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Mythbusting Medicine

— A conversation with Jen Gunter, MD

MedpageToday

"The Doctor's Art" is a weekly podcast that explores what makes medicine meaningful, featuring profiles and stories from clinicians, patients, educators, leaders, and others working in healthcare. Listen and subscribe/follow on , , Amazon, , and .

Despite advances in medicine, issues in women's health are still often mired in stigma, shame, misinformation, and disparities in access and societal standards.

In this episode, Henry Bair and Tyler Johnson, MD, are joined by , a well-known and outspoken gynecologist. She has made it her life's work to dispel potentially dangerous myths about women's health and, more broadly, the wellness industry.

Gunter is the author of , , , and the upcoming . She is also a for The New York Times and the host of the podcast ."

Over the course of this conversation, they discuss Gunter's work as an early pioneer in chronic pain medicine and vulvovaginal disorders, how experiencing a challenging childbirth led her to write her first book, the various spars she's had with celebrities over medical misinformation, the importance of discussing uncomfortable topics such as sex with patients candidly, and how she builds trust with her patients.

In this episode, you will hear about:

  • 2:20 An early accident that led Gunter to pursue a career in medicine
  • 5:02 Gunter's experience as a woman in medicine
  • 8:13 What led Gunter to specialize in the intersection of pain medicine and women's health
  • 11:37 How Gunter validates her patients' experiences
  • 16:19 The unique ways in which ob/gyns are "fluent" in both medical and surgical management
  • 21:24 The very challenging childbirth experience that led Gunter to write her first book, The Preemie Primer
  • 26:38 The ways in which doctors need to strive to do a better job communicating medical information to patients
  • 31:07 The growth of Gunter's media presence since she began sharing her writing publicly in the early days of Twitter
  • 36:34 How coming of age as a doctor during the early years of the HIV epidemic made Gunter committed to normalizing conversations about sex with patients
  • 41:18 Gunter's advice for dealing with misinformation on a daily basis

The following is a partial transcript (note errors are possible):

Bair: This is the first time we've had a gynecologist come on the show. So we are very excited about that. To kick us off, can you tell us what initially drew you to a career in medicine?

Gunter: Well, I actually had a bit of a run-in with the healthcare system when I was a child. So I had a skateboarding accident when I was 11 and I ruptured my spleen, which is a testimony to my bad skateboarding skills. And the long and short of it is my mother didn't believe that I was in pain, so I didn't get to go to the doctor till the next day.

Suffice it to say, it was a big brouhaha because people were like, hey, I think there's something really wrong. And this was back in the day. So there were no CT scans, there were no ultrasounds, so this didn't exist. And I think it was really hard for a lot of people to think like, really, there was a time, yeah, I'm that old. So I had to have an angiogram to make the diagnosis, alright? And I'm 11 and I was a little precocious and I was like, I don't want any sedation. They were going to give me Valium, probably. And I was like, I want to watch. And they were like, can you hold still? And I was like, you bet.

And I'm going to guess the interventional radiologist talked me through the whole thing. I was fascinated. Fortunately, I got to keep my spleen, but the angiogram found out that I had kidney disease, so I ended up having to have all kinds of investigations over the summer for my kidneys and then ended up with a nephrectomy. So I had sort of like 4 months of lots of tests, lots of going back and forth to the hospital. My mother had left school when she was 12 or 13, and so a lot of this was over her head. And so the doctors just explained everything to me. And I thought, well, this is pretty cool. And that's how I got interested in medicine.

Bair: So when you were getting that angiogram, you were just awake and looking at the procedure happening?

Gunter: Yeah, I was looking at the fluoro monitor. Isn't that wild? Yeah, in pediatric radiology at the Winnipeg General Hospital in Canada.

Johnson: Aside from everything else, I'm just trying to imagine an angiogram with no CT scan. I guess it would just look like the neon sort of outline of all of the vessels and looking for blood extravasate somewhere. That's really interesting.

Gunter: Yeah. You just see like a vascular flush and they were looking for, I'm going to, obviously I now know extravasation, and due to my mother's neglect, I got to keep my spleen because they figured if I hadn't bled out, this was just when they were starting to manage -- I now know this in retrospect -- splenic ruptures conservatively. So yeah, if my mother had actually been on the ball and taken me to the hospital, I might have lost my spleen. So there you go.

Johnson: Was there ever any doubt or digression between 11 years old not quite getting a splenectomy and then going into medicine? Like, did you think about going into other things or start going into anything else or you were just kind of a straight line from there on out?

Gunter: Yeah, it was pretty much a straight line. I mean, I loved science, I loved math. I liked, you know, I loved all that STEM stuff. And back in the day, I mean, there weren't that many women in medicine, but there was like no women in engineering. I knew of a couple of women in medicine. So I think knowing that it was kind of a possible route was also helpful. But yeah, I just, I found it like really interesting and neat and I just never thought about doing anything else after that. And I think that it's weird to sort of be 11 or 12 and think, yeah, that's what I'm going to do. And then along the way, all these adults are like, well, that's too hard, little Miss. You won't be able to do that. And the more people told me how hard it was and the more I wouldn't be able to do it, the more I was like, yeah, right, okay, double down here. I'm going to do that.

For the full transcript, visit .

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