Get her to the hospital. And the first doctor who came in
said, do you know you have a big old murmur? Which is
literally how he said it. And she was like, what? No. And he's like,
yeah, you have a heart murmur. And she's like, what? And
then he said, this sounds like heart failure to me. Like,
how long have you been treated for heart failure? And she said, I haven't been
treated for heart failure. This doctor sat with
my mother and talked through every single complaint she had, emergent
or otherwise, she talked through every
concern we had. We talked through every bad experience. We talked through all the
things that, that I felt were being mismanaged, that I felt weren't being
managed. She explained stuff to me that nobody has explained to me.
Boop. Hi everybody, I'm Lauren Howard.
Welcome to Different Not Broken, which is our
podcast on exactly that, that there are a lot of people in this world walking
around feeling broken, and the reality is you're just different. And that's fine.
Before I get into this, I just wanna say, I work in healthcare. I see
good healthcare every day. I see exceptional healthcare every
day. I work with incredible doctors. I work with clinicians who
blow me away with their intelligence and their skill. I tease them all the time
because that's like, of course I do, that's just me. But I love
the doctors I work with. I love the nurse practitioners I work with. I'm fortunate
that I get to work with them every day, and I see amazing healthcare being
delivered literally every day.
And so I know it's out there. I know it's possible. I know
there are people who benefit from it. But I also know
that some of the things I've seen lately, and I say this as a
person who knows healthcare inside and out, who knows what to look
for, who speaks medical jargon, who can keep up in conversations
about medical issues. I say this as
a person who is not new to this. The
shit care that has come out of people
who know better recently just has
me so frustrated. And
anybody who knows me knows that if I end up in a situation where something's
completely broken, I want to fix it. My brain immediately goes to, how
could we have done this better? How could this have been communicated better? What
product is missing to fix this problem? And the
totality of the number of things that had to go wrong
to end up here or to end up with what happened is so
huge. It is an entire system
that I can't fix by myself. I don't even know that 1,000 of us working
hard could fix it. I don't know that a million of us working hard could
fix it. Our healthcare system is so
mired in its own nonsense. That I don't know
how to fix it. I think some of it will be improved
by people aging out, like just doctors
retiring who need to retire. But then that
sounds like a solution, right? We're gonna get these providers who have
kind of antiquated ways of thinking out of our processes,
but we don't have doctors to replace them. Our primary care shortage is
so huge. Our specialist shortage is huge. But people are going into
medical school specialized now, or into residency specialized now.
We don't have as much option to put people into primary care
or general practice or internal medicine to become primary care. It's just
not the way our system works anymore. And so the primary care deficit that we
already have is huge. And then the one that follows as we go through the
retirements of the next 10 years, worse. It sounds
great that people are gonna retire. We're settling for insufficient care,
but is insufficient care better than no care? I don't have an answer for that,
but it is like a, a huge question that keeps coming up.
Anyway, anybody who has been around me in any
way in the last several months knows that my mom
has been sick and there's been a number of hospitalizations and she's back in the
hospital again, which sucks, but I don't like when she's in the
hospital. But I am less anxious when
she's in the hospital because it means there's somebody with her. It means that she's
not home alone. I don't have to worry about having somebody with her all the
time. And also it means she's getting medical care that she needs. They don't keep
you in the hospital academically. If you're in the hospital, you need to be in
the hospital. So she's there, but I'm really angry about the
reason that she's there. I'm glad she's there now and I'm glad they're addressing it
now, but her experience is so
typical, so common of what
we have seen so many times with
women in healthcare, just women getting healthcare. And
it truly took a bunch of women to
straighten it out or to at least get her on the right path. I am
not the most observant person. Minor changes in
people's like looks, I don't usually notice.
I certainly don't usually call them out, but 6 months ago,
I noticed that my mom just didn't look right. She looked different. She was
carrying weight in places where she had never carried weight before. It looked like she
had gained a bunch of weight. I wasn't sure why. It didn't make any sense
to me because that has not been a problem in recent years.
And it was enough that I was concerned. I wasn't concerned that she had gained
weight. People gain weight. I was concerned that she had gained weight in places where
she had never gained weight before. And she looked different.
