had just happened.
After 12 long hours, the resident doctor declared her clinically healthy with no signs of heart attack, stroke or anything physically wrong, then brought in the psychiatric team.
The psychiatrist assessed her, asking questions about stressful events leading up to her collapse. Yes… a distant relative overseas passed away, and she volunteered to help the local family cook and serve guests who came to pay their respects.
Diagnosis: PTSD.
It was 9 am when I received the call from her husband. Aiman, I need you to make the doctors understand. As recent refugees from Syria, he knew the language barrier might be the cause of the misdiagnosis.
Upon my arrival, I asked the nurse to fill me in as to why psychiatric got involved.
Then I sat by my friend’s bedside and asked her to recount what had happened.
“I was helping the family cook. It was busy, hectic and quite exhausting. I asked my son to take me home and I couldn’t walk down the corridor. I was weak, dizzy with chest pains and I could no longer carry the weight of my body. He managed to get me home to rest, which I did. Later that evening, I started to feel dizzy, everything spinning around me, my eyes became blurry, my speech slurred and heavy, I could no longer hear and I lost all feeling in my left arm. The chest pain got stronger and I was gasping for air and I truly believed I was dying. So I declared my shahada and then lost consciousness.”
The doctor wanted to discharge her, stating she fainted, her vitals are stable, the testings came back all negative and she was no longer an emergency.
Her husband, son and I refused to let them release her. I informed the resident doctor of her past medical history: the chest pains, the heart halter, the electrical current issue that appeared in that test, the 12 chest pain – collapse episodes she had had in the last eight months. I knew my friend couldn’t articulate her state, so I became her voice.
But despite my fervor to have the doctors understand that this isn’t PTSD; that she doesn’t have nightmares about Syria, that she’s encountered far more stressful situations to her immediate loved ones and did not collapse or have an anxiety attack. I wanted them to understand that this is a real physical illness and begged them to search deeper to find a diagnosis — they all came back with the same protocol.
Medicate her for 3 months with antipsychotics – and let’s see how she does.
Are you saying her illness is mental?
We aren’t sure. There is no way to diagnose that.
So why medicate her? Would you give her chemo to treat cancer, when you aren’t certain she has cancer?
No.
Then why medicate her?
If she continues to have the chest pain – collapses while medicated them we will know it is not mental.
Can you refer her to a cardiologist since she exhibited bradycardia as well as first-degree heart block in your testing?
No. Her family doctor can do that.
And they discharged her while referring her to a psychiatrist.
Her husband and son take her home reluctantly, entering back into the unknown of when will it strike again.
I am left speechless and defeated. This was the best hospital in the city. I had referred them there myself.
Is this what we have been reduced to? To be made to feel mentally ill if doctors are unable to understand the cause of our symptoms? If they are limited in their knowledge, then we are to be medicated so that we remain silenced?