“Listen to your patient; (s)he is telling you the diagnosis.” -Sir William Osler 

Thank you Serial Productions and The New York Times for giving a voice to the Yale Fertility Clinic victims. For those who haven’t yet listened, this podcast series presents a detailed report of women who were given saline instead of fentanyl for their egg retrievals by a nurse struggling with addiction. This left them in horrific pain during and after the procedure. There should probably be a trigger warning for those who are going through the vulnerable fertility journey— it’s very difficult to listen to the women’s harrowing experiences. As a perinatal psychiatrist who specializes in infertility and loss, I was horrified by the layers of trauma these patients had to endure. Ultimately, this is not just about someone with a substance use disorder inflicting pain on others; it’s the story of a failed medical system.

In my practice, I hear countless stories about the agony, isolation and frustration of infertility. Women often begin this journey feeling like there is something wrong with them — they blame their bodies for betraying them and think they need to endure whatever it takes to conceive. There can be lots of underlying anxiety, depression, anger and regret; some even feel this is “deserved punishment” for something they have done in the past. Even the issue of pain control, at the heart of this podcast story, is a microcosm of the real problem in medicine: that we do not adequately listen to women. As a result, women feel they need to grin and bear it, tough it out, pull up their socks (or any other euphemism for shutting the F up), and suffer in silence.

I understand there is a tangible end goal for fertility clinics: to help their patients conceive. I know medical teams have time constraints, packed schedules and many procedures to juggle. But even if most medical professionals do not have adequate time to check in with each patient, then someone on the team should be appointed who does — someone to ask about how she is coping, address any concerns with the process, and focus on each individual journey.  

And most of all, to truly listen to what she has to say.