And so I started calling all of her doctors, and I think
I've talked about this before. It's been a long process of like fighting to get
tests done, asking a bunch of questions, literally
calling her doctors anytime they would get on the phone with me and saying,
there's a problem here. Can someone intervene? What are we missing? What are we doing?
Taking her to new doctors. She's probably seen 10 or 12 doctors this year
alone. And trying to figure out why, getting tests run. I had to call
in favors to get tests run because, like,
one of her doctors literally told me that what the diagnosis that
I thought could be a problem, and I wasn't saying she had it, I was
just saying, can we test for this? One of the diagnoses that I
thought she had was really hard to diagnose, so running the labs doesn't do much.
And I was like, it's hard to diagnose, so you just don't, you just don't
run the labs? That doesn't, don't you want the labs anyway? Yeah.
What? That doesn't make sense. And so it's been stuff like that over and
over. And she's been complaining of weight gain. She's been complaining of
fatigue. She tells me she just falls asleep all the time, which is, I, I
mean, like, I can count on one hand the number of times that I remember
my mom napping growing up. It was never a thing that happened. And she would
just fall asleep. She was sleeping later. She had very little exercise
tolerance. She had very little motivation to do things, and she had
zero appetite, wasn't eating at all, and still gaining weight.
And I sat with her with multiple doctor's appointments
where she kept telling them, and I would pipe in and tell them, because sometimes
she, like, in front of her doctor, she'll downplay things. I don't know why,
because that's not usually her vibe. Her vibe is usually
upplay things, so all the eyeballs go on me. But sometimes with her
doctor, she just doesn't tell them enough about what's going on. And so even I
would say like, no, I'm watching, this is happening. And I
can't tell you how many times people told her to just lose weight.
And I kept saying, okay, but she's not eating. She's
eating so little and she has GI issues
and you're telling her to just lose weight, but she's not eating. Well, she needs
to exercise more. Okay, but she's short of breath. She has
really low exercise tolerance. She can't even walk like she used to.
Well, she's getting older. Okay, but this is not a 5-year decline. This is a
6-month decline. What is going on here? She needs to lose weight.
That was literally the outcome almost every time we had this conversation. I went to
my trip over the weekend or last week, had a great time, came back,
brought my mom lunch a day after I got back and could tell
like her, she sounded like a freight train when she was breathing. And I said,
are you having trouble breathing? And she said, yeah, I talked to my doctor
on Friday. You know, you're bringing me on Monday. Yeah. But I feel like I
can't breathe. And I said, why are you sitting at home alone when you can't
breathe? Like, why didn't we go to the hospital? She's like, well, I don't wanna
go to the hospital. And I was like, well, that's a stupid reason. So I
ordered a pulse ox machine that, listen, I'll be honest, Walmart
delivery is clutch. I don't love Walmart, but I just go on my phone
and tap 2 buttons and literally 19 minutes later I had a
pulse ox in my hand and I put it on her finger. Wow. Her
saturation was at 80. Anything below 90 is like a red flag.
Big problem. Go to the hospital. I called her doctor and he
said all the right things. He said, well, yeah, I talked to her about this
on Friday. It sounded like she was having trouble breathing. She said she
didn't have a pulse ox. And I'm thinking, you didn't tell her to
go get one? You didn't tell her to just, hey, do you have any
delivery apps that can deliver a pulse ox to you?
In a couple minutes, since that's a thing we do in
2026. Did you just let her sit here without
checking her oxygen level? Okay, cool. You have a
patient who called you and told you that she's short of breath and you said,
try some medicine and I'll see you on Monday without actually
checking whether she was hypoxic. Okay, whatever. I
said, yeah, all right, I'm taking her to the emergency room. I took her over
to the emergency room. She fought me a little bit, but for the most part,
she just like has to have the outburst. And then once the outburst is done,
she just does what she's told. She got in the car. I took her, get
her to the hospital, and the first doctor who came in
said, do you know you have a big old murmur? Which is
literally how he said it. And she was like, what? No. And he is like,
yeah, you have a heart murmur. And she's like, what? And
then he said, this sounds like heart failure to me. Like,
how long have you been treated for heart failure? And she said, I haven't been
treated for heart failure. And he was like, what? Yeah. It's in your chart.
