All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today

by Elizabeth Comen

Within the first two months of 2023, a series of patients suffering from the same problem came to psychiatrist Allie Baker’s office. All were women, and all had postural orthostatic tachycardia syndrome, a condition that results from dysautonomia (or a disorder of the parasympathetic nervous system) surrounding the regulation of blood pressure (per the Circulatory chapter, this condition is also known as Grinch syndrome because of its association with an undersized heart). All were experiencing classic symptoms: dizziness, fainting, heart palpitations, shortness of breath. But all of them, in what is more or less the contemporary iteration of the “bitches be crazy” theory of medicine, had been misdiagnosed: one was referred for an eating disorder, another for depression, and a third for panic disorder. “It is staggering, actually,” Baker says. “Not one clinician they encountered prior to me thought to check orthostatics [a measurement that compares a patient’s heart rate and blood pressure while lying down, sitting, and standing]. Now, if you walk into my office, you have to prove to me that you don’t have dysautonomia—before we even discuss meds and psychotherapy.” In one sense, Baker’s patients were lucky: their true medical problem was identified before they’d started down a fruitless road of trying to medicate and counsel away a psychiatric condition they didn’t actually have.