Becoming Sure of Myself

Content Notice: This story contains references to Child Abuse.

Every day of my childhood, I experienced abuse at the hands of my physician father.

I developed signs and symptoms of Post-Traumatic Stress Disorder (PTSD). Every time something reminded me of his abuse I’d show symptoms: heart-pounding, avoidance, feeling critical of myself, becoming easily startled, and an overwhelming sense of guilt. Despite the long-term effects of how my dad treated me, I too went into the medical field. I always knew I would. I admired the healer in my dad and had always envisioned this role for myself because of my same ability to build meaningful relationships, and my innate desire to want to help others.

After completing school, I entered the medical practice and started helping patients on my very own. I enjoyed using what I’ve learned to help solve patients’ problems. My ability to build and maintain relationships with patients meant I built up quite the practice wherever I went. It was fulfilling work.

Unfortunately, at one point I found myself working with an abusive head physician and management. Because of their behavior, the PTSD symptoms that stemmed from my upbringing returned. It became very challenging to focus on practicing medicine. I felt like I was slowly watching all the things that have made me a wonderful clinician slip away. For over a year I felt too paralyzed to do a thing about this situation. I grew accustomed to the abuse, telling myself everything was my fault. I had become a miserable shell of my prior self.

One night my husband said that if I did not leave that dysfunctional practice, he was afraid he would lose me. That is the truth. This job and the people that managed it were making me sick. I realized, at that moment, that I needed to make some changes to my environment and concluded that this was simply not a place I needed to be. I gave notice and moved on.

Desperate to hang on to my career, and to learn how I could do that, I sought treatment for my PTSD. I found cognitive behavioral therapy enlightening. I cultivated skills to help me be more assertive and gained the ability to set boundaries. I was taught to think of being assertive as preventative medicine for my PTSD because without assertiveness, you cannot have the time and energy to help others. With cognitive behavioral therapy came exposure therapy. While there was no exposure to my dad as part of my therapy, I was becoming able to navigate spaces that previously would have triggered my PTSD symptoms, such as being around people that reminded me of my dad or the abusive work situation I’d fled. I could see that the skills that I was learning and implementing were beginning to contribute to my healing. And that I was becoming a stronger person.

Simultaneously, while I was exploring treatment avenues for my PTSD, I started having mysterious symptoms: debilitating pain, constant fatigue, new-onset high blood pressure, and I gained a shocking amount of weight. Despite my complicated history with doctors, it was time to seek medical attention. With the support of my husband, I embarked on a journey to determine the cause of my symptoms. As a patient who is a survivor of abuse, when I sought medical care I tended to be shier and struggle to set boundaries. People with PTSD are less likely to be active participants in their own care. Luckily, being fresh out of therapy and maintaining the skills I learned in CBT, assertiveness and boundary-setting still came fairly easy to me—easier than any other point in my life.

On my quest to get my unusual symptoms diagnosed, I saw six different doctors.

One had no idea what was wrong, and I had to be firm about getting a referral for another medical opinion.

The next doctor tried to convince me nothing was wrong. My intuition was that nothing could be further from the truth. The doctor was steadfast in his opinion, so I had to move on to another doctor.

The next doctor knew enough to order the proper testing and make the necessary referrals. He’s the one that ordered the brain MRI that showed a tumor in my pituitary gland, which is characteristic of Cushing’s disease.

Cushing’s disease involves high stress hormone (aka cortisol) levels. High cortisol can affect every system in the body. By the point of diagnosis, the symptoms I’ve developed include 60-lb weight gain, high blood pressure, high blood sugar, muscle weakness, anxiety, depression, insomnia, chronic pain, and lots of changes to my skin. The cure is to remove the pituitary tumor.

Because Cushing’s is so rare, most doctors have little-to-no experience diagnosing it.

The doctor that diagnosed me wasn’t an expert in Cushing’s, so he referred me to someone at the medical school who was an expert. Unfortunately, he did not agree with a Cushing’s diagnosis. Luckily, I was able to convince him to refer me to his partner, who also specializes in Cushing’s.

The partner agreed with my initial diagnosis of Cushing’s disease. He was very knowledgeable in all things relating to high cortisol but wanted to repeat a lot of tests I had already had done with the prior providers. I could have gone along with the months of repeat testing, but I stood up for myself and sought the opinion of another expert.

The next expert I saw was the last one I saw. This doctor agreed with the initial Cushing’s diagnosis and wanted to take prompt action, namely refer me for curative surgery to remove the tumor on my pituitary gland.

Without the tools I gained in therapy in order to address my PTSD symptoms, I suspect my journey to getting diagnosed with Cushing’s would have been much longer and less successful because I wouldn’t have been such an active participant in my own care. Currently, I am waiting on a consultation with the neurosurgeon. Hopefully afterward, Cushing’s disease will no longer affect my life.

I now work in psychiatry, part-time, and am loving it. I have a good social support system, centered around my husband, mother (who lives close by), extended family, and my friends. I find I’m able to manage stress pretty well now. I have a better understanding of what triggers me and feel that I have a pretty good handle on the symptoms now, with only hypervigilance and self-criticism popping up from time to time. The tools I’ve shared throughout my story continue to help me live a meaningful and happy life, and I am grateful for the continued support I have received while also navigating this major health crisis. Despite being diagnosed with Cushing’s disease and PTSD, I believe I am on the path that will allow me to continue to help others while also helping myself.