She's like, I don't have heart failure. And he goes, I don't know, this kind
of sounds like heart failure. And she's like, nobody's ever diagnosed me with heart
failure. So he runs some tests, he leaves. We just happened to get there
right as shift change was happening. So this new doctor comes in,
and if I could sum her up in 2 words,
it would be fucking delight. I want her
to come be my friend. I want her to come hang out with me.
I want her to tell me all of the inside tea about all of the
hospital systems in our area, cuz I know she knows it. She kind of
told me she does. She needs to be my friend.
Emergency room doctors, their jobs are to treat 'em and street 'em. Like, you are
not supposed to be doing a complete medical history. You are not supposed to be
making referrals to 7,000 different providers unless it's the emergent issue
or the urgent issue. You should be working
with the immediate problem in front of you and either sending them home or admitting
them to a hospital. That's their job. This doctor sat with my
mother and talked through every single complaint she had,
emergent or otherwise. She talked through every
concern we had. We talked through every bad experience. We talked through all the
things that, that I felt were being mismanaged, that I felt weren't being
managed. She explained stuff to me that nobody has explained to me.
My mom has no appetite. She hasn't eaten. She really doesn't eat at
all for days and days on end and then is gaining weight. And
she said, this sounds like heart failure. And also you have what's called a
pleural effusion, which is fluid around the lungs. And if that's
pressing on your stomach, it's making you feel full,
and that's why you can't eat. And she went, oh,
why are you the first person to explain this to me? She was like, I
don't know. And I asked her, I said, is the pleural effusion new? She said,
no, it was on the imaging before. I said, so they just didn't
do anything about it? And she was like, there's, there's sometimes the right thing to
do is to watch it, but then sometimes the right thing to do is to
try to get the fluid off. And we definitely need to get the fluid off.
She said, and sometimes the right thing to do is to drain it, but I
don't know that they're gonna drain it. So I said to her, so you're
saying she has heart failure? And she said, yeah, I mean, she's had
6 studies that confirm heart failure, and
she was diagnosed with it 6 months ago. And I was like,
wait, she has never been referred to a cardiologist? I'm here for
all of this. She's never been referred to a cardiologist. She certainly is not
on any medication for it because she already takes 18 medications.
So somebody diagnosed her with heart failure and then nobody treated it? And
she was trying to be politically savvy and she was like, well, I can't really
speak to that, but it does look like she was diagnosed with heart failure and
it does look like it needs to be treated. And I looked at her in
the face and I said, I just want to be clear about this. She has
been complaining of weight gain, severe
fatigue, physical symptoms, poor
appetite, inability to eat, low exercise
tolerance. And you're telling me instead of diagnosing or treating
the heart failure that had already been diagnosed, they just called her
fat? And she didn't really have much to say to that. And not because— I
could tell she wanted to, but she was like, we know what to do now.
She's like, we— I'm confident we know what to do now. And I was like,
I'm confident too, because heart failure is super treatable. But she's been saying
this for 6 months, and her— even her doctors who know her
exceptionally well And who have been her doctors for decades
just told her to lose weight. And the reality is that her heart is literally
failing. And I have not been quiet about this. I have been a squeaky wheel
about this nonstop since it became apparent to me. Women could
walk into a doctor's office with their arm
literally falling off, and the doctor would say, have
you tried diet and exercise? It's really bad.
And I say that as somebody, one, who knows what to look for, two,
who has been fighting back against that for several months now just on behalf of
my mom, not even globally fighting against it, which I also do,
but three, like, knows how to find more resources. How
many people out there are going to their doctor— and I know that it's a
lot— how many people out there are going to their doctor with legitimate complaints and
just being told that if you diet and exercise, everything will be fine? You're just
anxious. You're just being neurotic. She has
actual heart failure. She could have died.
She already couldn't breathe. She was already not getting oxygen
because of this thing that everybody Spider-Man memed their way out of
treating. They all thought that somebody else was doing it.
Nobody was doing it. We are failing people in our
healthcare system in ways that I sit upright in the
middle of the night trying to figure out how to fix, and I just don't
freaking know how. This person, she has 10 doctors.
She has easily seen 10 doctors this year, and
everybody passed the buck to somebody else, and nobody referred her to a cardiologist.
How does that happen? And if it's happening to her, how many other
people is it happening to? Because I know it's happening to a lot. We have
to do better. She could have died. She could have died, and it would have
been someone's fault. It would not have been her body's fault. It would have been
someone's fault. It's just not acceptable. I promise
that women are more than just fat. It's not surprising, but there was a
moment about it that was, like, really devastating, because yesterday is when it
all came together for me. And of course, shit's coming together now
that there are 2 women doctors who are running the show. There's good data that
shows that women doctors have better outcomes and have lower mortality
rates than male doctors by, like, a stretch of a lot. It's not a small
margin. So 2 women doctors are finally kicking
asses and taking names and getting things straightened out. But she
was giving me some of the updates from some of the doctors that she talked
to and what they said and what they were doing. And yes, it definitely is
heart failure. And I finally text her later in the day because this felt like
somebody punched me in the stomach. And I said, do you understand that what they're
saying is you've had heart failure for
6 months? Or longer, but we just thought you were fat?
That's basically what they're saying. That's what is happening. I'm not usually the
reactive one. I'm usually the one that's like, okay, let's get all the information and
we'll make an assessment. And I was like, I'm gonna fight somebody.
And my mom, who usually is the reactive one, like she is literally like a
ticking time bomb all the time, was like, well, I'm just glad
that they're figuring it out now. And I was like, do you have heart
failure and dementia? Like, where— what just happened? She doesn't have dementia,
but she was like, I'm just glad they're figuring it out. And I was like,
who is this Zen person who has replaced my
borderline violent mother? I don't understand what's happening. I'm
so angry about it. But that, that was actually what— and I said to her,
I was like, I'm actually really angry about this. And she was like, don't be
mad, it's a waste of your energy to be mad. I'm like, that, that has
never been your philosophy before. You have never met a mad that you did not
have time for. So I don't know what's happening here. But I said back
to her, I was like, you just don't want me to go hit your primary
care with my car. And she goes, I also do not want you to do
that. You don't want me to fight with your internist. She's like, I do
not want you to fight with my internist. That is correct. Yeah. Welcome
to the American healthcare system. And now
we'll go to Alison, who has
this week's Small Talk. All right. We've got a Small Talk from
Brianna. And Brianna asks, what does joy
feel like for you with ADHD? Because for
me, it's massive and loud and it takes up the whole room and people
have always told me I'm too much or so extra. Lately,
I've been wondering if the joy was never the problem, if
maybe the problem was just people who couldn't hold it. What do you
think? First, I wanna say I've never actually been diagnosed with ADHD. I've never
been treated for it. I think. My brain probably has
read a lot of those tendencies, but I think
regardless what construct is around where you think your joy comes
from, like, it doesn't matter where it comes from, it's your joy. People who think
your joy is too much don't deserve your joy. We live in a world that
has way too little joy, way too little.
If you turn on the news, it is constant and unrelenting
doom and gloom about people who just give zero shits about other
people. About people who have no
soul, who are bleeding us
dry of everything good about our society,
who operate with no humanity. And joy is humanity
at its most basic. And so if you have joy to
share, share it. And if those people don't like it, let them
go be miserable curmudgeons somewhere else. And let's find somebody
who loves your joy as much as you do. You are not too much. They're
not enough. You can't have too much joy unless
you're like celebrating something awful. Don't
celebrate something awful. If little things in life bring you intense
amounts of joy, I am so jealous. I would love to
have that problem, and you should not darken that
light for anybody. Find new people. Don't
tamp down your joy. You have been born with a gift and a way
of approaching the world that is
special and magical and joyful. Those people can get bent.
That's usually my advice. At the end of the day, that's usually my advice. Get
bent. Those people can get bent. Maybe instead of Small Talk, we
should call this, like, The Ways That L2 Tells People to Get Bent.
But those people can get bent. Please go get bent. Be as
joyful as you have the capacity for and share it widely because
other people deserve your Enjoy and get bent. Thanks for being here,
guys. Have a good day. Love you mean it.
I don't know why that's so satisfying to say, but it really is.